Internal Medicine News back issues from December 2001:
Mammography Analysis Slammed. (No Change in Recommendations).(Brief Article)
Dec 01, 2001; ... Mammography screening policies in the United States are unlikely to change as a result of a new overview analysis that concluded mammography has not proved to cut mortality risk. The new review is a reanalysis of a controversial metaanalysis published last year by Dr. Peter C ....
Oximetry Aids Dx of Pneumonia In Nursing Homes: Oxygen saturation decline of over 3% from baseline was 73% sensitive, 100% specific. (Study of Male Veterans).(Brief Article)
Dec 01, 2001; ... SAN FRANCISCO - A greater than 3% decline from baseline in oxygen saturation value was a highly reliable indicator for differentiating pneumonia from other infectious illnesses among acutely ill elderly men in a veterans' nursing home. The findings, if applicable to larger ...
Inhaled Insulin Holds Its Own 2 Years Into Trial: HbA1c levels equal to injected insulin. (Type 1 and Type 2 Patients).(Brief Article)
Dec 01, 2001; ... BURLINGAME, CALIF. - Inhaled insulin maintains control of plasma glucose as well as injected insulin, with no diminution of effectiveness after 2 years, Dr. William H. Landschulz said at a meeting sponsored by the Diabetes Research Institute. Dr. Landschulz, a senior associate ...
Breast Calcifications in Dialysis Patients Don't Impair Mammograms. (Not A Diagnostic Dilemma).(Brief Article)
Dec 01, 2001; ... SAN FRANCISCO--Women with end-stage renal disease have an increased rate of benign breast calcifications, but these do not interfere with the accurate interpretation of their mammograms, Dr. Mario Castellanos said at the annual World Congress of Nephrology. In the largest study ...
Early Lyme Disease: Doxycycline for 10 Days as Good as 2O. (Randomized Trial).(Brief Article)
Dec 01, 2001; ... SAN FRANCISCO -- Ten days of doxycycline are as effective as 20 for the treatment of early Lyme disease with erythema migrans, Dr. Gary P. Wormser reported at the annual meeting of the Infectious Diseases Society of America. Lyme disease is the most common vector-borne disease ...
Intrathecal Baclofen Reduces Spasticity in Stroke. (Patients Able to Walk, Climb Stairs).(Brief Article)
Dec 01, 2001; ... SAN DIEGO - Intrathecal infusions of baclofen reduce lower limb spasticity and improve function in stroke survivors, even years after the initial stroke, Dr. Gerard Francisco reported at a meeting sponsored by the National Stroke Association. This finding, based on the 1-year follow up ...
One-Third of Vertebral Fractures Get Missed. (Radiologists' Reports Often Ambiguous).(Brief Article)
Dec 01, 2001; ... PHOENIX -- One-third of vertebral fractures evident on lateral x-ray are missed by radiologists or reported in an ambiguous manner to the primary care physician, according to the results of a multinational study The rate of missed findings and spurious reports was even higher, ...
To Be Fully Alive. (Guest Editorial).(Brief Article)(Editorial)
Dec 01, 2001; ... patients wit advanced cancer are typically offered surgery, chemotherapy, radiation-or "there is nothing we can do for you." The last option seems not to be a choice, and yet I have often observed that this realization is the most liberating news that a dying person can receive. ...
ENT Woes Plague 62% of Inpatients. (Not Hospitalized for Ent Issues).(Brief Article)
Dec 01, 2001; ... DENVER -- Ear, nose, and throat symptoms "run rampant" in hospitals, according to an inpatient survey presented at the annual meeting of the American Academy of Otolaryngology. Dr. Raymond Howard and his coinvestigators at Downstate Medical Center in Brooklyn, N.Y., conducted a ...
In-Office Injection Snoreplasty Results Compare to Surgery. (Sotradecol Stiffens Soft Palate).(Brief Article)
Dec 01, 2001; ... DENVER -- At 19 months' follow-up, injection "snoreplasty" has an 18% relapse rate, Dr. Scott E. Brietzke reported at the annual meeting of the American Academy of Otolaryngology. This rate is as good as that of uvulopalatopharyngoplasty and other surgical therapies, which cost ...
Anthrax Diagnosis and Management. (The Effective Physician).(Brief Article)
Dec 01, 2001; ... Background The issue of anthrax exposure has dominated American public awareness in recent weeks. The Centers for Disease Control and Prevention has provided updates on the diagnosis and prevention of disease due to this organism on its bioterrorism Web site, www.bt.cdc.gov. ...
Medicare to Cover Diabetic Podiatric Exam. (In Neuropathy).(Brief Article)
Dec 01, 2001; ... WASHINGTON--Medicare will begin to cover semiannual podiatric foot exams for diabetes patients, as long as the referring physician has established a diagnosis of peripheral neuropathy with loss of protective sensation. "The diagnosis of peripheral neuropathy with LOPS [loss of ...
Cidopirox Cut Nail Infection In Diabetics. (Onychomycosis).(Brief Article)
Dec 01, 2001; ... MUNCICH -- Ciclopirox nail lacquer is a safe and effective therapy in diabetic patients with onychomycosis, Dr. Claus See-bacher reported at the annual congress of the European Academy of Dermatology and Venereology. Six months of once-daily application of the 8% ciclopirox ...
A Bowl a Day May Keep Tumors Away. (Pilot Study Findings).(Brief Article)
Dec 01, 2001; ... ARLINGTON, VA. -- Daily consumption of a soup containing vegetables and herbs used in traditional Chinese medicine was associated with tumor regression and prolonged survival in a pilot study of patients with stage IIIb and IV non-small cell lung cancer. A group of 14 patients ...
Breast Cancer Patients Advised To Consider Avoiding Soy. (Estrogenic Effects).(Brief Article)
Dec 01, 2001; ... ARLINGTON, VA. -- Caution is the word for now on soy consumption for women with a history of breast cancer. Epidemiologic findings indicate a lower risk for breast cancer in women whose diets include soy, but studies have found that soy phytoestrogens may stimulate tumor cells ...
Saw Palmetto for Benign Prostatic Hyperplasia. (Alternative Medicine).(Brief Article)
Dec 01, 2001; ... * Saw palmetto has long been used for relief of symptoms of benign prostatic hyperplasia (BPH) and has a good safety record. * A careful physical examination by a physician should always precede herbal treatment for urinary symptoms. History of Use The ...
Death Rate After Hip Fracture Is Higher in Men. (Link to Upper Respiratory Infection).(Brief Article)
Dec 01, 2001; ... PHOENIX, ARIZ. - Men are two to three times more likely than women to die within 2 years of a hip fracture, and the specific cause of the higher mortality appears to be infection-particularly respiratory infection, Dr. Lois E. Wehren said at the annual meeting of the American Society for ...
Periodontitis Linked to Renal Insufficiency. (Study of 7,000 Patients).(Brief Article)
Dec 01, 2001; ... SAN FRANCISCO - Periodontal disease was linked to compromised kidney function in a cross-sectional study of nearly 7,000 men and women presented by Dr. Abhi Kshirsagar at the annual World Congress of Nephrology. Patients with periodontitis were more likely to have a compromised ...
Panel Splits on Advice to Approve Sepsis Therapy. (Use Questioned in Less-Severe Sepsis).(Brief Article)
Dec 01, 2001; ... GAITHERSBURG, MD. -- A federal advisory panel was evenly divided over whether to recommend approval of a genetically engineered product for treating patients with severe sepsis. The members of the Food and Drug Administration's Anti-Infective Drugs Advisory Committee who voted ...
High-Dose Drug Combo Limits Chronic HCV. (Sustained Viral Response).(Brief Article)
Dec 01, 2001; ... High-dose peginterferon alfa-2b plus ribavirin increased the rate of sustained virologic response among patients with chronic hepatitis C virus infections. Dr. Michael P. Manns and his associates of the International Hepatitis Interventional Therapy Group randomized patients to ...
Remicade Warnings. (Clinical Capsules).(Brief Article)
Dec 01, 2001; ... Remicade, a biologic agent indicated for rheumatoid arthritis and Crohn's disease, has been associated with tuberculosis and other opportunistic infections, including histoplasmosis, listeriosis, and pneumocystosis, according to an Oct. 5 "Dear Healthcare Professional" letter from ...
Sinusitis Treatment. (Clinical Capsules).(Brief Article)
Dec 01, 2001; ... There is no clinical benefit to prescribing second-line antibiotics for acute uncomplicated sinusitis, according to results of a study by Dr. Jay F. Piccirillo of Washington University, St. Louis, and his colleagues. Nearly 60% of the 29,102 patients in the retrospective cohort ...
Infective Endocarditis. (Clinical Capsules).(Brief Article)
Dec 01, 2001; ... Early surgical intervention appears to prolong survival in patients with endocarditis due to Staphylococcus aureus infection. A retrospective chart review of 252 patients with definite or possible infective endocarditis revealed that the 44 patients ...
Antimicrobials in Animal Feed. (Clinical Capsules).(Brief Article)
Dec 01, 2001; ... Three recent studies found evidence that antimicrobials in animal feed promote emergence of resistant strains of bacteria. In one randomized study 18 healthy volunteers ingested either glycopeptide-resistant or streptogramin-resistant strains of Enterococcus faecium, or ...
Travel Health Publication. (Clinical Capsules).(Brief Article)
Dec 01, 2001; ... "Health Information for International Travel" includes immunization requirements and ...
[Histamine.sub.2] Blockers May Reduce Colorectal Adenoma Recurrence. (Especially in First Year After Excision).(Brief Article)
Dec 01, 2001; ... LAS VEGAS - [Histamine.sub.2] receptor blockers may reduce the risk that colorectal adenomas will recur, especially in the first year following adenoma excision, Dr. Carol Burke said at the annual meeting of the American College of Gastroenterology. The association, a casual ...
Adenomas Often Lie Above Flex Sig Level. (Colonoscopies Warranted for High Risk).(Brief Article)
Dec 01, 2001; ... LAS VEGAS -- Flexible sigmoidoscopy findings are poor predictors of proximal colon findings in asymptomatic women. That's a key finding from an ongoing trial of women being conducted at four military hospitals nationwide, Dr. Philip Schoenfeld reported at the annual meeting of the American ...
Stricturoplasty for Crohn's Jejunoileitis. (Treatment of Choice).(Brief Article)
Dec 01, 2001; ... SAN DIEGO -- Stricturoplasty deserves to be considered the treatment of choice for diffuse Crohn's jejunoileitis, Dr. David W. Dietz said at the annual meeting of the American Society of Colon and Rectal Surgeons. Patients with this form of Crohn's disease develop extensive ...
Missed Appendicitis. (Clinical Capsules).(Brief Article)
Dec 01, 2001; ... The misdiagnosis of appendicitis has increased in the elderly and in women of childbearing age, despite significant advances in diagnostic imaging, reported Dr. David R. Flum and his associates at the University of Washington, Seattle. The investigators reviewed 85,790 ...
Food Post-GI Surgery. (Clinical Capsules).(Brief Article)
Dec 01, 2001; ... Any form of early feeding may benefit patients who have just undergone gastrointestinal resection, according to Dr. Stephen J. Lewis of Addenbrooke's Hospital, Cambridge, England, and his associates. Investigators undertook a systematic review and metaanalysis of 11 clinical ...
HCV Risks by Design. (Clinical Capsules).(hepatitis C virus)
Dec 01, 2001; ... Study design influences estimates of the progression rate of chronic hepatitis C infection to cirrhosis, reported Dr. Anthony J. Freeman of the Prince of Wales Hospital in Sydney Australia, and his associates. A 57-study metaanalysis found that the rate of progression to ...
IBS in Twins. (Clinical Capsules).(irritable bowel syndrome)
Dec 01, 2001; ... The likelihood that someone will develop irritable bowel syndrome is influenced as much by social learning as by genetics, said Rona L. Levy Ph.D., of the University of Washington, Seattle, and her associates. Irritable bowel syndrome (IBS) was reported by 117 pairs of ...
Medicare Covers Monitors for White Coat HT. (Ambulatory Blood Pressure Monitors).(hypertension)
Dec 01, 2001; ... The Centers for Medicare and Medicaid Services now covers the cost of ambulatory blood pressure monitoring for patients with suspected cases of "white coat hypertension." "ABPM [ambulatory blood pressure monitoring] ...can provide useful information ... to determine whether a ...
European CVD Risk Charts Dwarf Framingham Tables. (Data Focus on Cardiovascular Deaths).(cardiovascular disease risk)
Dec 01, 2001; ... STOCKHOLM -- Epidemiologic data from about 250,000 European patients and 3 million person-years of observation have been used to create new tables for estimating an individual's risk of death from cardiovascular disease. The new European tables were shown for the first time at ...
Ezetimibe Slows Cholesterol Absorption; Levels Drop 12%. (Novel Drug Raised HDL Levels 1%).
Dec 01, 2001; ... STOCKH0LM -- Ezetimibe, an investigational drug that slows cholesterol absorption from the intestine, cut serum cholesterol levels by 12% in a trial with 828 patients. Ezetimibe also cut serum levels of low-density lipoprotein-cholesterol by 18%, and raised serum levels of ...
Stents for Mediastinal Fibrosis. (Clinical Capsules).
Dec 01, 2001; ... Stents are the first treatment shown to relieve central pulmonary artery and vein obstructions caused by mediastinal fibrosis, reported Dr. Thomas P. Doyle and his associates at Vanderbilt University, Nashville, Tenn. This rare complication of Histoplasma capsulatum infection is ...
Is Low-Dose Aspirin Too Low? (Clinical Capsules).(may not provide adequate protection against ischemic stroke in heart attack patients)
Dec 01, 2001; ... Low-dose aspirin therapy may not be adequate to prevent ischemic stroke in myocardial infarction patients, reported Dr. Christopher O'Connor of the Duke Clinical Research Institute, Durham, N.C., and his associates. A secondary analysis of data from a randomized trial of stroke ...
Unnecessary Pacemakers. (Clinical Capsules).(cardiac pacemaker implantation guidelines)
Dec 01, 2001; ... In coronary artery disease patients with unexplained syncope, an implanted car-dioverter defibrillator appears to be unnecessary when ventricular fibrillation can be induced during the course of electro-physiologic testing. The American College of Cardiology/American Heart ...
Intermittent Claudication. (Clinical Capsules).
Dec 01, 2001; ... In peripheral arterial disease, leg symptoms extend beyond those of classic intermittent claudication, according to Dr. Mary McGrae McDermott of Northwestern University Medical School, Chicago, and her associates. Of 460 patients with peripheral arterial disease, ...
FDA Panel Splits Over CHF Indication for Valsartan. (Concern About Use With [beta]-Blockers).(congestive heart failure)
Dec 01, 2001; ... BETHESDA, MD. -- An angiotensin II receptor blocker under consideration as a treatment for congestive heart failure got a mixed recommendation for approval from a Food and Drug Administration expert panel. The FDA's Cardiovascular and Renal Drugs Advisory Committee split their ...
Drug Update: Outpatient Treatment of Deep Vein Thrombosis.
Dec 01, 2001; ... Outpatient management with a low-molecular-weight heparin is the wave of the future for treating deep vein thrombosis. Already prevalent in Europe and Canada, a surge of outpatient programs in the United States is expected in the next 5 years. Low-molecular-weight heparin (LMWH) ...
PROs Deliver 'Special Alerts' on Bioterrorism. (Rapid Physician Education).(peer review organizations)
Dec 01, 2001; ... WASHINGTON -- The Centers for Disease Control and Prevention is enlisting the aid of peer review organizations to speed the delivery of accurate clinical in formation on bioterrorism. "Special Alert" is the insignia of the new rapid distribution network by which PROs will assist ...
AAMC Guidelines Limit Residents' On-Duty Hours to 80 per Week. (Consecutive Hours Cut To 24).(American Association of Medical Colleges)
Dec 01, 2001; ... The American Association of Medical Colleges has issued new guidelines on graduate medical education that include limits on resident duty hours. According to the new guidelines, residents should be on duty no more than 80 hours per week and no more than 24 hours consecutively ...
Long-Lived Americans. (Policy & Practice).
Dec 01, 2001; ... Age-adjusted death rates for heart disease and cancer, the two leading causes of death in the United States, continue to fall, and the estimated life expectancy of a child born in the year 2000 reached a record high of 76.9 years, according to The Centers for ...
Regulatory Relief Ahead? (Policy & Practice).(for Medicare)
Dec 01, 2001; ... Even as Congress concentrates on war an homeland security issues, "We hope [regulatory relief] will be resolved very shortly," Dr. Donald Palmisano, secretary-treasurer for the American Medical Association, said in an ...
Medicare Simplified. (Policy & Practice).(Centers for Medicare and Medicaid Services releases user-friendly enrollment form)
Dec 01, 2001; ... On Nov. 1, the Centers for Medicare and Medicaid Services (CMS) rolled out a streamlined, "user-friendly" enrollment form. In developing the new form, CMS analyzed enrollment data to see how long it took for an application to be processed, and the reasons-for ...
Retiree Benefits Erosion. (Policy & Practice).(fewer employers provide retiree health care benefits)
Dec 01, 2001; ... Fewer employers are providing retiree health care coverage, and alternative sources of coverage have become costly or limited, reports the General Accounting Office. Testifying before a House sub-committee of employer-employee relations, William Scanlon, GAO's director for health care ...
Unapproved Drug Seized. (Policy & Practice).(AMP II Pro Drops manufactured by Biogenics Inc. (E'ola International) seized by FDA)
Dec 01, 2001; ... U.S. marshals seized close to $3 million worth of dietary supplements that were unlawfully produced with ephedrine. In its inspections of Biogenics Inc., a Utah drug company doing business as E'ola International, the Food and Drug Administration discovered that the company was ...
French Firm Guilty of Felony. (Policy & Practice).(Roussel Uclaf)
Dec 01, 2001; ... The French corporation Roussel Uclaf pleaded guilty to felony charges of conspiracy and defrauding the Food and Drug Administration and will pay more than $33 million in penalties. This is one of the largest monetary penalties ever imposed in a criminal pharmaceutical prosection. According ...
Nurse Aid. (Policy & Practice).(Department of Health and Human Services awards nursing scholarships and loans)
Dec 01, 2001; ... The Department of Health and Human Services is awarding about $20 million to colleges, universities, and other organizations to increase the number of nurses with bachelor's degrees ....
HMO Decline. (Policy & Practice).(Statistical Data Included)
Dec 01, 2001; ... The number of health HMOs continues to drop despite stabilizing enrollment in the second half of 2000, according to the most recent Competitive Edge HMO directory published by InterStudy Publications. As of Jan. 1, 2001, 541 full-service HMOs were in operation, down from 560 as of July 1, ...
Acupuncture: It's No Gag. (Indications).
Dec 01, 2001; ... Patients who dread dental visits because they have a strong gag reflex may get relief from a few well-placed needles. In a British study of 10 patients with the problem, a dentist trained in acupuncture inserted needles into an "antigagging point" on each ear, manipulated them briefly, and ...
Heading Off Alzheimer's. (Indications).
Dec 01, 2001; ... A small head might be a big risk factor for Alzheimer's disease, which is 14 times more likely in people with a small head and the apolipoprotein E e4 gene, compared with people without those two factors, researchers found. They studied 1,869 healthy Japanese Americans aged 65 years and ...
Voice of Experience. (Indications).
Dec 01, 2001; ... Dr. Yashashri Choudhari was not enthusiastic about having to perform an emergency C-section at the end of a long and busy on-call shift. But the exhausted ob.gyn. in Belfast, Ireland, received effusive praise from the patient's husband, who was in the operating room during the early ...
Erectile Disability? (Indications).
Dec 01, 2001; ... An employer does not have to make special accommodations if an occupational injury prevents a worker from having sex five times a week, the U.S. Supreme Court ruled. Antonio Contreras, a forklift operator, was injured in 1995 while working at an Illinois garden equipment plant run by ...
Doctor UFO. (Indications).(Dr. Steven Greer of The Disclosure Project)
Dec 01, 2001; ... The Disclosure Project, a group devoted to the release of secret government information on unidentified flying objects, believes that if alien messages had been heeded, the Sept. 11 tragedy could have been prevented. "There exist the technologies to monitor, intercept, and penetrate the ...
Celiac Disease Raises Risk of Several Cancers, Mild Cases Often Go Undiagnosed.
Dec 01, 2001; ... LAS VEGAS -- People who prove to have celiac disease have twice the risk of cancer as is seen in the general population, Dr. Peter Green reported at the annual meeting of the American College of Gastroenterology. European studies have previously documented an association between ...
Renal Disease Referrals Delayed, Mortality Doubled in Elderly. (Longer Hospital Stays).
Dec 01, 2001; ... SAN FRANCISCO -- Elderly patients referred to a nephrologist were more likely to have advanced renal disease and require immediate dialysis than were younger patients, Dr. Anu Trehan reported at the World Congress of Nephrology Delayed referral also led to higher mortality and ...
Anemia in Acute Renal Failure, Lower Mortality. (Retrospective Study).
Dec 01, 2001; ... SAN FRANCISCO - Acute renal failure patients who develop anemia secondary to their kidney disease have a lower mortality rate than those who do not develop anemia, Dr. Gangadarshni Chandramohan said at the World Congress of Nephrology. This observation comes from a retrospective ...
CDC issues battle plan for smallpox. (Vaccine to be Stockpiled).
Dec 15, 2001; ... Teams of specialists from the Centers for Disease Control and Prevention were vaccinated against smallpox last month and began training for rapid deployment in the event a suspected case of smallpox is reported. "There has been no credible threat [of smallpox bioterrorism]," ...
Vascular benefits of statin exceed all expectations: Patients with baseline LDL less than 100 mg/dL also reaped benefits from Zocor. ('Statins are the New Aspirin').
Dec 15, 2001; ... ANAHEIM, CALIF. -- Aggressive lipid lowering reduced major vascular events by one-third in high-risk patients, regardless of their baseline levels of total or LDL cholesterol. "Stunning" and "spectacular" were the comments made after the initial findings of the 20,536-patient ...
In pneumonia, guidelines affect patient outcomes: Recommended antibiotics shorten stays. (Community-Acquired Cases).
Dec 15, 2001; ... SAN FRANCISCO -- Treating community-acquired pneumonia using antimicrobials recommended in national guidelines pays off in terms of significantly shorter hospital stays, even in low-risk cases, Dr. Mark A. Jewell said at the annual meeting of the Infectious Diseases Society of America. ...
Vital signs.(Statistical Data Included)
Dec 15, 2001 ... <Pre> VITAL SIGNS Percent of Office Visits by Physician Specialty Family Practice23% Internal Medicine 18% Pediatrics 10% Ob. Gyn.8% Dermatology 4% Psychiatry 3% Other ...
ATA backs bill on potassium iodide stockpiling. (Preparation for Nuclear Terrorism).(American Thyroid Association)
Dec 15, 2001; ... WASHINGTON -- Federal legislation that would require stockpiling of potassium iodide to prepare for potential terrorist attacks on nuclear facilities, as well as for accidents at nuclear plants, has the endorsement of the American Thyroid Association. ATA representatives took ...
Nails over 3 mm beyond fingertip spread infections. (Health Care Worker Study).
Dec 15, 2001; ... SAN FRANCISCO -- Long fingernails spread nosocomial infections, Dr. Shelly A. McNeil reported at the annual meeting of the Infectious Diseases Society of America. Nails extending more than 3 mm beyond the fingertip are more likely to harbor pathogens and shouldn't be worn by any ...