Internal Medicine News back issues from March 2005:
Device may reduce liver biopsy rate.(News)
Mar 01, 2005; ... A new device for noninvasively measuring liver fibrosis could decrease the number of liver biopsies performed on patients with chronic hepatitis C. especially when used with other noninvasive tests. The device, called FibroScan, might bring more patients with chronic hepatitis C ...
Internists worked more than 36 clinical hours per week in 2003.(VITAL SIGNS)(Brief Article)(Illustration)
Mar 01, 2005 ... <Pre> Internists Worked More Than 36 Clinical Hours per Week in 2003 Mean Hours per Week General Pediatrics (n = 1,548)47.22 General Surgery (n = 717) 46.56 Internal Medicine: Hospitalist (n = 525) 36.68 ...
Evidence finally links dietary fat, sodium to stroke: public health guidelines may change.(News)
Mar 01, 2005; ... NEW ORLEANS -- For the first time, physicians have evidence independently linking high dietary levels of fat and sodium to an increased risk of ischemic stroke, based on findings from an epidemiologic study in New York. Experts who heard these findings at the 30th International ...
IM recertification to gain link to NCQA recognition.(News)(National Committee for Quality Assurance)
Mar 01, 2005; ... Starting this summer, internists seeking maintenance of certification in diabetes care can apply for a new feather in their caps: recognition from the National Committee for Quality Assurance. Any American Board of Internal Medicine diplomate who completes the practice ...
Health advisory issued for nevirapine.(News)(Brief Article)
Mar 01, 2005; ... The Food and Drug Administration has issued a public health advisory to alert physicians to label changes for nevirapine (Viramune), addressing an increased risk of liver toxicity in certain women. The Indications and Usage section of the HIV drug's label now recommends against ...
Cochrane review favors vaginal hysterectomy: report cites evidence of shorter hospital stays, faster recovery.(News)
Mar 01, 2005; ... Vaginal rather than abdominal hysterectomy should be performed "whenever technically feasible" to reduce complications and to speed hospital discharge and patients' return to normal activities, according to a new review of randomized controlled trials that have compared hysterectomy ...
Guidelines for nonoccupational HIV prophylaxis: high-risk exposures may involve unprotected sex, condom breakage or slippage, or injection drug use.(News)
Mar 01, 2005; ... For the first time, the federal government has issued guidelines on attempting to avoid HIV infection after accidental exposure to the virus outside of the health care workplace. The Centers for Disease Control and Prevention-issued guidelines call for a 28-day course of a ...
Researchers still puzzled about U.S. monkeypox outbreak.(News)
Mar 01, 2005; ... MIAMI BEACH -- Investigators at the Centers for Disease Control and Prevention are still perplexed as to why a monkeypox outbreak in the United States was less virulent than a simultaneous outbreak in Africa. But genetic differences in the pox strains may provide an answer. ...
Collaborating to serve.(GUEST EDITORIAL)
Mar 01, 2005; ... Cultural rhetoric paints doctors and lawyers as natural enemies. In reality, both share a fundamental mission: to use specialized knowledge of systems (legal and medical) to help people in the course of their lives. Efforts to join the two professions in the pursuit of a common cause can ...
Is spinal fusion surgery overused in the United States?(PRO & CON)
Mar 01, 2005; ... YES Spinal fusion surgery is undoubtedly effective for some conditions, such as fractures, spinal tumors, and spondylolisthesis. But its efficacy for the most common indications, such as degenerative disk disease, remains unclear. High rates of reoperation and complications, ...
COX-2 inhibitors.(LETTERS)(Letter to the Editor)
Mar 01, 2005; ... I am dismayed that the leadership in medicine is not participating in discussions to force the drug companies to assist both physicians and patients in interpreting the data on cyclooxygenase-2 inhibitors ("COX-2 Inhibitors Continue to Come Under Fire," Dec. 1, 2004, p. 7). In ...
Corrections.(Correction Notice)
Mar 01, 2005 ... An article that appeared in the Feb. 1 issue ("Depot Drug Looks Safe, Helpful for Endometriosis," p. 60) should have stated that depot medroxyprogesterone acetate-subcutaneous was approved by the Food and Drug Administration in December 2004. A story about an experimental ...
Guidelines urge aggressive diabetes management.(Endocrinology)
Mar 01, 2005; ... WASHINGTON -- Diabetes must be managed with an "uncompromising insistence to treat to target," according to new guidelines issued by the American College of Endocrinology and the American Association of Clinical Endocrinologists. The document is aimed at ending the common ...
Diabetes educator can help improve patient outcomes.(Endocrinology)
Mar 01, 2005 ... WASHINGTON -- A "chronic care model" that includes a diabetes educator in the primary care office can ease the burden on the physician and improve patient outcomes, Linda M. Siminerio, Ph.D., said at a consensus conference organized by the American College of Endocrinology and the American ...
Sleep loss tied to impaired glucose tolerance.(Endocrinology)
Mar 01, 2005; ... RANCHO MIRAGE, CALIF. -- Healthy young adults who are chronic "short sleepers"--getting an average of about 5 hours of sleep a night--must secrete 30% more insulin than other adults to achieve a normal glucose curve. The finding, which points to a potentially important ...
Doxazosin helps fight metabolic syndrome.(Endocrinology)(Brief Article)
Mar 01, 2005; ... ORLANDO, FLA. -- Doxazosin improves multiple components of the metabolic syndrome in hypertensive ethnic Asian Indians, F.D. Richard Hobbs, M.D., reported at Wonca 2004, the conference of the World Organization of Family Doctors. This makes doxazosin a particularly attractive ...
Obesity and risk of kidney stones.(CLINICAL CAPSULES)(Brief Article)
Mar 01, 2005; ... Obesity and weight gain may increase the risk of kidney stone formation, especially in women, reported Eric N. Taylor, M.D., of Brigham and Women's Hospital, Harvard Medical School, Boston. He and his associates prospectively studied three cohorts: the Health Professionals ...
Diets and cardiac risk factors.(CLINICAL CAPSULES)(Brief Article)
Mar 01, 2005; ... Four popular diets all appear to reduce body weight and several cardiac risk factors at 1 year, but the benefits are modest, apparently because of low adherence, said Michael L. Dansinger, M.D., of Tufts-New England Medical Center, Boston. In a single-center, randomized trial of ...
Protecting bone during dieting.(CLINICAL CAPSULES)(Brief Article)
Mar 01, 2005; ... Even modest weight loss from exercise training is associated with a reduction in bone mineral density (BMD), particularly in women who are not taking raloxifene or hormone therapy (HT), reported Wendolyn S. Gozansky, M.D., of the University of Colorado, Denver. In a 6-month, ...
Eyeing the next generation of glucose monitors.(Endocrinology)
Mar 01, 2005; ... KEYSTONE, COLO. -- Look for next-generation continuous glucose monitoring devices to be more accurate, less obtrusive, and easier for diabetic patients and their families to use, according to H. Peter Chase, M.D. Among the numerous devices in development, he singled out two for ...
Islet grafts still face major challenges.(Endocrinology)
Mar 01, 2005; ... KEYSTONE, COLO. -- Formidable obstacles continue to prevent pancreatic islet transplantation from having a major impact on type 1 diabetes despite the spectacular technical advances of the past 4 years, Ronald G. Gill, Ph.D., said at a conference on management of diabetes in youth. ...
Islet transplants reduce fears of hypoglycemia.(Endocrinology)
Mar 01, 2005; ... QUEBEC CITY -- Patients with severe, labile, type 1 diabetes experience a significant reduction in anxiety and fear of hypoglycemia after undergoing islet cell transplantation, according to a study of the Clinical Islet Transplant Program, the world's largest and most experienced islet ...
New surgical technique repairs ingrown toenails: the approach preserves the nail by targeting the granulation tissue and reducing the size of the toe.(Dermatology)
Mar 01, 2005; ... FLORENCE, ITALY -- A newly developed alternative to the classic, 150-year-old surgical technique for repairing ingrown toenails may be associated with fewer recurrences and a much-improved aesthetic result, two Swiss dermatologists reported at the 13th Congress of the European Academy of ...
Imaging devices may reduce the need for nail biopsies.(Dermatology)
Mar 01, 2005 ... FLORENCE, ITALY -- High-resolution ultrasound and dermoscopy hold promise for distinguishing benign conditions of the nail from suspicious lesions that require a biopsy, researchers said at the 13th Congress of the European Academy of Dermatology and Venereology. High-frequency ...
If the shoe doesn't fit, focus on these failures in the foot.(Dermatology)
Mar 01, 2005 ... FLORENCE, ITALY -- If you shove variably shaped human feet into uniformly shaped shoes--some with pointy toes and impossibly narrow widths--the result will be toenail trauma, a common etiology of toenail disorders. Friction of a patient's foot against his or her shoe may cause ...
Psoriasis may respond to intermittent etanercept.(Dermatology)
Mar 01, 2005; ... KOHALA COAST, HAWAII -- New data suggest that etanercept can be given intermittently like other psoriasis treatments, according to a poster that Alice B. Gottlieb, M.D., presented at a conference on clinical dermatology sponsored by the Center for Bio-Medical Communication Inc. ...
Sentinel node biopsy may aid melanoma survival: for primary cutaneous melanoma, SLN biopsy appeared to be both predictive and therapeutic.(Dermatology)
Mar 01, 2005; ... KEY BISCAYNE, FLA. -- Sentinel lymph node biopsy confers a survival benefit in patients with primary cutaneous melanoma, according to preliminary results of a 5-year study. "We're thrilled to see these data support not only sentinel lymph node biopsy for staging, but [also] that ...
Survival rates after 5 years have improved for invasive melanoma.(Dermatology)
Mar 01, 2005; ... SAN DIEGO -- Over the next 15 years, 5-year survivors of melanoma have a 91.5% chance of having achieved cure, Duane C. Whitaker, M.D., reported at a melanoma update sponsored by the Scripps Clinic. "Stated another way, all comers with an invasive melanoma--regardless of ...
Keep an eye out for ocular and periocular melanoma.(Dermatology)
Mar 01, 2005; ... SAN DIEGO -- Ocular and periocular melanoma will occur in fewer than 2,900 people in the United States in 2005, Geva Mannor, M.D., said at a melanoma update sponsored by the Scripps Clinic. Despite the rare prevalence of these lesions, it's important to understand who is at risk ...
Melanoma in pregnancy: 'prompt biopsy is key'.(Dermatology)
Mar 01, 2005; ... SAN DIEGO -- Pregnant women who present with changing nevi should not be treated differently from other patients of similar age, Dina R. Massry, M.D., said at a melanoma update sponsored by the Scripps Clinic. "Prompt biopsy is key," said Dr. Massry, a dermatologist with the ...
Watch for extracutaneous melanoma during routine exams.(Dermatology)
Mar 01, 2005; ... SAN DIEGO -- Only 15% of melanomas are extracutaneous, but you can easily miss these lesions if you don't keep them in mind during routine skin exams, Terence O'Grady, M.D., said at a melanoma update sponsored by the Scripps Clinic. The most commonly affected sites include the ...
Rash often seen with new class of cancer drugs.(Dermatology)
Mar 01, 2005; ... One of the hottest new treatment advances in oncology has spawned an unwelcome dermatologic side effect. Signal transduction inhibitors, a new class of cancer drugs targeting solid tumors without the toxic side effects of chemotherapy, are causing treatment-resistant ...
Full-body exam may uncover hidden cancers.(Dermatology)(Brief Article)
Mar 01, 2005; ... KEY BISCAYNE, FLA. -- A full-body examination is a quick and useful tool to screen patients and uncover benign and cancerous lesions that would otherwise remain undetected, according to a study presented at the annual meeting of the Noah Worcester Dermatological Society. Kenneth ...
Terbinafine pulse dosing cures onychomycosis.(Dermatology)(Brief Article)
Mar 01, 2005; ... FLORENCE, ITALY -- Terbinafine can cure onychomycosis in patients who take the drug for only 1 week every 2-3 months for up to a year, Martin N. Zaias, M.D., reported at 13th Congress of the European Academy of Dermatology and Venereology. "From an economic point of view, our ...
Desloratadine effective for chronic urticaria.(Dermatology)(Brief Article)
Mar 01, 2005; ... VICTORIA, B.C. -- An open-label trial of Canadian patients seen in regular clinics and offices has confirmed that treatment with desloratadine for chronic idiopathic urticaria is highly effective. This finding--that the drug was highly effective--was previously reported only in ...
Pharmacogenetics may help in smoking cessation.(Psychiatry)
Mar 01, 2005; ... ORLANDO, FLA. -- Pharmacogenetics will play a major role in the war on tobacco, Sean P. David, M.D., predicted at Wonca 2004, the conference of the World Organization of Family Doctors. It's already possible in research settings to significantly improve upon the traditional and ...
Survey shows 60% of African Americans have never smoked.(Psychiatry)
Mar 01, 2005; ... A survey has found mixed results regarding smoking cessation among African Americans, reported Gary King, Ph.D., of Pennsylvania State University, University Park, Pa. In a survey that included 30,660 African Americans and 209,828 whites aged 18-64 years, Dr. King and his ...
Percent of various age groups who currently smoke.(DATA WATCH)(Brief Article)(Illustration)
Mar 01, 2005 ... <Pre> Percent of Various Age Groups Who Currently Smoke (n = 30,706) 18-24 28.5% 25-44 25.7% 45-64 22.7% [greater than or equal ...
Consider biologic rhythms of sleepy patients.(Psychiatry)
Mar 01, 2005; ... ARLINGTON, VA. -- About 40 million Americans are affected by sleep disorders, and more than 100,000 motor vehicle accidents per year are sleep related, Teodor Postolache, M.D., said at the annual conference of the Academy of Organizational and Occupational Psychiatry. An ...
Drug use pervasive among gay men.(Psychiatry)
Mar 01, 2005; ... ATLANTA -- Substance abuse is pervasive among gay men and is so intricately intertwined with epidemics of depression, partner abuse, and childhood sexual abuse that adequately addressing one issue requires attention to the others as well, said Ronald Stall, Ph.D., chief of prevention ...
Health status blurs depression-mortality link.(Psychiatry)
Mar 01, 2005; ... Depressive symptoms are not independent predictors of mortality, according to data from a national sample of 3,617 adults. The findings of previous studies regarding associations between depressive symptoms and mortality have been inconsistent, and few of these studies have used ...
Psychotherapy evaluated in depression care.(Psychiatry)(Brief Article)
Mar 01, 2005; ... Psychotherapy alone and combined with pharmacotherapy reduced symptoms of mild to moderate depression, but neither of the two approaches showed a clear advantage over the other, Frans de Jonghe, Ph.D., said, reporting on a study conducted at two outpatient clinics in Amsterdam. ...
St. John's wort equals paroxetine in new study.(Psychiatry)
Mar 01, 2005; ... EXETER, ENGLAND -- A proprietary formulation of St. John's wort was equivalent in efficacy to paroxetine for moderate to severe depression in a prospective, randomized, multicenter study, Stephan Klement, M.D., reported at a symposium on alternative and complementary therapies sponsored by ...
Visits, calls may help elderly depression.(Psychiatry)
Mar 01, 2005; ... FORT MYERS, FLA. -- Home visits and follow-up telephone calls improved elderly depression in a program that used existing community services for seniors in Seattle, according to a presentation at the annual meeting of the Academy of Psychosomatic Medicine. Rates of depression ...
Genetic defect may raise depression risk.(Psychiatry)
Mar 01, 2005; ... A recently discovered genetic mutation that causes dysfunction in the synthesis of serotonin might explain why some depressed patients are resistant to drug treatment, researchers say. Xiaodong Zhang, M.D., and colleagues at Duke University, Durham, N.C., screened 87 adults with ...
EEG database can help guide psychotropic Rx: proprietary system assesses electroencephalogram based on outcomes in more than 12,000 patients.(Psychiatry)(referenced electroencephalogram)
Mar 01, 2005; ... Brain waves may be the wave of the future when it comes to prescribing medications for the treatment of psychiatric disorders. Using a normative EEG database and an extensive and growing outcomes database that includes more than 12,000 patient electroencephalograms, researchers ...
How adults feel about the cost-benefit ratio of mental health therapy.(DATA WATCH)(Brief Article)
Mar 01, 2005 ... <Pre> How Adults Feel About the Cost-Benefit Ratio of Mental Health Therapy Costs generally outweigh benefits 43% Usually about right 29% Not sure16% Benefits generally outweigh costs 11% No answer ...
Chemotherapy can affect cognitive function.(Neurology)
Mar 01, 2005; ... LOS ANGELES -- Cancer patients call it "chemobrain"--a soggy mental state that seems to be a frequent side effect of chemotherapy. It is rarely studied and poorly understood, but as the number of cancer survivors grows, the impact of chemotherapy on cognitive function will ...
Mutation linked to some cases of Parkinson's.(Neurology)
Mar 01, 2005; ... Screening for a recently identified mutation--shown to cause about 5%-6% of familial and 1%-2% of apparently sporadic cases of Parkinson's disease--is likely to become an important component of genetic testing and counseling for this disease, investigators said. "No other single ...
Rivastigmine may delay dementia in Parkinson's.(Neurology)
Mar 01, 2005; ... The cholinesterase inhibitor rivastigmine transiently halted cognitive deterioration associated with Parkinson's disease, but fell short of actually modifying the course of either Parkinsonism or related dementia, reported Murat Emre, M.D., of Istanbul (Turkey) University and his ...
Less depression in black caregivers of patients with dementia.(Neurology)(Brief Article)
Mar 01, 2005; ... WASHINGTON -- Black women caring for patients with Alzheimer's disease or other dementias are less likely to be depressed than their nonblack counterparts, Betsy Sleath, Ph.D., of the University of North Carolina School of Pharmacy, Chapel Hill, said at the annual meeting of the American ...
Coping skills can prevent, relieve headache pain.(Neurology)
Mar 01, 2005; ... SCOTTSDALE, ARIZ. -- Medications have their rightful place in headache treatment, but a strong dose of some key coping and behavioral tools can go a long way toward helping patients manage their own headaches. Alvin E. Lake III, Ph.D., said at a symposium sponsored by the American Headache ...
Variety of drugs available for cluster headache prophylaxis.(Neurology)
Mar 01, 2005; ... LAS VEGAS -- Every cluster headache patient needs to be on a prophylactic drug, Todd D. Rozen, M.D., said at a symposium sponsored by the American Headache Society. "I tell them, 'I'm not happy, and you shouldn't be happy, until you're cluster free on prevention,'" said Dr ....
Increase oxygen flow rate if cluster headache patients don't respond initially.(Neurology)
Mar 01, 2005; ... LAS VEGAS -- The flow rate of oxygen that is routinely prescribed to abort cluster migraine is too low to be effective in many patients. Todd D. Rozen, M.D., said at a symposium sponsored by the American Headache Society. Since the effectiveness of inhaled 100% oxygen for ...
Butterbur for migraine prophylaxis.(ALTERNATIVE MEDICINE)
Mar 01, 2005; ... History of Use Medicinal properties have been ascribed to the peculiar plant Petasites hybridus, common butterbur, since the first-century Greek physician Dioscurides used its pounded leaves to treat skin ulcers. The leaves can reach a diameter of 3 feet and were said to ...
Low-dose monophasic OCs are best type for menstrual migraines.(Neurology)(oral contraceptives)
Mar 01, 2005; ... SCOTTSDALE, ARIZ. -- Fluctuating hormones are believed to be the key culprit behind menstrual migraines, so low-dose monophasic oral contraceptives are generally the best alternative to help such patients, Christine Lay, M.D., said at a symposium sponsored by the American Headache Society ....
Physiotherapy beats brief CBT for neck pain.(Neurology)
Mar 01, 2005; ... Standard physiotherapy appears more effective than a brief, hands-off intervention for neck pain, although patient preference for the brief intervention can enhance its effectiveness, according to the findings from a randomized trial. However, because confidence intervals ...
Sciatica improved little with IV corticosteroid.(Neurology)
Mar 01, 2005; ... SAN ANTONIO -- A single, intravenous injection of methylprednisolone performed just slightly better than placebo in alleviating pain from acute discogenic sciatica, Axel Finckh, M.D., said at the annual meeting of the American College of Rheumatology. Dr. Finckh presented a ...
Radiosurgery for trigeminal neuralgia helpful.(Neurology)(Brief Article)
Mar 01, 2005; ... SAN FRANCISCO -- For people who are too old or ill to withstand the rigors of microvascular decompression, the gamma knife is a "reasonable treatment option" for recalcitrant trigeminal neuralgia, Jason Sheehan, M.D., said at the annual meeting of the Congress of Neurological Surgeons. ...
Expect more lawsuits over pain undertreatment.(Neurology)
Mar 01, 2005; ... Physicians who used to worry about prescribing too much pain medication now have a new liability problem to worry about: not prescribing enough. "The pendulum has swung," said Jay Westbrook, clinical director for palliative care and bereavement service at Valley Presbyterian ...
Study probes chronic pain care.(Neurology)
Mar 01, 2005; ... SAN FRANCISCO -- Emergency physicians seldom see eye to eye with patients who seek help for chronic pain, according to preliminary results from a small, ongoing study. The emergency physicians end up frustrated, and the patients seldom get the help they need, Scott M. Fishman, ...
Older antiseizure drugs boost statin metabolism.(Neurology)
Mar 01, 2005; ... BRECKENRIDGE, COLO. -- Carbamazepine and certain other older antiepileptic drugs accelerate hepatic metabolism of statins to such a degree that either their concomitant use needs to be avoided or the statin dose must be increased to often impractical levels, Jose E. Cavazos, M.D., said at ...
Even newer antiepileptics may lead to worse osteoporosis risk in the elderly.(Neurology)
Mar 01, 2005; ... BOSTON -- Keep the risk of osteoporosis and osteopenia in mind when elderly patients are being treated even with the newer antiepileptic drugs, Georgia D. Montouris, M.D., advised at a meeting on epilepsy in the elderly sponsored by Boston University. Drug-to-drug interactions ...
Screening refractory epilepsy patients for neurosurgery takes time.(Neurology)
Mar 01, 2005; ... FORT MYERS, FLA. -- Comprehensive assessment of patients who are possible candidates for surgery to reduce epileptic seizures can be complicated and can take up to a year and a half, David C. McCarthy Jr., M.D., said at the annual meeting of the Academy of Psychosomatic Medicine. ...
Zoledronic acid protects bone in breast Ca patients: prophylactic treatment may avert osteoporosis and fractures resulting from aromatase inhibitor therapy.(Women's Health)
Mar 01, 2005; ... SAN ANTONIO -- Zoledronic acid prevents the profound loss of bone mineral density that often occurs with combined adjuvant endocrine therapy in premenopausal breast cancer patients, Michael Gnant, M.D., reported at a breast cancer symposium sponsored by the Cancer Therapy and Research ...