Internal Medicine News back issues from September 2005:
Concierge practices grow more diverse.(News)
Sep 01, 2005; ... Garrison Bliss, M.D., is not convinced that so-called concierge care has to involve a $4,000 yearly fee. The Seattle internist charged patients only $65 a month when he opened his practice in Washington state in 1997--one of the first U.S. practices to adopt the concierge care ...
Most people support restrictions on direct-to-consumer advertising of new drugs.(VITAL SIGNS)(Brief Article)
Sep 01, 2005 ... <Pre> Most People Support Restrictions on Direct-to-Consumer Advertising of New Drugs Favor mandatory ban for limited time 35% Favor voluntary ban for limited time 16% Oppose any ban23% Not sure ...
Groups seek curb on 'metabolic syndrome' label: diabetes specialists want further research.(Endocrinology)
Sep 01, 2005; ... Physicians should avoid labeling patients with the term "metabolic syndrome," at least until its meaning and medical usefulness can be further clarified, the American Diabetes Association and the European Association for the Study of Diabetes said in a joint statement. The ...
CMS proposes 4.3% pay reduction for next year.(News)
Sep 01, 2005; ... Physicians face a 4.3% cut to Medicare reimbursements next year unless Congress takes action to change the sustainable growth rate formula. The reduction was announced in a proposed rule that would update payment rates and revise payment policies under the program's fee ...
Say goodbye to paper Medicare claims Oct. 1.(News)
Sep 01, 2005; ... Hello, October--goodbye, paper Medicare claims. Oct. 1 marks the date that physicians and other providers may no longer submit any paper Medicare claims; electronically filed claims not in compliance with federal regulations also will be prohibited. The rules are part ...
Legal expert highlights potential risks of concierge care.(News)
Sep 01, 2005; ... DALLAS -- Among the so-called concierge-care models, practices that offer fees for non-covered services to patients who have insurance carry the highest legal risk, attorney John Marquis said at a national conference on concierge medicine. In light of recent actions taken by ...
Millions of doses of avian flu vaccine on order.(News)
Sep 01, 2005; ... The U.S. government is aiming to buy millions of doses of avian influenza vaccine, which preliminary data have shown produces a robust immune response against the A (H5N1) virus in some doses. "We have been asked to provide up to 20 million doses of the vaccine, in addition to ...
U.S. government should buy all vaccines for flu pandemic, two committees agree.(News)
Sep 01, 2005; ... ROCKVILLE, MD. -- If the United States faces an influenza pandemic, the federal government should buy all the vaccine, members of the National Vaccine Advisory Committee agreed at a joint meeting with the Advisory Committee on Immunization Practices. The committees reviewed the ...
Senior citizens get first shots during shortage.(News)
Sep 01, 2005; ... In the event of an influenza vaccine shortage during the 2005-2006 season, the Centers for Disease Control and Prevention has advised physicians to prioritize people age 65 years and older with comorbid conditions if their local vaccine supplies are extremely limited. A ...
Imaging breakthroughs reveal early AD changes: new techniques detect preclinical changes in the brain's biochemistry, water diffusion, and structures.(News)
Sep 01, 2005; ... WASHINGTON -- Imaging techniques designed to enable identification of preclinical Alzheimer's disease were showcased in numerous presentations at an international conference sponsored by the Alzheimer's Association. Preclinical Biochemical Changes Using magnetic ...
Diabetes tracking is now a necessity.(GUEST EDITORIAL)
Sep 01, 2005; ... Diabetes is epidemic in New York City and throughout the United States. Self-reported diabetes prevalence among New York City adults has more than doubled in the past decade, from less than 4% to almost 10%. Diabetes is now the fourth leading cause of death and ninth leading cause of ...
Pain relievers.(Opinion)(Cartoon)
Sep 01, 2005 ... "Congratulations on completing your residency ....
Marijuana is not medicine.(LETTERS)
Sep 01, 2005; ... Relative to the diatribe by Dr. Marcus Conant, marijuana is not a medicine by any stretch of a sober person's imagination ("The Future of Medical Marijuana," Guest Editorial, July 1, 2005, p. 11). Legislative actions [to legalize marijuana for medical use] seriously jeopardize ...
Provisions for marijuana rx.(LETTERS)(Brief Article)
Sep 01, 2005; ... The issue of "medical marijuana," which is not going to go away anytime soon despite its debatable benefits, must be addressed in a reasonable manner, preferably by the medical community first. Although it is probably not reasonable to deny the pleasures of marijuana use to ...
Recertification not worth the effort.(LETTERS)(Brief Article)
Sep 01, 2005; ... I had to recertify in internal medicine in 2003 and found recertification to be nothing more than an expensive and enormous waste of time ("Some Subspecialists Only Recertifying in Own Field," May 15, 2005, p. 70). The whole recertification process was a list of subspecialty ...
The value of patient-specific care.(LETTERS)(Brief Article)
Sep 01, 2005; ... Those who promote hospitalists speak of the value of "disease-specific experience" ("Hospitalists' Impact on Outcomes Not So Clear," June 1, 2005, p. 71). As a community physician, I also appreciate the value of "patient-specific experience." Having built up a body of ...
Should hypertension be treated with a renin-angiotensin blocker?(PRO & CON)
Sep 01, 2005; ... YES Certainly, lowering high blood pressure in hypertensive patients is important. But blocking the renin-angiotensin system also makes a difference in hypertensive patients; what is good for the kidney also is likely to be good for the heart. I won't say that I know ...
Thyroid storm rare following I-131 treatment.(Endocrinology)
Sep 01, 2005; ... TORONTO -- The risk of provoking thyroid storm with administration of radioactive iodine appears to be vanishingly small even in cases of severe thyrotoxicosis, Vani Vijayakumar, M.D., said at the annual meeting of the Society of Nuclear Medicine. Patients who are undergoing ...
Thyroid cancer data support aggressive therapy.(Endocrinology)
Sep 01, 2005; ... Multifocal tumors in papillary thyroid cancer appear to often arise as independent tumors--a finding that supports the use of bilateral thyroidectomy and radioablation of remaining tissue, according to Trisha M. Shattuck of the University of Connecticut, Farmington, and her associates. ...
Depression may worsen diabetes.(Endocrinology)(Brief Article)
Sep 01, 2005; ... In a study of 231 adolescents with type 1 diabetes, those who had depressive symptoms were at increased risk for hospitalization from diabetes complications during a 2-year follow-up. On the Center for Epidemiological Studies-Depression Scale, 33% of the patients (aged 11-18 ...
Diagnostic code for metabolic syndrome rarely used in U.S.(Endocrinology)
Sep 01, 2005; ... Despite America's obesity epidemic, use of the diagnostic code for metabolic syndrome in U.S. clinical practice is "rarer than a blue moon," according to Earl S. Ford, M.D. In 2001, the National Cholesterol Education Program (NCEP) established a definition for the metabolic ...
Obesity, inactivity tied to diabetes.(CLINICAL CAPSULES)(Brief Article)
Sep 01, 2005; ... Target both fitness and fatness to help control diabetes and diabetes-related comorbidities in the general population, advised Patrick W. Sullivan, Ph.D., of the University of Colorado, Denver, and his associates. The Medical Expenditure Panel Survey, a nationally representative ...
More desk time, bigger waistline.(CLINICAL CAPSULES)(Brief Article)
Sep 01, 2005; ... The more time men spend sitting at work, the greater their risk of being overweight or obese, reported W. Kerry Mummery, Ph.D., of Central Queensland University, Rockhampton, Australia, and associates. In a cross-sectional study of 875 men and 704 women who worked full time, ...
Plasma peptides influence satiety.(CLINICAL CAPSULES)(Brief Article)
Sep 01, 2005; ... Apelin, orexin-A, and leptin levels in the plasma appear to work together to influence satiety, reported M.V. Heinonen and colleagues at the University of Kuopio (Finland). The investigators measured basal plasma values in 32 morbidly obese subjects and 12 healthy controls; a ...
Setting up obesity programs.(CLINICAL CAPSULES)(Brief Article)
Sep 01, 2005; ... To launch effective obesity treatment programs in primary health care centers, health professionals need education, support from colleagues, and backing from management, reported Ingela Melin of the Karolinska Institute, Stockholm, and her associates. In a study of 135 health ...
Rosiglitazone: no hepatotoxicity seen at 10 years.(Endocrinology)
Sep 01, 2005; ... SAN DIEGO -- Rosiglitazone has shown no hint of excess liver toxicity in 10 years of safety monitoring by GlaxoSmithKline, Alexander R. Cobitz, M.D., Ph.D., reported at the annual scientific sessions of the American Diabetes Association. The withdrawal of the first ...
Spironolactone reduces edema from rosiglitazone.(Endocrinology)
Sep 01, 2005 ... SAN DIEGO -- Spironolactone appears to be the most effective antidiuretic for the management of rosiglitazone-associated fluid retention, Janaka Karalliedde, M.D., reported at the annual scientific sessions of the American Diabetes Association. Edema is a common side effect of ...
Novel insulin sensitizer cuts glucose without edema or weight gain.(Endocrinology)
Sep 01, 2005 ... SAN DIEGO -- Metaglidasen is a novel insulin sensitizer that appears to lower blood glucose as effectively as the thiazolidine-diones without causing weight gain or edema, Julio Rosenstock, M.D., reported at the annual scientific sessions of the American Diabetes Association. ...
Insomnia curbs antidepressant response in aged.(Psychiatry)
Sep 01, 2005; ... DENVER -- Chronic insomnia in depressed elderly patients confers roughly a ninefold increased risk of continued depression after as much as 12 months of antidepressant therapy, Wilfred Pigeon, Ph.D., reported at the annual meeting of the Associated Professional Sleep Societies. ...
Comorbid insomnia/depression responds to cotherapy.(Psychiatry)
Sep 01, 2005; ... DENVER -- Coadministration of eszopiclone (Lunesta) and fluoxetine (Prozac) for newly diagnosed major depressive disorder with coexistent insomnia was associated with larger and quicker improvements in both disorders than fluoxetine and placebo in a randomized controlled trial. ...
Body piercings, tattoos may reflect suicidality.(Psychiatry)
Sep 01, 2005; ... BROOMFIELD, COLO. -- Body modification enthusiasts--individuals who undergo piercing, tattooing, and/or scarification--have a high rate of self-reported prior suicide attempts, David Lester, Ph.D., said at the annual conference of the American Association of Suicidology. This ...
Depression, PTSD timing varies in injured soldiers.(Psychiatry)(posttraumatic stress disorder)
Sep 01, 2005; ... ATLANTA -- There is no one-size-fits-all formula for the course of posttraumatic stress disorder and depression among battle-injured soldiers, Capt. Thomas A. Grieger, MC, USN, reported in a poster presentation at the annual meeting of the American Psychiatric Association. ...
Quick depression scale proves useful in primary care settings.(Psychiatry)
Sep 01, 2005; ... BOCA RATON, FLA. -- An abbreviated Hamilton Depression Rating Scale can quickly assess depression severity and monitor patient response to treatment in a primary care setting, according to a multicenter study. Complete remission of symptoms is the optimal outcome with ...
Target physical symptoms, boost depression outcomes.(Psychiatry)
Sep 01, 2005; ... BOCA RATON, FLA. -- Targeting physical symptoms of depression in a primary care setting increases the likelihood of treatment response and remission, according to a multicenter, naturalistic study. Somatic symptoms of depression are getting increased attention as part of a drive ...
Posttraumatic stress disorder.(THE EFFECTIVE PHYSICIAN)
Sep 01, 2005; ... Background Posttraumatic stress disorder afflicts many patients who have undergone personal ordeals. The American Psychiatric Association recently issued a guideline to assist practitioners in managing this disorder. Conclusions Between 50% and 80% of the ...
16% of combat medical personnel hit by PTSD.(Psychiatry)
Sep 01, 2005; ... ATLANTA -- Medical personnel returning from combat deployment experience rates of post-traumatic stress disorder only slightly below those of returning soldiers, a study has shown. Nearly 16% of medical personnel from one U.S. military hospital who had been deployed to the ...
Drug for opioid-induced constipation welcomed.(Neurology)
Sep 01, 2005; ... ORLANDO -- Single injections of methylnaltrexone relieved opioid-induced constipation within 4 hours for 60% of hospice and palliative care patients in a randomized, placebo-controlled phase III trial. The earliest responses occurred within 5 minutes, and most patients ...
If pain and depression coexist, assume the pain came first.(Neurology)(Brief Article)
Sep 01, 2005; ... SAN DIEGO -- When chronic pain and depression coexist, treat the patient under the assumption that the pain is causing the depression, not the reverse, Rollin M. Gallagher, M.D., said at a psychopharmacology congress sponsored by the Neuroscience Education Institute. Studies ...
Assessing headache: differential diagnosis is key.
Sep 01, 2005; ... MIAMI BEACH -- A differential diagnosis is the first task in distinguishing between primary and secondary headache disorders, David J. Capobianco, M.D., said at the American Academy of Neurology annual meeting. With well over 300 causes of head and face pain, identification of ...
Neuroimaging useful in diagnosing secondary headaches.(Neurology)
Sep 01, 2005; ... ORLANDO -- Neuroimaging is key to diagnosing relatively rare secondary headaches, Laszlo L. Mechtler, M.D. said at the annual meeting of the American Society of Neuroimaging. "Secondary headaches are where neuroimaging is of paramount importance," said Dr. Mechtler, director of ...
Preventive migraine treatment is underutilized.(Neurology)
Sep 01, 2005; ... PHILADELPHIA -- Millions of U.S. patients who could benefit from migraine prophylaxis are not being offered this treatment by their doctors, Stephen Silberstein, M.D., said at the annual meeting of the American Headache Society. Based on the results of the American Migraine ...
Score identifies TIA patients at risk for stroke.(transient ischemic attacks )
Sep 01, 2005; ... A simple, 6-point scoring system identifies patients with transient ischemic attacks who are at highest risk of progressing to stroke within a week. The ABCD score--which is based on a quick assessment of patient age, blood pressure, two clinical features, and duration of ...
Cerebrovascular disease death rates on the decline.(Brief Article)(Illustration)
Sep 01, 2005 ... <Pre> Cerebrovascular Disease Death Rates on the Decline Male Female 2000 Black90 76 White60 57 Hispanic 51 43 2001 Black85 74 White57 55 Hispanic 49 ...
Benefits of mobile-bearing knee implants unclear.
Sep 01, 2005; ... WASHINGTON -- Mobile-bearing knee implants are hyped in advertisements and demanded by patients, but the jury is still out on whether the device/deliver what's promised. During a panel discussion at the annual meeting of the American Academy of Orthopaedic Surgeons, several ...
Meniscal tear may signal knee osteoarthritis: surgical intervention 'merely removes evidence of the disorder,' a Swedish orthopedic surgeon suggests.(Rheumatology)
Sep 01, 2005; ... VIENNA -- Long-term outcomes after partial meniscectomy in middle-aged and elderly patients aren't nearly as favorable as they ought to be for an operation that does a good job of preserving the key meniscal functions of shock absorption and load transmission--and the reason may be that ...
In short term, real acupuncture beats sham for osteoarthritis.
Sep 01, 2005; ... Acupuncture relieves pain and improves function in knee osteoarthritis significantly better than sham acupuncture, at least in the short term, according to the findings of a randomized controlled study. Over the long term, however, real and sham acupuncture provide about the ...
Medicare vertebroplasty coverage not likely soon.
Sep 01, 2005; ... BALTIMORE -- Although some local carriers already cover vertebral augmentation through vertebroplasty or kyphoplasty, the Centers for Medicare and Medicaid Services does not intend to consider a national coverage policy for the procedures, especially given the lack of solid data available, ...
Specialists differ in dealing with osteoporosis.(Rheumatology)
Sep 01, 2005; ... WASHINGTON -- Endocrinologists and rheumatologists are the most aggressive specialists when it comes to the screening, diagnosis, and treatment of osteoporosis, Tiffany Karas, M.D., and her associates reported in a poster at the annual meeting of the American Association of Clinical ...
Low calcium intake seen in educated women.(Rheumatology)(Brief Article)
Sep 01, 2005; ... INDIAN WELLS, CALIF. -- Even educated women of high socioeconomic status do not appear to get enough daily calcium, Andrea Stein, M.D., said at the annual meeting of the Pacific Coast Reproductive Society. In a survey of 180 middle-aged patients seen in her gynecology practice, ...
In hot flash trials, venlafaxine beats clonidine: the hormonal alternative MPA is clearly better, but safety issues linger for breast cancer survivors.(Women's Health)
Sep 01, 2005; ... ORLANDO -- Venlafaxine controls hot flashes more effectively than clonidine, but not as well as a single dose of medroxyprogesterone acetate, according to randomized, controlled trials presented in posters at the annual meeting of the American Society of Clinical Oncology. In a ...
Expert: don't discount sleep problems during perimenopause.(Women's Health)
Sep 01, 2005; ... ATLANTA -- Sleep problems in perimenopausal women can diminish quality of life significantly and should not be minimized or overlooked, according to Hadine Joffe, M.D. In general, hormonal fluctuations may be to blame, but hot flushes and night sweats are often linked to ...
Breast irradiation may raise angiosarcoma risk.(Women's Health)
Sep 01, 2005; ... NAPLES, FLA. -- In the last year, Michael B. Morgan, M.D., has seen four cases of angiosarcoma on the breast of women who previously underwent radiation therapy for breast cancer. Historically, there are only about 100 cases of angiosarcoma a year in the United States, and ...
Trachelectomy indications, complications studied: prolapse was the main reason in vaginal procedures; pelvic mass was most common in abdominal cases.
Sep 01, 2005; ... RANCHO MIRAGE, CALIF. -- Renewed interest in performing supracervical rather than total hysterectomies in the past 2 decades means some of these women will need trachelectomy or cervical stump removal at some point in the future. To better understand the indications for ...
Life, sex seen no better after supracervical hysterectomy.(Women's Health)
Sep 01, 2005; ... RANCHO MIRAGE, CALIF. -- Supracervical hysterectomy did not leave women with better sexual function or quality of life, compared with total abdominal hysterectomy in the first randomized study to evaluate these outcomes in women who have had an abdominal hysterectomy. Renewed ...
Uterine fibroid embolization offers economic advantages.
Sep 01, 2005; ... SAN FRANCISCO -- Compared with hysterectomy and myomectomy, uterine fibroid embolization actually bolsters rather than bleeds the health care system, Anne Bussard, M.D., reported. "Fibroid embolization is financially advantageous for the health care system, the insurer, and the ...
Lasofoxifene: first SERM to reduce dyspareunia.(selective estrogen receptor modulator)
Sep 01, 2005; ... SAN FRANCISCO -- Lasofoxifene, a selective estrogen receptor modulator that is under investigation for treatment of postmenopausal bone loss, significantly improves dyspareunia associated with postmenopausal vaginal atrophy and is the first drug of its class to show such an effect, ...
ED drugs overprescribed by primary care docs: psychiatrists are said to underuse such drugs, while primary care physicians treat them like aspirin.(erectile dysfunction drugs)
Sep 01, 2005; ... SANTA FE, N.M. -- Psychiatrists underprescribe erectile dysfunction drugs, and primary care physicians prescribe them like aspirin to virtually any man who asks, H. George Nurnberg, M.D., said at a psychiatric symposium sponsored by the University of Arizona. Men who suffer ...
Vardenafil found superior for improving premature ejaculation.
Sep 01, 2005; ... SAN ANTONIO -- Vardenafil improved premature ejaculation more than sertraline. Frank Sommer, M.D., reported at the annual meeting of the American Urological Association. Both vardenafil (Levitra), a phosphodiesterase-5 inhibitor, and sertraline (Zoloft), a selective serotonin ...
Research links homocysteine levels, erectile dysfunction.(Brief Article)
Sep 01, 2005; ... SAN ANTONIO -- Men who have abnormally high levels of homocysteine--a marker already linked to increased risk of coronary artery disease--may be at increased risk of erectile dysfunction, Ralf Herwig, M.D., said at the annual meeting of the American Urological Association. "The ...
Study links prostate drug to sexual dysfunction.(Prostate agents side effects)
Sep 01, 2005; ... SAN ANTONIO -- Patients treated with [alpha]-blockers for enlarged prostate may not need to endure sexual dysfunction, according to research presented at the annual meeting of the American Urological Association. The [alpha]-blockers often prescribed to treat some of the ...
Rectal exams nail prostate cancers missed by PSA.(Urology)(Brief Article)
Sep 01, 2005; ... SAN ANTONIO -- The digital rectal exam continues to play a critical role in identifying men with prostate cancer, according to a poster presentation by Joel Slaton, M.D., and Cesar Ercole, M.D., at the annual meeting of the American Urological Association. Of 85 men, 27 (32%) ...
Sea changes forecast in arrhythmia management: with technologic advances, primary care physicians will manage patients currently seen by cardiologists.(Cardiovascular Medicine)
Sep 01, 2005; ... NEW ORLEANS -- In coming years, technologic advances will allow primary care physicians to function more and more like cardiologists--and to actually take over some aspects of traditional cardiology practice, Douglas P. Zipes, M.D., predicted at the annual meeting of the Heart Rhythm ...
Simple score predicts benefit of early revascularization.(Cardiovascular Medicine)
Sep 01, 2005; ... LOS ANGELES -- Specific findings on adenosine stress myocardial perfusion imaging can be combined with other risk factors to offer precise guidance about whether a patient would obtain a significant survival advantage with early revascularization, Rory Hachamovitch, M.D., said at a meeting ...
Myocardial perfusion imaging urged as initial prognostic test in women.(Cardiovascular Medicine)
Sep 01, 2005; ... ORLANDO -- Myocardial perfusion imaging substantially restratifies women who have a moderate or high Duke Treadmill Score on exercise stress testing, with resultant markedly improved identification of those at elevated risk of a cardiovascular event as well as those who are not, Justin B ....
Fewer blacks than whites reaching LDL goals.(low-density lipoprotein)
Sep 01, 2005; ... WASHINGTON -- African American patients with dyslipidemia are less likely than non-Hispanic whites to achieve LDL cholesterol treatment goals, Luther T. Clark, M.D., and his associates reported in a poster at a conference on cardiovascular disease epidemiology and prevention sponsored by ...