Internal Medicine News back issues from October 2005:
Hospital system takes on MRSA.(News)(Methicillin-Resistant Staphylococcus Aureus )
Oct 01, 2005; ... A Chicago-area hospital system has launched an ambitious effort to sharply reduce the rate of in-hospital methicillin-resistant Staphylococcus aureus infections by screening all patients. The new admissions screening process at each of three Evanston Northwestern Healthcare ...
Information technology used mostly for electronic billing in 2003.(VITAL SIGNS)(Illustration)
Oct 01, 2005 ... <Pre> Information Technology Used Mostly For Electronic Billing in 2003 Electronic billing 73% Electronic medical recards 17% Computerized prescription order entry 8% Note: Based on ...
Homocysteine hypothesis of CV disease is 'dead': lowering plasma levels may be dangerous.(News)
Oct 01, 2005; ... STOCKHOLM -- Lowering plasma homocysteine with B vitamin therapy does not prevent subsequent MIs and strokes in patients who have had an MI--to the contrary, it may even be harmful, according to the results of the first large randomized treatment trial to examine the issue. "The ...
Act now to disaster-proof clinical, business records.(News)
Oct 01, 2005; ... The recent disaster along the Gulf coast may be a wake up call for all physicians to establish some kind of emergency backup system for their businesses. "Physicians don't always think of themselves as running a business, but they're going to think of it now," Rosemarie Nelson, ...
Feds delay OTC decision for Plan B.(over the counter drugs)
Oct 01, 2005; ... Citing difficult and novel regulatory issues, the Food and Drug Administration delayed its decision on over-the-counter marketing status for the emergency contraceptive Plan B (levonorgestrel), to seek public comment. The FDA cannot decide whether to approve "the application ...
Prevention is key to curbing MDR gram-negative bugs.(persistent multidrug-resistant)
Oct 01, 2005; ... BETHESDA, MD. -- The supply of weapons against multidrug-resistant gram-negative pathogens is running low, Henry M. Blumberg, M.D., said at an annual conference on antimicrobial resistance sponsored by the National Foundation for Infectious Diseases. "We are struggling to treat ...
Pennsylvania agency pushes hospitals to fess up about inpatient infections.(News)
Oct 01, 2005; ... In the wake of what appears to be underreporting of nosocomial infections, a Pennsylvania state agency is poised to use its leverage to force hospitals to divulge more accurate and full information. This summer, the Pennsylvania Health Care Cost Containment Council issued a ...
Displaced medical schools find alternative locations.(News)(Brief Article)
Oct 01, 2005; ... Medical schools affected by Hurricane Katrina and its aftermath scrambled to find alternative locations and resources, to ensure that their students and residents would be able to continue practicing medicine. At press time, most of the students from Tulane University in New ...
Emergency physicians share their storm stories.(News)
Oct 01, 2005; ... While television relentlessly conveyed Hurricane Katrina's destructive impact on property, the catastrophe's human costs emerged most powerfully in the clarity of individual voices. In the following e-mails, emergency physicians shared their experiences in the first chaotic days after the ...
Florida needs bariatric coverage.(insurers seriously restricted access to bariatric surgery)
Oct 01, 2005; ... In January of this year major Florida insurers, including Blue Cross Blue Shield of Florida, seriously restricted access to bariatric surgery, the only proven treatment for the morbidly obese. As reported in the media, Blue Cross Blue Shield of Florida's self-appointed expert panel cited a ...
Pay-for-performance pitfalls for AMA.(LETTERS)(Letter to the Editor)
Oct 01, 2005; ... The article regarding the American Medical Association policy debate demonstrates the reason many doctors do not want to be involved with the organization ("AMA Targets 'Pay for Performance' but Hits Resistance," July 15, 2005, p. 1). The approach is sheepish and rather ...
PT for joint hypermobility syndrome.(LETTERS)(Letter to the Editor)
Oct 01, 2005; ... We are hopeful that your excellent article on JHS will help raise awareness of this common condition, which too often goes overlooked by primary care physicians and specialists alike ("Joint Hypermobility Syndrome Often Overlooked," May 15, 2005, p. 35). We are concerned, however, that ...
Pain relievers.(Opinion)(Cartoon)
Oct 01, 2005 ... "I already diagnosed myself on the ...
Assuming cost is not an issue, should every patient with RA receive biologic therapy?(PRO & CON)(rheumatoid arthritis)
Oct 01, 2005; ... YES Therapy for rheumatoid arthritis (RA) has three goals: preventing joint damage, preventing loss of function, and fostering self-understanding in our patients. It's clear that we're most likely to reach those goals with early diagnosis and the control of inflammation. ...
New drugs scale high-altitude pulmonary edema: novel therapies for prevention and treatment include inhaled [beta]-agonists, sildenafil, and dexamethasone.(Pulmonary Medicine)
Oct 01, 2005; ... SNOWMASS, COLO. -- Physicians have recently gained a brace of new pharmacologic options for preventing and treating high-altitude pulmonary edema, Peter Hackett, M.D., said at the annual meeting of the Wilderness Medical Society. The novel therapies targeting this potentially ...
Cyclophosphamide may prop up lung function in scleroderma.(Pulmonary Medicine)
Oct 01, 2005; ... The immunosuppressant drug cyclophosphamide may attenuate the decline in lung function that comes with scleroderma, according to a recent multicenter trial. The study suggests that differences in lung function as small as 2%-3% may brighten the quality of life among scleroderma ...
Oral appliances offer option for sleep apnea: if patients can't tolerate CPAP, they may want to try a dental appliance before undergoing surgery.(Pulmonary Medicine)(continuous positive airway pressure device)
Oct 01, 2005; ... When a patient with obstructive sleep apnea can't tolerate using a continuous positive airway pressure device, what's the next step? "The option people end up thinking about when CPAP fails is typically surgery," said Kent Moore, M.D., D.D.S., president of the Academy of Dental ...
Heavy snoring in pregnancy endangers the fetus.(Pulmonary Medicine)
Oct 01, 2005; ... DENVER -- Obstructive sleep apnea is far more common during pregnancy than most physicians realize, and in its more severe forms it can jeopardize the fetus, Meir H. Kryger, M.D., said at a satellite symposium held in conjunction with the annual meeting of the Associated Professional Sleep ...
Treating apnea may help correct PCOS hormonal abnormalities.(Pulmonary Medicine)
Oct 01, 2005; ... SAN DIEGO -- A small but intriguing study has found that treating obstructive sleep apnea in patients with polycystic ovary syndrome lowered their cortisol levels not only at night, but during the daytime as well. Obstructive sleep apnea symptoms also improved markedly in five ...
Sleep apnea detected in 70% of candidates for gastric bypass.(Pulmonary Medicine)(Brief article)
Oct 01, 2005; ... DENVER -- All patients who are candidates for gastric bypass surgery should be evaluated for obstructive sleep apnea. Brian Abaluck, M.D., said at the annual meeting of the Associated Professional Sleep Societies. The prevalence of this sleep disorder is extremely high among the ...
Armodafinil useful adjunct to CPAP in apnea.(Pulmonary Medicine)
Oct 01, 2005; ... DENVER -- The investigational drug armodafinil significantly increased daytime wakefulness in patients with obstructive sleep apnea who experienced excessive sleepiness despite regular use of nighttime continuous positive airway pressure therapy, according to the results of two phase III ...
CPAP may improve cognitive function in Alzheimer's patients.(Pulmonary Medicine)(continuous positive airway pressure)
Oct 01, 2005; ... DENVER -- Continuous positive airway pressure improved both excessive daytime sleepiness and--in a particularly encouraging finding--cognitive function in a randomized trial involving Alzheimer's disease patients with obstructive sleep apnea, investigators reported at the annual meeting of ...
Apnea may link apo E4, Alzheimer's.(Pulmonary Medicine)
Oct 01, 2005; ... DENVER -- The well-documented association between the apolipoprotein E4 allele and development of cognitive decline and Alzheimer's disease may be mediated at least in part by obstructive sleep apnea, Ruth O'Hara, Ph.D., said at the annual meeting of the Associated Professional Sleep ...
Nearby natural asbestos deposits increase mesothelioma risk.(Pulmonary Medicine)
Oct 01, 2005; ... Mesothelioma is significantly more likely to occur in people who live near deposits of naturally occurring asbestos, Marc Schenker, M.D., and his colleagues reported. The largest epidemiologic study of mesothelioma and naturally occurring asbestos to date concluded that the risk ...
DHEA fizzles in long-term Mayo Clinic study.(Geriatric Medicine)(dehydroepiandrosterone)
Oct 01, 2005; ... SAN DIEGO -- A long-term study of dehydroepiandrosterone supplementation in elderly men and women found no effect on body composition, muscle strength or performance, glucose metabolism, or quality of life. There was a "trend ... of borderline significance" for the effect of ...
Bright light may lessen insomnia in the elderly.(Geriatric Medicine)(Brief Article)
Oct 01, 2005; ... DENVER -- Exposure to bright light has already been established as effective therapy for depression. Now it is also showing promise for improving daytime sleepiness and mood in nondepressed older individuals with primary insomnia. The evidence comes from a study of 51 patients ...
Creatine, exercise increase strength in Parkinson's.(Geriatric Medicine)
Oct 01, 2005; ... NASHVILLE, TENN. -- Creatine monohydrate, in combination with resistance training, appears to increase strength and endurance in patients with Parkinson's disease more than resistance training alone. The additional benefits may be related to creatine's ability to stimulate ...
Statins failed to lower dementia risk in elderly.(Geriatric Medicine)(Brief Article)
Oct 01, 2005; ... Statins didn't decrease the risk of Alzheimer's or vascular or mixed dementia in patients 65 years or older. A secondary analysis of the Cardiovascular Health Study found no protective cognitive effects of any statin among 2,798 subjects (mean age 75 years), said Thomas D. Rea, M.D., of ...
PET scans predict Alzheimer's, mild impairment: the imaging technique may have the potential to fast-forward the search for preventive measures.(Geriatric Medicine)(Positron emission tomography)
Oct 01, 2005; ... WASHINGTON -- Hippocampal metabolic reductions seen on PET scans in people with no clinical signs of cognitive impairment may be able to predict who will go on to develop Alzheimer's disease and mild cognitive impairment, according to data presented at an international conference sponsored ...
Screening for genetic susceptibility to Alzheimer's does more good than harm.(Geriatric Medicine)
Oct 01, 2005; ... WASHINGTON -- Screening for the [epsilon]4 form of the apolipoprotein E gene may offer psychological benefit, not harm, to the adult children of people with Alzheimer's, said Robert C. Green, M.D., at an international conference sponsored by the Alzheimer's Association. ...
High homocysteine linked to memory decline in women.(Geriatric Medicine)(Brief Article)
Oct 01, 2005; ... Hyperhomocysteinemia was associated with poorer performance on memory tests in postmenopausal women, Margaret S. Clark, Ph.D., and her associates have reported. While the performance levels weren't low enough to be classified as mild cognitive impairment, they do raise the ...
Quick screening tool boosts dementia diagnosis.(Geriatric Medicine)
Oct 01, 2005; ... WASHINGTON -- Routine use of a simple dementia screening tool can boost the number of possible dementia cases identified in primary care without putting a substantial drain on physician time, according to data presented at an international conference sponsored by the Alzheimer's ...
Alzheimer's disease prevention booklet.(Geriatric Medicine)(Genes, Lifestyles, and Crossword Puzzles: Can Alzheimer's Disease Be Prevented?)(Brief Article)(Book Review)
Oct 01, 2005 ... The National Institute on Aging's Alzheimer's Disease Education and Referral Center is offering a free booklet that explores potential prevention strategies. "Genes, Lifestyles, and Crossword ...
Here's three easy pieces for dementia screening.(Geriatric Medicine)
Oct 01, 2005; ... WASHINGTON -- Short on time for screening older patients for dementia? Try the Memory Impairment Screen, the Mini-Cog, and the General Practitioner Assessment of Cognition tests. The three appear to be the best tools for routine screening in the primary care setting, according ...
Clinical methods rival imaging for AD diagnosis.(Geriatric Medicine)
Oct 01, 2005; ... WASHINGTON -- Clinical diagnosis of Alzheimer's disease may be just as accurate as neuroimaging, blood work, and interview of a knowledgeable informant, David A. Bennett, M.D., said at an international conference sponsored by the Alzheimer's Association. Rates of pathologic ...
Pioglitazone improves CV outcomes in diabetics.(Endocrinology)
Oct 01, 2005; ... Pioglitazone significantly reduced the combined risk of myocardial infarction, stroke, and death in high-risk patients with type 2 diabetes, investigators reported at the annual meeting of the European Association for the Study of Diabetes. The Prospective Pioglitazone Clinical ...
Strategies to motivate diabetic patients for self-management.(Endocrinology)
Oct 01, 2005; ... WASHINGTON -- Although there are major gaps in the literature about the psychosocial aspects of diabetes management, certain evidence-based strategies do tend to work for many patients, Leonard Jack Jr., Ph.D., said at the annual meeting of the American Association of Diabetes Educators. ...
FDA panel gives guarded okay to inhaled insulin.(Endocrinology)
Oct 01, 2005; ... SILVER SPRING, MD. -- Advisors to the Food and Drug Administration voted to recommend approval of inhaled insulin, but also expressed concern about the product's long-term pulmonary effects as well as the level of training that patients would need to properly use the inhaler device. ...
FDA advisory panel recommends muraglitazar for type 2 diabetes: the panel endorsed the drug's use alone and with metformin, but not combined with sulfonylureas.(Endocrinology)
Oct 01, 2005; ... SILVER SPRING, MD. -- A Food and Drug Administration advisory board endorsed muraglitazar for the treatment of type 2 diabetes, as monotherapy and in combination with metformin, but rejected its use in combination with sulfonylureas due to cardiovascular safety concerns. If ...
Metabolic syndrome Dx upheld by cardiologists: unlike the diabetes groups, AHA/NHLBI finds the syndrome to be valid and clinically useful.(Endocrinology)
Oct 01, 2005; ... Less than a month after two major diabetes organizations called metabolic syndrome a poorly defined and misleading diagnosis, the American Heart Association and the National Heart, Lung, and Blood Institute issued a joint statement reaffirming that the syndrome is valid and clinically ...
ARBs boost endothelial function in impaired glucose tolerance.(Endocrinology)(angiotensin receptor blockers)
Oct 01, 2005; ... TORONTO -- Endothelial function improves significantly with angiotensin II receptor-1 blockade in patients with impaired glucose tolerance, and quickly reverts to baseline after discontinuation of therapy, Thomas H. Schindler, M.D., reported at the annual meeting of the Society of Nuclear ...
Rosiglitazone and obesity.(CLINICAL CAPSULES)(Brief Article)
Oct 01, 2005; ... Rosiglitazone may be an effective adjunct to insulin therapy in patients with type 1 diabetes and a body mass index (BMI) of at least 30 kg/[m.sup.2], reported Suzanne M, Strowig, R.N., and Philip Raskin, M.D., of the University of Texas Southwestern Medical Center, Dallas. In ...
Obesity, smoking, and aging.(CLINICAL CAPSULES)(Brief Article)
Oct 01, 2005; ... Obesity and cigarette smoking are associated with accelerated aging in white women, reported A.M. Valdes, Ph.D., of the Twin Research and Genetic Epidemiology Unit, St. Thomas' Hospital, London. Both smoking and obesity result in oxidative stress, which increases white blood ...
Nutritional adjunct tied to savings.(CLINICAL CAPSULES)(Brief Article)
Oct 01, 2005; ... Supplementation with chromium picolinate plus biotin may substantially reduce the cost of treating type 2 diabetes, reported Joseph P. Fuhr Jr., Ph.D., of Widener University, Chester, Penn., and Thomas Jefferson University, Philadelphia, and his associates, based on an economic analysis. ...
Body mass and stature.(CLINICAL CAPSULES)(Brief Article)
Oct 01, 2005; ... The acute response of the spine to loading may be a risk factor for low back pain in obese subjects, reported Andre Luiz Felix Rodacki of Parana Federal University, Curitiba, Brazil, and his associates. Ten obese men with a BMI greater than 30 kg/[m.sup.2] and 10 monobese men ...
Learn to recognize gender identity disorder: the program for transgender teens at Childrens Hospital Los Angeles requires 1 year of therapy.(Adolescent Medicine)
Oct 01, 2005; ... Most adolescents wrestle with some form of angst as they develop a personal identity separate from their family and gain a sense of belonging with their peers. But wrestling with gender identity and being an adolescent can be "a double whammy," said Marvin E. Belzer, M.D., ...
Teens willing to risk health in pursuit of bigger muscles.(Adolescent Medicine)(Brief Article)
Oct 01, 2005; ... Both boys and girls who reported a desire to look like celebrities in magazines were significantly more likely to use potentially unhealthful supplements to enhance their physiques, reported Alison E. Field. Sc.D., of Harvard University, and her colleagues. In a cross-sectional ...
FDA reviews oral contraceptive safety in teens: one-year study of adverse events raises no new concerns for adolescents taking combination drugs.(Adolescent Medicine)
Oct 01, 2005; ... ROCKVILLE, MD. -- No new safety concerns were raised by a review of adverse events reported during a recent 1-year period in adolescents taking a combination oral contraceptive, according to Jean Wendy Temeck, M.D., of the Food and Drug Administration's divisions of pediatric drug ...
Longitudinal data show teen girls change contraception often.(Adolescent Medicine)
Oct 01, 2005; ... NEW ORLEANS -- Changes in contraceptive methods are frequent among adolescent girls, and tend to reflect pregnancy status and changes in sexual relationships and behaviors. Jennifer L. Woods, M.D., reported at the annual meeting of the North American Society for Pediatric and Adolescent ...
Girls' birth control knowledge does not equate to safe sexual behavior.(Adolescent Medicine)(Brief Article)
Oct 01, 2005; ... NEW ORLEANS -- Adolescent girls at high risk for pregnancy and sexually transmitted infections who participated in a recent study were knowledgeable about common birth control methods, but most reported having unprotected sex. Of 332 girls aged 12-18 from a cohort with a high ...
Contraceptive methods used by young women.(DATA WATCH)(Illustration)
Oct 01, 2005 ... <Pre> Contraceptive Methods Used by Young Women Age 15-19 Years Pill52.8% Condom 27% 3-Month Injectable 13.9% Other6.3% Age 20-24 Years Sterilization3.6% Pill ...
Pharmacotherapy may help some obese teens: some MDs may be reluctant to prescribe weight-loss medications until long-term effects are known.(Adolescent Medicine)
Oct 01, 2005; ... SAN FRANCISCO -- The epidemic of childhood obesity shows no signs of abating, and studies have demonstrated only modest results from diet and exercise, unless an intensive boot-camp approach is used, Robert H. Lustig, M.D., said at a meeting on clinical pediatrics, sponsored by the ...
Early signs of CVD seen in teens with type 1 diabetes.(Adolescent Medicine)(cardiovascular diseases)
Oct 01, 2005; ... ATLANTA -- Adolescents with type 1 diabetes may have early evidence of atherosclerosis, Maria V. Karantza, M.D. reported at the annual scientific sessions of the American Diabetes Association. The increased risk appears to be related to conventional cardiovascular disease risk ...
Smoking 'dose' may be associated with risk for metabolic syndrome.(Adolescent Medicine)
Oct 01, 2005; ... Intensity of exposure to tobacco smoke appears to be associated with the rate of metabolic syndrome in a dose-response relationship in adolescents, according to a study in the cross-sectional third National Health and Nutrition Examination Survey. The study is the first of its ...
Late return of potency after radical prostatectomy.(Urology)
Oct 01, 2005; ... SAN ANTONIO -- A large, longitudinal study of men who underwent radical prostatectomy has shown a small but statistically significant increase in sexual potency between 2 and 5 years after radical prostatectomy, David F. Penson, M.D., reported at the annual meeting of the American ...
Surgery has advantages for advanced prostate cancer.(Urology)
Oct 01, 2005 ... SAN ANTONIO -- A large retrospective study with patients from the Mayo Clinic has demonstrated the advantages of radical prostatectomy in men with clinically advanced prostate cancer, John F. Ward, M.D., said at the annual meeting of the American Urological Association. Most ...
Radiation, radical prostatectomy: neither had better quality of life.(Urology)
Oct 01, 2005 ... SAN ANTONIO -- A prospective, randomized study comparing external beam radiotherapy with radical prostatectomy for localized prostate cancer found no clear winner in terms of quality of life during the 2 years after treatment, Savino M. Di Stasi, M.D., said at the annual meeting of the ...
Sexual potency preserved with transurethral prostatectomy.(Urology)(Brief Article)
Oct 01, 2005 ... SAN ANTONIO -- Patients with benign prostatic hyperplasia who undergo transurethral radical prostatectomy are likely to retain their sexual potency, although their ejaculatory function worsens significantly, Michael Muentener, M.D., reported at the annual meeting of the American Urological ...
Robotic prostatectomy effective but expensive.(Urology)
Oct 01, 2005; ... SAN ANTONIO -- Compared with radical retroperitoneal prostatectomy, patients undergoing robot-assisted laparoscopic prostatectomy lose less blood but experience more complications within 30 days, according to a study presented at the annual meeting of the American Urological Association. ...
Regular tadalafil may up endothelial function.(Urology)
Oct 01, 2005; ... SAN DIEGO -- Men who took the impotence drug tadalafil (Cialis) every other day for a month experienced significant and lasting improvement in endothelial function and cavernous artery blood flow, Italian researchers reported at the annual meeting of the Endocrine Society. ...
Nodular melanoma signs not as simple as ABCs.(Dermatology)
Oct 01, 2005; ... GLASGOW, SCOTLAND -- The success in recent years of public- and professional-relations efforts to spread awareness of early signs of melanoma has had one unfortunate downside: The common checklists that identify worrisome features of skin lesions do not apply to the highly lethal nodular ...
Two genetic melanoma subtypes seen in patients with sun damage.(Dermatology)
Oct 01, 2005; ... VIENNA -- Genomic analyses suggest that there are biologically distinct subtypes of cutaneous melanoma, Boris C. Bastian, M.D., reported at the 10th World Congress on Cancers of the Skin. He and his colleagues at the comprehensive cancer center of the University of California, ...
Histology distinguishes malignant melanoma from Bowen's disease.(Dermatology)
Oct 01, 2005; ... GLASGOW, SCOTLAND -- The importance of diagnostic biopsy for solitary lesions was underscored by three cases presented in a poster session by Daniel Glass, M.B., at the annual meeting of the British Association of Dermatologists. In case 1, a 77-year-old woman presented with an ...
Teledermatology services offered worldwide.(Dermatology)
Oct 01, 2005; ... VIENNA -- Teledermatology is expanding in Europe through an online international dermatology community that provides open-access consultations. H. Peter Soyer, M.D., reported at the 10th World Congress on Cancers of the Skin. The consultations are free of charge for now, and ...
Legislating teens' indoor tanning, state by state: restrictions on minors are lacking and vary widely; the AMA urges federal prohibitions and warnings.(Dermatology)
Oct 01, 2005; ... If a 14-year-old girl walks into an indoor tanning facility in California, she would need parental consent to get a tan. But in Wisconsin, that same teen would be turned away at the door. A total of 21 states, as well as numerous counties acting on their own, restrict minors' ...