Internal Medicine News back issues from November 2005:
Live organ donors sought via Internet.(News)
Nov 01, 2005; ... Internet sites that match live organ donors with unrelated patients needing transplants appear to be getting more popular--and raising new ethical issues that some critics consider worrisome. One reason for the increased popularity may be the long waiting lists for organs ....
Are patients willing to pay for quality?(VITAL SIGNS)(Brief Article)
Nov 01, 2005 ... <Pre> Are Patients Willing to Pay for Quality? Would you go to a highly recommended doctor who doesn't take your insurance? Very willing14% Somewhat willing39% Not very willing26% Not at all willing 21% ...
New HPV vaccine shown to prevent early cervical Ca: another vaccine also is in phase III trials.(News)(human papillomavirus)
Nov 01, 2005; ... SAN FRANCISCO -- A multinational study of 11,502 young women showed for the first time that a vaccine for human papillomavirus can prevent precancerous cervical lesions and early in situ cervical cancers, Laura A. Koutsky, Ph.D., reported. The recombinant vaccine against HPV ...
Drug sequence not crucial in heart failure treatment.(News)
Nov 01, 2005; ... STOCKHOLM -- A [beta]-blocker and an ACE inhibitor, the two mainstays of heart failure treatment, can be started in either order and be safe and effective, according to data on more than 1,000 patients. Treatment of heart failure typically begins with an ACE inhibitor or an ...
Stable angina tied to high mortality risk.(News)(Brief Article)
Nov 01, 2005; ... STOCKHOLM -- Patients in the community with stable angina have a higher risk of dying than has been calculated in clinical trials, according to an analysis of more than 100,000 patients. "It's widely assumed that stable angina has a good prognosis," especially in women, Harry ...
Organ allocation system improves outlook for liver recipients.(News)
Nov 01, 2005; ... CAMBRIDGE, MD. -- A new model for donor liver allocation has reduced the number of patients on the transplant waiting list and improved wait-list time for those with hepatocellular carcinoma, but waiting time still varies greatly between regions, Warren Maley, M.D., said at a hepatobiliary ...
Web site lets doctors tap evacuees' Rx data.(News)
Nov 01, 2005; ... A broad coalition of public and private sector groups has launched a secure Web site where physicians and pharmacists can access medication histories for patients who were evacuated from their homes in the aftermath of Hurricane Katrina. The Web site can be accessed from any ...
Storm-displaced doctors strive to stay in practice: physicians face challenges as they search for ways to rebuild practices that were disrupted by hurricanes.(News)
Nov 01, 2005; ... In the wake of the severe hurricane season on the Gulf Coast, thousands of displaced physicians have been forced to look for ways to keep practicing medicine. For some, this means relocating to another part of the country, or holding down a temporary job in the hopes that ...
Be prepared to treat cutaneous radiation injuries.(News)
Nov 01, 2005; ... NEW YORK -- The mantra for the new world order is "It is not if, but when," and physicians must be prepared to care for victims of radiation injury resulting from terrorist events, Lt. Col. Norvell V. Coots, MC, USA, said at the annual meeting of the National Medical Association. ...
Studies finally link tanning beds to melanoma.(News)
Nov 01, 2005; ... VANCOUVER, B.C. -- Two new studies presented at the Sixth World Congress on Melanoma have linked tanning bed use and melanoma. "The year 2005 sees the first real, indisputable evidence that tanning bed use contributes to melanoma risk," said Philippe Autier, M.D., of the Jules ...
FDA panel backs approval of oral iron chelator.(News)
Nov 01, 2005; ... ROCKVILLE, MD. -- A long-awaited alternative to highly effective--but cumbersome and often painful--subcutaneous infusions of the iron chelator deferoxamine may soon be available for patients with chronic iron overload caused by repeated blood transfusions. Deferasirox, an ...
Guillain-Barre cases prompt vaccine alert.(News)
Nov 01, 2005; ... Any physician with a patient who develops Guillain-Barre syndrome after receiving the meningococcal conjugate vaccine should report the case to the Vaccine Adverse Event Reporting System, according to an alert issued by the Food and Drug Administration and the Centers for Disease Control ...
Expect higher standards in research.(GUEST EDITORIAL)
Nov 01, 2005; ... Peer-reviewed research should provide clear guidance to clinical practice. However, there is considerable information that we as physicians have a right to expect from peer-reviewed research but are not getting. This deficiency makes it harder for us to practice evidence-based medicine. ...
Making the move to concierge care.(LETTERS)(Letter to the Editor)
Nov 01, 2005; ... I converted to a "concierge" practice with the aid of MDVIP just over a year ago, and it was the best move I ever made ("Concierge Practices Grow More Diverse," Sept. 1, 2005, p. 1, and "Legal Expert Highlights Potential Risks of Concierge Care," p. 6). I found I was too busy ...
Retainer practices better for patients.(LETTERS)(Letter to the Editor)
Nov 01, 2005; ... I would like to congratulate Dr. Garrison Bliss on recreating the traditional doctor-patient relationship that third-party payers have degraded. In my retainer practice, my only concern and loyalty is to the patient, because my only financial relationship is with the patient. I ...
Putting patients' interests first.(LETTERS)
Nov 01, 2005; ... The article about concierge medicine raises--albeit tangentially--the question of what to do when the health insurance plan's interests run contrary to the patient's. Since every U.S. health insurance plan, apart from that of Kaiser Permanente and the Department of Veterans ...
Corrections.(Correction Notice)
Nov 01, 2005 ... The article, "Loss of Cap Worries Wisconsin Doctors" (Sept. 15, 2005, p. 1) should have stated that Wisconsin's cap on noneconomic damages in malpractice cases had been cut to ...
Adult immunization comes of age.(GUEST EDITORIAL)
Nov 01, 2005; ... The era of adult immunization is here. The publication of the adult immunization schedule by the Centers for Disease Control and Prevention marks the fourth year in a row that physicians who treat adults get a vaccine chart to post on their walls, as pediatricians have had for decades ....
Pain relievers.(Opinion)(Cartoon)
Nov 01, 2005 ... "I can't afford health care, so I'm ...
Do coated or expanding coils optimize treatment of brain aneurysms, compared with bare platinum coils?(PRO & CON)
Nov 01, 2005; ... YES Coil embolization with bare platinum coils (BPCs) has been proved to be a safe, effective, and durable means of treating aneurysms, with outcomes superior to clipping in selected patients. In the last 15 years, however, coiling with BPCs resulted in higher short-term risks ...
WHO to release absolute fracture risk index.(Rheumatology)
Nov 01, 2005; ... SAN FRANCISCO -- A tool being developed by the World Health Organization should help physicians calculate a patient's absolute risk for bone fracture and provide counseling about treatment, experts said at a meeting on osteoporosis sponsored by the University of California, San Francisco. ...
Bone density screening belongs in primary care.(Rheumatology)
Nov 01, 2005; ... SAN FRANCISCO -- Measuring bone mineral density in older patients is as justifiable as measuring lipids, Dennis M. Black, Ph.D., said at a meeting on osteoporosis sponsored by the University of California, San Francisco. Lipid testing and treatment for high cholesterol are ...
Use T and z scores to explain bone densitometry to patients.(Rheumatology)
Nov 01, 2005; ... SAN FRANCISCO -- Patients under-going bone densitometry should be counseled about their T and the z scores, Steven T. Harris, M.D., advised at a meeting on osteoporosis sponsored by the University of California, San Francisco. The T score compares the patient's bone mineral ...
Genetic role in fracture risk diminishes with patient age.(Rheumatology)
Nov 01, 2005; ... The genetic influence on fracture susceptibility depends on the type of fracture and age at the time of the event, results from a large Swedish twin study suggest. In addition, the heritability of osteoporotic fractures is stronger than has been previously estimated, especially ...
Race didn't affect response to infliximab in RA.(Rheumatology)
Nov 01, 2005; ... NEW YORK -- Race does not appear to be a factor in the clinical presentation of rheumatoid arthritis or in response to treatment with infliximab, according to Alvin F. Wells, M.D., Ph.D., of Chicago Medical School, North Chicago, and his colleagues. The findings, reported at the ...
Etanercept's safety similar in all age groups.(Rheumatology)(Brief Article)
Nov 01, 2005; ... The safety of the biologic etanercept (Enbrel) doesn't appear to vary depending on the age of the patient taking it for a rheumatic disease, according to the findings of a 22-clinical trial review. Roy Fleischmann, M.D., of the University of Texas Southwestern Medical Center at ...
Forefoot reconstruction preserves function in RA.(Rheumatology)(Brief Article)
Nov 01, 2005; ... VIENNA -- A new approach to forefoot reconstruction in patients with rheumatoid arthritis has shown superior results with regard to pain, deformity, and function compared with conventional techniques, according to Takeshi Mitsuka, M.D. Reconstruction of the lateral toes is ...
Fasting for rheumatoid arthritis.(ALTERNATIVE MEDICINE)
Nov 01, 2005; ... History and Rationale for Use Fasting was a central component of many ancient medical and spiritual systems, but its modern use began in the United States with the natural and physical medicine movements of the late 19th century. Enthusiasm for the practice burgeoned until, in ...
Musculoskeletal ultrasound showing promise: ultrasound for rheumatology gained acceptance first in Europe, and is meeting some resistance in U.S.(Rheumatology)
Nov 01, 2005; ... Increasingly deemed by European rheumatologists as an indispensable tool for their practices, musculoskeletal ultrasound will make inroads in the United States, according to many people who have tried the technology and believe in its benefits. In Europe, where access to more ...
Adverse lipid profiles in lupus may stem from autoimmunity.(Rheumatology)
Nov 01, 2005; ... BOSTON -- Heightened activity of anti-double-stranded DNA antibodies may contribute to the poor cholesterol profiles of patients with active systemic lupus erythematosus, according to study findings. Patients with SLE are often afflicted with a complex triad of risk factors ...
Smoking linked to DNA autoantibodies in lupus.(Rheumatology)
Nov 01, 2005; ... Patients with systemic lupus erythematosus who smoke are more likely to be seropositive for double-stranded DNA autoantibodies, compared with those patients who never smoked or were former smokers, according to the findings of a recent study. Epidemiologic evidence suggests that ...
Childhood-onset SLE has long-term effects on organs.(Rheumatology)(systemic lupus erythematosus )
Nov 01, 2005; ... VIENNA -- Nearly two-thirds of a cohort of childhood-onset systemic lupus erythematosus patients had evidence of irreversible organ damage after a decade of disease, Vibke Lilleby, M.D., reported at the annual European congress of rheumatology. The most frequently affected organ ...
Major infectious episodes common in systemic lupus erythematosus.(Rheumatology)(Brief Article)
Nov 01, 2005; ... VIENNA -- Patients with systemic lupus erythematosus experience an exceptionally high rate of major infections, Irene E.M. Bultink, M.D., reported at the annual European congress of rheumatology. In her retrospective series of 103 unselected SLE patients, one-half experienced a ...
Novel hip-resurfacing implant jumps first hurdle.(Rheumatology)
Nov 01, 2005; ... GAITHERSBURG, MD. -- A Food and Drug Administration advisory panel recommended for approval a new hip-resurfacing implant based on data from a large, nonrandomized case series performed by the investigator who invented the device and is a consultant to the company seeking approval. ...
View hyperuricemia as a red flag for CVD risk.(Rheumatology)(cardivascular diseases)
Nov 01, 2005; ... VIENNA -- The time has come for a change in thinking regarding nongouty asymptomatic hyperuricemia, traditionally dismissed as a clinically irrelevant laboratory abnormality, George Nuki, M.D., asserted at the annual European Congress of Rheumatology. "We actually need at this ...
Vaccine may help some heavy smokers to quit.(Psychiatry)
Nov 01, 2005; ... ORLANDO -- Swiss researchers have reported that a vaccine against nicotine addiction helped a subgroup of long-term, heavy smokers kick the habit. At first, the CYT002-NicQb vaccine did not perform significantly better than placebo in intent-to-treat data from a phase II ...
More young adults abusing prescription pain meds: the steady escalation of painkiller abuse needs to be better understood, taken seriously, and confronted.(Psychiatry)
Nov 01, 2005; ... WASHINGTON -- The lifetime prevalence of prescription pain reliever abuse by young adults rose from 22% to 24% from 2002 to 2004, a survey released by the Substance Abuse and Mental Health Services Administration shows. Pain relievers with "significant increases" in lifetime ...
Predictors of recovery from alcohol dependency identified.(Psychiatry)
Nov 01, 2005; ... SANTA BARBARA, CALIF. -- People who receive any form of treatment to help them with alcohol dependency are twice as likely to recover as are those who receive no treatment. But recovery that is prompted by treatment is often a slow process, and may take longer than recovery that ...
Admissions to substance abuse treatment facilities rise in adults aged 55 years to older.(DATA WATCH)
Nov 01, 2005 ... Admissions to Substance Abuse Treatment Facilities Rise in Adults Aged 55 Years to Older Source: ...
Many insomnia drugs in therapeutic pipeline.(Psychiatry)
Nov 01, 2005; ... DENVER -- The pharmaceutical industry envisions the insomnia market as a field of dreams, judging by the sizable array of agents moving through the developmental pipeline. And these aren't "me-too" drugs, either. They involve a wealth of new therapeutic targets and novel ...
Insomnia.(THE EFFECTIVE PHYSICIAN)
Nov 01, 2005; ... Background Providing effective treatment for insomnia remains a challenge in medical practice. The National Institutes of Health recently released its final statement from a state-of-the-science conference on this common clinical condition. Conclusions ...
Novel sleep drug gaboxadol looks promising.(Psychiatry)(Brief Article)
Nov 01, 2005; ... DENVER -- Gaboxadol improved sleep initiation and maintenance while increasing time spent in restorative slow-wave sleep in an acute phase II placebo-controlled trial, Stephen Deacon, Ph.D., reported at the annual meeting of the Associated Professional Sleep Societies. Based ...
Treatments for excess sleepiness compared.(Psychiatry)
Nov 01, 2005; ... SAN DIEGO -- All three main treatments for problem sleepiness--caffeine, modafinil, and central nervous system stimulants--can perk patients up, but they differ in cost and side effects, Milton Erman, M.D., said at a psychopharmacology congress sponsored by the Neuroscience Education ...
Many elderly can stop hypnotics, sleep better.(Psychiatry)
Nov 01, 2005; ... DENVER -- Older adults with longstanding hypnotic-dependent insomnia who wish to stop taking their sleep medication usually can do so successfully--with resultant improvement in sleep--by participating in a program of gradual weaning preceded by behavioral therapy, Kenneth L. Lichstein, ...
Drug improves sleep induction without sedation.(Psychiatry)
Nov 01, 2005; ... DENVER -- The novel melatonin receptor agonist ramelteon was associated with significant reductions in the time it took to fall asleep in two phase III clinical trials totaling 1,234 adults with primary insomnia, investigators reported at the annual meeting of the Associated Professional ...
Tesaglitazar pares down metabolic syndrome.(Endocrinology)
Nov 01, 2005; ... STOCKHOLM -- Tesaglitazar markedly reduces the prevalence of both metabolic syndrome and impaired fasting glucose in hypertriglyceridemic, insulin-resistant nondiabetic patients, Steen Stender, M.D., reported at the annual congress of the European Society of Cardiology. ...
Chronically ill need coping skills training.(Endocrinology)
Nov 01, 2005; ... WASHINGTON -- Increasing evidence suggests that patients with chronic conditions such as diabetes and heart disease who receive coping skills training do better physically and mentally, Redford B. Williams, M.D., said at the annual meeting of the American Association of Diabetes Educators ....
Teen girls' activity levels drop.(CLINICAL CAPSULES)(Brief Article)
Nov 01, 2005; ... A steep decrease in activity levels among teen girls as they age has led to increases in body mass index and adiposity, particularly among black girls, reported Sue Y.S. Kimm, M.D., of the University of New Mexico, Albuquerque. Dr. Kimm and associates assessed body mass index ...
Binge eating disorder.(CLINICAL CAPSULES)(Brief Article)
Nov 01, 2005; ... Guided self-help cognitive-behavioral therapy was associated with a significantly higher remission rate for binge eating disorder than was guided self-help behavioral weight loss treatment, but weight loss was minimal among both groups, reported Carlos M. Grilo, Ph.D., and Robin M. Masheb, ...
Managing gastrogastric fistulas.(CLINICAL CAPSULES)
Nov 01, 2005; ... Gastrogastric fistulas are a rare but serious complication of Roux-en-Y gastric bypass, often marked by unresponsive marginal ulcers, failure of weight loss, nausea, and/or vomiting, reported Lester Carrodeguas, M.D., and his associates at the Bariatric Institute and Division of Minimally ...
Antipsychotic-related weight gain.(CLINICAL CAPSULES)(Brief Article)
Nov 01, 2005; ... A behavioral weight control program was associated with modest improvements in obese patients taking antipsychotic medications, but longer and more robust interventions are necessary, reported Melissa A. Kalarchian, Ph.D., of the University of Pittsburgh Medical Center, and her associates ....
Type 1 and type 2 diabetes can overlap in teens: a patient can have a genetic predisposition to type 2 diabetes but develop type 1; diagnosis can be difficult.(Adolescent Medicine)
Nov 01, 2005; ... For most pediatric patients with high blood sugar, the distinction between type 1 and type 2 diabetes is straightforward. However, there can be an overlap, and patients can fit criteria for both conditions, making diagnosis and management more challenging. Michelle Ditto is a ...
Obesity may hamper trauma recovery.(Adolescent Medicine)
Nov 01, 2005; ... PHOENIX -- A retrospective study of 316 trauma patients suggests that obese children and adolescents could have more difficulty recovering from severe injuries than patients who are leaner. Youngsters with a body mass index of 30 kg/[m.sup.2] or greater developed more ...
Obesity-prevention group seeks to intensify efforts, provide leadership.(Adolescent Medicine)(Brief Article)
Nov 01, 2005; ... An obesity-prevention initiative chartered by the American Diabetes Association aims to provide leadership and information "to help families and communities make improved nutrition and greater physical activity a priority, especially for children," said Michael Jensen, M.D. He ...
Decidual casts linked to DMPA use in teens: inform patients that decidual cast expulsion is a rare side effect of depot medroxyprogesterone acetate.(Adolescent Medicine)(depot medroxyprogesterone acetate)
Nov 01, 2005; ... NEW ORLEANS -- Decidual cast expulsion may occur in young patients using depot medroxyprogesterone acetate, Stephen M. Scott, M.D., said at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology. Although decidual casts are typically associated ...
Adolescent birth rates down, but 18% of children still live in poverty.(Adolescent Medicine)
Nov 01, 2005; ... Health statistics for children showed record improvements in 2003, although the rate of infants born at low birth weights continues to increase, the Federal Interagency Forum on Child and Family Statistics reported in "America's Children: Key National Indicators of Well-Being 2005." ...
Access to confidential care is key for teen girls.(Adolescent Medicine)(Brief Article)
Nov 01, 2005; ... NEW ORLEANS -- The interval between sexual debut and initiation of gynecologic health care was substantial in a recent study of urban adolescent girls, but access to confidential care predicted more timely gynecologic care, M. Diane McKee, M.D., reported at the annual meeting of the North ...
Mandatory isotretinoin registry draws fire: the FDA is requiring that patients, prescribers, and manufacturers be in compliance as of Jan. 1, 2006.(Dermatology)
Nov 01, 2005; ... SANTA BARBARA, CALIF. -- Who's responsible for iPLEDGE, the new, highly restrictive, mandatory registry for isotretinoin prescriptions? A Vioxx-jittery Food and Drug Administration, noncompliant pharmacists, the American Academy of Dermatology, dermatologists, and other ...
Low-dose flutamide effective for female refractory acne.(Dermatology)
Nov 01, 2005; ... QUEBEC CITY -- The androgen receptor blocker flutamide at 125 mg/day appears to be effective in treating acne in women who have not responded to other medications, James C. Shaw, M.D., reported at the annual conference of the Canadian Dermatology Association. Flutamide has been ...
Combination topical agent prevents jellyfish stings.(Dermatology)
Nov 01, 2005; ... SNOWMASS, COLO. -- The best product for preventing jellyfish stings is a combination sunscreen/topical jellyfish sting inhibitor called Safe Sea, Paul S. Auerbach, M.D., said at the annual meeting of the Wilderness Medical Society. "I use the stuff all the time. I think it's a ...
Extending higher dosage of etanercept found safe.(Dermatology)
Nov 01, 2005; ... CHICAGO -- Maintaining patients with moderate to severe psoriasis on a higher than recommended dose of etanercept is safe, according to new long-term multicenter phase III data. Although the recommended dosing in the United States is for 3 months of 50 mg etanercept twice ...
Fumaric acid esters from Germany may offer help in severe psoriasis.(Dermatology)
Nov 01, 2005; ... GLASGOW, SCOTLAND -- A proprietary formulation of fumaric acid esters has proved, during decades of use in Germany, to be a useful option for some patients with severe, recalcitrant psoriasis. Although the therapy is less than perfect--with common gastrointestinal side effects, ...
Biologic therapies may tackle palmoplantar pustular psoriasis.(Dermatology)
Nov 01, 2005; ... CHICAGO -- Evidence is mounting that biologic therapies such as alefacept and efalizumab can successfully treat palmoplantar pustular psoriasis. Preliminary data from a pilot study of 15 patients at two sites showed a 16-week course of alefacept (Amevive), including 8 weeks of ...
Promise of xenotransplants tempered by viruses.
Nov 01, 2005; ... Human xenotransplantation trials could begin in 5 years, thanks to advances in immunosuppression and the creation of miniature swine whose organs do not provoke hyperacute rejection, experts say. But even as researchers overcome the hurdle of immune response, they must tangle ...
FDA to review risk management for natalizumab.(Rx)
Nov 01, 2005; ... The manufacturers of natalizumab expect the U.S. Food and Drug Administration to convene an advisory panel to discuss whether to allow the monoclonal antibody back on the market, according to a spokesperson for Biogen Idec, one of the drug's makers. The specifics of when the ...