Internal Medicine News back issues from July 2006:
AMA tackles ads, insurance, clinics.(News)(Report)
Jul 01, 2006; ... CHICAGO -- Individual health insurance mandates, store-based clinics, and direct-to-consumer advertising topped the list of issues addressed at the annual meeting of the American Medical Association's House of Delegates. On the heels of Massachusetts' new mandate that all ...
Distribution of medical schools.(VITAL SIGNS)(Brief article)
Jul 01, 2006 ... Distribution of Medical Schools Note: Puerto Rico and the District of Columbia have three schools each ....
New drug class for type 2 diabetes looks promising: two drugs inhibit dipeptidyl peptidase 4.(News)
Jul 01, 2006; ... WASHINGTON -- A new class of drugs for type 2 diabetes shows promise in reducing blood glucose, improving beta-cell function, and helping patients control their weight--all via one oral dose per day, researchers reported at the annual scientific sessions of the American Diabetes ...
Panel endorses dasatinib for imatinib-resistant CML.(chronic myeloid leukemia)(News)(Clinical report)
Jul 01, 2006; ... ATLANTA -- Based on input from an expert advisory panel, the oral tyrosine kinase inhibitor dasatinib may be approved by the Food and Drug Administration for the treatment of imatinib-resistant or -intolerant adults with chronic myeloid leukemia. Other potential indications ...
FDA evaluates hepatic events linked to Ketek.(News)(Clinical report)
Jul 01, 2006; ... As a Senate committee investigated the approval of and postmarketing experience with the antibiotic Ketek, the Food and Drug Administration reportedly compiled data on cases of severe liver toxicity tied to the drug. In some cases, the toxicity has led to transplant or death. ...
Safety issues mar future of dual PPAR agonists.(peroxisome proliferator-activated receptor)(News)(Report)
Jul 01, 2006; ... The future of dual [alpha]-/[gamma]-peroxisome proliferator-activated receptor agonists may now be in question since development of two agents has been halted after the completion of phase III trials. In May, AstraZeneca announced discontinuation of tesaglitazar (Galida), its ...
Once-weekly formulation of exenatide being developed.(News)
Jul 01, 2006; ... WASHINGTON -- A long-acting formulation of exenatide was well tolerated and lowered blood glucose effectively during 15 weeks in a study of patients with type 2 diabetes that Dr. Dennis Kim, of Amylin Pharmaceuticals Inc., and his associates presented in a poster at the annual scientific ...
Liraglutide, a once-daily incretin mimetic, lowers Hb[A.sub.1c] levels.(News)(Drug overview)
Jul 01, 2006; ... WASHINGTON -- A new glucagonlike peptide-1 agonist known as liraglutide significantly reduced Hb[A.sub.1c] when used as monotherapy in a phase II trial that was presented at the annual scientific sessions of the American Diabetes Association. Liraglutide, an incretin mimetic ...
Misconceptions reduce quality of cancer care.(News)(Report)
Jul 01, 2006; ... ATLANTA -- Cancer patients face numerous barriers to quality care that place them needlessly at risk for poor outcomes, researchers said at the annual meeting of the American Society of Clinical Oncology. In addition to the obvious barriers to quality care, such as lack of ...
Recertification too burdensome.(LETTERS)(Letter to the editor)
Jul 01, 2006; ... The American Board of Internal Medicine's participation in Medicare's Physician Voluntary Reporting Program is of great concern to me ("Medicare Data Tied to Certification," April 15, 2006, p. 1). There is no question that this added regulatory burden will reduce the amount of ...
HPV vaccine won't replace screening.(LETTERS)(Letter to the editor)
Jul 01, 2006 ... The article on Gardasil highlights a very important issue about which many physicians maybe underinformed: the fact that the HPV vaccine will be an important contribution to the elimination of cervical cancer, but will not replace the need for regular screening ("HPV Vaccine Prevents ...
HSAs a 'viable option' for uninsured.(LETTERS)(Letter to the editor)
Jul 01, 2006; ... Most evaluations assume that the alternative to the HSA-compatible high-deductible insurance plan is a comprehensive insurance policy ("Experts Debate Pros, Cons of Health Savings Accounts," March 15, 2006, p. 75). But for individuals who cannot afford a more comprehensive ...
The global workforce challenge.(GUEST EDITORIAL)(Editorial)
Jul 01, 2006; ... The fact that a physician shortage is occurring and is expected to worsen in the next decade has been acknowledged by the Council on Graduate Medical Education and the Association of American Medical Colleges. By 2016, when the first of the 78 million baby boomers will have reached age 70, ...
Should physicians communicate with patients via e-mail?(POINT/COUNTERPOINT)(Report)
Jul 01, 2006; ... E-Mail Offers Advantages E-mail opens up the bandwidth of communication with our patients. With this medium, patients can initiate contact 24 hours a day, 7 days a week at their convenience, and physicians can reply at a time most convenient for them. Unlike telephone ...
'Clinical inertia' hampers diabetes management.(Endocrinology)(Report)
Jul 01, 2006; ... WASHINGTON -- "Clinical inertia" is a common, chronic condition among U.S. physicians who treat patients with diabetes, according to several studies presented at the annual scientific sessions of the American Diabetes Association. "Clinical inertia" is defined as the "lack of ...
Tuning fork test for neuropathy found widely useful.(Endocrinology)(Clinical report)
Jul 01, 2006; ... CHICAGO -- Results of a tuning fork test to identify neuropathy appear to be reproducible beyond the diabetic population, according to findings from a blinded, observational study. In a presentation at the annual meeting of the American Association of Clinical Endocrinologists, ...
New antiresorptive agents may be better tolerated.(Endocrinology)(Drug overview)
Jul 01, 2006; ... DESTIN, FLA. -- Investigational antiresorptive agents with novel methods of action and dosing regimens may improve patient compliance and persistence, but will not reduce the risk of fracture associated with osteoporosis beyond that seen with current agents. "The objective of ...
Don't switch drugs if BMD fails to improve.(Endocrinology)(bone mineral density)(Brief article)
Jul 01, 2006; ... DESTIN, FLA. -- A lack of increase in bone mineral density does not necessarily indicate a failure of antiresorptive therapy for osteoporosis, and is not a reason to switch a patient's drugs, Dr. Michael McClung said at a rheumatology meeting sponsored by the Virginia Commonwealth ...
Relative risk data favor benefits of bisphosphonates.(Endocrinology)
Jul 01, 2006; ... LOS ANGELES -- Physicians and patients are less likely to favor bisphosphonate therapy for osteoporosis when efficacy is expressed in terms of absolute risk reduction as opposed to relative risk reduction, Dr. Christine A. Sinsky reported at the annual meeting of the Society of General ...
Better detection key to rise in thyroid cancer.(Endocrinology)
Jul 01, 2006; ... Thyroid cancer incidence has more than doubled over the last 30 years in the United States, and virtually all of that increase has resulted from improved detection of small papillary tumors, reported Dr. Louise Davies and Dr. H. Gilbert Welch of the Veterans Affairs Medical Center, White ...
Thyroid disease rate increased in immunologic thrombocytopenia.(Endocrinology)(Brief article)
Jul 01, 2006; ... CHICAGO -- Immunologic thrombocytopenia was associated with an increased prevalence of thyroid disease in a retrospective longitudinal study. The data support routine screening for thyroid disease in immunologic thrombocytopenia. Treating the thyroid disease did not alter the ...
Testosterone replacement therapy.(THE EFFECTIVE PHYSICIAN)(Disease/Disorder overview)
Jul 01, 2006; ... Background The use of testosterone preparations to treat androgen deficiency is a controversial area in medicine. The Endocrine Society recently issued a clinical practice guideline to assist practitioners with this difficult topic. Conclusions The ...
Diagnostic manual takes psychoanalytic approach.(Psychiatry)(Psychodynamic Diagnostic Manual)
Jul 01, 2006; ... The DSM-IV-TR and the ICD-10 are no longer the only handbooks for psychiatric diagnosis. A consortium of psychoanalytic groups has published its own guide to the full spectrum of disorders after more than 2 years of preparation: It is titled the Psychodynamic Diagnostic Manual ...
IOM: it's time to wake up to sleep disorders.(Psychiatry)(Institute of Medicine)
Jul 01, 2006; ... It's time for physicians and the public alike to wake up to the staggering impact of sleep disorders, a new report from the Institute of Medicine charges. An estimated 50-70 million Americans suffer from chronic sleep disorders such as insomnia, sleep apnea, and restless legs ...
Untreated insomnia may precipitate anxiety disorders.(Psychiatry)
Jul 01, 2006; ... MIAMI -- People with anxiety often present with insomnia, but recent evidence suggests untreated insomnia might lead to anxiety disorders, according to a presentation at the annual conference of the Anxiety Disorders Association of America. "We know ... that anxiety disorders ...
Insomnia.(DRUG UPDATE)
Jul 01, 2006; ... Several new prescription medications have been introduced recently for treating insomnia and have largely taken the place of the benzodiazepines, once the most commonly used medications for insomnia. The newer nonbenzodiazepine benzodiazepine receptor agonists (BRAs)--eszopiclone ...
Think bronchiectasis in frequent antibiotic users.(Pulmonary Medicine)
Jul 01, 2006; ... KEYSTONE, COLO. -- Any patient who needs two or more courses of antibiotics within a year for respiratory tract infections deserves to be evaluated for bronchiectasis, Dr. Gwen A. Huitt asserted at a meeting sponsored by the National Jewish Medical and Research Center. "It's not ...
Sinus surgery curbs worst symptoms.(Pulmonary Medicine)(Brief article)
Jul 01, 2006; ... CHICAGO -- Patients who underwent surgery for chronic rhinosinusitis showed significant improvement in their most severe clinical symptoms, wrote Dr. Francis T.K. Ling in a poster presented at the Combined Otolaryngology Spring Meetings. Nasal obstruction, postnasal drip, and ...
OSA treatment pearls include tennis balls on back.(Pulmonary Medicine)(obstructive sleep apnea)
Jul 01, 2006; ... KEYSTONE, COLO. -- Because oral appliances and surgery don't cut the mustard as broadly applicable alternatives to nasal continuous positive airway pressure for treatment of obstructive sleep apnea, what clinically useful options remain for the patient who flat-out doesn't want to wear a ...
AMP challenge helps discriminate between COPD and asthma.(Pulmonary Medicine)(adenosine 5'-monophosphate)(chronic obstructive pulmonary disease)
Jul 01, 2006; ... MIAMI BEACH -- Measuring airway responsiveness to inhaled adenosine helps discriminate between a diagnosis of asthma and chronic obstructive pulmonary disease, Dr. Riccardo Polosa reported at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. ...
Medication beliefs affect compliance with inhaled steroids in urban adults.(Pulmonary Medicine)(Clinical report)
Jul 01, 2006; ... LOS ANGELES -- Adherence to a prescribed regimen of daily inhaled corticosteroids was associated with beliefs about these medications among inner-city adults with asthma, Dr. Diego Ponieman reported at the annual meeting of the Society of General Internal Medicine. In a ...
Cochrane review favors use of inhaled corticosteroids for chronic asthma control.(Pulmonary Medicine)
Jul 01, 2006; ... Inhaled corticosteroids are better than sodium cromoglycate in measures of lung function and asthma control in children and adults with chronic asthma, the first-ever systematic review of its kind has concluded. "The results suggest that the superiority of ICS over SCG may be ...
Joint hypermobility syndrome underdiagnosed: in a series of unselected new patients referred to a rheumatology clinic, 45% met the diagnostic criteria.(Rheumatology)
Jul 01, 2006; ... GLASGOW, SCOTLAND -- Joint hypermobility syndrome is profoundly underdiagnosed and its impact underestimated despite its being one of the most common causes of widespread chronic pain--and indeed it may be the most common rheumatic disorder, Dr. Rodney Grahame said at the annual meeting of ...
Atherosclerosis common in early inflammatory polyarthritis.(Rheumatology)
Jul 01, 2006; ... GLASGOW, SCOTLAND -- Subclinical atherosclerosis is common among patients early in the course of inflammatory polyarthritis, even among those not considered to be otherwise at high risk for cardiovascular disease, Diane K. Bunn reported at the annual meeting of the British Society for ...
New total hip arthroplasty technique promising.(Rheumatology)
Jul 01, 2006; ... CHICAGO -- Less invasive hip arthroplasty techniques continue to progress and offer new advantages for patients, said Dr. Bryan J. Nestor. Anterior two-incision total hip arthroplasty (THA), only recently touted as being "revolutionary," is falling into disfavor and many ...
Ankle sprain pain: intermittent ice pack better.(Rheumatology)(Brief article)
Jul 01, 2006; ... Applying ice intermittently to mild or moderate ankle sprains resulted in better pain relief after 1 week than did applying ice continuously, researchers from Northern Ireland reported. Dr. Chris Bleakley of the University of Ulster and colleagues randomized 89 patients (58 men ...
Abatacept yields sustained benefits in RA.(Rheumatology)(rheumatoid arthritis)
Jul 01, 2006; ... GLASGOW, SCOTLAND -- Abatacept demonstrated "significant and sustained" clinical efficacy in two new studies, providing further evidence in support of the therapeutic concept of T-cell costimulation in rheumatoid arthritis, Dr. Paul Emery reported at the annual meeting of the British ...
Anti-TNF merits 'extreme caution' in cancer survivors.(Rheumatology)(tumor necrosis factor)
Jul 01, 2006; ... GLASGOW, SCOTLAND -- Data from a large cohort of patients with rheumatoid arthritis receiving anti-tumor necrosis factor-[alpha] therapy has determined that those with a history of malignancy are at heightened risk for additional cancers, and therefore such treatment should be used "with ...
Avemar as supportive therapy in cancer.(ALTERNATIVE MEDICINE)
Jul 01, 2006; ... The Extract and Its Effects An extract of fermented wheat germ, Avemar, was developed during the 1990s by Hungarian biochemist Mate Hidvegi, Ph.D. Initially, Avemar was available as an over-the-counter dietary supplement, but in 2002 the product was registered as a medical ...
More herbal therapies entering clinical trials.(Clinical Rounds)
Jul 01, 2006; ... LA JOLLA, CALIF. -- An emerging trend in complementary and alternative medicine is a shift away from animal-only studies and toward clinical trials involving the use of herbs for cancer treatment, Dr. Mary L. Hardy said a meeting on natural supplements in evidence-based practice sponsored ...
Reagent recalled: screening tests for over 40 disorders could be inaccurate.(Clinical Rounds)(Brief article)
Jul 01, 2006; ... Adiagnostic reagent has been recalled because it may produce a weak signal that could translate into inaccurate results for tests used to screen more than 40 disorders. The reagent is used with the Vitros Immunodiagnostic ECi/ECiQ System to diagnose conditions such as cardiac ...
Lab test cuts need for food challenge in suspected allergy.(Clinical Rounds)
Jul 01, 2006; ... KEYSTONE, COLO. -- Quantitative measurements of food-specific IgE antibodies are a useful shortcut in predicting symptomatic food allergy--provided they are interpreted cautiously, Dr. F. Dan Atkins said at a meeting sponsored by the National Jewish Medical and Research Center. ...
Few doctors comfortable treating food allergies.(Clinical Rounds)(Brief article)
Jul 01, 2006; ... MIAMI BEACH -- Primary care and emergency department physicians provide care to a growing number of patients with food allergies, but they aren't necessarily comfortable doing so. That's the conclusion of a survey of 82 primary care and ED physicians in the Mount Sinai and ...
Ethicists debate ways to solve U.S. organ shortage.(Clinical Rounds)
Jul 01, 2006; ... The growing gulf between patients requiring organ transplants and the number of persons willing to give them is spurring some ethicists to call for new--and sometimes radical--ways to encourage donations. The proposals range from loosening current restrictions on qualified ...
Aggressive secondary prevention urged in CHD.(Cardiovascular Medicine)(coronary heart disease)
Jul 01, 2006; ... Updated secondary prevention guidelines pull together the latest data from clinical trials to advocate more aggressive management of patients with coronary heart disease. The American Heart Association/American College of Cardiology Guidelines for Secondary Prevention for ...
Whole grain barley products can claim heart health benefits.(Cardiovascular Medicine)(Brief article)
Jul 01, 2006; ... Certain whole grain barley products can now officially bear the claim that they may reduce the risk of heart disease. The U.S. Food and Drug Administration finalized a rule that allows labeling on such products to state that "soluble fiber from food such as [name of food], as ...
Imaging targets vulnerable coronary plaques.(Cardiovascular Medicine)
Jul 01, 2006; ... CHICAGO -- A furiously competitive race is on to develop new imaging methods capable of identifying vulnerable coronary plaques. The first of these technologies to undergo evaluation in prospective clinical trials are virtual histology, palpography, thermography, and multislice ...
Sleep apnea treatment noted as cardioprotective.(Cardiovascular Medicine)
Jul 01, 2006; ... BOSTON -- Obstructive sleep apnea is a risk factor for cardiac arrhythmias, and the diagnosis and treatment of this sleep disorder should be considered in terms of cardioprotective benefit, according to Dr. Maria Teresa La Rovere. In a study that she presented in a poster at the ...
Hemofiltration averts contrast nephropathy.(Cardiovascular Medicine)
Jul 01, 2006; ... CHICAGO -- Hemofiltration is the first and only strategy for the prevention of contrast-induced nephropathy that rises to the standard of proven efficacy, Dr. Peter A. McCullough said at the annual meeting of the Society for Cardiovascular Angiography and Interventions. This is ...
Global survey: age is big factor in antibiotic noncompliance.(Infectious Diseases)
Jul 01, 2006; ... NICE, FRANCE -- Although many people are concerned about antibiotic resistance, far fewer understand how their actions contribute to the problem, according to a global patient survey. Results from the COMPLy (Compliance, Modalities by Population, Lifestyle and Geography) survey ...
Clindamycin 'D test' called vital in MRSA.(Infectious Diseases)(methicillin-resistant Staphylococcus aureus)
Jul 01, 2006; ... CHICAGO -- The "D test" is a critical second-step test when methicillin-resistant Staphylococcus aureus cultures come back showing erythromycin resistance and clindamycin susceptibility, according to Dr. Jeffrey Starke. "It should be automatic--every hospital in the country ...
Hospital's infection rate defies clean-hands effort.(Infectious Diseases)(Brief article)
Jul 01, 2006; ... NICE, FRANCE -- A campaign to improve hand hygiene at a Danish hospital failed to decrease hospital-acquired infections, Dr. Sussie Laustsen and colleagues reported in a poster at the 16th European Congress of Clinical Microbiology and Infectious Diseases. The finding comes at a ...
Acyclovir may cut postherpetic neuralgia.(Infectious Diseases)
Jul 01, 2006; ... Intravenous acyclovir significantly reduced postherpetic neuralgia in half of the older patients who received it in an openlabel pilot study, reported Dr. Dianna Quan and her associates at the University of Colorado Health Sciences Center, Denver. These "promising" results will ...
Old chlamydia variant tied to new STD outbreak.(Infectious Diseases)(sexually transmitted diseases)(Brief article)
Jul 01, 2006; ... NICE, FRANCE -- An old nemesis appears to be the cause of a new outbreak of lymphogranuloma venereum proctitis. The Chlamydia trachomatis L2b variant was thought to be a new strain when it was first identified as the major cause of the lymphogranuloma venereum (LGV) proctitis ...
Too many given 'unnecessary' gonorrhea tests.(Infectious Diseases)(Brief article)
Jul 01, 2006; ... JACKSONVILLE, FLA. -- A majority of privately insured women tested for chlamydia are also checked for gonorrhea, which may be unnecessary given its significantly lower incidence, according to a study presented at a conference on STD prevention sponsored by the Centers for Disease Control ...
Screening colonoscopy questions are explored: studies address the value of screening at age 80 and older, and the 10-year interval after a negative result.(Gastroenterology)
Jul 01, 2006; ... Two studies that addressed unrelated, lingering questions about colonoscopy screening should help physicians decide when to recommend the procedure and should help patients decide when to undergo it. One group of researchers investigated whether it is reasonable to recommend a ...
Low literacy undercuts proper preparation for colonoscopy.(Gastroenterology)
Jul 01, 2006; ... LOS ANGELES -- Low literacy was by far the most common independent predictor of poor bowel preparation and incomplete colonoscopy in a study presented at the annual Digestive Disease Week. Among 195 patients who underwent colonoscopy at an inner city hospital, John H. Stroger ...
Diabetes, CAD linked to increased risk of colorectal adenomas.(Gastroenterology)(coronary artery disease)
Jul 01, 2006; ... LOS ANGELES -- The risk of developing colorectal adenomas is increased both in women with diabetes and in individuals with coronary artery disease, according to two studies presented at the annual Digestive Disease Week. Postmenopausal women with type 2 diabetes mellitus who are ...
Watch for signs of gastric lymphoma.(Gastroenterology)
Jul 01, 2006; ... LOS ANGELES -- Have a high index of suspicion for gastric lymphoma in a patient who presents with severe abdominal pain, weight loss, and melena, Dr. Ijeoma A. Azodo advised in a poster session at the annual Digestive Disease Week. "They will have other symptoms, such as early ...
Combination therapy for HCV assessed.(Gastroenterology)(hepatitis C virus)
Jul 01, 2006; ... LOS ANGELES -- Extended combination therapy with consensus interferon for 72 weeks appears to help improve the viral response of patients with chronic hepatitis C virus who have previously relapsed after a 48-week course of treatment, according to a study presented at the annual Digestive ...
'Red flags' predict progression to Crohn's disease.(Gastroenterology)
Jul 01, 2006; ... LOS ANGELES -- A number of clinical, laboratory, and serologic "red flags" may distinguish patients with ulcerative colitis who will progress to a diagnosis of Crohn's disease, researchers reported at the annual Digestive Disease Week. Dr. Gil Y. Melmed and his associates at the ...
Wanted: docs to help craft pay for performance.(Gastroenterology)
Jul 01, 2006; ... CHICAGO -- Physicians need to help design the pay-for-performance programs now being initiated by Medicare and other payers, or they may not like the results, Dr. Trent Haywood said at the annual meeting of the American Association of Clinical Endocrinologists. "What it comes ...
FDA accused of playing politics with Plan B.(Practice Trends)(Food and Drug Administration)
Jul 01, 2006; ... The Food and Drug Administration is once again under fire for its evaluation of the proposed over-the-counter use of the emergency contraceptive Plan B, with advocates for approval accusing the agency of putting politics first. Fueling the accusations are recently released ...
Feds seek electronic credential.(POLICY & PRACTICE)(Brief article)
Jul 01, 2006; ... The ability to verify the identity and credentials of physicians after a disaster may be achieved via a chip or other technology, Anthony M. Cieri of the Department of Homeland Security said at a briefing sponsored by the Information Technology Association of America. Experts at the ...
Survey: FDA influenced by politics.(POLICY & PRACTICE)(Food and Drug Administration)(Survey)(Brief article)
Jul 01, 2006; ... A majority of Americans--82%--believe the Food and Drug Administration is greatly influenced by politics when making decisions about the safety and efficacy of new prescription drugs, according to a Wall Street Journal online Harris Interactive poll. The finding was similar across parties, ...