Internal Medicine News back issues from January 2007:
HIV testing poses clinical challenge.(News)(human immunodeficiency virus)
Jan 01, 2007; ... WASHINGTON -- Efforts to make HIV screening an integral part of primary care have created a new set of educational, reimbursement, and workforce challenges for physicians. In response, the Society of General Internal Medicine (SGIM) is gearing up to help primary care physicians ...
States requiring consent from nonpregnant patients for HIV testing.(VITAL SIGNS)
Jan 01, 2007 ... States Requiring Consent From nonpregnant Patients for HIV Testing Source: ...
FDA scrutinizes antidepressants, risk of suicidality: warning may be applied to young adults.(News)(Food and Drug Administration)
Jan 01, 2007; ... SILVER SPRING, MD. -- Concerns about the risk of suicidality in patients on antidepressant therapy have deepened as a result of a Food and Drug Administration advisory panel's recommendation to expand a black box warning to include young adults. The proposal also sparked ...
Medicare pay expected to climb 5% for internists.(News)
Jan 01, 2007; ... In one of its last actions, the 109th Congress approved a sweeping tax and health bill that included a 1-year delay in the scheduled cut in Medicare physician fees. In 2007, physicians were due to see an overall 5% reduction in pay, thanks to targets set by a payment formula ...
Universal HIV screening may overload care system.(News)
Jan 01, 2007; ... WASHINGTON -- New recommendations to test routinely for HIV in all patients aged 13-64 years will overburden the U.S. health care system with newly diagnosed patients unless additional funding is provided, experts said at a press briefing by the Centers for Disease Control and Prevention. ...
Even with low HIV prevalence, routine screening pays off.(News)
Jan 01, 2007; ... WASHINGTON -- Routine HIV screening among all adults is cost-effective even in settings where the prevalence is low, Dr. Rochelle P. Walensky said at a meeting on HIV diagnosis, prevention, and care in the United States. But there's a catch: The cost-effectiveness of HIV ...
Health IT adoption is critical.(GUEST EDITORIAL)(information technology for physicians)
Jan 01, 2007; ... Although the field of medicine has been on the cutting edge of technology in many areas, critical medical information is stored and accessed in largely the same way as it was 50 years ago. The average patient chart is simply a folder with hundreds of pieces of paper. In an industry that ...
What is the best way to reform the U.S. health care system?(POINT/COUNTERPOINT)
Jan 01, 2007; ... Single payer is the way to go. The health care financing organ in the United States is failing. It has all the manifestations of a patient with heart failure. We have poor output, where we can't circulate health insurance to cover the entire population, so we have ...
'Quality' measures riddled with errors.(LETTERS)(Letter to the editor)
Jan 01, 2007; ... The topic of quality-of-care ratings by insurers needs far more media exposure ("Doctors Sue Over 'Quality' Exclusion," Nov. 1, 2006, p. 1). In our practice in western Massachusetts, we get such "quality" reports up to four times yearly from at least five insurers. We have to ...
Much of our work can't be measured.(LETTERS)(Letter to the editor)
Jan 01, 2007; ... You reported that the Washington State Medical Association and six of the state's physicians sued an HMO because its pay-for-performance standards excluded many physicians ("Doctors Sue Over 'Quality' Exclusion," Nov. 1, 2006, p. 1). Obviously, they did the right thing. The ...
Problems with quality-of-care ratings.(LETTERS)(Letter to the editor)
Jan 01, 2007; ... As medical director of the Boulder Valley Individual Practice Association in Colorado, I can tell you that we have had very negative experiences with the United-Healthcare designation program for 2 years running ("Doctors Sue Over 'Quality' Exclusion," Nov. 1, 2006, p. 1). This ...
Zoster vaccine may be money loser.(LETTERS)(Letter to the editor)
Jan 01, 2007; ... As a internal medicine physician in primary care practice, I am working with a very narrow profit margin ("Zoster Vaccination Faces Payment Gap," Nov. 15, 2006, p. 1). The zoster vaccine is terribly expensive and fragile, and it requires strict temperature control. Heaven help ...
Financial data on income misleading.(LETTERS)(Letter to the editor)
Jan 01, 2007; ... The recent "Vital Signs" graph looks impressive, but it represents only a 3% rise per year ("Median Income of Internists in Group Practice Up 34% Over the Past Decade," Nov. 15, 2006, p. 1). This barely keeps us even with inflation, and for a significant portion of the graph, we ...
Pain relievers.(Opinion)(Cartoon)
Jan 01, 2007 ... "Lose some weight, quit smoking, ...
Cholesterol level tied to prostate ca prognosis.(Urology)(cancer)
Jan 01, 2007; ... BOSTON -- Among men with prostate cancer, those with low plasma cholesterol are significantly less likely to develop more aggressive forms of the disease, compared with those who have higher cholesterol levels, Elizabeth A. Platz, Sc.D., reported at the annual international conference of ...
'Male lumpectomy' works well in prostate cancer: the 'very aggressive' focal cryoablation technique succeeds without affecting potency or continence.(Urology)
Jan 01, 2007; ... CHICAGO -- Focal cryoablation results in better local control of prostate cancer than other standard treatments, Dr. Gary Onik said at the annual meeting of the Radiological Society of North America. By destroying only the cancerous portion of the prostate, a "male lumpectomy" ...
Prostate cancer drugs linked to higher diabetes, CHD risk.(Urology)(coronary heart disease)
Jan 01, 2007; ... Prostate cancer treatment with a gonadotropin-releasing hormone agonist increases the risk of developing diabetes and coronary heart disease, according to an observational study of about 73,000 men with local or regional prostate cancer. Men in the study who received a GnRH ...
Sildenafil can also relieve lower urinary tract problem.(Urology)
Jan 01, 2007; ... TUCSON, ARIZ. -- Monotherapy with sildenafil provides relief for men with both erectile dysfunction and lower urinary tract symptoms, Dr. Jay Young and his associates reported in a poster at the annual meeting of the North American Primary Care Research Group. The study ...
Rosiglitazone has lower treatment failure rate.(Endocrinology)
Jan 01, 2007; ... A multinational study showing that rosiglitazone monotherapy was associated with a lower treatment failure rate at 5 years than either metformin or glyburide has fueled debate over whether thiazolidinediones should be considered for first-line therapy in type 2 diabetes. The ...
Rimonabant cut Hb[A.sub.1c] in type 2 diabetic patients.(Endocrinology)
Jan 01, 2007; ... New data on rimonabant suggest that the selective endocannabinoid type 1-receptor blocker has beneficial effects on glycemic control and other risk factors in diabetic patients. In treatment-naive patients with type 2 diabetes, 6 months of rimonabant therapy produced ...
Radioiodine-131 overused in low-risk thyroid ca.(Endocrinology)(cancer)
Jan 01, 2007; ... VERONA, ITALY -- Radioactive iodine-131 therapy is appropriate for patients with high-risk thyroid cancer, but unjustified in low-risk patients, Dr. Bryan McIver said at a joint meeting of the Italian Association of Clinical Endocrinologists and the American Association of Clinical ...
Guidelines seek tighter opioid therapy control.(Nephrology)
Jan 01, 2007; ... SCOTTSDALE, ARIZ. -- Sustained opioid therapy should be prescribed only for chronic headache patients, according to stringent new guidelines that would exclude most headache patients, Dr. Joel R. Saper proposed at a symposium sponsored by the American Headache Society. Dr ....
Mirapex.(NEW & APPROVED)(Boehringer Ingelheim Corp)
Jan 01, 2007; ... Mirapex (pramipexole, Boehringer Ingelheim) A dopamine agonist that was approved by the Food and Drug Administration for moderate to severe restless legs syndrome (RLS). This is the second drug and the second dopamine agonist approved for this condition; the first ...
Apitherapy for multiple sclerosis.(ALTERNATIVE MEDICINE)
Jan 01, 2007; ... History of Use Bee products were widely used for therapeutic purposes in various ancient civilizations. Drawings on ancient Egyptian temples depict beekeeping and the preparation of honey, and Hippocrates and Galen described treatments, particularly for arthritic conditions, ...
Wine intake may have cognitive benefits.(Nephrology)
Jan 01, 2007; ... MENDOZA, ARGENTINA -- Many studies show that light to moderate drinkers have better cognitive function than do abstainers--particularly in old age--Dr. Roger Pinder reported at the Sixth World Congress on Depressive Disorders. Moderate daily consumption of wine appears to reduce ...
Strong quad muscles may slow knee osteoarthritis: participants who had the greatest quadriceps strength were 60% less likely to lose knee cartilage.(Rheumatology)
Jan 01, 2007; ... WASHINGTON -- Strong quadriceps muscles appear to protect against cartilage loss in some parts of the knee in most people, but larger muscle mass in the knee may be associated with x-ray progression of knee osteoarthritis in women, according to findings from two studies presented at the ...
Chondroitin reduces joint space narrowing in OA.(Rheumatology)(osteoarthritis)
Jan 01, 2007; ... WASHINGTON -- The dietary supplement chondroitin sulfate significantly reduced the progression of joint space narrowing among patients with knee osteoarthritis in a multicenter, prospective, double-blind study presented in a late-breaking abstract session at the annual meeting of the ...
Total new hip eases spine syndrome pain, aids function.(Rheumatology)
Jan 01, 2007; ... SEATTLE -- Total hip replacement surgery may alleviate low back pain and significantly improve spinal function in patients with severe osteoarthritis of the hip, according to a small, multicenter study presented at the annual meeting of the North American Spine Society. "These ...
Acupuncture eases back pain.(CLINICIAL CAPSULES)
Jan 01, 2007 ... A short course of traditional acupuncture can relieve nonspecific lower-back pain better than usual care at a small increased cost, a new study has found. The study randomized 160 adults from York, England, into acupuncture and 81 into usual care of physical therapy, ...
Brace-wrap combo aids ankle sprains.(CLINICIAL CAPSULES)(Brief article)(Clinical report)
Jan 01, 2007 ... Use of the Air-Stirrup brace in combination with an elastic wrap promotes a more rapid return to function following first-time grade I and II ankle sprains than either treatment alone or other modes of treatment, reported Bruce D. Beynnon, Ph.D., of McClure Musculoskeletal Research Center, ...
Smoking tied to arthritis in women.(CLINICIAL CAPSULES)(Brief article)
Jan 01, 2007 ... Smoking is associated with increased risk of rheumatoid arthritis in older white women who are not genetically predisposed to the disease, according to Dr. Lindsey A. Criswell of the University of California, San Francisco, and her associates. The study patients were white women ...
Antidepressants tied to suicide attempts only.(Psychiatry)(Statistical data)
Jan 01, 2007; ... PARIS -- A cohort study of 15,390 suicide-prone people in Finland found that those who used antidepressants were much more likely to attempt suicide, but also much less likely to complete suicide or to die of any cause. Antidepressant use was associated with a 39% increase in ...
FDA issues warning on venlafaxine overdose risk.(Psychiatry)(Food and Drug Administration)(Wyeth)(Brief article)
Jan 01, 2007; ... A warning about an increased risk of overdose associated with venlafaxine and a recommendation to prescribe small quantities of the medication have been issued by the Food and Drug Administration and Wyeth, manufacturer of the antidepressant. The warning is based on ...
Triiodothyronine enhances response to sertraline.(Psychiatry)
Jan 01, 2007; ... PARIS -- Triiodothyronine supplementation significantly increased the antidepressant effects of sertraline in a randomized placebo-controlled clinical trial presented by Dr. Bernard Lerer in a breaking news session at the annual congress of the European College of Neuropsychopharmacology. ...
Interventional oncology: a field on the move.(Clinical Rounds)
Jan 01, 2007; ... ROME -- The future of the fledgling field known as interventional oncology lies in the development of multimodal combination therapies and fusion imaging, Dr. Luigi Solbiati predicted at the annual meeting of the Cardiovascular and Radiological Interventional Society of Europe. ...
Torcetrapib failure may not doom other drugs in class.(Cardiovascular Medicine)
Jan 01, 2007; ... The demise of torcetrapib may be a "bitter disappointment" to researchers, but it's too soon to give up on the entire class of HDL cholesterol-raising agents, several of which are still under development, experts say. "While this is a huge setback for the field of lipid therapy, ...
Fluvastatin XL cuts LDL level with less myalgia: trial finds drug is well tolerated and less likely than other statins to cause muscle-related side effects.(Cardiovascular Medicine)(low density lipoprotein)
Jan 01, 2007; ... CHICAGO -- Fluvastatin XL, either alone or in combination with ezetimibe, is an effective, well-tolerated, and safe option for lowering LDL cholesterol in patients who can't tolerate other statins because of muscle-related side effects, Dr. Evan A. Stein said at the annual scientific ...
Medication combo trumps rosuvastatin in cutting LDL.(Cardiovascular Medicine)
Jan 01, 2007; ... COPENHAGEN -- A combination of ezetimibe and simvastatin provides additional lipid-modifying benefits compared with rosuvastatin monotherapy among patients with type 2 diabetes or with metabolic syndrome without diabetes, Dr. Alberico L. Catapano reported at the annual meeting of the ...
Off-Label DES raise thrombosis risk, panel warns.(Cardiovascular Medicine)(drug-eluting stents )
Jan 01, 2007; ... GAITHERSBURG, MD. -- When used off label, coronary drug-eluting stents are associated with a greater risk of stent thrombosis, death, and myocardial infarction, and this critical information needs to be communicated to physicians and patients, a Food and Drug Administration advisory panel ...
Wi-Fi no threat to implanted cardiac devices.(Cardiovascular Medicine)(Brief article)
Jan 01, 2007; ... CHICAGO -- The mushrooming proliferation of wireless computer networks poses no clinically significant threat to pacemaker or implantable cardioverter defibrillator users, Dr. Fritz Mellert said at the annual scientific sessions of the American Heart Association. Dr. Mellert, a ...
Tools predict community pneumonia's course.(Infectious Diseases)
Jan 01, 2007; ... SAN FRANCISCO -- Two simple new tools may help predict which patients with community-acquired pneumonia are likely to die or to need ICU care, investigators reported in separate presentations at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy. The ...
Resistance can torpedo treatment with macrolides.(Infectious Diseases)(Brief article)
Jan 01, 2007; ... SAN FRANCISCO -- Drug resistance was a common cause of treatment failure in 26 patients with community-acquired pneumonia who developed bacteremia while being treated with macrolide antibiotics, Dr. Gavin Bayan Grant said at the annual Interscience Conference on Antimicrobial Agents and ...
Garenoxacin shows promise for community-acquired pneumonia.(Infectious Diseases)
Jan 01, 2007; ... SAN FRANCISCO -- An experimental fluoroquinolone compared favorably with amoxicillin or ceftriaxone for treating community-acquired pneumonia in two phase III trials, researchers reported in poster presentations at the annual Interscience Conference on Antimicrobial Agents and ...
Dental, oral clues can point to celiac disease.(Gastroenterology)(Clinical report)
Jan 01, 2007; ... NEW YORK -- Dental enamel defects and aphthous ulcers are both strongly associated with celiac disease, and should be followed up with a full investigation for the disorder in undiagnosed people, Theologos Malahias, D.D.S., said at an international symposium on celiac disease. ...
Check for IgA deficiency in suspected celiac cases.(Gastroenterology)(Immunoglobulin A)(Brief article)
Jan 01, 2007; ... NEW YORK -- Serology tests for suspected celiac disease are often inappropriately ordered or managed, increasing the chance of missed diagnosis, according to a study presented at an international symposium on celiac disease. An analysis of 349 positive antiendomysial antibody ...
Natalizumab takes Crohn's remission Past 2 years.(Gastroenterology)
Jan 01, 2007; ... BERLIN -- Treatment with natalizumab maintained remission for more than 2 years in selected patients with severe Crohn's disease, in an open-label extension study with 87 patients. "The data show that if a patient [with Crohn's disease] goes into initial remission [on ...
Fecal-tagging prep tested for CT colonography.(Gastroenterology)(computed tomographic)
Jan 01, 2007; ... BOSTON -- Computed tomographic colonography using a fecal-tagging bowel preparation performed well, showing high sensitivity, specificity, and negative predictive value for polyps measuring 8 mm or more, Dr. Didier Bielen reported at an international symposium on virtual colonoscopy ...
Virtual colonoscopy compares well with optical screening in two studies.(Gastroenterology)
Jan 01, 2007; ... BOSTON -- New data from two studies are putting virtual colonoscopy in a good light compared with optical colonoscopy. Interim results from a large military study comparing virtual and optical colonoscopy for colorectal cancer screening suggest that the two methods are ...
Screening colonoscopy finds more cancers in men.(Gastroenterology)(Brief article)
Jan 01, 2007; ... Colonoscopy detects cancers and advanced neoplasia at a higher rate in men than in women, according to a cross-sectional analysis of more than 50,000 participants in a Polish national colon cancer screening program. The findings suggest that screening guidelines should include ...
Medical schools just say no to pharmaceutical gifts.(Practice Trends)
Jan 01, 2007; ... SACRAMENTO -- Another medical school has joined what could be a growing movement to ban faculty and residents from accepting any gifts whatsoever from drug company representatives. The University of California, Davis, Health System decided in late November to forbid its medical ...
Public NPI directory possible.(POLICY & PRACTICE)(National Provider Identifiers)(Brief article)
Jan 01, 2007; ... The Centers for Medicare and Medicaid Services is strongly considering publishing a directory of physicians who have National Provider Identifiers. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that all providers who submit claims or conduct other ...
Poll: no off-label use.(POLICY & PRACTICE)(Survey)
Jan 01, 2007; ... About half of Americans said physicians should not be allowed to prescribe pharmaceuticals for unapproved uses, according to a WSJ.com/Harris Interactive poll. About half of those polled--about 3,000 adults in November--were not even aware that the FDA allowed off-label prescribing. But ...
Medicare Advantage costs more.(POLICY & PRACTICE)(Brief article)
Jan 01, 2007; ... If the incoming Democrat-majority Congress is looking for funding to expand the Medicare drug benefit, Medicare Advantage may be a ripe target, according to an analysis by researchers at the Commonwealth Fund. They estimate that in 2005, the federal government paid private Medicare managed ...
Consumer-directed plans dictated.(Practice Trends)(Survey)
Jan 01, 2007; ... Many individuals enrolled in consumer-directed health plans may not have much of a choice in the matter, according to a report from the Center for Studying Health System Change. The report, based on survey responses from employers, found that about 39% of the 2.7 million American workers ...
ALS linked to military service.(POLICY & PRACTICE)(amyotrophic lateral sclerosis)(Brief article)
Jan 01, 2007; ... There is "limited and suggestive evidence" of a link between military service and the later development of amyotrophic lateral sclerosis (ALS), according to a report from the Institute of Medicine. A panel of experts convened by IOM reviewed the literature and identified one high-quality ...
Better quality at integrated groups?(POLICY & PRACTICE)(Brief article)
Jan 01, 2007; ... University of Pittsburgh researchers say patients receiving care at integrated medical groups may get better-quality care, according to a study in the Dec. 5 issue of Annals of Internal Medicine. Dr. Ateev Mehrotra and colleagues analyzed data from 119 California physician groups that ...
Bonus linked to Physician Voluntary Reporting.(Practice Trends)
Jan 01, 2007; ... Physicians who report quality data to Medicare will receive bonus payments of 1.5% starting in July, under a provision of the omnibus legislation passed at the end of the 109th Congress. Under the provision, bonus payments would be linked to participation in the Physician ...
Federal Web site offers health data.(Practice Trends)(www.hhs.gov/transparency)(Brief article)
Jan 01, 2007 ... The U.S. Department of Health and Human Services has launched a Web site for providers and consumers that describes the federal initiative to bring transparency to health care. The site includes a link to Hospital Compare ...
Looking ahead: 10 ideas at 10 years.(THE EFFECTIVE PHYSICIAN)(health care system management)
Jan 01, 2007; ... As the Effective Physician starts its 10th year of publication, we'd like to share 10 thoughts and predictions about evidence, practice, and the health care system: 1. All guidelines are not created equal. In selecting material for this column, we continue to be surprised and ...
New Part D program targets top script fillers.(Practice Trends)
Jan 01, 2007; ... PHILADELPHIA -- Starting this month, Medicare Part D will feature a new wrinkle in the drug insurance program: medication therapy management. A medication therapy management (MTM) program was mandated for 2007 by the Centers for Medicare and Medicaid Services (CMS) for selected ...
Jury out on health courts for malpractice suits.(Practice Trends)
Jan 01, 2007; ... WASHINGTON -- The concept of using administrative law judges instead of civil jury trials to settle malpractice suits has gained some admirers in the U.S. Congress and generated interest among state legislatures. But it is uncertain whether such a system is the solution to skyrocketing ...
Saving time and money with computerized dictation.(REINVENTING YOUR PRACTICE)
Jan 01, 2007; ... If you're frustrated with the expense and delays of Dictaphone transcriptions, Dr. Jonathan Krant's solution may be just what the doctor ordered. "Until 5 years ago, I utilized a Dictaphone with off-site transcriptions, a process that resulted in chart and referral consultation ...
'Black bag' internist takes his practice to his patients.(REINVENTING YOUR PRACTICE)(Dr. Randolph J. Swiller)
Jan 01, 2007; ... About 300 people in the Fort Lauderdale, Fla., area are fortunate to be in the care of self-described patient advocate Dr. Randolph J. Swiller, an internist and psychiatrist who ministers to his patients in their homes. In fact, Dr. Swiller's practice is made up almost ...
Barbecue breath next.(INDICATIONS)(lawsuits on employee smoking)(Brief article)
Jan 01, 2007; ... A Massachusetts man is suing the Scotts Miracle-Gro company after he was fired when his blood test came back positive for nicotine content, Reuters reports. Massachusetts, unlike some other states, does not have laws to protect employees from being fired for smoking away from work. The ...
But who smells worse?(INDICATIONS)(multiple pet dogs results in lower wheezing incidence)(Brief article)
Jan 01, 2007; ... According to a report published in the December issue of the Journal of Allergy and Clinical Immunology, infants in homes with high levels of endotoxins had a lower incidence of wheezing when the home was shared with multiple pet dogs. Dr. David Bernstein and his colleagues at the ...