Internal Medicine News back issues from March 2007:
Geriatrics pay, workforce linked.(News)
Mar 01, 2007; ... Improved reimbursement remains the focus of efforts to shore up the nation's supply of geriatricians. Medicare's physician fee schedule for nursing home care urgently needs to be adjusted to reflect the real costs of diagnosis and treatment, according to Dr. Steven A. Levenson, ...
Number of U.S. hospitalists expected to double in 5 years.(VITAL SIGNS)
Mar 01, 2007 ... Number of U.S. Hospitalists Expected to Double in 5 Years ...
Hormone therapy risks assessed in NAMS statement.(Women's Health)(North American Menopause Society)
Mar 01, 2007; ... The benefits of hormone therapy outweigh its risks in healthy perimenopausal and early-postmenopausal women with menopause-related symptoms and a low baseline risk of stroke, according to a revised position statement from the North American Menopause Society. However, the paper ...
Glucose stabilization not helpful in acute stroke.(News)
Mar 01, 2007; ... SAN FRANCISCO -- Stabilizing glucose levels in acute stroke patients failed to reduce mortality or influence survival with severe disability at 90 days in a large randomized controlled trial presented at the 32nd International Stroke Conference. Patients treated with a ...
ADA offers new online resources.(News)(American Diabetes Association)(Brief article)
Mar 01, 2007 ... The American Diabetes Association has launched a new initiative, Check Up America, to help physicians and consumers recognize risk factors for diabetes and heart disease. Recognition and ...
Orlistat wins approval as OTC weight-loss drug: the thrice-daily drug blocks up to 25% of total fat absorption in the intestine, which is then excreted.(News)
Mar 01, 2007; ... Orlistat will soon be available to consumers without a prescription, making it the first weight-loss product available over the counter that has been recognized as safe and effective. The approval of orlistat (Alli) by the Food and Drug Administration on Feb. 7 is notable ...
Protege GPS and Protege RX Carotid Stent Systems.(NEW & APPROVED)
Mar 01, 2007; ... Protege GPS and Protege RX Carotid Stent Systems (ev3, Inc.) A carotid stent approved for treating patients at high risk for adverse events from carotid endarterectomy who meet certain criteria. The third carotid stent system to be approved by the Food and Drug ...
Alphanate.(NEW & APPROVED)
Mar 01, 2007; ... Alphanate (Antihemophilic Factor/von Willebrand Factor Complex [Human], Grifols Biologicals) This clotting factor concentrate is the first biologic product approved for patients with von Willebrand disease (vWD) who are undergoing surgery or invasive procedures and ...
Off-label androgen therapy for women.(Editorial)
Mar 01, 2007; ... Although male sexual dysfunction has grabbed the lion's share of the headlines and punch lines, it is important that women also receive optimal care for this condition. A landmark 1999 study showed that about 43% of American women aged 18-59 years had some form of sexual ...
Is radical debulking the best strategy for treating ovarian cancer?(POINT/COUNTERPOINT)
Mar 01, 2007; ... Evidence supports cytoreductive surgery. The general rule of thumb in treating ovarian cancer is that the greater the amount of tumor removed, the better the outcome. Since the 1970s, research has shown that survival is directly related to the amount of disease that ...
Motivate patients, explain Hb[A.sub.1c].(Letter to the editor)
Mar 01, 2007; ... While I concede the arguments made for a more accurate reporting of true "mean" blood glucose levels instead of hemoglobin [A.sub.1c], this fact must be acknowledged: Hb[A.sub.1c] is now a household word with physicians, and that benchmark has motivated physicians to push for better ...
Don't be mean about blood glucose.(Letter to the editor)
Mar 01, 2007; ... I hope the American Diabetes Association, of which I am a member, involves the diabetes care community before embarking on a major change in the terminology of [A.sub.1c]. The last time such an effort was undertaken, the ADA changed metabolic syndrome without adequate scientific ...
Don't report 'mean blood glucose'.(Letter to the editor)
Mar 01, 2007; ... I object to reporting a "mean blood glucose" instead of the glycosylated hemoglobin as percent of total, when the change is based on data from a study of only about 600 individuals. The new test will not have any validation in terms of long-term studies. The hemoglobin ...
Scrutinize those free drug samples.(Letter to the editor)
Mar 01, 2007; ... I agree that further study and hard evidence are needed to address the appropriateness of providing free drug samples in clinical care ("Free Drug Samples Create Ethical Rift Among MDs," Jan. 15, 2007, p. 72). I suggest that future studies focus on both quality and marketing of ...
We can take a lesson from lawyers.(Letter to the editor)
Mar 01, 2007; ... With regard to the 74% pass rate during the spring 2006 internal medicine recertification exam, several thoughts occurred to me. When I first started my practice 20 years ago, I almost did not bother taking the exam because nobody--including hospitals, insurance companies, and ...
Drug testing works if done right.(Letter to the editor)
Mar 01, 2007; ... One of Dr. John R. Knight's arguments against drug testing in schools is the risk of false positives and false negatives ("Does drug testing have a place in our schools?" Point/Counterpoint, Dec. 15, 2006, p. 7). There is a risk of a false positive when the specimen is tested ...
Pain relievers.(Opinion)(Cartoon)
Mar 01, 2007 ... "I've authorized heroic ...
Autologous conditioned serum may aid osteoarthritis.(Rheumatology)
Mar 01, 2007; ... PRAGUE -- Intra-articular injections of autologous conditioned serum reduced symptoms of knee osteoarthritis significantly more than did saline or hyaluronan injections in the therapy's first controlled clinical trial, Dr. Carsten Moser reported at the 2006 World Congress on ...
Dynamic wedging eases knee osteoarthritis pain.(Rheumatology)(Clinical report)
Mar 01, 2007; ... PRAGUE -- Individually calibrated shoes that provide dynamic wedging can significantly improve pain and function in patients with knee osteoarthritis--sometimes immediately, Dr. Yuval Ran reported at the 2006 World Congress on Osteoarthritis. "We have clearly demonstrated ...
Everyday walking shoes may step up risk of OA.(Rheumatology)
Mar 01, 2007 ... PRAGUE -- In patients with osteoarthritis--and even in healthy subjects--standard walking shoes result in significantly more knee adduction compared with barefoot walking or walking with a specially designed "unloading" shoe, Dr. Najia Shakoor reported in a poster at the 2006 World ...
Knee OA associated with low vitamin D intake.(Rheumatology)(Brief article)
Mar 01, 2007 ... PRAGUE -- Low dietary vitamin D intake is associated with an increased prevalence of knee osteoarthritis, Dr. Nigel K. Arden reported at the 2006 World Congress on Osteoarthritis. The association was seen in tibiofemoral but not patello-femoral disease, and in women but not in ...
Blood lead levels linked to osteoarthritis.(Rheumatology)(Clinical report)
Mar 01, 2007 ... PRAGUE -- Blood lead levels significantly below those that are defined as toxic by the Centers for Disease Control and Prevention are associated with increased rates of moderate to severe knee osteoarthritis, reported Dr. Joanne M.Jordan, associate director of the Thurston Arthritis ...
HAQ score at 1 year predicts mortality in arthritis patients.(Rheumatology)(Health Assessment Questionnaire)
Mar 01, 2007; ... WASHINGTON -- Early functional disability is predictive of both all-cause and cardiovascular mortality in patients with inflammatory polyarthritis, Dr. Tracey M. Farragher reported at the annual meeting of the American College of Rheumatology. An association between early ...
New recommendations target management of early arthritis.(Rheumatology)
Mar 01, 2007; ... The availability of more effective arthritis drugs and monitoring techniques has created a critical window of opportunity when joint destruction can be averted and function maintained. To help clinicians make the most of this crucial period in management of the disease, an expert committee ...
Proportion of adults whose physician-diagnosed arthritis limited their activity in 2003-2005.(DATA WATCH)(Brief article)
Mar 01, 2007 ... <Pre> Proportion of Adults Whose Physician-Diagnosed Arthritis Limited Their Activity in 2003-2005 White, non-Hispanic 35% Black, non-Hispanic 43% Hispanic 42% Other, non-Hispanic 40% ...
Citalopram relieves depression in CAD patients.(Psychiatry)(Clinical report)
Mar 01, 2007; ... TUCSON, ARIZ. -- A randomized, multicenter Canadian trial testing interpersonal psychotherapy and citalopram in 284 depressed patients with stable coronary artery disease produced mixed results, investigators reported at the annual meeting of the Academy of Psychosomatic Medicine. ...
Use of diagnostic mammography drops by 39%.(Women's Health)
Mar 01, 2007; ... CHICAGO -- Growth in the use of mammography in the United States slowed in recent years among Medicare beneficiaries, Dr. David C. Levin said at the annual meeting of the Radiological Society of North America. Between 1996 and 2004, the total utilization rate of mammography, ...
Figure family structure into BRCA screening.(Women's Health)(Brief article)(Clinical report)
Mar 01, 2007; ... SAN ANTONIO -- Consider lowering the threshold for BRCA mutation testing in patients with early-onset breast cancer who have fewer than two first- or second-degree female relatives older than age 45, Dr. Jeffrey N. Weitzel advised at a breast cancer symposium sponsored by the Cancer ...
Percentage of women aged [greater than or equal to]40 years having regular mammograms is decreasing.(DATA WATCH)(Brief article)
Mar 01, 2007 ... <Pre> Percentage of Women Aged [greater than or equal to]40 Years Having Regular Mammograms Is Decreasing 2000 76.4% 2002 75.9% 2004 74.3% Note: Based on data from ...
New genetic test predicts breast Ca recurrence.(Women's Health)
Mar 01, 2007; ... A new molecular test that profiles the activity of 70 genes may be especially useful for identifying women with early-stage breast cancer who are unlikely to have recurrences within 5-10 years. The MammaPrint test, developed by Amsterdam-based Agendia and approved in February by ...
Risk for diabetes is lower in women on hormone therapy.(Women's Health)
Mar 01, 2007; ... Women considering the risks and benefits of hormone therapy should be informed of the link between hormones and a decreased risk of diabetes, especially if they are at risk for the disorder, according to Dr. Wulf Utian, executive director of the North American Menopause Society, Cleveland ....
Study finds osteoarthritis linked to hysterectomy, HT withdrawal.(Women's Health)(Brief article)(Clinical report)
Mar 01, 2007; ... PRAGUE -- Hysterectomy and the withdrawal of hormone therapy are associated with an increase in self-reported osteoarthritis, Dr. L.A. Walker and colleagues reported in a poster at the 2006 World Congress on Osteoarthritis. "Whether these factors are directly involved in the ...
Rings, patches broaden contraceptive options.(Women's Health)
Mar 01, 2007; ... ATLANTA -- Contraceptive rings and patches appear to have an efficacy similar to that of oral contraceptives and eliminate the need for daily pills, Joyce King, Ph.D., said at a conference on contraceptive technology sponsored by Contemporary Forums. "When we are initiating ...
New contraceptive options are in the pipeline.(Women's Health)(Brief article)
Mar 01, 2007; ... ATLANTA -- Novel contraceptives currently being developed include norprogesterone-derived progestins, new barrier methods, and combination spermicides-microbicides, Dr. Michelle Fox said at a conference on contraceptive technology sponsored by Contemporary Forums. Closest to ...
AAD to give its approval to selected sunscreens.(Dermatology)(American Academy of Dermatology)
Mar 01, 2007; ... WASHINGTON -- The American Academy of Dermatology will soon start giving its official imprimatur to sunscreen products that it deems worthy, outgoing AAD President Stephen Stone said at the academy's annual meeting. Two sunscreens, both made by Johnson & Johnson, will bear the ...
Time in car linked to increased skin cancer risk.(Dermatology)
Mar 01, 2007; ... WASHINGTON -- People who spend a lot of time behind the wheel may be at increased risk of skin cancer, especially on the left side of the face, according to data presented in a poster at the annual meeting of the American Academy of Dermatology. U.S. dermatologists have long ...
Use of tanning beds linked with melanoma.(Dermatology)(Brief article)
Mar 01, 2007; ... CORONADO, CALIF. -- People who have used indoor tanning beds at some point in their lives face a modest 1.15-fold increased risk of developing cutaneous melanoma, Dr. Seaver Soon said at an update on melanoma sponsored by the Scripps Clinic. But the risk jumps to 1.75-fold in ...
Adalimumab clears phase III psoriasis hurdle.(Dermatology)
Mar 01, 2007; ... WASHINGTON -- Adalimumab treatment was effective in treating adults with moderate to severe chronic plaque psoriasis in a phase III study, Dr. Alan Menter reported in a poster presentation at the annual meeting of the American Academy of Dermatology. Adalimumab, an injectable ...
Salt dressings on wounds can ease debridement.(Dermatology)
Mar 01, 2007; ... OTTAWA -- Using salt dressings as part of a wound care protocol can help prepare the wound bed for additional treatment and enhance healing, Virginia Salter, R.N., reported at the annual conference of the Canadian Wound Care Association. "Hypertonic salt dressings complement, ...
Glucose control key in diabetic stroke patients.(Neurology)(Clinical report)
Mar 01, 2007; ... SAN FRANCISCO -- Diabetic patients who have recently had a stroke should receive aggressive glucose and lipid management, Dr. Lee H. Schwamm said at the 32nd International Stroke Conference. Many patients with diabetes--both those newly diagnosed and those previously ...
Depression increases stroke risk in young and middle-aged adults.(Neurology)(Brief article)(Clinical report)
Mar 01, 2007; ... Adults under age 65 years with a history of depressive symptoms have a fourfold higher risk of stroke and transient ischemic attack, Margaret Kelly-Hayes, Ed.D., and her colleagues reported. The researchers evaluated data from the Framingham Heart Study, looking at 4,120 ...
Poor outcomes hinder high-risk carotid stenting.(Neurology)
Mar 01, 2007; ... HOLLYWOOD, FLA. -- Carotid artery stenting has become a procedure in search of patients. Several thousand patients have now undergone carotid artery stenting (CAS) in controlled trials or as part of data-collecting registries, and the periprocedural rates of death and stroke ...
CMS proposes to expand its coverage for carotid stenting.(Neurology)
Mar 01, 2007; ... Officials at the Centers for Medicare and Medicaid Services are proposing to expand coverage for carotid artery stenting to patients younger than 80 years old who are at high risk for carotid endarterectomy and have asymptomatic carotid artery stenosis of 80% or greater. Under ...
Overuse of headache drugs can be overcome.(Neurology)
Mar 01, 2007; ... SCOTTSDALE, ARIZ. -- Withdrawing patients from overused headache medications is long, hard work for them, but it can be accomplished with strong physician support, Dr. Todd D. Rozen told clinicians at a symposium sponsored by the American Headache Society. Dr. Rozen, a ...
Riboflavin for migraine.(ALTERNATIVE MEDICINE)
Mar 01, 2007; ... Rationale for Use Riboflavin, or vitamin [B.sub.2], is a precursor of flavin adenine dinucleotide (FAD), a coenzyme involved in the electron transport aspect of energy metabolism. Some of the support for the use of riboflavin in migraine derives from the observation ...
Early migraine therapy can backfire.(Neurology)(Clinical report)
Mar 01, 2007; ... SCOTTSDALE, ARIZ. -- Early treatment of migraine can contribute to the development of medication-overuse headaches in pain-averse patients, Dr. James R. Couch warned at a symposium sponsored by the American Headache Society. These patients will take their pills every time they ...
Energy drink sales top $3 billion--at what cost?(Adolescent Health)
Mar 01, 2007; ... Energy drinks are all the rage, and the media--along with the millions of people who use the drinks--are buzzing. At the same time, there has been surprisingly little research into the potential health hazards of the caffeine- and sugar-laden drinks that have become a $3 ...
Among adolescents, black females have highest prevalence of overweight.(DATA WATCH)
Mar 01, 2007 ... Among Adolescents, Black Females Have Highest Prevalence Of Overweight ...
New VTE guidelines issued for primary care.(Cardiovascular Medicine)
Mar 01, 2007; ... New venous thromboembolism guidelines aimed at primary care providers emphasize the need for swift diagnosis and initial treatment with low-molecular-weight heparin over the unfractionated formulation. Issued jointly by the American College of Physicians and the American Academy ...
Hypofibrinolysis linked with increased VT risk.(Cardiovascular Medicine)(venous thrombosis)
Mar 01, 2007; ... ORLANDO -- Hypofibrinolysis is a risk factor for venous thrombosis, particularly in women, younger individuals, and those who also have Factor V Leiden, Dr. Mirjam E. Meltzer reported at the annual meeting of the American Society of Hematology. In a study of 2,420 patients with ...
HDL may protect against venous thrombosis.(Cardiovascular Medicine)(Brief article)
Mar 01, 2007; ... ORLANDO -- High-density lipoproteins, which are known protectors against arterial atherothrombosis, also appear to protect against recurrent venous thrombosis, Dr. Sabine Eichinger reported at the annual meeting of the American Society of Hematology. In a prospective study of ...
Five reports advance drug-eluting stent debate.(Cardiovascular Medicine)
Mar 01, 2007; ... Results from five new safety analyses of drug-eluting coronary stents, compared with bare-metal stents, gave added reassurance about using drug-eluting stents for their labeled indications and framed some of the concerns about off-label use of the stents. The five reports, ...
New guidelines focus on heart disease in women.(Cardiovascular Medicine)
Mar 01, 2007; ... The American Heart Association's new evidence-based guidelines for preventing cardiovascular disease in women emphasize a woman's lifetime risk and provide new recommendations on aspirin, folic acid, antioxidant therapy, and hormone therapy. The updated guidelines are the most ...
Integrase inhibitors show promise in HIV therapy: at 16 weeks, 50% of the treated patients had a viral load below 50 copies/mL.(Infectious Diseases)(Clinical report)
Mar 01, 2007; ... SAN FRANCISCO -- The expected introduction of the integrase inhibitors will usher in the most exciting time in HIV treatment since the advent of highly active antiretroviral therapy, Dr. George Beatty predicted at a meeting on HIV management sponsored by the University of California, San ...
Effect of nonadherence to HIV therapy is variable.(Infectious Diseases)
Mar 01, 2007 ... SAN FRANCISCO -- Adherence to highly active antiretroviral therapy remains important, even though treatment may be more forgiving of nonadherence than some have suggested, Dr. Kristen M. Ries said at a meeting on HIV management sponsored by the University of California, San Francisco. ...
Early treatment of HIV may be beneficial, despite uncertainties.(Infectious Diseases)(human immunodeficiency virus)
Mar 01, 2007 ... SAN FRANCISCO -- Treating a recently infected HIV patient may provide some benefit, particularly if that treatment begins before or within a few weeks of antibody seroconversion, Dr. Frederick Hecht said at a meeting on HIV management sponsored by the University of California, San ...
Experts call for wider flu vaccine coverage.(Infectious Diseases)
Mar 01, 2007; ... Despite promising advances, clinicians, hospitals, and public health officials remain largely unprepared for a global influenza pandemic similar to the one in 1918 that killed more than 50 million people worldwide, according to an expert panel that held a Feb. 1 teleconference during the ...
Roche corrects last fall's Tamiflu dosing chart.(Infectious Diseases)
Mar 01, 2007; ... A pediatric dosing chart for the influenza drug oseltamivir (Tamiflu) sent by Roche Laboratories Inc. to health care providers last November contained an error and should have indicated a standard dosage of once daily--rather than twice daily--for 10 days, according to a letter from the ...
Refrigerated FluMist FDA-approved for ages 5-49.(Infectious Diseases)(Food and Drug Administration)
Mar 01, 2007; ... A new formulation of intranasal influenza live virus vaccine that can be stored in a standard refrigerator, rather than kept frozen, has been approved by the Food and Drug Administration. The new formulation of the trivalent vaccine, FluMist, is approved for healthy children and ...
Feds launch AIDS searchable Web site.(Infectious Diseases)(www.aids.gov.)(Website overview)(Brief article)
Mar 01, 2007 ... The U.S. Department of Health and Human Services has launched AIDS.gov, a searchable Web site for the public. The site provides information on HIV and AIDS research programs, prevention, ...
Community-acquired pneumonia.(THE EFFECTIVE PHYSICIAN)
Mar 01, 2007; ... Background To simplify and clarify clinical practice guidelines for the treatment of community-acquired pneumonia, the Infectious Diseases Society of America and the American Thoracic Society recently issued a joint document regarding the diagnosis and treatment of this common ...
FDA scraps two Ketek indications.(Infectious Diseases)
Mar 01, 2007; ... The Food and Drug Administration has eliminated two indications for the antibiotic telithromycin and added a black box warning to its label stating the drug is contraindicated in people with myasthenia gravis. Telithromycin, which is marketed by Sanofi-Aventis as Ketek, is no ...
Technology is revolutionizing colon imaging.(Gastroenterology)
Mar 01, 2007; ... SAN DIEGO -- Colonoscopy remains the standard for imaging the colon, but the future may rest in nonoptical techniques such as virtual colonography and colonic visualization devices such as the PillCam, Dr. P. Jay Pasricha said at a meeting jointly sponsored by the AG A Institute and the ...
Esophageal erosion in GERD worse in men.(Gastroenterology)(gastroesophageal reflux disease)(Brief article)(Clinical report)
Mar 01, 2007; ... BERLIN -- Women with gastroesophageal reflux disease had a lower prevalence of severe esophageal erosion than did men in an analysis of more than 6,000 patients. "The lower prevalence of severe erosive changes in women suggests they respond differently to reflux, which may ...
Study aims to improve pancreatic Ca screening.(Gastroenterology)
Mar 01, 2007; ... SAN DIEGO -- Screening for pancreatic cancer in people with a family history of the disease is not a perfect science, Dr. Marcia Irene Canto said at a meeting jointly sponsored by the AGA Institute and the Japanese Society of Gastroenterology. "Much of our understanding of the ...