Internal Medicine News back issues from May 2007:
New diabetes cut 64% by novel drug.(News)
May 01, 2007; ... NEW ORLEANS -- Succinobucol, a novel antioxidant with anti-inflammatory properties, achieved a 64% reduction in new-onset diabetes in patients with a recent acute coronary syndrome in the phase III Aggressive Reduction of Inflammation Stops Events (ARISE) trial. Use of the ...
New data support limit of 13 g/dL for hemoglobin in CKD: adverse effects seen with higher Hb levels.(News)
May 01, 2007; ... ORLANDO -- New evidence about the potential hazards of high hemoglobin levels in patients with chronic kidney disease is prompting the National Kidney Foundation to narrow the target range for hemoglobin levels. According to a draft update of the Clinical Practice Guidelines on ...
Medicare set to launch pay-for-reporting program.(News)
May 01, 2007; ... Starting July 1, physicians who report on selected quality measures will have a chance to earn a small bonus payment from Medicare. The congressionally mandated Physician Quality Reporting Initiative offers incentive payments to physicians who report on one to three quality ...
No NPI by May 23? Have a contingency plan.(News)
May 01, 2007; ... Physicians and other health care providers who fail to comply with the May 23 deadline to acquire and start using National Provider Identifiers will not be penalized if they can show they deployed a "contingency plan," the Centers for Medicare and Medicaid Services announced. ...
Top ten prescriptions by U.S. sales.(VITAL SIGNS)(Statistical table)(Brief article)
May 01, 2007 ... <Pre> Top Ten Prescriptions by U.S. Sales (in billions of dollars) Lipitor$8.6 Nexium $5.1 Advair diskus $3.9 Aranesp$3.9 Prevacid $3.5 Epogen ...
Parkinson's drug Permax removed from market.(News)(Brief article)
May 01, 2007; ... The manufacturers of the Parkinson's therapy Permax (pergolide) on March 29 agreed to take the dopamine agonist off the market as soon as possible, according to the Food and Drug Administration, which sought the recall. The FDA was spurred to take action in light of data ...
Shipping of Tigan suppositories halted by FDA.(News)(Brief article)
May 01, 2007; ... Tigan and other suppository drug products that contain trimethobenzamide hydrochloride have not been shown to be effective for nausea and vomiting and should no longer be marketed, according to the Food and Drug Administration. The FDA announced that it was asking manufacturers ...
Lipitor.(NEW & APPROVED)(Drug overview)
May 01, 2007; ... Lipitor (atorvastatin, Pfizer Inc.) The lipid-lowering drug approved for five new indications in adults with coronary heart disease; namely, to reduce the risk of these five cardiovascular events: nonfatal myocardial infarction, fatal and nonfatal stroke, angina, ...
HepaGam B.(NEW & APPROVED)(Brief article)
May 01, 2007; ... HepaGam B (Hepatitis B Immune Globulin Intravenous [Human], Cangene Corp.) An immune globulin product approved for the prevention of hepatitis B recurrence following liver transplantation in hepatitis B surface antigen (HBsAg)-positive liver transplant patients, and ...
The demise of 21/7 contraceptives.(GUEST EDITORIAL)
May 01, 2007; ... The 21/7-day oral contraceptive regimen (21 days active/7 days hormone-free) was arbitrarily created to mimic the average spontaneous menstrual cycle of 28 days. After more than 40 years of use, the traditional 21/7-day OC regimen is undergoing necessary, overdue changes in design ....
Health insurance mandates backfire.(LETTERS)(Letter to the editor)
May 01, 2007; ... Dr. Kevin Grumbach would have us emulate the Canadian health system, but fails to list the long waits for most surgeries and imaging studies--waits that most U.S. citizens would find unacceptable ("What is the best way to reform the U.S. health care system?" Point/Counterpoint, Jan. 1, ...
Get government out of the way.(LETTERS)(Letter to the editor)
May 01, 2007; ... Both Dr. Kevin Grumbach and Robert Moffit, Ph.D., are off the mark. The recommendation by Dr. Grumbach to apply the single-payer method (a la Canada or the United Kingdom) is outrageous, and would predictably result in the highly unsatisfactory situation seen in Canada, where long waits ...
Editorial board includes new members.(Opinion)
May 01, 2007 ... Internal Medicine News is pleased to welcome these new members of our editorial advisory board: Dr. Jon O. Ebbert is associate professor of medicine, Mayo Clinic College of Medicine, and associate program director of the General Internal Medicine Research Fellowship, Mayo ...
Should a first epileptic seizure be treated?(POINT/COUNTERPOINT)
May 01, 2007; ... Therapy should often be started after a first seizure. About 10% of patients will experience a seizure sometime in their lives, yet fewer than half will have a second or recurrent seizure. After a second unprovoked seizure, it has been found that risk of a third seizure is ...
DXA images can motivate weight-loss patients.(Endocrinology)(Dual-energy x-ray absorptiometry )
May 01, 2007; ... TAMPA, FLA. -- Dual-energy x-ray absorptiometry is an excellent method to measure and monitor body composition changes in obese patients undergoing weight loss and to assess body composition in athletes. Dr. Mary K. Oates reported at the annual meeting of the International Society for ...
Prevention of weight gain is as important as weight loss.(Endocrinology)(Report)
May 01, 2007; ... SAN FRANCISCO -- Helping patients even overweight patients to avoid gaining more weight is an important therapeutic goal by itself. Dr. Robert Baron said at a diabetes update sponsored by the University of California, San Francisco. "It's very, very hard to get people to lose ...
No rise in heart risk when HT is started early.(Women's Health)(Hormone therapy)(Report)
May 01, 2007; ... Hormone therapy's effect on coronary heart disease risk appears to be somewhat modified by the length of time that elapses between the onset of menopause and the start of hormone therapy, a secondary analysis of data in the Women's Health Initiative showed. Coronary heart ...
HPV vaccine.(THE EFFECTIVE PHYSICIAN)(human papillomavirus vaccine )(Clinical report)
May 01, 2007; ... Background The development and release of the quadrivalent human papillomavirus vaccine against HPV types 6, 11, 16, and 18 promises to substantially reduce the rates of cervical cancer, but it has also raised questions and controversy. The Advisory Committee on Immunization ...
Not all anogenital HPV infection needs treatment.(Women's Health)(human papillomavirus infections)(Clinical report)
May 01, 2007; ... HOUSTON -- Although most clinicians treat all anogenital human papillomavirus infections, nontreatment is something to consider in certain cases, Dr. Peter J. Lynch said at a conference on vulvovaginal diseases jointly sponsored by Baylor College of Medicine and the Methodist Hospital. ...
Vaginal hysterectomy can be option for endometrial cancer.(Women's Health)(Clinical report)
May 01, 2007; ... HOT SPRINGS, VA. -- Total vaginal hysterectomy may be an appropriate therapy for patients with endometrial cancers whose medical comorbidities put them at increased risk of complications with standard surgery, Dr. Susan Smith said at the annual meeting of the South Atlantic Association of ...
Opioid medication errors common in hospitals: of 644 harmful error reports, 60% were errors in the route of administration.(Neurology)(Report)
May 01, 2007; ... SALT LAKE CITY -- Opioid administration and prescribing errors are common in hospitals, and frequently result in uncontrolled pain as well as overdoses, according to a retrospective study presented at the annual meeting of the American Academy of Hospice and Palliative Medicine and the ...
Considering route, bioavailability can minimize opioid abuse.(Neurology)
May 01, 2007; ... BETHESDA, MD. -- Physicians can help minimize the potential for abuse of opioid pain medications by considering the agents' delivery route, bioavailability, and pharmacokinetics, said Dr. Pamela P. Palmer, director of PainCARE--Center for Advanced Research and Education at the University ...
Enoxaparin may reduce poststroke clots by 43%.(Neurology)(Clinical report)
May 01, 2007; ... SAN FRANCISCO -- Enoxaparin, a low-molecular-weight heparin, gave acute ischemic stroke patients significantly better protection against venous thromboembolism when compared with unfractionated heparin in a large, open-label trial presented at the 32nd International Stroke Conference. ...
Metabolic syndrome linked with stroke subtype.(Neurology)(Clinical report)
May 01, 2007; ... SAN FRANCISCO -- Diabetes mellitus and metabolic syndrome are significant risk factors for intracranial atherosclerosis-related stroke, according to data from the Northern Manhattan Stroke Study. The findings from the nested case-control study might help explain the higher ...
Systemic psoriasis therapies lower CV risk.(Dermatology)(cardiovascular risk)
May 01, 2007; ... MAUL HAWAH -- Recent evidence that psoriasis markedly increases cardiovascular risk will lead to a major shift toward greater use of systemic psoriasis therapies in an effort to reduce the disease's impact beyond the skin and joints, dermatologists predicted at the annual Hawaii ...
Yong melanoma patients have better outcomes: despite higher rates of sentinel lymph node metastases, younger patients have better survival.(Dermatology)(Clinical report)
May 01, 2007; ... PHOENIX -- An explanation may finally be at hand for a long-standing paradox concerning cutaneous melanoma in young adults. It's well established that adults who are younger at diagnosis have a better survival rate than those who are older. Yet younger patients also have a ...
Melanoma in situ epidemic causes needless morbidity.(Dermatology)
May 01, 2007; ... MAUI, HAWAII -- The increased pressure to detect early melanoma has had the unwelcome side effect of causing an epidemic of morbidity in patients with biologically indolent melanoma in situ, Dr. Allan C. Halpern said at the annual Hawaii Dermatology Seminar sponsored by Skin Disease ...
Mechanical treatment for head lice is nontoxic: treatment with Resultz eliminated 100% of live lice at 24 hours, resulting in an overall 96.5% cure rate.(Dermatology)(Clinical report)
May 01, 2007; ... MONTREAL -- A product that dehydrates, rather than poisons, head lice should be available soon in the United States to fill a gap widened by concerns about the toxicity of existing treatments, Dr. Ian Landells said at Dermatology Update 2007. The treatment--which was launched in ...
Green tea cream decreases number of rosacea lesions.(Dermatology)(Brief article)
May 01, 2007; ... WASHINGTON -- Twice-daily application of 2% polyphenone epigallocatechin-3-gallate (ECGC [green tea extract]) in a hydrophilic cream resulted in a significant reduction in inflammatory lesion counts in patients with papulopustular rosacea, Dr. Tanweer Syed and his colleagues wrote in a ...
Topical antifungals: newer agents work faster but not better than older ones.(Dermatology)
May 01, 2007; ... MAUI, HAWAII -- The newer topical antifungals have essentially the same cure rates as do those available since the 1970s--their advantage is that they work faster, Dr. Douglas W. Kress said at the annual Hawaii Dermatology seminar sponsored by Skin Disease Education Foundation. ...
FDA advisers reject Merck's newest COX-2.(Rheumatology)(Food and Drug Administration)
May 01, 2007; ... GAITHERSBURG, MD. -- Safety concerns about Merck's Arcoxia (etoricoxib) led the Food and Drug Administration's Arthritis Drugs Advisory Committee to vote 20-1 against approval of the COX-2 inhibitor. In presentations to the FDA and at scientific meetings in the last year, Merck ...
TNF-[alpha] inhibitors may boost risk of coccidioidomycosis.(Rheumatology)(Clinical report)
May 01, 2007; ... WASHINGTON -- Coccidioides species represent a serious threat to patients taking tumor necrosis factor-[alpha] inhibitors, Dr. Andrew Racette said at the annual meeting of the American Academy of Dermatology. Drugs that inhibit tumor necrosis factor-[alpha] (TNF-[alpha]) are ...
Lifestyle factors can cause gout but not cure it.(Rheumatology)
May 01, 2007; ... DESTIN, FLA. -- The incidence of gout is on the rise, and lifestyle factors are largely to blame, Dr. N. Lawrence Edwards said at the annual Rheumatology on the Beach. For example, one study showed that between 1977-1978 and 1995-1996, the annual rate of primary gout more than ...
Panel backs approval of hip resurfacing system.(Rheumatology)
May 01, 2007; ... GAITHERSBURG, MD. -- The majority of the members of a federal advisory panel supported the conditional approval of a hip resurfacing system for people likely to need to have the same hip replaced more than once over their lifetimes. At a meeting of the Food and Drug ...
Questions remain about RA lymphoma risk.(Rheumatology)(rheumatoid arthritis)
May 01, 2007; ... NEW YORK -- Data from large observational registries ultimately should provide answers about the long-term risks of lymphoma associated with the tumor necrosis factor-blocking drugs, but for now, questions and contradictions remain. Patients with rheumatoid arthritis (RA) have ...
Enzyme accelerates subcutaneous infusion rate.(Clinical Rounds)
May 01, 2007; ... SALT LAKE CITY -- Recombinant human hyaluronidase makes it possible to safely hydrate patients subcutaneously with a gravity line feed at flow rates approaching 500 cc/hour, according to a preliminary study presented at the annual meeting of the American Academy of Hospice and Palliative ...
New imaging probes may identify cancer tissues.(Clinical Rounds)
May 01, 2007; ... PHILADELPHIA -- New molecular imaging technologies promise to transform the diagnosis and treatment of cancer by focusing on biological targets, Dr. Sanjiv Sam Gambhir said at the annual meeting of the American Society for Therapeutic Radiology and Oncology. Diagnostic PET ...
Guide offers help for cancer patients.(Clinical Rounds)
May 01, 2007 ... A new guidebook offers information on the top treatment facilities and specialists for different cancers, plus financial tips, drug trial information, and success stories. "Patient Resource: A Cancer ...
Nabilone relieves many advanced Ca symptoms.(Clinical Rounds)(cancer)
May 01, 2007; ... SAN ANTONIO -- The synthetic cannabinoid nabilone appears to be of substantial benefit in managing multiple symptoms common among patients with advanced cancer, thereby minimizing problems caused by polypharmacy, Dr. Vincent Maida reported at a breast cancer symposium sponsored by the ...
Noni juice for cancer and more.(ALTERNATIVE MEDICINE)
May 01, 2007; ... Use: Traditional and Modern Morinda citrifolia (noni) is thought to have been one of the most important plants in traditional Polynesian medicine, possibly originating in Southeast Asia and being distributed throughout the islands of the South Seas by ancient seafaring ...
Torcetrapib fails to halt atherosclerosis.(Cardiovascular Medicine)
May 01, 2007; ... NEW ORLEANS -- Torcetrapib profoundly raised HDL cholesterol values and decreased LDL cholesterol levels, yet failed to halt the progress of atherosclerosis in two separate international trials, Dr. Steven Nissen said at the annual meeting of the American College of Cardiology. ...
Rosuvastatin slowed progress of carotid atherosclerosis.(Cardiovascular Medicine)(Clinical report)
May 01, 2007; ... NEW ORLEANS -- Rosuvastatin slowed the progression of carotid intima-media thickness in asymptomatic subjects at low risk of cardiovascular events but who nonetheless had subclinical atherosclerosis, Dr. John R. Crouse III reported at a conference sponsored by the American College of ...
Depression screening in CAD patients worthwhile.(Cardiovascular Medicine)(coronary artery disease )
May 01, 2007; ... ORLANDO -- Depression is not a proven risk factor for coronary artery disease events, but the data available now are compelling enough to warrant screening patients with coronary disease for depression and treating it when it's diagnosed. "Depression is a very complicated ...
MERLIN finds new evidence of ranolazine safety.(Cardiovascular Medicine)
May 01, 2007; ... NEW ORLEANS -- Ranolazine may have earned a product labeling upgrade from second-line to first-tier status for treatment of chronic angina on the strength of its reassuring safety performance in the 6,560-patient MERLIN trial. "Safety concerns have been at the forefront for this ...
Nicotine patches appear safe for CAD patients.(Cardiovascular Medicine)(coronary artery disease)(Brief article)
May 01, 2007; ... NEW ORLEANS -- Nicotine patches are safe for use in smokers with known coronary artery disease and stress-induced myocardial ischemia, according to the results of the first-ever randomized, placebo-controlled, multicenter clinical trial to examine this issue. Nicotine ...
Aspirin, NSAIDs risky for colorectal Ca prevention.(Gastroenterology)(nonsteroidal anti-inflammatory drugs)(cancer)(Brief article)
May 01, 2007; ... Routine use of aspirin or nonsteroidal anti-inflammatory drugs should not be recommended as preventive therapy for colorectal cancer in patients at average risk for the disease, according to a statement released by the U.S. Preventive Services Task Force. The caution against ...
Fatalism tied to lower colorectal screening rates.(Gastroenterology)(Brief article)
May 01, 2007; ... HOUSTON -- Barriers to early detection of colorectal cancer among underserved patients include limited access to care and fatalistic beliefs about a cancer diagnosis, Aimee James, Ph.D., reported at the annual meeting of the American Society of Preventive Oncology. "Fatalist ...
Screen sleep disorder patients for GI reflux: treating gastrointestinal reflux can improve sleep--and treating sleep disorders can improve reflux.(Gastroenterology)(gastrointestinal reflux)
May 01, 2007; ... SCOTTSDALE, ARIZ. -- Patients with sleep disorders should be screened for gastrointestinal reflux, Dr. Susan M. Harding advised at a meeting on sleep medicine sponsored by the American College of Chest Physicians. Heartburn is common in patients with sleep complaints and can ...
Screening for apnea cuts ICU admissions after gastric bypass.(Gastroenterology)(intensive care unit )
May 01, 2007; ... CHICAGO -- Mandatory screening for obstructive sleep apnea can significantly reduce the need for intensive care unit admission following bariatric surgery, Dr. Peter T. Hallowell said at the annual meeting of the Central Surgical Association. "In our center, mandatory screening ...
Surgery still an option for some GERD patients.(Gastroenterology)(gastroesophageal reflux disease)(Report)
May 01, 2007; ... ORLANDO -- Laparoscopic Nissen fundoplication is a feasible option for some patients with medically refractory gastroesophageal reflux disease, Dr. Ignazio M. Civello said at a meeting on laparoscopy and minimally invasive surgery sponsored by the Society of Laparoendoscopic Surgeons. ...
GHRH analogue trims visceral fat in HIV study.(Infectious Diseases)(growth hormone-releasing hormone )
May 01, 2007; ... LOS ANGELES -- Visceral adipose tissue declined by 15% in HIV patients treated for 26 weeks with a growth hormone-releasing hormone (GHRH) factor analogue, while visceral fat in patients assigned to placebo increased 5%, Dr. Steven Grinspoon reported at the 14th Conference on Retroviruses ...
Nationwide survey says 10% of HIV is resistant.(Infectious Diseases)
May 01, 2007; ... LOS ANGELES -- Surveillance data indicate that 10% of people in the United States who become infected with HIV have acquired a virus with some resistance, Dr. Ulana Bodnar said at the 14th Conference on Retroviruses and Opportunistic Infections. The 11-state survey represents ...
New tests on the horizon for detecting latent TB.(Infectious Diseases)(latent tuberculosis )
May 01, 2007; ... KEYSTONE, COLO. -- New tests that detect latent tuberculosis infection by quantifying interferon-[gamma] released from sensitized lymphocytes in whole blood may be a big step toward the elimination of TB, Dr. Charles Daley said at a meeting on allergy/clinical immunology, asthma, and ...
Neisseria gonorrhoeae now sidesteps fluoroquinolones.(Infectious Diseases)
May 01, 2007; ... Fluoroquinolones should no longer be used for the treatment of gonorrhea in the United States, the Centers for Disease Control and Prevention has concluded. The recommendation is based on new evidence suggesting that the prevalence of fluoroquinolone-resistant strains in the ...
Cuts in imaging payments will deepen over time.(Practice Trends)
May 01, 2007; ... Endocrinologists are bracing for deep cuts in outpatient imaging services slated to be phased in over the next few years. If nothing is done to stop the spiraling decline in payment under Medicare, some endocrinologists say they may have to stop providing services such as ...
Docs abuse tax system.(POLICY & PRACTICE)(Report)(Brief article)
May 01, 2007; ... Thousands of Medicare Part B physicians, health professionals, and suppliers abused the federal tax system with little consequence, an analysis from the Government Accounting Office found. More than 21,000 Medicare Part B providers--about 5% of the total--had tax debts totaling more than ...
Penalized by high-deductible plans.(POLICY & PRACTICE)(Report)(Brief article)
May 01, 2007; ... High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults aged 45-64 years, those with any chronic condition such as ...
Retail clinics replacing PCPs.(POLICY & PRACTICE)
May 01, 2007; ... More than 1 in 10 retail medical clinic users said the clinics have mostly or completely replaced their primary care physicians for the types of treatments offered at such facilities, according to a study from Market Strategies Inc., a research firm. "Consumers are telling us in no ...
Negotiation could save $30 billion.(POLICY & PRACTICE)(Brief article)
May 01, 2007; ... Legislation that would allow Medicare to use its bulk purchasing power to negotiate for lower prescription drug prices under Part D could save U.S. taxpayers and seniors more than $30 billion annually, an advocacy group reported. The Institute for American Research said that about $10 ...
Cuts would harm seniors.(POLICY & PRACTICE)(Survey)(Brief article)
May 01, 2007; ... Three-fourths of physicians said they believe that seniors will be harmed if Congress cuts the Medicare Advantage program, and the vast majority of doctors said lawmakers should cut other programs or raise taxes rather than cut Medicare Advantage, according to the industry group America's ...
Changing MD demographics.(POLICY & PRACTICE)(doctor of medicine)(Survey)(Brief article)
May 01, 2007; ... A major demographic shift is underway in medicine as female physicians become more numerous, and this trend will influence the way medical groups recruit and retain physicians throughout their career cycles, according to the 2006 Retention Survey from the American Medical Croup Association ...
NPs can advance palliative nursing home care: nurse practitioners who have received proper training can provide palliative care in nursing homes.(Practice Trends)(nurse practitioners )
May 01, 2007; ... SALT LAKE CITY -- A nurse-practitioner model can overcome regulatory and reimbursement barriers to the delivery of palliative care to patients in nursing homes, according to Dr. Jeanne Elnadry, medical director of the Hospice of Yuma (Ariz.). "These chronically ill and terminal ...
Western regions have smallest hospice caseload in skilled nursing or long-term care facilities.(DATA WATCH)(Statistical table)(Brief article)
May 01, 2007 ... <Pre> Western Regions Have Smallest Hospice Caseload In Skilled Nursing or Long-Term Care Facilities Region 1 37.5% Region 2 26.3% Region 3 23.0% Region 4 27.4% Region 5 41.0% Region 6 39.0% ...
Do-it-yourself EMR system modernizes a solo practice.(REINVENTING YOUR PRACTICE)(electronic medical record)
May 01, 2007; ... Rather than spend a large sum of money on a prepackaged electronic medical record system, Dr. L. Allen Kindman decided to construct his own path to a paperless practice by building on existing software. "My solo cardiology practice went from being a paper-based, ...
Fast screening tool rates patients' health literacy.(Practice Trends)
May 01, 2007; ... PHOENIX -- Three brief screening questions enable physicians to spot patients lacking the literacy skills necessary to understand and act upon health care information, Lorraine S. Wallace, Ph.D., said at a congress sponsored by the Association for Academic Surgery and the Society of ...