Internal Medicine News back issues from January 2008:
FDA gets flak for contrast warning.(News)(Food and Drug Administration)
Jan 01, 2008; ... Black box restrictions imposed by the Food and Drug Administration on the use of ultrasound contrast agents have caused consternation among cardiologists and radiologists who fear that the agency's decision will have a chilling effect upon the use and further development of these ...
Top 10 reasons for internist visits in 2007.(VITAL SIGNS)(Table)(Brief article)
Jan 01, 2008 ... <Pre> Top 10 Reasons for Internist Visits in 2007 Hypertension*15.9% Uncomplicated diabetes6.9% Hyperlipidemia*[dagger] 6.6% Routine medical exam 2.5% Hypercholesterolemia 2.4% Hypothyroidism* 2.2% Esophageal ...
Low-carb diets are okay for diabetic patients, ADA says: practice guidelines updated for 2008.(News)(American Diabetes Association)
Jan 01, 2008; ... New guidance from the American Diabetes Association gives a green light to the use of low-carbohydrate diets as a weight-control measure for patients with diabetes. As part of the ADA's annual update of its clinical practice recommendations, the organization has dropped its ...
Physicians get a 6-month reprieve from 10% pay cut.(News)
Jan 01, 2008; ... In what has become a year-end tradition, last-minute congressional action has staved off deep cuts to the Medicare physician fee schedule. The 2007 version means that physicians won't feel the pinch of a 10.1% pay cut under Medicare; instead, they will get a 0.5% increase ...
Inpatient mortality from heart attack and heart failure declining.(DATA WATCH)(Table)(Brief article)
Jan 01, 2008 ... <Pre> Inpatient Mortality From Heart Attack and Heart Failure Declining (per 1,000 admissions)Acute myocardial infarction Heart failure 1994 125 67 1995 1996 1997 112 57 1998 1999 2000 104 ...
Timely trends in 2008 and beyond.(THE EFFECTIVE PHYSICIAN)
Jan 01, 2008; ... Trends that we've seen in the first 7 years of this century will continue to shape medical practice as we head into 2008. Here are some key developments to keep an eye on as the decade marches on: * Health information technology (HIT). Policy makers may finally understand that ...
CT screening for which patients?(Letter to the editor)
Jan 01, 2008; ... Without belaboring the controversy, I would suggest that the problem with CT screening for lung cancer is with the patient study mix ("CT Not Advised for Lung Cancer Screening," Oct. 15, 2007, p. 1). In our area of upper-middle-class golf communities, it seems that there are ...
Easier formula, similar results.(Letter to the editor)
Jan 01, 2008; ... For years, I have been taking the hemoglobin [A.sub.1c], subtracting 2, then multiplying this number by 30 to get my estimated blood glucose level ("Equation Ties Hb[A.sub.1c] to Average Blood Glucose," Nov. 1, 2007, p. 25). So for an Hb[A.sub.1c] of 7.0, I would subtract 2, ...
CPT: current procedural tyranny.(Letter to the editor)
Jan 01, 2008; ... Am I the only physician who is stunned by the ready acceptance of coding by a once-proud profession? You may be the best MD in the U.S.A. and save lives daily, but if you don't enter the proper code number for your work, you don't get a penny. That sounds like a plot for a Ray ...
Correction.(Correction notice)
Jan 01, 2008 ... In "From Magic to Racing, the Hobbies of Physicians" (The Rest of Your Life, Nov. 15, ...
Pain relievers.(Opinion)(Cartoon)
Jan 01, 2008 ... "I'm afraid the tests indicate that what ...
In fight against MRSA, panic is unwarranted.(methicillin-resistant Staphylococcus aureus)(Editorial)
Jan 01, 2008; ... Methicillin-resistant Staphylococcus aureus has become the disease of the moment, with alarming headlines almost daily about the "killer" bacterium. While of course MRSA is a real concern, we physicians can help by reassuring people that we have tools to deal with this problem. ...
'Behind-the-counter' prescribing problematic.(Editorial)
Jan 01, 2008; ... Americans are desperate for ways to reduce the costs of health care and improve access to care. At the same time, physicians are frustrated with the status quo. After a 30-year campaign by the media to disparage physicians with negative stories about them; reductions in reimbursement by ...
MRI spots lung damage from secondhand smoke.(Pulmonary Medicine)
Jan 01, 2008; ... CHICAGO -- A novel magnetic resonance imaging technique may have provided the proverbial smoking gun in the secondhand smoking debate. Using helium-3 diffusion MRI, researchers at the University of Virginia in Charlottesville and the Children's Hospital of Philadelphia have for ...
Carbon monoxide test can be used to identify smokers.(Pulmonary Medicine)
Jan 01, 2008; ... CHICAGO -- Dr. Sridhar P. Reddy may have found a way to get around the nearly one-half of patients who lie about their smoking status: pulse CO-oximetry. Pulse CO-oximeters have been used in emergency departments and fire stations to detect carbon monoxide poisoning, but can ...
Hypomagnesemia may predict acute COPD exacerbations.(Pulmonary Medicine)(chronic obstructive pulmonary disease)
Jan 01, 2008; ... CHICAGO -- Serum magnesium is an independent predictor of frequent readmissions for acute exacerbation of chronic obstructive pulmonary disease, Dr. Surya Prakash Bhatt and colleagues reported in a poster at the annual meeting of the American College of Chest Physicians. That ...
Preventable hospitalizations for respiratory conditions.(DATA WATCH)(Table)(Brief article)
Jan 01, 2008 ... <Pre> Preventable Hospitalizations for Respiratory Conditions (number of admissions per 100,000 population)Asthma Chronic obstructive pulmonary disease Bacterial pneumonia 1997 124.5 266.8 399.2 1998 1999 ...
OA guidelines take evidence-driven approach.(Rheumatology)(osteoarthritis)
Jan 01, 2008; ... FORT LAUDERDALE, FLA. -- New guidelines on the management of hip and knee osteoarthritis aim to provide a consensus about which modalities have been shown to be effective, according to presentations at the World Congress on Osteoarthritis. More than 2 years in the making, the 25 ...
Joint replacement booklet.(Rheumatology)(Joint Replacement Surgery and You)(Brief article)
Jan 01, 2008 ... A 16-page booklet, "Joint Replacement Surgery and You," describes the procedure to the patient or lay reader in simple terms. It is available ...
Topical diclofenac significantly eased OA pain.(Rheumatology)(osteoarthritis)
Jan 01, 2008; ... BOSTON -- Topical diclofenac sodium gel was associated with statistically significant, clinically meaningful improvements in hand osteoarthritis symptoms in a multicenter, double-blind trial, according to a report at the annual meeting of the American College of Rheumatology. A ...
Single Botox injection reduces osteoarthritis shoulder pain.(Rheumatology)
Jan 01, 2008; ... BOSTON -- A single botulinum toxin type A injection can decrease joint pain and improve function in patients with refractory shoulder osteoarthritis, Dr. Jasvinder Singh reported at the annual meeting of the American College of Rheumatology. In a double-blind, randomized ...
Inpatient mortality from hip replacement declining.(DATA WATCH)
Jan 01, 2008 ... Inpatient Mortality From Hip Replacement Declining (per 1,000 admissions) ...
Stop ESAs in nonresponders after 6-8 weeks.(Hematology)(erythropoiesis-stimulating agents)
Jan 01, 2008; ... An updated clinical practice guideline from the American Society of Hematology and American Society of Clinical Oncology on the use of erythropoiesis-stimulating agents declares epoetin alfa and darbepoetin alfa equally safe and effective. It also addresses the blood-clotting ...
Rivaroxaban beats enoxaparin for averting thromboembolism.(Hematology)
Jan 01, 2008; ... ATLANTA -- Rivaroxaban, an investigational oral anticoagulant, is significantly more effective than subcutaneous enoxaparin--the current standard of care--in warding off deep vein thrombosis and pulmonary embolism in patients who have undergone total hip replacement, a phase III study has ...
Human thrombin approved for intraoperative bleeding.(Hematology)
Jan 01, 2008; ... The Food and Drug Administration has approved a thrombin product derived from human plasma to help control bleeding during surgery. The product, which will be marketed as Evithrom, is the first human thrombin approved since 1954 and is the only such product currently licensed by ...
Leukemia Tx may be guided by genomic profile.(Hematology)
Jan 01, 2008; ... NEW YORK -- When it comes to predicting the behavior of a cancer or its likely response to treatment, epigenomic profiling may be as important as genotyping, perhaps even more so, Dr. Ari Melnick said at the 25th annual Chemotherapy Foundation symposium. Subtyping cancers ...
Novel melatonergic antidepressant piques interest.(Psychiatry)
Jan 01, 2008; ... VIENNA -- "Agomelatine" was the word on everyone's lips at the annual congress of the European College of Neuropsycho-pharmacology. The buzz surrounding the first melatonergic antidepressant rose in reaction to the presentation of favorable results of a large randomized trial ...
Getting the NAC of a novel schizophrenia therapy.(Psychiatry)(N-acetylcysteine)
Jan 01, 2008; ... VIENNA -- N-acetylcysteine, an inexpensive supplement widely available over the counter in health food stores, proved safe and effective as adjunctive therapy for chronic schizophrenia in a 6-month, double-blind, placebo-controlled trial, Dr. Michael Berk said at the annual congress of the ...
Haloperidol may raise risk of heart arrhythmia.(Psychiatry)(Brief article)
Jan 01, 2008; ... Patients taking the antipsychotic drug haloperidol may be at increased risk for heart rhythm abnormalities, according to a Food and Drug Administration alert. Revised labeling on the drug, marketed as Haldol, Haldol decanoate, and Haldol lactate, includes a cardiovascular ...
Postmarket reports spur new modafinil warnings.(Psychiatry)
Jan 01, 2008; ... Warnings about serious rashes--including Stevens-Johnson syndrome and hypersensitivity reactions--as well as psychiatric symptoms have been added to the label of modafinil, according to a MedWatch notice issued by the Food and Drug Administration. Modafinil, described as a ...
Updated guidelines allow cautious use of TZDs.(Endocrinology)(thiazolidinediones)
Jan 01, 2008; ... In light of new information regarding thiazolidinediones, the American Diabetes Association and the European Association for the Study of Diabetes have updated their previous diabetes treatment guidelines to urge "greater caution" in the use of TZDs, particularly in patients with heart ...
Ethnicity affects triglycerides' predictive value.(Endocrinology)
Jan 01, 2008; ... BOSTON -- When using triglycerides to identify insulin resistance, patient ethnicity must be taken into account. An assessment of the relationship between insulin resistance and triglycerides in nearly 6,000 individuals representing four ethnic groups has shown that although a ...
Oral 'speed bump': eat slowly, lose weight.(Endocrinology)
Jan 01, 2008; ... NEW ORLEANS -- An oral device that fits in the mouth much like a retainer could help overweight individuals eat more slowly and, in the process, eat less and lose weight, according to a poster presented at the annual meeting of NAASO, the Obesity Society. Almost half of those ...
Narcotic bowel syndrome requires withdrawal.(Gastroenterology)
Jan 01, 2008; ... SALT LAKE CITY -- Narcotic bowel syndrome is a problem that physicians have been sweeping under the rug, and it may be growing in frequency, Dr. Douglas A. Drossman said at the annual meeting of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. ...
Number of adenomas predicts colonic recurrence.(Gastroenterology)(Brief article)
Jan 01, 2008; ... PHILADELPHIA -- A finding of three or more adenomas on colonoscopy was the strongest predictor of classification of a patient as being at high risk for recurrent adenomas in a review of 800 patients with colonic adenomas identified at their baseline examination. "When doing ...
Gastric bypass trumps band for weight loss.(Gastroenterology)
Jan 01, 2008; ... NEW ORLEANS -- Gastric bypass surgery resulted in more rapid and greater weight loss over a 2-year period than did gastric band surgery, according to a retrospective analysis of both procedures presented at the annual meeting of NAASO, the Obesity Society. At 24 months after the ...
Invasive GAS contacts may not need prophylaxis.(Infectious Diseases)(group A streptococcal )
Jan 01, 2008; ... CHICAGO -- Offering prophylaxis to all household contacts of patients with invasive group A streptococcal disease may not be cost effective, according to findings from an epidemiologic study presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy. The ...
Adenovirus 14 caused outbreak of severe CAP.(Infectious Diseases)(community acquired pneumonia)
Jan 01, 2008; ... SAN DIEGO -- During the winter of 2006 and the spring of 2007, adenovirus 14 caused a community outbreak of respiratory disease in Oregon, with a fatality rate of 19%, Dr. Paul Lewis reported at the annual meeting of the Infectious Diseases Society of America. "This seemed to ...
Assessment tool offers insight into pneumonia severity.(Infectious Diseases)
Jan 01, 2008; ... CHICAGO -- A simple severity-assessment tool for community-acquired pneumonia accurately identified patients needing intensive respiratory or inotropic support in a 7,464-patient, multicenter validation study. SMART-COP was developed as part of the Australian Community-Acquired ...
Pneumonia patients admitted late to ICU have higher mortality.(Infectious Diseases)(Intensive care units)(Brief article)
Jan 01, 2008; ... SAN FRANCISCO -- Patients with community-acquired pneumonia who were admitted to the intensive care unit 2 or more days after diagnosis were more than twice as likely to die within 30 days as were those who were admitted in 24 hours or less, according to a poster presentation at the ...
Inpatient mortality from pneumonia declining.(DATA WATCH)
Jan 01, 2008 ... Inpatient Mortality from Pneumonia Declining (per 1,000 admissions) ...
'Empty calories' increase risk for heart disease.(Cardiovascular Medicine)
Jan 01, 2008; ... Women with a so-called empty calorie diet--high in sweetened beverages, red meat, and desserts--had significantly elevated intima-media thickness, compared with women who followed other dietary patterns, including diets high in fat. The finding comes from an analysis of the ...
Epicardial fat may signal increased cardiovascular risk.(Cardiovascular Medicine)
Jan 01, 2008; ... NEW ORLEANS -- The fat that surrounds the heart is associated with cardiac abnormalities, including low stroke volume and cardiac output, that are independent of body mass index, a study has found. The finding casts doubt on the widespread practice of using body mass index (BMI) ...
NCQA [beta]-blocker measure to focus on outpatient use.(Cardiovascular Medicine)(National Committee for Quality Assurance )(Report)
Jan 01, 2008; ... WASHINGTON -- The National Committee for Quality Assurance in 2008 will begin reporting in earnest on how many myocardial infarction patients are receiving [beta]-blockers 6 months after hospital discharge, as recommended by the American Heart Association and the American College of ...
DASH diet shown to lower risk of heart disease and stroke.(Cardiovascular Medicine)
Jan 01, 2008; ... Women who followed the Dietary Approaches to Stop Hypertension diet had significant risk reductions of coronary heart disease and stroke, results from a cohort of participants in the ongoing Nurses Health Study showed. Previous studies have shown that the diet--heavy in fruits ...
Polyvascular disease boosts risk of CV events.(Cardiovascular Medicine)(cardiovascular)
Jan 01, 2008; ... ORLANDO -- Polyvascular disease--symptomatic atherosclerotic disease in more than one arterial bed--was a significant risk factor for new cardiovascular events in a review of nearly 100,000 patients with acute coronary syndrome. "Although the incremental risk [from polyvascular ...
Hypertension algorithm boosts control rate.(Cardiovascular Medicine)
Jan 01, 2008; ... ORLANDO -- A simple hypertension-treatment algorithm was more effective than was guideline-led practice for controlling blood pressure in a controlled study involving 45 family practices in southern Ontario. The cornerstone of the algorithm was initial, low-dose treatment with a ...
Expand subclinical CVD testing to close the detection gap.(Cardiovascular Medicine)(Cardiovascular diseases)
Jan 01, 2008; ... SAN DIEGO -- Consider expanding subclinical cardiovascular disease testing to include asymptomatic high-risk patient populations, Leslee J. Shaw, Ph.D., advised attendees at the annual meeting of the American Society of Nuclear Cardiology. Primary care physicians considering ...
McCain opposes mandating health insurance coverage.(Practice Trends)
Jan 01, 2008; ... For Sen. John McCain (R-Ariz.), having health insurance is desirable but not mandatory. "I don't think there should be a mandate for every American to have health insurance," the Republican presidential hopeful said at a forum on health care policy sponsored by Families USA and ...
ED visits by elderly increase.(POLICY & PRACTICE)(Elderly)(Survey)(Brief article)
Jan 01, 2008; ... The number of emergency department visits among elderly persons could almost double from 6 million in 2003 to almost 12 million by 2013, according to an analysis using National Hospital Ambulatory Medical Care Survey data from 1993 to 2003. The overall rate of admission in patients aged ...
Center takes on nursing shortage.(POLICY & PRACTICE)(Brief article)
Jan 01, 2008; ... A new think tank will address the burgeoning nursing shortage and its impact on patient care. The Center to Champion Nursing in America will focus on increasing funding for nursing education, expanding nurse representation on hospital boards, and informing policy makers and the public ...
DEA accused of electronic stalling.(POLICY & PRACTICE)(Drug Enforcement Administration)(Brief article)
Jan 01, 2008; ... The Drug Enforcement Administration, which prosecutes crimes involving illicit use of controlled substances, has been criticized for stalling implementation of a national electronic prescribing system for controlled substances. At a Senate Judiciary Committee hearing on e-prescribing, Sen ....
FDA can't fulfill mission.(POLICY & PRACTICE)(Food and Drug Administration)(Brief article)
Jan 01, 2008; ... Three members of the Food and Drug Administration's Science Board issued a damning report on the state of the agency, saying that it "suffers from serious scientific deficiencies and is not positioned to meet current or emerging regulatory responsibilities." The authors wrote that the ...
Access reduced by cost.(POLICY & PRACTICE)(Brief article)
Jan 01, 2008; ... Forty million Americans can't get access to needed health care, and 20% said the main reason was because they could not afford the services, according to a December report by the Centers for Disease Control and Prevention. "Health, United States," 2007, is a compilation of pertinent data ...
Agency's approval plan flawed.(POLICY & PRACTICE)(Brief article)
Jan 01, 2008; ... The Food and Drug Administration is considering new guidance that would allow drug companies to use journal articles to promote "potentially dangerous uses" of drugs and medical devices without prior FDA review and approval, according to a top lawmaker. Rep. Henry Waxman (D-Calif.), who ...
Safety net being stretched to the breaking point.(Practice Trends)
Jan 01, 2008; ... WASHINGTON -- Community health centers, public hospitals, and other safety net providers are seeing a steadily growing number of low-income patients, while specialty care for these patients is becoming scarce, according to the results of a biennial national survey conducted by the Center ...
Should alcohol-dependent patients be reported?(Practice Trends)
Jan 01, 2008; ... MIAMI BEACH -- Only six states have mandatory reporting laws, so most physicians can be in a quandary when a patient is alcohol dependent and works where impairment could threaten public safety, according to a poster presented at the annual meeting of the American Academy of Psychiatry and ...
Helping people on the fringes in Ethiopia.(WORLD WIDE MED)(Interview)
Jan 01, 2008; ... DR. RICK HODES, a Johns Hopkins-trained internist practicing in Addis Ababa, Ethiopia, crunches numbers to see how he can raise funds for his endless stream of patients who need spine and heart surgeries performed in the United States and other countries. In stark contrast, his ...
Indications' case of the month.(INDICATIONS)(Brief article)
Jan 01, 2008; ... A new weight-loss fad is gaining traction following the publication in the New England Journal of Medicine of a unique case of severe trichophagia. For those of you who are rusty on your Trivial Pursuit-worthy medical terminology, that means eating one's own hair--10 pounds worth, in the ...
Tuition well spent.(INDICATIONS)(Brief article)
Jan 01, 2008; ... Rates of alcohol consumption by University of Texas, Austin, college students on days of football games rivaled levels seen on such "traditional" drinking days as New Year's Eve and Halloween. "Many college students view campus sporting events as an opportunity for heavy drinking, both to ...
Dancing, not falling.(INDICATIONS)(Brief article)
Jan 01, 2008; ... A series of 20 hour-long dance classes led to a greater improvement in Parkinson's disease patients' balance than did regular exercise classes, according to a study in the American Journal of Dance Therapy. The study recruited 9 PD patients and 9 controls into an Argentine tango class, and ...
Surgeon General hates fun, children.(INDICATIONS)(Brief article)
Jan 01, 2008; ... Now that the holidays are over and the presents already have been delivered, we think it's safe to say--Santa could stand to lose a few pounds. Or anyway, that's what U.S. Surgeon General Dr. Steven K. Galson told the Boston Herald. "It is really important that the people whom kids look up ...
Less recurrence with anastrozole.(News)
Jan 15, 2008; ... SAN ANTONIO -- The efficacy of the aromatase inhibitor anastrozole for prevention of breast cancer recurrence persists for years after treatment completion--but the side effects do not, according to the 100-month follow-up analysis of the landmark Arimidex, Tamoxifen, Alone or in ...
Adults who did not receive needed health care because they could not afford it.(VITAL SIGNS)(Statistical table)(Brief article)
Jan 15, 2008 ... <Pre> Adults Who Did Not Receive Needed Health Care Because They Could Not Afford It Age (years) 18-44 8.1% 45-64 7.7% [greater than or ...
ESAs may boost leukemia risk in myelofibrosis: retrospective analysis shows association.(News)(erythropoietic-stimulating agents)
Jan 15, 2008; ... ATLANTA -- Physicians at the Mayo Clinic in Rochester, Minn., stopped giving erythropoietic-stimulating agents to patients with primary myelofibrosis after finding an unexpected association with transformation to leukemia in these patients. Use of erythropoietic-stimulating ...