Internal Medicine News back issues from February 2008:
PCPs lack info on hematologic Ca.(News)(Primary care providers)(cancer)(Reprint)(Survey)
Feb 01, 2008; ... ATLANTA -- Primary care providers often have knowledge gaps that undermine their ability to diagnose and manage the few patients they see with hematologic malignancies, according to sample survey responses from 357 participants in a medical education initiative funded by the U.S. Centers ...
Projected aggregate physician and clinical service expenditures in the U.S.(VITAL SIGNS)
Feb 01, 2008 ... Projected Aggregate Physician and Clinical Service Expenditures in the U.S. (in billions of dollars) Notes: Based on the 2005 version of the National ...
Guidelines endorse goals for palliative care at end of life: ACP backs five evidence-based measures.(Geriatrics)
Feb 01, 2008; ... Palliative care at the end of life should focus on the assessment and alleviation of symptoms of pain, shortness of breath, and depression, according to new guidelines released by the American College of Physicians. "The ACP's drawing a line in the sand and saying this is ...
Gene profile test effective in node-positive breast Ca.(News)
Feb 01, 2008; ... SAN ANTONIO -- The 70-gene profile known as the MammaPrint test is a powerful and independent prognostic marker in breast cancer patients who have one to three positive axillary lymph nodes, according to two studies presented at the annual San Antonio Breast Cancer Symposium. ...
FDA issues alert on fentanyl patches.(News)(Food and Drug Administration )
Feb 01, 2008; ... Recent reports of death and life-threatening side effects associated with the fentanyl patch prompted the Food and Drug Administration to once again issue a warning about improper prescribing and use of the transdermal administration. The last warning came in 2005 after similar reports. ...
Zoledronic acid zaps bone loss in breast cancer.(News)(Clinical report)
Feb 01, 2008; ... SAN ANTONIO -- Zoledronic acid proved dramatically effective in preventing the pronounced bone loss that accompanies combination estrogen-reducing adjuvant endocrine therapy in premenopausal breast cancer patients, according to an update from a major Austrian clinical trial. ...
21-gene assay predicts recurrence in node-positive breast Ca.(News)
Feb 01, 2008; ... SAN ANTONIO -- The 21-gene assay called Oncotype DX can predict risk of recurrence in postmenopausal women with node-positive, estrogen receptor-positive breast cancers, researchers said at the annual San Antonio Breast Cancer Symposium. The assay also may be able to define ...
Modern evidence lacking on phenylephrine dosages.(News)
Feb 01, 2008; ... SILVER SPRING, MD. -- Phenylephrine, a primary ingredient in hundreds of over-the-counter nasal decongestants, appears to be effective at the current dose, but further research is needed to determine whether higher doses might be more effective, according to a Food and Drug Administration ...
Intranasal desmopressin tied to hyponatremia.(News)
Feb 01, 2008; ... Intranasal formulations of desmopressin acetate are no longer indicated for treating primary nocturnal enuresis because of the risk of severe hyponatremia and seizures associated with these products when used for this indication, according to the Food and Drug Administration. ...
Bystolic.(NEW & APPROVED)(Drug overview)
Feb 01, 2008; ... Bystolic (nebivolol, Mylan Bertek Pharmaceuticals and Forest Laboratories Inc.) A [beta]-blocker approved for the treatment of hypertension, alone or in combination with other antihypertensive agents. * Recommended Dosage: Recommended starting dose is 5 mg ...
xTAG Respiratory Viral Panel.(NEW & APPROVED)(Brief article)
Feb 01, 2008; ... xTAG Respiratory Viral Panel (Luminex Molecular Diagnostics) A nucleic acid--based test that simultaneously detects and identifies 12 respiratory viruses and viral subtypes. This is the first test cleared by the FDA for "infectious respiratory disease samples that ...
Universal screening renews HIV debate.(GUEST EDITORIAL)
Feb 01, 2008; ... When a person discloses a positive HIV status to a partner, the disclosure eliminates many of the moral, ethical, and legal considerations inherent in the opposite scenario. Just what is our responsibility as physicians in this regard? Do we have a duty to protect and warn the known sexual ...
Internists are not adequately credited.(LETTERS)(Letter to the editor)
Feb 01, 2008; ... Many practicing internists assume on a daily basis the responsibilities listed in your article about maintenance of certification ('ABIM Proposes Comprehensive Internist Concept," Dec. 15, 2007, p. 1). This program might help to acknowledge what is already being done. I would ...
Buzzwords no substitute for advocacy.(LETTERS)(Letter to the editor)
Feb 01, 2008; ... In reading the list of "core competencies" being proposed by the American Board of Internal Medicine, I was reminded of the TV commercial where the office workers play "buzzword bingo" ("ABIM Proposes Comprehensive Internist Concept," Dec. 15, 2007, p. 1). It looks like the ...
ABIM taking the wrong approach.(LETTERS)(Letter to the editor)
Feb 01, 2008; ... These are the people who have ruined internal medicine as a specialty ("ABIM Proposes Comprehensive Internist Concept," Dec. 15, 2007, p. 1). What is the benefit of having boards in IM or being recertified at the present time? There are none! I have been a board-certified ...
Low-dose dexamethasone beneficial in myeloma.(Hematology)
Feb 01, 2008; ... ATLANTA -- Not only reduced toxicity but also less disease progression led to superior overall survival when patients with newly diagnosed multiple myeloma were given low-dose dexamethasone in a pivotal phase III trial comparing high and low doses of the steroid in combination with ...
Immunoglobulin test may signal cancer risk.(Hematology)(Clinical report)
Feb 01, 2008; ... ATLANTA -- Healthy blood donors with positive direct antiglobulin tests develop cancer more than twice as often as those who test negative, according to a provocative study that linked thousands of blood bank records to Israel's national cancer registry. Absolute cancer risk was ...
Reducing iron stores lowers cancer risk in PAD.(Hematology)(peripheral artery disease )
Feb 01, 2008; ... ATLANTA -- Patients with peripheral artery disease who were randomized to an iron reduction program significantly reduced their risk of developing a malignancy by 37%, compared with patients who received no iron reduction. After an average follow-up of 3 years, a new cancer was ...
Elevated ferritin tied to transplant mortality.(Hematology)(Clinical report)
Feb 01, 2008; ... ATLANTA -- Elevated ferritin levels were associated with poor outcomes following autologous hematopoietic stem-cell transplantation in a retrospective analysis of 397 patients with hematologic malignancies. A ferritin level of 685 ng/mL or greater was an independent predictor of ...
Endometriosis not predicted by hormone effect.(Women's Health)(Clinical report)
Feb 01, 2008; ... WASHINGTON -- Response to hormonal therapy does not accurately predict whether a patient has endometriosis, Dr. Todd R. Jenkins reported at the annual meeting of the AAGL. Laparoscopy has long been considered the standard for diagnosing endometriosis. However, a 1999 paper by ...
Histology necessary to confirm diagnosis of endometriosis.(Women's Health)
Feb 01, 2008; ... SAN DIEGO -- When it comes to diagnosing endometriosis, visual inspection is not enough, Dr. Georgine Lamvu said at the annual meeting of the International Pelvic Pain Society. "We need to be more careful to use excisional biopsies during laparoscopies and careful about the ...
Routine anal Pap smear testing gains ground.(Women's Health)
Feb 01, 2008; ... CHICAGO -- Routine screening for anal intraepithelial neoplasia could pick up missed cancers, Dr. Thomas C. Wright Jr. said at a conference on vulvovaginal diseases. The role of routine anal Pap smear screening is controversial in part because a clear link between anal ...
Cervical cancer screening feasible, effective in STD clinics.(Women's Health)(Sexually transmitted diseases)
Feb 01, 2008; ... SAN DIEGO -- Cervical cancer screening in STD clinics is feasible and highly effective, according to results from a 2-year single clinic study. "From previous studies we know that women who attend STD clinics are at greater risk for having abnormal cervical cytology, but ...
Prozac no better than placebo in some teens.(Adolescent Health)
Feb 01, 2008; ... BOSTON -- Fluoxetine is not an effective treatment for depression in adolescents with comorbid substance-related disorders, suggest results of a placebo-controlled trial presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry. Previous studies ...
Initiating substance use linked with major depressive episodes in teenagers.(DATA WATCH)(Statistical table)(Brief article)
Feb 01, 2008 ... <Pre> Initiating Substance Use Linked With Major Depressive Episodes in TeenagersMajor depressive No major depressive episode in past year episode in past year Alcohol use 29.2% 14.5% Illicit drug use ...
Adolescent depression.(THE EFFECTIVE PHYSICIAN)(Disease/Disorder overview)
Feb 01, 2008; ... Background The diagnosis and management of adolescents with depression is a common issue for primary care physicians. Evidence-based guidelines and tools to assist clinicians in the evaluation and treatment of major depression in 10-to 21-year-olds have recently been published. ...
Policy on adolescent contraception updated.(Adolescent Health)
Feb 01, 2008; ... The revised American Academy of Pediatrics policy statement on contraception and adolescents includes updates on recently introduced contraceptives, as well as an emphasis on the recommendation that adolescents postpone sexual activity "until they are fully ready for the emotional, ...
Treat obesity before using anticholesterol drugs.(Adolescent Health)
Feb 01, 2008; ... STANFORD, CALIF. -- Picture a 15-year-old Hispanic girl who is 152.5 cm tall, weighs 88.7 kg, and has a body mass index of 38 kg/[m.sup.2]. Her father has hyperlipidemia, but she has no family history of a premature coronary artery event (such as a myocardial infarction in a family member ...
Little known about effective treatments for delirium.(Geriatrics)
Feb 01, 2008; ... LONG BEACH, CALIF. -- So little is known about effective interventions for delirium that efforts to help elderly patients with the condition leave many clinicians, well, delirious. The goal of treating delirium is not just to control agitation or hallucinations, but also to ...
Treatment of insomnia in elderly can be tricky.(Geriatrics)
Feb 01, 2008; ... MINNEAPOLIS -- Metabolic changes and comorbid conditions are just a few of the factors that challenge clinicians when they treat insomnia in older adults. "The predictability of your giving drug X to patient A and knowing what is going to happen goes way down. That's the bottom ...
Geriatric assessments require individualization.(Geriatrics)
Feb 01, 2008; ... PHILADELPHIA -- People in their 80s are much more varied in their physical condition than people in their 20s, Dr. Moira Fordyce said at a conference sponsored by the American Society on Aging. As a result, a physician must carefully assess each elderly patient to determine ...
Treating insomnia may reduce osteoarthritis pain.(Geriatrics)
Feb 01, 2008; ... SAN FRANCISCO -- Cognitive-behavioral therapy for comorbid insomnia in patients with osteoarthritis not only improved sleep but also reduced self-reported pain in a randomized, controlled pilot study of 51 patients, reported Michael V Vitiello, Ph.D. The improvements in both ...
Older adults receptive to trying lifestyle changes.(Geriatrics)(Clinical report)
Feb 01, 2008; ... SAN FRANCISCO -- A surprisingly high 85% of older adults with hypertension, hyperglycemia, or hyperlipidemia reported engaging in lifestyle modifications, such as diet change or exercise, in a longitudinal study of 666 people, Eleanor M. Simonsick, Ph.D., said at the annual meeting of the ...
Diabetes found in one-third of nursing home residents.(Geriatrics)(Report)
Feb 01, 2008 ... SAN FRANCISCO -- The prevalence of diabetes mellitus in a study of 2,317 U.S. nursing home residents was 33%, higher than previous reports that pegged the prevalence at 11%-27% of residents. Previous estimates predominantly relied on the Minimum Data Set, a standardized ...
Tai Chi improved cognitive function in older adults.(Geriatrics)
Feb 01, 2008 ... SAN FRANCISCO -- The Eastern exercise, tai chi, improved scores on a measure of cognitive function in a yearlong, randomized, controlled study of 132 healthy older adults. This is the first study to document mental improvements resulting from tai chi, Ruth E. Taylor-Piliae, ...
Identifying hereditary cancer syndromes.(GENETICS IN YOUR PRACTICE)
Feb 01, 2008; ... In the Dec. 1, 2007, issue of INTERNAL MEDICINE NEWS, Dr. Michael F. Murray reviewed the importance of the family health history as a risk assessment tool for internists. The renewed interest in family history information in the era of "genetic medicine" has occurred in parallel with the ...
Novel anticancer agents have autoimmune toxicities.(Clinical Rounds)
Feb 01, 2008; ... AMSTERDAM -- The highly promising new class of investigational anticancer agents known at cytotoxic T-lymphocyte antigen 4 blockers has a characteristic group of side effects, Dr. Alexander M.M. Eggermont said at the 11th World Congress on Cancers of the Skin. Two fully human ...
Prevalence of peripheral artery disease rising in United States.(Cardiovascular Medicine)(Survey)
Feb 01, 2008; ... ORLANDO -- The prevalence of peripheral artery disease in asymptomatic adults is increasing in the United States, according to data collected on a total of more than 5,000 people by the National Health and Nutrition Examination Survey during 1999-2004. The spike in peripheral ...
Coronary calcium IDs young men at cardiac risk.(Cardiovascular Medicine)
Feb 01, 2008; ... ORLANDO -- Coronary artery calcium identified young men at relatively high risk for a coronary heart disease event even when their Framingham risk score was low, in a study with more than 1,600 men. The new findings "challenge the notion that a coronary artery calcium [CAC] ...
Ezetimibe fails to further slow atherosclerosis.(Cardiovascular Medicine)
Feb 01, 2008; ... Results of a controversial study assessing ezetimibe's ability to slow atherosclerotic progression, when used in conjunction with a high-dose statin regimen, have cardiologists split on whether the findings signal a flawed study or a flawed drug. The results were "disappointing, ...
Calcium supplementation increases MI risk in older women.(Cardiovascular Medicine)(myocardial infarction )
Feb 01, 2008; ... Calcium supplementation significantly increased the risk of a myocardial infarction among healthy, postmenopausal women, compared with those taking placebo, in a secondary analysis of an osteoporosis study. Physicians should consider this increased cardiovascular risk against ...
Genital wart treatment options expanding.(Infectious Diseases)
Feb 01, 2008; ... CHICAGO -- A topical ointment containing components derived from green tea leaves is the latest addition to the available therapies for genital warts, Dr. Thomas C. Wright Jr. said at a conference on vulvovaginal diseases. The ointment was approved by the Food and Drug ...
Dexamethasone beneficial in bacterial meningitis.(Infectious Diseases)(Clinical report)
Feb 01, 2008; ... CHICAGO -- The use of dexamethasone therapy either before or with the first dose of standard antibiotics was associated with a favorable outcome in adults with community-acquired bacterial meningitis, according to preliminary data from a prospective nationwide cohort of 154 Dutch patients ....
Image-enhanced endoscopy has 'come of age'.(Gastroenterology)
Feb 01, 2008; ... In the not-so-distant past, endoscopists always sought the input of pathologists when diagnosing gastrointestinal cancers. Now, thanks to the maturation of image-enhanced endoscopy, endoscopists are sometimes able to make a diagnosis on the spot. "The time for ...
Diabetes tied to colorectal cancer risk in women.(Gastroenterology)
Feb 01, 2008; ... Diabetes may significantly increase a woman's risk of developing colorectal cancer, based on the findings of a study involving more than 45,000 women across the United States. "There was about a 50% increased risk of colorectal cancer in women with diabetes," said Andrew Flood, ...
Laparoscopic-assisted colonoscopy useful for treating difficult polyps.(Gastroenterology)
Feb 01, 2008; ... SAN FRANCISCO -- A combined laparoscopic-endoscopic approach can be effective in treating difficult colonic polyps, Dr. Morris E. Franklin Jr. said at the annual meeting of the Society of Laparoendoscopic Surgeons. In a case series of 144 patients from whom 190 polyps were ...
Low-income seniors helped.(POLICY & PRACTICE)(Brief article)
Feb 01, 2008; ... The Centers for Medicare and Medicaid Services has proposed new rules that would allow more low-income Medicare beneficiaries to remain in their current prescription drug plan without having to pay a premium. Each year, CMS recalculates the amount of premium that will be paid by Medicare ...
Coverage improves health.(POLICY & PRACTICE)(Brief article)
Feb 01, 2008; ... Uninsured adults 55-64 years old, particularly those with cardiovascular disease or diabetes, saw their health improve significantly once they became eligible for Medicare, a study from Harvard Medical School, Boston, reported. The study looked at more than 5,000 adults who were ...
Grant funds medical home study.(POLICY & PRACTICE)(Brief article)
Feb 01, 2008; ... The American College of Physicians has received a $225,000 grant from the Commonwealth Fund to study the cost of providing a patient-centered medical home. The grant, part of the Commonwealth Fund's Patient-Centered Primary Care Initiative, will help underwrite a 10-month study which began ...
Retiree benefits can be cut.(POLICY & PRACTICE)(Brief article)
Feb 01, 2008; ... A new federal regulation will allow employers to provide more limited health care benefits for retirees who are eligible for Medicare. The rule, which the Equal Employment Opportunity Commission released in late December, responds to a court of appeals case in which the court held that ...
Expanded INR monitor coverage.(POLICY & PRACTICE)(international normalized ratio)(Brief article)
Feb 01, 2008; ... CMS is considering expanding coverage for home prothrombin time (international normalized ratio) monitoring. Currently, monitoring is limited to patients with mechanical heart valves. The agency proposes to expand coverage to those patients with chronic atrial fibrillation or deep vein ...
Judge overturns Rx info law.(POLICY & PRACTICE)(Brief article)
Feb 01, 2008; ... A federal judge has overturned a Maine law that would have restricted medical data companies' access to physician prescribing information. In a decision that relied heavily on a previous ruling in New Hampshire, U.S. District Judge John Woodcock said that the law would prohibit "the ...
Study charts success of physicians in recovery.(Practice Trends)
Feb 01, 2008; ... CORONADO, CALIF. -- Of 104 physicians in New York state who were admitted to substance abuse treatment programs between 2003 and 2004 and were monitored for a mean of 41 months by the state's Committee for Physicians' Health, only 9 (9%) were discharged because of noncompliance with ...
Simple interventions make a big difference in Bolivia.(WORLD WIDE MED)(Interview)
Feb 01, 2008; ... For Dr. Susan Hou, the practice of medicine is a family affair. Far from her U.S. career in nephrology, Dr. Hou's family connection to medicine is rooted in the rain forest of Bolivia, where in 2001, she cofounded a clinic called Centro Medico Humberto Parra, in the village of Palacios ....
MedPAC recommends 1.1% fee increase for 2009.(Practice Trends)(Report)
Feb 01, 2008; ... WASHINGTON -- The Medicare Payment Advisory Commission has voted to recommend that Congress increase the fees that physicians receive from Medicare by 1.1% in 2009. The recommendation will be included in MedPAC's final report to Congress next month but was discussed and voted on ...
Popularity of personal health records growing.(Practice Trends)
Feb 01, 2008; ... As physicians struggle to decide whether and when to incorporate electronic health records into their practices, personal health records are gaining popularity. Personal health records (PHRs) allow patients to store and access their medical information electronically. Various ...
Medicare payment situation makes planning difficult.(Practice Trends)
Feb 01, 2008; ... Doubt and low morale are rampant in many primary care practices in light of the uncertainty surrounding Medicare physician payment rates this year. Although members of Congress averted a 10% cut in the Medicare physician fee schedule, replacing it instead with a 0.5% increase, ...
Medicare training, brochures available.(Practice Trends)(Brief article)
Feb 01, 2008 ... The Centers for Medicare and Medicaid Services offers an updated Web-based training course to explain Medicare's coverage and billing for women's preventive health services. The 90-minute course features billing guidelines for services including mammographies, pelvic exams, and ...
Health care spending varies widely according to region.(Practice Trends)
Feb 01, 2008; ... Dramatic regional differences exist in the way in which severely chronically ill patients, who consume 75% of Medicare's budget, are treated in their last 2 years of life, according to a report based on data from nearly 5 million Medicare enrollees. The authors compared ...
Cupid's all-natural fix, guaranteed.(INDICATIONS)(Brief article)
Feb 01, 2008; ... Valentine's Day is nearly upon us, and the Bureau of Indications would like to pass along some recent warnings from the Food and Drug Administration. According to a press statement, the use of the following supposedly "all-natural" erectile dysfunction products should be discouraged: Super ...
Till rehab do us part.(INDICATIONS)(rehabilitation)(Brief article)
Feb 01, 2008; ... Spouses who report discordant drug use--meaning one uses and one does not--are the least satisfied with their marriages, leading researchers to conclude that the best way to get high while married is secretly, according to a recent report in the journal Addictive Behaviors. But confirmed ...
Alpha kappa Drosophila.(INDICATIONS)(Brief article)
Feb 01, 2008; ... "Disinhibited sexual behavior is highly associated with alcohol consumption; however, the physiological support for this notion is largely lacking and a suitable animal model to address this issue is instrumental," researchers wrote in PLoS ONE, explaining a study of Drosophila's sexual ...
Primal attraction, macaque-style.(INDICATIONS)(Brief article)
Feb 01, 2008; ... A new study of the copulation habits of Barbary macaques may shed some light on the nature of your romantic Valentine's evening tryst. Researchers at the German Primate Center wondered whether the loud and frequent calls by female Barbary macaques during sex serve any particular function, ...
Pain relievers.(Comic)(Cartoon)
Feb 01, 2008 ... "I was a 24-hour bug, but thanks to ...
Fighting needle fear in diabetes.(News)
Feb 15, 2008; ... Needle fear can complicate many doctor-patient relationships, but for patients with insulin-treated diabetes, fear of needles can become a serious barrier to compliance. Studies show that up to one-quarter of people with diabetes have needle anxiety (Diabetes Res. Clin. Pract ....