Internal Medicine News back issues from June 2008:
ACP backs effort to rate treatments.(American College of Physicians)
Jun 01, 2008; ... WASHINGTON -- The American College of Physicians, saying it is time for patients, physicians, and policy makers to consider the economic impact of health care choices along with their clinical impact, has issued a call for the creation of a new, independent entity that would conduct and ...
Low Vitamin D tied to poor prognosis in breast cancer: significant differences seen at 10 year.(Clinical report)
Jun 01, 2008; ... Vitamin D deficiency at the time of breast cancer diagnosis is common and is associated with a significantly increased risk of metastasis and mortality, according to data from a study of 512 women with newly diagnosed breast cancer. The women were enrolled in the study at three ...
Medicare adds options to Quality Reporting Initiative.
Jun 01, 2008; ... Physicians now have nine different options for submitting quality data to Medicare under the Physician Quality Reporting Initiative. The new options include three ways to submit claims-based data and six registry-based methods for reporting. (See box on page 5.) For example, ...
Women's health web site unveiled.(Website overview)(Brief article)
Jun 01, 2008 ... Women's Health Resources is a one-stop Web resource with the latest information on significant topics in women's health research from scientific journals and other peer-reviewed sources. The site is offered by the National Library of Medicine, a division of ...
FDA approves smaller implantable ventricular assist device.
Jun 01, 2008; ... The Food and Drug Administration has approved an implantable ventricular assist device that is markedly smaller than previously available devices and is the first that can be used in smaller adults, which will make this technology available to many more women with heart failure. ...
Parkinson's patch recall is hard for some patients.(Clinical report)
Jun 01, 2008; ... The recent recall of the rotigotine patch used in early Parkinson's disease has been difficult for some patients, according to Dr. Irene Litvan, director of the movement disorder program at the University of Louisville (Ky.). Patients liked the fact that they had to apply the ...
FDA approves generic versions of ropinirole.(Brief article)
Jun 01, 2008; ... The Food and Drug Administration has approved generic formulations of ropinirole for the treatment of restless legs syndrome but not for Parkinson's disease, the other approved indication for the drug. Generic ropinirole hydrochloride tablets--manufactured by Roxane Laboratories ...
Patanase nasal spray, Relistor.(NEW & APPROVED)(Drug overview)
Jun 01, 2008; ... Patanase Nasal Spray (olopatadine HCI, Alcon Inc.) An [H.sub.1]-receptor antagonist approved by the Food and Drug Administration for the relief of symptoms of seasonal allergic rhinitis in patients aged 12 years and older. * Recommended Dosage: Two sprays ...
Transplant drugs under scrutiny.(NEWS FROM THE FDA)
Jun 01, 2008 ... Recent actions by the Food and Drug Administration have called attention to potential safety issues involving drugs used to prevent organ rejection and treat diabetic skin ulcers; expanded the indications for drugs used to treat anemia, irritable bowel syndrome, and chronic obstructive ...
Label expanded for ESA.(NEWS FROM THE FDA)
Jun 01, 2008 ... The Food and Drug Administration on May 5 expanded the indication for the erythropoietin-stimulating agent darbepoetin alfa to include its use as therapy for new chronic renal failure patients who are not on dialysis. Under the expanded label, darbepoetin alfa (Aranesp) can be ...
Combo migraine drug gets go-ahead.(NEWS FROM THE FDA)(Brief article)
Jun 01, 2008 ... GlaxoSmithKline and developmental partner Pozen have received marketing approval for a combination drug for short term treatment of migraine attacks with or without aura in adults, ending a nearly 3-year regulatory review process. GlaxoSmithkline said it received approval in ...
Amitiza indication expanded.(NEWS FROM THE FDA)(Brief article)
Jun 01, 2008 ... The chronic idiopathic constipation drug Amitiza (lubiprostone) was approved by the Food and Drug Administration for irritable bowel syndrome with constipation in women 18 years and older, making it the only prescription drug available for irritable bowel syndrome with constipation. ...
Advair use extended for COPD.(NEWS FROM THE FDA)
Jun 01, 2008 ... The Food and Drug Administration approved expanded use of the asthma drug Advair to reduce exacerbations of chronic obstructive pulmonary disease. Inhaled Advair, taken by way of the manufacturer GlaxoSmithKline's Diskus device, combines 250 mcg of fluticasone propionate (a ...
Becaplermin tied to cancer risk.(NEWS FROM THE FDA)
Jun 01, 2008 ... The risk of death from cancer may be increased in patients prescribed becaplermin (Regranex) more than three times, according to a statement issued by the Food and Drug Administration. Becaplermin is made by Johnson & Johnson's Ethicon division and is used to treat diabetic leg ...
All practicing MDs should recertify.(LETTERS)(Letter to the editor)
Jun 01, 2008; ... I agree with Dr. Christine K. Cassel's assertion that the American Board of Internal Medicine is committed to improving and supporting a certification process "that reflects what physicians are doing in practice" and facilitates efforts in quality improvement ("Clarifying the ABIM's ...
Boards miss key traits, intangibles.(LETTERS)(Letter to the editor)
Jun 01, 2008; ... Dr. Jerome Arnett Jr. expressed poignant criticisms about the American Board of Internal Medicine ("Is the ABIM the Only Stakeholder?" Letters, April 15,2008, p.8). Being boarded is not a guarantee of competence, and it requires excessive hours of cramming, which takes away from ...
ACP's bold defense of science.(LETTERS)(Letter to the editor)
Jun 01, 2008; ... I applaud the American College of Physicians for its recently published position on the utilization of medical marijuana ("Medical Marijuana Gets ACP's Okay," March 15, 2008, p. 1). The college's bold defense ...
Medical marijuana = easy cash?(LETTERS)(Letter to the editor)
Jun 01, 2008; ... I recently visited Lake Tahoe. Medical marijuana clinics there charge cash for brief visits. This means no insurance forms ("Medical Marijuana Gets ACP's Okay," March 15,2008, p.1). Headaches and ...
AAP should stick to science.(LETTERS)(Letter to the editor)
Jun 01, 2008; ... The American Academy of Pediatrics' stand on adolescent sexuality is unscientific and impractical ("Policy on Adolescent Contraception Updated," Feb. 1, 2008, p.6). Pontification is no way to address a biologic phenomenon governed by various hormones and neurotransmitters ...
Correction.(Correction notice)
Jun 01, 2008 ... In the March 15 issue, p. 15, in the article, "HT Thrombosis Risk Tied to Coagulation Factors," the fifth paragraph should have read: Other factors that were found to be associated with an elevated venous thrombosis risk in the presence of HT included lower free protein S and higher ...
Redefine diabetes to lower costs of care.(GUEST EDITORIAL)(Clinical report)
Jun 01, 2008; ... Here's a solution to the enormous cost of caring for diabetes: Give the diagnosis to 54 million more people. Diabetes per se is not what cost the United States $174 billion last year. Poorly controlled diabetes and its resulting complications were far and away the biggest ...
Stepping up to fight STDs in teens.(GUEST EDITORIAL)(Report)
Jun 01, 2008; ... Like many health care providers, I was taken aback by the data from the Centers for Disease Control and Prevention population-based study showing that, overall, one in four 14-to 19-year-olds tested positive for at least one sexually transmitted disease, according to a representative ...
Screen teens for abuse of inhalants.(Adolescent Health)(Report)
Jun 01, 2008; ... WASHINGTON -- The drugs of choice for children aged 12 and 13 years are inhalants, surpassing pain relievers, marijuana, and any other illegal drug, with 3.4% of 12-year-olds and 4.8% of 13-year-olds using in the past year. This is according to a report by the Substance Abuse ...
Developmental factors play role in teen drinking: 'drinking problems of youths have their beginnings well before alcohol use is initiated,' researchers find.(Adolescent Health)(Report)
Jun 01, 2008; ... A complex mixture of biologic, psychological, and social evidence suggests that alcohol consumption in children and adolescents is a developmental issue, based on data from several studies. Studying the developmental components of underage drinking at all developmental stages ...
Teen confidante important after family violence.(Adolescent Health)
Jun 01, 2008; ... CHICAGO -- Adolescents exposed to long-term intimate partner violence against their mothers can reduce their own risk of depression by relying less on negative coping strategies and more on emotional disclosure to a confidante, according to Rebecca L. Thompson. Teens who had ...
Controversial sunscreen ingredient ubiquitous.(Dermatology)
Jun 01, 2008; ... Exposure to the sunscreen ingredient benzophenone-3 is "widespread in the U.S. general population," according to a study from the Centers for Disease Control and Prevention. "This high level of detection most likely resulted from routine use of consumer products that contain ...
Acne vulgaris gets two new treatment options.(Dermatology)(Clinical report)
Jun 01, 2008; ... WAIKOLOA, HAWAII -- In a regulatory turnaround, it looks like physicians will gain ready access to dapsone gel 5% for the treatment of acne vulgaris after all, Dr. David M. Pariser said at the annual Hawaii dermatology seminar sponsored by Skin Disease Education Foundation. The ...
Diet gaining legitimacy as potential factor in acne.(Dermatology)
Jun 01, 2008; ... WAIKOLOA, HAWAII -- Most physicians, taught that diet is unrelated to the pathogenesis of acne vulgaris, dismiss as folklore the frequent questions posed by patients and family members as to whether eating greasy foods or chocolate or other sweets is what causes their skin problem. ...
Lymph node dissection overlooked in melanoma.(Dermatology)(Report)
Jun 01, 2008; ... CHICAGO -- Only half of close to 3,000 patients with a positive sentinel lymph node biopsy underwent a completion lymph node dissection in a controversial retrospective analysis of 47,643 patients with invasive melanoma that suggests common practice is falling far short of guidelines. ...
Adherence to guidelines improves melanoma outcomes.(Dermatology)(Clinical report)
Jun 01, 2008; ... CHICAGO -- Adherence to national cancer treatment guidelines was associated with decreased local and regional recurrence, improved disease-free and overall survival, and decreased treatment-associated morbidity in a study of 327 clinically node-negative melanoma patients. A ...
'Closed-loop' insulin delivery is within reach.(Endocrinolosy)
Jun 01, 2008; ... COLUMBUS, OHIO -- A fully functional external "closed-loop" insulin delivery system for patients with diabetes is still down the road, but the availability of continuous glucose monitoring has brought that long-held goal within sight. While "open-loop" insulin pumps have been on ...
Fetuin-A is risk factor for type 2 diabetes in elderly.(Endocrinology)(Report)
Jun 01, 2008; ... COLORADO SPRINGS -- Serum fetuin-A level is an independent risk factor for subsequent development of diabetes in the well-functioning elderly, Dr. Joachim H. Ix said at a conference of the American Heart Association. The burning issue now becomes whether fetuin-A is a modifiable ...
Choose the right patients for continuous monitors.(Endocrinology)
Jun 01, 2008; ... COLUMBUS, OHIO -- Real-time continuous glucose monitoring is likely to become the standard of care for the treatment of type 1 diabetes within the next 5-10 years, but for now it's best to reserve the technology for selected patients, Dr. Irl B. Hirsch said at a meeting on diabetes ...
Timing important when calibrating glucose monitors.(Endocrinology)
Jun 01, 2008; ... SAN FRANCISCO -- The physiological lag between glucose levels in the blood and in interstitial fluid can wreak havoc in continuous glucose monitoring if the lag isn't considered when calibrating the monitors, according to Dr. Howard A. Wolpert. Patients who use continuous ...
Integrated care works best against mental illness.(Psychiatry)
Jun 01, 2008; ... Patients with serious mental disorders will be best served when psychiatrists start thinking like primary care physicians, and primary care physicians start thinking like psychiatrists, experts said at a forum on integrating physical and mental health care. 'There has always ...
Study: integrating mental and physical care serves patients and saves money.(Psychiatry)
Jun 01, 2008 ... Treatment at an integrated behavioral/physical health care clinic not only reduced emergency department admissions among patients with serious mental illness but also saved a health care company $32,000 per patient in psychiatric care costs. The clinic, run by nurse ...
Institute of medicine details geriatric care ills.(Geriatrics)
Jun 01, 2008; ... WASHINGTON -- The U.S. health workforce, including physicians, is "woefully unprepared" to deal with the coming onslaught of aging Americans, according to an Institute of Medicine panel that cited poor training and perverse payment incentives in geriatrics as among the chief problems. ...
Screen for geriatric syndromes in diabetic elderly.(Geriatrics)
Jun 01, 2008; ... SAN FRANCISCO -- Managing blood sugar, lipids, and blood pressure levels in elderly patients with diabetes is important, but don't forget to address their quality of life, Dr. Hermes Florez said at a meeting sponsored by the American Diabetes Association. Be aware of common ...
Diabetes linked to risk, not cause, of Parkinson's.(Geriatrics)(Report)
Jun 01, 2008; ... WASHINGTON -- A history of type 2 diabetes was associated with a 34% higher risk of new-onset Parkinson's disease in older men, but diabetes did not appear to cause Parkinson's, according to data from the Physicians' Health Study. Data from epidemiology studies have suggested a ...
Type 2 diabetes doesn't affect risk of late-life Alzheimer's.(Geriatrics)(Alzheimer's disease)(Report)
Jun 01, 2008; ... WASHINGTON -- Type 2 diabetes did not increase the risk of onset or progression of Alzheimer's disease in older adults, according to results from a study of more than 700 individuals presented in a poster at the annual meeting of the American Geriatrics Society. The prevalences ...
Older patients' stoicism hinders pain management.(Geriatrics)(Report)
Jun 01, 2008; ... ORLANDO -- Despite a high prevalence of chronic pain in older adults, adherence to pain medications is low--fueled largely by patients' stoicism, beliefs about pain and aging, and concerns about safety and addiction, according to Dr. Stephen Thielke, a psychiatrist at the University of ...
Managing pain with Methadone can be complex.(Neurology)
Jun 01, 2008; ... TAMPA -- Methadone is an excellent choice for pain management as long as the drug's prescribing complexities are understood, said two experts at the annual meeting of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association. ...
Fentanyl buccal tablets effective for breakthrough pain.(Neurology)(Report)
Jun 01, 2008; ... ORLANDO -- Fentanyl buccal tablets effectively and safely relieved breakthrough cancer pain in opioid-tolerant cancer patients, according to a multicenter open-label trial presented at the annual meeting of the American Academy of Pain Medicine. Of 197 patients who used the ...
Ten minutes of exercise reduces chronic pain.(Neurology)(Clinical report)
Jun 01, 2008; ... ORLANDO -- A physical conditioning program that consisted of just 10 minutes a day of walking on a treadmill at a moderate pace for 3 weeks significantly improved measures of pain perception, aerobic capacity, depression, and anxiety in chronic pain patients, according to the findings of a ...
RNA in diagnosis and therapy.(GENETICS IN YOUR PRACTICE)(Clinical report)
Jun 01, 2008 ... Ribonucleic acid, or RNA, is often overlooked in discussions of genetics and genomics. Depending on when you last formally studied biology and genetics, you may still think of RNA as a simple messenger that is the intermediary between a gene's deoxyribonucleic acid (DNA) instructions and ...
Newsletter covers FDA drug safety.(Brief article)
Jun 01, 2008 ... The Food and Drug Administration has launched its new online Drug Safety Newsletter. The quarterly publication provides information for health care professionals about selected postmarketing drug safety ...
Extra test boosts cardio assessment.(Cardiovascular Medicine)(Clinical report)
Jun 01, 2008; ... CHICAGO -- The Framingham Risk Score failed to identify a substantial number of people who were at risk for cardiovascular disease events on the basis of their ankle-brachial index, in a review of more than 1,700 asymptomatic people. An ankle-brachial index (ABI) of less than ...
Warfarin gene tests described.(Cardiovascular Medicine)(Brief article)
Jun 01, 2008 ... The American Medical Association has issued the brochure "Personalized Health Care Report 2008: Warfarin and Genetic Testing," which outlines the gene variations that affect warfarin metabolism and response, and ...
Resistant hypertension.(THE EFFECTIVE PHYSICIAN)
Jun 01, 2008; ... Background Resistant hypertension is defined as blood pressure that remains above goal despite the simultaneous use of three antihypertensives from different medication classes. The American Heart Association recently released a guideline to aid physicians in the care of ...
Ratio of sodium to potassium affects CV risk.(Cardiovascular Medicine)(Clinical report)
Jun 01, 2008; ... COLORADO SPRINGS -- The dietary intake ratio of sodium to potassium bears a much stronger association with subsequent development of cardiovascular disease than does consumption of either alone, according to new findings from the Trials of Hypertension Followup (TOPH) Study. "We ...
Dengue fever is increasing in Texas and Florida.(Infectious Diseases)(Report)
Jun 01, 2008; ... MIAMI -- From 1977 to 2004, there were 3,806 suspected cases of dengue imported to the United States, according to the Centers for Disease Control and Prevention. "Many more cases probably go unreported each year because surveillance in the United States is passive and relies on ...
Bubonic plague was surprise culprit.(Infectious Diseases)
Jun 01, 2008; ... WAIKOLOA, HAWAII -- An infamous, deadly disease that killed a large portion of the population of Europe in medieval times can still make rare and disruptive appearances in the modern emergency department. Speaking at a symposium on emergency medicine sponsored by Stanford ...
Neuropsychiatric events added to flu drug's label.(Infectious Diseases)(Brief article)
Jun 01, 2008; ... Information about neuropsychiatric events associated with zanamivir in people being treated for influenza was added to the warnings and precautions section of the antiviral drug's label. The addition reflects postmarketing reports of delirium and abnormal behavior in patients ...
Bariatric surgery leads to bone density decrease: 'we can really do a lot for these patients by just making sure we minimize their risk of falling'.(Gastroenterology)(Clinical report)
Jun 01, 2008; ... SAN FRANCISO -- Weight loss after bariatric surgery induces a drop in bone mineral density and increases the risk for falls and fractures, but it's unclear whether most of theses changes are clinically significant, Dr. Brian N. Sabowitz said. The sparse data that exist tend to ...
Bariatric outcomes tied to surgeon and hospital volume.(Gastroenterology)
Jun 01, 2008; ... Three-year data on surgical patients in Pennsylvania support using surgeon and hospital volume as part of the credentialing process for bariatric surgery centers of excellence, according to a study of 14,716 patients who underwent bariatric surgery in Pennsylvania hospitals from 2000 to ...
Senate targets industry payments to physicians.(Practice Trends)
Jun 01, 2008; ... WASHINGTON -- Drug and device manufacturers came under scrutiny at a recent hearing of the Senate Special Committee on Aging, during which witnesses said payments to high-profile physicians appear to be more of a marketing strategy than an attempt to improve patient care. The ...
Medicare commission flags rising hospice costs.(Practice Trends)
Jun 01, 2008; ... WASHINGTON--Staggering growth in the popularity of hospice services--and in the rise of for-profit hospice providers--has caught the attention of the Medicare Payment Assessment Commission. At their recent meeting, MedPAC commissioners debated the potential impact of rising ...
FDA hiring experts.(POLICY & PRACTICE)(Brief article)
Jun 01, 2008; ... The Food and Drug Administration has begun a multiyear hiring initiative and plans to fill more than 1,300 positions within the next several months--nearly triple the number hired during the period spanning 2005 to 2007, the FDA said. The agency said it plans to hire hundreds of ...
RUC recommendations submitted.(American Medical Association/Specialty Society Relative Value Scale Update Committee)(POLICY & PRACTICE)(Brief article)
Jun 01, 2008; ... The American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) has submitted recommendations on the new Medicare medical home demonstration project to the Centers for Medicare and Medicaid Services. The RUC recommendations are specific to the development of ...
Report: food safety in crisis.(POLICY & PRACTICE)(Brief article)
Jun 01, 2008; ... Approximately 76 million Americans--one in four--are sickened by foodborne illnesses every year, and of these, an estimated 325,000 are hospitalized and 5,000 die, according to a report from the advocacy group Trust for America's Health. Medical care and lost productivity resulting from ...
GAO: prioritize infection control.(Government Accountability Office)(POLICY & PRACTICE)(Brief article)
Jun 01, 2008; ... The federal government is not doing enough to prevent hospital-acquired infections, and the Department of Health and Human Services needs to identify priorities and establish greater consistency in reporting rates, the U.S. Government Accountability Office found in a report. The report, ...
Insurance cost rises fast.(POLICY & PRACTICE)(Brief article)
Jun 01, 2008; ... Americans who get health insurance for their families through their jobs have seen their premiums increase 10 times faster than their incomes in recent years, according to an analysis of government data. The study, supported by the Robert Wood Johnson Foundation and conducted by ...
Part D helps adherence.(POLICY & PRACTICE)(Brief article)
Jun 01, 2008; ... The Medicare Part D drug benefit has made it less likely that elderly beneficiaries will forego basic needs such as food or housing in order to pay for medications, a study published in JAMA found. In addition, the study found a small but significant decrease in cost-related medication ...
Inspired to promote health care in Haiti.(WORLD WIDE MED GLOBAL PERSPECTIVES ON MEDICAL PRACTICE)(Interview)
Jun 01, 2008; ... During a break from an exhausting day of her residency in Atlanta, Dr. Charmaine Lewis stepped into a downtown church near the hospital where she worked in search of some inspiration--and found a new focus. People at the church were passing out flyers to attract volunteers to help with a ...
Indications.
Jun 01, 2008; ... Red Hot Chile Seniors? When it comes to entitlement programs, who can beat Lo Prado, a working-class suburb of Chile's capital city, Santiago? There, the mayor is handing out free 50mg Viagra pills to senior citizens who are doctor certified as suffering from erectile ...