Internal Medicine News back issues from November 2008:
Experts respond to Barrett's guidelines.(News)
Nov 01, 2008; ... ORLANDO -- Screening strategies and treatment approaches for Barrett's esophagus, addressed in clinical practice guidelines released earlier this year by the American College of Gastroenterology, continued to trigger discussion during the college's annual meeting. Screening of ...
Vital signs.
Nov 01, 2008 ... <Pre> Internists Spent More Than 36 Hours Per Week in Direct Patient Care in 2007Mean clinical hours per week Hospitalist: internal medicine (n = 755) 41.8 General ob.gyn. (n = 1,292)38.0 General ...
Subclinical thyroid dysfunction tied to increased mortality; data support 'more aggressive strategy.(News)(Clinical report)
Nov 01, 2008; ... CHICAGO -- Subclinical hyperthyroidism significantly increases the risks of both cardio vascular and all-cause mortality, according to findings from a prospective cohort study. Subclinical hypothyroidism was similarly an independent risk factor for all-cause mortality in the ...
HHS guidelines specify physical activity goals.(News)(Department of Health and Human Services)
Nov 01, 2008; ... Adults who engage in at least 2.5 hours of moderate-intensity aerobic exercise each week and children who are physically active for 1 hour a day can realize "substantial" health benefits, according to guidelines from the U.S. Department of Health and Human Services. Strong ...
Food product allergen labels due for overhaul.(NEWS FROM THE FDA)
Nov 01, 2008; ... College Park, MD. -- Efforts to improve the confusing, inconsistent, and often misleading statements on food packages that indicate a food allergen may be present in the product are underway at the Food and Drug Administration. Manufacturers of food products that contain a major ...
FDA panel backs lasofoxifene for osteoporosis indication.(NEWS FROM THE FDA)
Nov 01, 2008; ... Rockville, MD. -- The majority of a federal advisory panel agreed that the benefits of treatment with lasofoxifene, a selective estrogen receptor modulator, would probably outweigh the risks in some postmenopausal women with osteoporosis. At a meeting of the Food and Drug ...
TNF blockers to carry stronger infection warning.(News)(tumor necrosis factor)
Nov 01, 2008; ... The Food and Drug Administration has announced that it will require warnings about fungal infections in the labels of tumor necrosis factor-[alpha] blockers be strengthened to reflect reports of histoplasmosis and other opportunistic fungal infections, some of which have been fatal. ...
Certain groups of patients can benefit.(Subclinical hypothyroidism: Is there a benefit to treatment?)
Nov 01, 2008; ... Subclinical hypothyroidism, defined as a thyroid-stimulating hormone (TSH) elevation of between 5 and 10 mIU/L and normal free thyroxine (FT4) level, constitutes early hypothyroidism and presents with mild symptoms. But it is not an entirely benign condition. Up to 5% of ...
Little evidence of benefit exists.(Subclinical hypothyroidism: Is there a benefit to treatment?)
Nov 01, 2008; ... Although treating patients with SCH may improve some lipid profiles, there is scanty evidence that it benefits quality of life, cardiovascular health, or mortality. But giving thyroxine to the millions of Americans with questionably elevated TSH levels could put many--especially ...
Revisiting AMD and vitamins.(LETTERS)(Letter to the editor)
Nov 01, 2008 ... I understand the methodology by which Dr. Jon O. Ebbert and Dr. Eric G. Tangalos arrived at their conclusion to suggest that no benefit would be gained from nutritional supplementation in age-related macular degeneration ("Vitamins for Age-Related Macular Degeneration," Mindful Practice, ...
What is normal thyroid function?(Editorial)(Case study)
Nov 01, 2008; ... There "s been a lot of talk these days about "subclinical" thyroid disease, what it means, and who should be treated. So much discussion, in fact, that not only are physicians confused, but also our patients, who read everything on the Internet and don't know what to do. As a ...
Multiple large-vessel events common in Behcet's.(Rheumatology)(Clinical report)
Nov 01, 2008; ... PARIS -- Fully one-quarter of patients with Behcet's syndrome who experience a large-vessel vascular event will have another within 5 years--and the second is typically more severe than the first. This was among the most striking findings of a large Turkish retrospective study ...
Step up foot care in psoriatic arthritis patients.(Rheumatology)
Nov 01, 2008; ... PARIS -- When it comes to psoriatic arthritis, don't forget the feet. The foot is a neglected area of the body in patients with psoriatic arthritis. The burden of foot pain and deformity is high and the level of foot care provision is low, Deborah E. Turner, Ph.D., reported at ...
HPV vaccine's safety trumps concerns about sex.(Adolescent Health)(Clinical report)
Nov 01, 2008; ... Safety, not sexuality, was a key factor in the reluctance of mothers to have their teenage daughters vaccinated against human papilloma virus, according to results of a survey. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices ...
Look for PCOS in teens with oligomenorrhea.(Adolescent Health)(polycystic ovary syndrome)(Brief article)(Clinical report)
Nov 01, 2008; ... NEWPORT BEACH, CALIF. -- Most adolescent girls with infrequent menstruation have treatable polycystic ovary syndrome. A prospective observational study of 229 patients compared 111 adolescents with oligomenorrhea and 118 with secondary amenorrhea. The mean age -in both groups ...
Youth with diabetes have more CV risk factors.(Adolescent Health)(Clinical report)
Nov 01, 2008; ... ROME -- Youth with type 2 diabetes had an average of nearly three cardiovascular risk factors each, compared with just one among healthy controls, in an analysis of 295 participants in a large, multicenter, case-control study. The data come from 106 patients with type 2 diabetes ...
[beta]-cell abnormalities predict type 2 diabetes in obese teens.(Adolescent Health)(Clinical report)
Nov 01, 2008; ... LOS ANGELES -- Impaired [beta]-cell function appears to be one of the earliest signs of type 2 diabetes risk in obese adolescents, according to a study of 60 obese but otherwise healthy teens. Over a 3-year period, 14 (23%) of the teens had a progressive decline in insulin ...
Among adolescents, black females have highest prevalence of overweight.(DATA WATCH)(Statistical table)(Brief article)
Nov 01, 2008 ... <Pre> Among Adolescents, Black Females Have Highest Prevalence of Overweight Males aged 12-19 years Females aged 12-19 years Blacks 17.7%23.8% Mexican ...
Model predicts pain in patients with dementia.(Geriatrics)(Clinical report)
Nov 01, 2008; ... Nursing home residents with dementia are at risk for undiagnosed, underestimated, and undermanaged pain as a result of having difficulty communicating, but an ongoing study suggests that objective assessment of a resident's health status can identify individuals with dementia who are in ...
Chemotherapy beneficial in BRCA1/2 carriers.(Women's Health)(Clinical report)
Nov 01, 2008; ... Stockholm -- Adjuvant chemotherapy appears critical to overcoming adverse prognostic factors for recurrence and survival in women with BRCAl or BRCA2 breast cancer, according to a large prospective study presented at the annual meeting of the European Society for Medical Oncology. ...
Molecular imaging needs lower radiation dose.(Women's Health)
Nov 01, 2008; ... A new way to image breast tumors with a nuclear tracer has shown promise as a more sensitive screen than is conventional mammography in women with dense breasts, who account for about a quarter of all women older than age 40. Molecular breast imaging (MBI) is also less labor ...
Single mammogram plus CAD comparable to double reading.(Women's Health)(computer-aided detection)
Nov 01, 2008; ... Computer-aided detection technology helped a single reader of screening mammography films detect as many cancers as would two readers, but the jury is still out on whether adding such technology to routine screening is cost effective overall, according to a report in the New England ...
Merck drops taranabant, cites psychiatric effects.(Endocrinology)(Clinical report)
Nov 01, 2008; ... Pharmaceutical manufacturer Merck & Co. has stopped developing taranabant, a weight-loss drug, because of concerns over psychiatric side effects, the company announced last month. "Available phase III data showed that both efficacy and adverse events were dose related, with ...
ACP guidelines address osteoporosis therapy.(Endocrinology)(American College of Physicians)(Clinical report)
Nov 01, 2008; ... A new set of osteoporosis treatment guidelines from the American College of Physicians streamlines evidence-based recommendations, potentially making them more useful for busy physicians. The committee that created the document mined hundreds of published studies as the basis of ...
Annual zoledronic acid dose reduces back pain disability.(Endocrinology)(Clinical report)
Nov 01, 2008; ... Washington -- A yearly dose of zoledronic acid significantly reduced the number of days of disability because of back pain in older women with osteoporotic fractures, based on data from the HORIZON Pivotal Fracture study. "Osteoporotic fractures can result in back pain, ...
Suicide risk 15 times higher for PTSD patients.(Psychiatry)(posttraumatic stress disorder)
Nov 01, 2008; ... BARCELONA -- The risk of attempting suicide increases by up to 15 times for patients with posttraumatic stress disorder, compared with those in the general population, a national French mental health survey has found. Although the survey of 36,000 citizens found a low rate of ...
Cognitive therapies beat antidepressant for PTSD.(Psychiatry)(Post-traumatic stress disorder)(Clinical report)
Nov 01, 2008; ... Barcelona -- When given within a month of the precipitating event, cognitive therapy and prolonged exposure therapy are equally effective at decreasing the incidence of posttraumatic stress disorder--and both strategies are significantly more effective than treatment with escitalopram, ...
Extended-release quetiapine maintained antianxiety effects.(Psychiatry)
Nov 01, 2008; ... Phoenix -- The extended-release form of quetiapine, an atypical antipsychotic, worked better than placebo to maintain the antianxiety effects of short-term treatment with the drug in a year-long study of 432 patients. Extended-release (XR) quetiapine (Seroquel) is approved for ...
Skipping elevator at work can lower CV risk.(Cardiovascular Medicine)(cardiovascular )
Nov 01, 2008; ... MUNICH -- "No thanks, I'll take the stairs instead." This was the cry that rang through the corridors of University Hospital, Geneva, last year as physicians and nurses participating in the Geneva stair study eschewed elevators in favor of foot power. The study was ...
Concomitant antiplatelet/NSAID use requires caution.(Cardiovascular Medicine)
Nov 01, 2008; ... Identifying and treating the potentially life-threatening problem of gastrointestinal complications in patients who use the combination of antiplatelet therapy and NSAIDs are the focus of a new scientific statement by the American College of Cardiology Foundation, the American College of ...
Hypertension vigilance called for in diabetics.
Nov 01, 2008; ... New York -- Patient-centered management and early, aggressive treatment of hypertension are necessary in patients with diabetes to address the sevenfold mortality increase in this patient population, according to an updated guidance from the American Society of Hypertension. ...
Low Vitamin D seen as factor in tuberculosis.(Infectious Diseases)(Clinical report)
Nov 01, 2008; ... Kyoto, JAPAN -- The rationale for proposed clinical trials of vitamin D supplementation as adjunctive therapy in tuberculosis--and perhaps in a wide-ranging assortment of other diseases--has origins stretching as far back as the tuberculosis sanatorium movement that originated in Germany ...
FDA approves rapid test to detect Flu.(Infectious Diseases)(Food and Drug Administration )
Nov 01, 2008; ... The Food and Drug Administration approved a new test that can diagnose human influenza infections, including the highly pathogenic influenza A (H5N1) virus, and produce results within 4 hours. The device, known as the Human Influenza Virus Real-Time RT-PCR Detection and ...
Ample supply of tamiflu available for 2008-2009 season.(Infectious Diseases)(Brief article)
Nov 01, 2008; ... A sufficient amount of the prescription antiviral medication oseltamivir will be available throughout the United States during the upcoming flu season, according to a statement released by its manufacturer, Roche. Oseltamivir (Tamiflu) can be distributed to pharmacies with low ...
MRSA types different in hospital and community.(Infectious Diseases)(methicillin-resistant Staphylococcus aureus)
Nov 01, 2008; ... SANTA BARBARA, CALIF. -- Community-acquired methicillin-resistant Staphylococcus aureus is unlike its hospital-acquired cousin epidemiologically, clinically, and genetically, an infectious disease specialist explained. "It is a different organism," Dr. Paul Holtom said at the ...
DNA-based colon ca screen 80% sensitive.(Gastroenterology)(deoxyribonucleic acid)(cancer)(Clinical report)
Nov 01, 2008; ... PHILADELPHIA -- A newly available, noninvasive screening test for colorectal cancer based on detecting a cancer-specific form of DNA had a sensitivity and specificity of greater than 80% in studies with a total of 363 people. The indication for this screening test, known as ...
Chronic hepatitis B.(THE EFFECTIVE PHYSICIAN)(Clinical report)
Nov 01, 2008; ... Background Chronic hepatitis B virus (HBV) infection remains a major public health risk. The Centers for Disease Control and Prevention has released recommendations to guide management of patients with this common viral illness. Conclusions The prevalence ...
Medication confirmed as first choice for GERD.(Gastroenterology)(gastroesophageal reflux disease)
Nov 01, 2008; ... Antisecretory drug therapy should be the first-line treatment for gastroesophageal reflux disease, with antireflux surgery offered only to those whose symptoms are not controlled by medication or who can't tolerate the drugs, according to a new management guideline from the American ...
A colonoscopy screen every 5 years may be safe.(Gastroenterology)(Clinical report)
Nov 01, 2008; ... For patients at average risk for colorectal cancer whose initial screening colonoscopy reveals no abnormalities, an interval of 5 years or longer before the next exam appears to be safe. The 5-year risk of colorectal cancer in such patients is extremely low, and the risk of ...
Community-level efforts target health disparities.(Practice Trends)
Nov 01, 2008; ... Washington -- Simple yet targeted efforts to improve minority patients' access to health care are growing in communities across the nation. Often, language is the first component that needs to be addressed. The first step in Expecting Success, a national project to ...
Short-term service in Fiji yields long-term benefits.(GLOBAL PERSPECTIVES ON MEDICAL PRACTICE)(Interview)
Nov 01, 2008; ... Dr. Howard Homier, an internist in solo practice in Carmichael, Calif, knows firsthand that short-term services can have long-term benefits when it comes to practicing medicine overseas in underserved areas. "I have volunteered at a medical clinic in Mexico," he said. "I was ...
Mass. Medicaid waiver extended.(POLICY & PRACTICE)(Brief article)
Nov 01, 2008; ... The Centers for Medicare and Medicaid Services has granted Massachusetts a 3-year, $21.2 billion Medicaid waiver that will allow the state to continue to expand access to care through its health reform law. The agreement represents a $4.3 billion increase over the current waiver and fully ...
Cephalon pays $425 million.(POLICY & PRACTICE)(Brief article)
Nov 01, 2008; ... Cephalon Inc. has agreed to pay more Indian $425 million to settle claims that it inappropriately marketed three drugs for off label uses, according to the U.S. Justice Department. The settlement will resolve civil and criminal complaints alleging that the company marketed Gabitril ...
Consumers like flat Rx pricing.(POLICY & PRACTICE)(Brief article)
Nov 01, 2008; ... Pharmacy customers who take advantage of flat-rate generic prescription drug prices have higher levels of satisfaction than those who don't, according to the second annual J.D. Power and Associates National Pharmacy Study. Nearly one-fourth of pharmacy customers participate in a [section]4 ...
Nationwide RAC launched.(POLICY & PRACTICE)(Brief article)
Nov 01, 2008; ... CMS has launched its national recovery audit contractor program as part of its "aggressive new steps to find and prevent waste, fraud and abuse in Medicare." The new RACs, which will be paid on a contingency fee basis, soon will begin to contact providers about the program, CMS said. The ...
Many drug studies unpublished.(POLICY & PRACTICE)(Brief article)
Nov 01, 2008; ... Studies on new prescription drugs are less likely to be published if they conclude that the medication is ineffective, researchers reported in the journal PLoS Medicine. The researchers found that only 43% of all clinical trials submitted to the Food and Drug Administration to support drug ...
Florida files Vioxx suit.(POLICY & PRACTICE)
Nov 01, 2008; ... Florida Attorney General Bill McCollum has sued Merck & Co. on behalf of state agencies he said were damaged by "the company's allegedly deceptive marketing and promotion" of Vioxx. The lawsuit follows a 3-year investigation of Merck's promotional practices of Vioxx (rofecox-ib) and ...
HHS committee calls for medical home funding.(Practice Trends)(Health and Human Services )
Nov 01, 2008; ... Support for the concept of the patient-centered medical home continues to grow, with the latest nod coming from the federal Advisory Committee on Training in Primary Care Medicine and Dentistry. The committee, which provides policy advice to Congress and the Health and Human ...
Health insurance premiums rose 5% in 2008.(Practice Trends)(Survey)(Brief article)
Nov 01, 2008; ... The average employer-sponsored health insurance premium rose 5% from 2007 to 2008, with average premiums for family coverage reaching $12,680, according to a report from the Kaiser Family Foundation and the Health Research and Educational Trust. While experts said the 1-year ...
CMS puts drug acquisition program on hold.(Practice Trends)
Nov 01, 2008; ... Medicare officials have pulled the plug at least temporarily on their Competitive Acquisition Program for Part B drugs. The program was put on hold because of "contractual issues" with the successful vendor bidders for the 2009 cycle of the program. The Competitive Acquisition ...
Document warnings before firing bad employees.(Practice Trends)
Nov 01, 2008; ... MIAMI -- A "progressive discipline" system of warnings and suggestions for improvement before firing an underperforming employee maximizes chances of winning a wrongful termination lawsuit, according to a labor and employee attorney. In addition, perform regular and honest performance ...
CME may slip without commercial funding.(Practice Trends)(continuing medical education)
Nov 01, 2008; ... Washington -- Without pharmaceutical industry funding, continuing medical education is in danger of faltering, said a group of CME providers, several physicians, and a medical journal editor at a forum held this fail. The forum--designed to educate Capitol Hill staffers--was ...
Drugmakers to disclose payments.(Practice Trends)
Nov 01, 2008 ... Two pharmaceutical companies will begin publicly disclosing how much each pays physicians. Eli Lilly & Co. was the first company to step forward, followed a day later by Merck & Co. Lilly is starting a registry that will compile payments to physicians who have served ...
When the (only a) moment is right.(INDICATIONS)(Brief article)
Nov 01, 2008; ... Despite long being popularly perceived as a major concern for men, premature ejaculation did not have an evidence-based definition until earlier this year, when the International Society for Sexual Medicine (ISSM) presented the conclusion of a panel of world-class sexual health experts. To ...
From the national enquirer dept.(INDICATIONS)(Brief article)
Nov 01, 2008; ... A Greek girl, aged 9 years, was recently taken to a hospital with stomach pains. Doctors at Larissa General Hospital in central Greece surgically removed a 2-inch-long growth, and the girl made a full recovery. Upon biopsy, however, the doctors concluded that the tumor was in fact the ...
From the big brother research dept.(INDICATIONS)(Brief article)
Nov 01, 2008; ... Speaking of markets and consumers, a couple of West Coast firms are adapting brain-scanning technology to gain insight into how people react to advertisements, computer games, and even presidential candidates. The companies use EEG sensors to correlate brain activity with physiological ...
From the that 70s lifesaver dept.(INDICATIONS)
Nov 01, 2008; ... Last but not least, in mind-bending research, the world recently learned that the Bee Gees still rule. Yes, their iconic 1977 disco smash "Stayin' Alive" has been shown to help heart patients do just that, according to research presented at the American College of Emergency Physicians ...
Prostate cancer treatment guides.(FYI)(Brief article)
Nov 01, 2008 ... The Agency for Healthcare Research and Quality has released two new plain-language guades on the treatment of prostate cancer. The guide for clinicians is titled "Treatments for Clinically Localized Prostate Cancer," and the publication aimed at consumers is called "Treating Prostate ...
Youth substance use awareness.(FYI)(Brief article)
Nov 01, 2008 ... A report from the 2006 National Survey on Drug Use and Health has found that youth substance use is higher among one-parent households, particularly father-child pairs, than it is in two-parent households. Awareness of youth substance use ...
Videos on helping heavy drinkers.(FYI)(Brief article)
Nov 01, 2008 ... The National Institute on Alcohol Abuse and Alcoholism has released "Video Cases: Helping Patients Who Drink Too Much." This course for clinicians demonstrates strategies that can be used to screen patients for heavy drinking and to help them cut ...
Pain relievers.(Cartoon)
Nov 01, 2008 ... "Can I come along? I need ...
PPV immunization urged for smokers.(News)(pneumococcal polysaccharide vaccination)
Nov 15, 2008; ... ATLANTA -- Cigarette smoking in adults aged 19-64 years should be considered an indication for 23-valent pneumococcal polysaccharide vaccination, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention decided at its fall meeting. ...
Vital signs.
Nov 15, 2008 ... Projected U.S. Health Expenditures (in trillions of dollars) Note: ...
Medicare bonus to push e-prescribing beginning in 2009: average reward pegged at $2,000-$3,000.(News)
Nov 15, 2008; ... BOSTON -- "E-prescribing saves lives, it saves money, and it's time we implement it," according to Health and Human Services Secretary Mike Leavitt. Streamlining the bloated health care system "is an economic imperative for our country. We have to get down to making the system ...
Bisphosphonates not tied to atrial fib, FDA finds.(News)(Food and Drug Administration)
Nov 15, 2008; ... A Food and Drug Administration safety review of bisphosphonates has not found a clear association between bisphosphonate therapy and atrial fibrillation, the agency announced. "Based on the data available at this time, health care professionals should not alter their prescribing ...