Internal Medicine News back issues from February 2009:
Amyloid theory sputters for AD.(NEWS)(Alzheimer's disease)(Report)
Feb 01, 2009; ... The amyloid hypothesis isn't dead, but it seems to be limping a bit in the race for an Alzheimer's cure. Some researchers who predicted 5 years ago that an antiamyloid disease-modifying therapy was imminent are now reevaluating that optimism--including the geneticist who first ...
Breast cancer decline linked to HT cessation: new WHI data affirm hormonal link.(NEWS)(hormone therapy)(Report)
Feb 01, 2009; ... SAN ANTONIO - Two new statistical analyses of Women's Health Initiative data persuasively indicate that the recent abrupt decline in breast cancer incidence in the United States is attributable to a dramatic drop in the use of estrogen-plus-progestin menopausal hormone therapy, and not--as ...
Myelodysplastic syndrome 'severely underestimated'.(NEWS)(Report)
Feb 01, 2009; ... SAN FRANCISCO -- Myelodysplastic syndrome is far more common than previous estimated, and patients with this blood disorder tend to be older and sicker than the general Medicare population, based on an analysis of claims by more than 1.7 million Medicare enrollees. Each year, ...
Most states allow deductions for health savings account contributions.(VITAL SIGNS)
Feb 01, 2009 ... Note: 2008 data from Thomson West's Health Policy ...
Oral contraceptives linked to vascular stiffness.(NEWS)(Report)
Feb 01, 2009; ... NEW ORLEANS -- The use of an oral contraceptive for at least 10 years was associated with increased carotid and femoral pulse wave velocity, a marker of increased vascular damage and arterial stiffness, in a study of about 1,300 women. "In light of the widespread and usually ...
Epilepsy drug warnings to add suicidal ideation.(NEWS)
Feb 01, 2009; ... The Food and Drug Administration has directed physicians to inform patients taking anticonvulsant medications that the drugs have the potential to increase suicidal thoughts and behavior. Families and caregivers should also be notified of this risk so that they can be attuned to ...
CV risk studies encouraged for diabetes drugs.(NEWS)(cardiovascular diseases)
Feb 01, 2009; ... The Food and Drug Administration has issued new guidance to manufacturers of type 2 diabetes therapies seeking more information on how the products may increase or decrease the risk of cardiovascular comorbidities. The agency mailed letters to several dozen manufacturers and ...
IOM outlines ways to improve adolescent care.(NEWS)(Institute of Medicine)
Feb 01, 2009; ... Health care services for adolescents are fragmented, leaving gaps in care that "safety-net" resources cannot fill, especially for those who are uninsured or vulnerable to risky behavior or poor health, according to a report issued by the Institute of Medicine and the National Research ...
Suicidality report: more harm than good?(Editorial)
Feb 01, 2009; ... For years, we've had scientifically sound data telling us that patients with epilepsy have an increased risk of depression. But the recent federal warning of an increased risk of suicidal ideation in patients on antiepileptic drugs is based on much less rigorous data, and could do more ...
Pain relievers.(Cartoon)
Feb 01, 2009 ... "That's my ...
Seeking Rx for e-prescribing.(LETTERS)(Letter to the editor)
Feb 01, 2009; ... My practice has implemented Sure-Scripts in preparation for the 2009 Medicare bonus for e-prescribing ("Medicare Bonus to Push E-Prescribing Beginning in 2009," Nov. 15, 2008, p. 1). However, I have not been able to find out how to communicate with Medicare about this or how to ...
Skepticism about ezetimibe persists.(LETTERS)(Letter to the editor)
Feb 01, 2009; ... Your article on ezetimibe and cancer missed a crucial point ("Cancer Concerns Over Ezetimibe Linger for Some," Oct. 1, 2008, p. 6). The SEAS trials reported an increase in total cancer, and especially in fatal cancers. In a thinly disguised attempt at damage control, the Oxford Clinical ...
'Self-embedding' of foreign objects reported.(ADOLESCENT HEALTH)
Feb 01, 2009; ... Chicago -- Radiologists have reported cases of self-mutilation by adolescents involving the deliberate embedding of foreign objects such as paper clips, staples, and pieces of glass into soft tissues of the arms, hands, feet, and ankles. The behavior, which exceeds in severity ...
Teenage menstruation: what's normal and what's not?(ADOLESCENT HEALTH)
Feb 01, 2009; ... STANFORD, CALIF. -- A teenage patient complains of "heavy" menstrual periods. Her mother mentions that her daughter never gets periods during soccer season. Should you evaluate the girl for abnormal uterine bleeding? Or is a bit of hand-holding going to be enough in this ...
Endoscopic resection of Barrett's safe, effective.(GASTROENTEROLOGY)
Feb 01, 2009; ... ORLANDO -- Endoscopic mucosal resection of Barrett's esophagus can provide a safe and effective alternative to esophagectomy, according to a retrospective study of long-term clinical experience at the University of Chicago Medical Center. The endoscopic technique also allows ...
Guidelines survey psoriatic arthritis treatments.(RHEUMATOLOGY)(Report)
Feb 01, 2009; ... FORT LAUDERDALE, FLA. -- An international group of dermatologists and rheumatologists has published new recommendations for the treatment of the heterogeneous manifestations of psoriatic arthritis, but they caution that randomized data remain sparse and the recommendations may change as ...
After years of decline, RA on the rise among women.(RHEUMATOLOGY)(rheumatoid arthritis)
Feb 01, 2009; ... SAN FRANCISCO -- An unexpected, significant uptick in rheumatoid arthritis incidence among women may point to increased exposure to hormonal and environmental risk factors, although investigators remain unsure of a clear explanation. "What we had seen over the last 50 years was ...
Fitness can reduce mortality in diabetes.(ENDOCRINOLOGY)(Report)
Feb 01, 2009; ... MUNICH -- Middle-aged men with type 2 diabetes can reduce their long-term mortality risk by roughly 14% for each 1-MET increase they achieve in peak exercise capacity through improved physical fitness, according to a large epidemiologic study. The findings provide a persuasive ...
Glycemia management in type 2 diabetes.(THE EFFECTIVE PHYSICIAN)
Feb 01, 2009; ... Background Last month, a consensus panel representing the American Diabetes Association and European Association for the Study of Diabetes published revised recommendations for management of hyperglycemia in patients with type 2 diabetes (INTERNAL MEDICINE NEWS, Jan. 15, 2009, ...
Weekly exenatide improves multiple CV risks.(ENDOCRINOLOGY)(cardiovascular diseases)(Report)
Feb 01, 2009; ... NEW ORLEANS -- Exenatide, in a novel once-weekly formulation, resulted in simultaneous improvements in blood pressure, lipid levels, and body weight as well as glycemic control in a year-long study in 241 type 2 diabetic subjects. These multiple metabolic improvements were of ...
Emergence of C. gattii in Northwest kills four.(INFECTIOUS DISEASES)(Cryptococcus gattii)
Feb 01, 2009; ... WASHINGTON -- Cryptococcus gattii, a meningitis-causing fungus previously confined to tropical and subtropical climates outside of the United States, has caused severe illness in at least 19 individuals--of whom 4 died--in the Pacific Northwest United States since 2006. The ...
Antipsychotics may boost Alzheimer's mortality.(NEUROLOGY)
Feb 01, 2009; ... Antipsychotics appeared to increase the risk of death in patients with Alzheimer's disease, especially if taken for more than 12 months, in a randomized controlled trial. Nursing home patients with Alzheimer's who continued taking the drugs for 1 year were 7% more likely to die ...
Genetics in your practice 2008: year of the GWAS.(MEDICAL GENETICS)(genome-wide association studies)
Feb 01, 2009; ... Finding a needle in a haystack is a favorite metaphor of geneticists for describing the process of connecting a disease to a gene or genetic marker. For many years, gene hunters have used family-based linkage studies of large, multi-generational families to successfully pair hundreds of ...
Hibiscus tea lowers BP in clinical trial.(CARDIOVASCULAR MEDICINE)(blood pressure)
Feb 01, 2009; ... NEW ORLEANS -- Quaffing three cups of hibiscus tea daily for 6 weeks resulted in a mean 7.2-mm Hg reduction in systolic blood pressure in mildly hypertensive or prehypertensive adults in a randomized, double-blind, placebo-controlled trial. "This suggests regularly incorporating ...
Metabolic syndrome ups PAD risk in women.(CARDIOVASCULAR MEDICINE)(peripheral artery disease)
Feb 01, 2009; ... NEW ORLEANS -- Women with metabolic syndrome have an increased risk of developing symptomatic peripheral artery disease, mediated mainly by the syndrome's associated inflammation and endothelial activation, according to a study of more than 27,000 women. "The bottom line is if ...
Policy & practice.(PRACTICE TRENDS)
Feb 01, 2009; ... FDA Posts Guidance on Handouts The Food and Drug Administration has issued updated guidance for manufacturers that distribute journal articles or other scientific publications concerning off-label uses for their FDA-approved drugs, devices, or biologies. Guidance doesn't carry ...
MedPAC proposes 1.1% fee increase for 2010.(PRACTICE TRENDS)(Medicare Payment Advisory Commission)
Feb 01, 2009; ... WASHINGTON -- Medicare advisers unanimously voted to recommend increasing physician fees by 1.1% next year, while expressing dismay that their June 2008 recommendation to boost primary care pay has not yet been acted upon. The Medicare Payment Advisory Commission--better known ...
CMS will expand coverage for initial PET scans.(PRACTICE TRENDS)(Centers for Medicare and Medicaid Services, positron emission tomography)
Feb 01, 2009; ... Medicare officials are preparing to expand the coverage of positron emission tomography for initial diagnostic testing in individuals with suspected solid tumors. Under a proposed national coverage determination issued by the Centers for Medicare and Medicaid Services, Medicare ...
CT colonography endorsed, with caveats.(PRACTICE TRENDS)(computed tomographic )
Feb 01, 2009; ... BALTIMORE -- A panel of Medicare advisers has tentatively expressed support for the use of computed tomographic colonography to screen for colorectal cancer in average-risk Medicare beneficiaries. Based on an overview of existing evidence on sensitivity, specificity, and cost ...
Buoyed by faith in Niger: global perspectives on medical practice.(WORLD WIDE MED)(Kate Venable)(Interview)
Feb 01, 2009; ... "I just can't seem to stay in the U.S.," Dr. Kate Venable said. A love for the poor and a strong Christian faith combined to inspire her to plan a medical career practicing overseas. Dr. Venable first felt called to overseas medical mission work during a trip to the Dominican Republic with ...
Medicare PHR test launched in two states.(PRACTICE TRENDS)(personal health records, Arizona and Utah)
Feb 01, 2009; ... Medicare and Medicaid beneficiaries living in Arizona and Utah are among the first to test-drive a pilot program that lets them access their personal health records online. They also can add pertinent information such as their medications, preexisting conditions, and lab ...
Indications.
Feb 01, 2009; ... Hallucination Nation ... British researchers report that a high intake of caffeine--more than the equivalent of seven cups of instant coffee a day--may cause you to hear voices and see things that aren't there. The authors from Durham University (England) say "high caffeine ...
Survivor care key after breast cancer.(NEWS)
Feb 15, 2009; ... Breast cancer survivors are more likely to receive recommended care when they see both an oncology specialist and a primary care physician, data from a study of trends in survivor care between 1998 and 2002 in nearly 24,000 survivors suggest. Claire F. Snyder, Ph.D., of Johns ...
Third treatment for fibromyalgia gets FDA approval: milnacipran to be available by March.(NEWS)(United States Food and Drug Administration)
Feb 15, 2009; ... Milnacipran, a norepinephrine-serotonin reuptake inhibitor, has been approved by the Food and Drug Administration for the management of fibromyalgia in adults, the third drug approved for this indication. Approval was based on the results of two phase III studies of a total of ...
Online tool makes family history a living document.(NEWS)
Feb 15, 2009; ... A revised high-tech tool from the Department of Health and Human Services may make filling out a pre-exam checklist in the doctor's office obsolete, if doctors and patients will use it. "We know that a large percentage of our risk for developing certain diseases is related to ...
Vital signs.(women physicians)(Statistical table)(Brief article)
Feb 15, 2009 ... <Pre> Percentage of Physicians Who Are Women (Active physicians by specialty, 2007) Geriatric medicine43.7% Endocrinology, diabetes, and metabolism 35.2% Rheumatology 32.9% Internal medicine...
Good physical health boosts survival after breast cancer.(NEWS)
Feb 15, 2009; ... SAN ANTONIO--Breast cancer survivors with poor physical health, particularly those with limited physical activity, have a worse prognosis than those with adequate physical health, based on the results of a study of almost 3,000 survivors followed for 6 years. "Approximately 40% ...
Americans' mental health needs unmet, report says.(NEWS)(National Survey on Drug Use and Health)
Feb 15, 2009; ... Just 45% of the 24 million U.S. citizens who experienced serious psychological distress in the past year received any kind of mental health services for their symptoms, a new national report has found. Young adults bore much of the burden of untreated illness, according to the ...
The nation's health care is 'poor,' ACP says.(NEWS)(American College of Physicians)
Feb 15, 2009; ... Expansion of the primary care workforce is necessary to improve the "poor" state of the nation's health care, according to Dr. Jeffrey P. Harris, president of the American College of Physicians. "We have too many uninsured. We have too few primary care physicians. We spend more ...
Advisory says use topical anesthetic with caution.(NEWS)
Feb 15, 2009; ... The use of topical lidocaine products to mitigate pain during mammograms and other medical tests has the potential to cause life-threatening events, according to a public health advisory issued by the Food and Drug Administration. "Before recommending a topical anesthetic for ...
Ranolazine label has new claims, fewer restrictions.(NEWS)
Feb 15, 2009; ... The Food and Drug Administration has approved a revised indication and several label additions for the angina drug ranolazine, including a statement that the drug reduced hemoglobin [A.sub.1c] in people with diabetes. The indication is still for "the treatment of chronic angina, ...
FDA review backs ezetimibe and simvastatin combination.(NEWS)(United States Food and Drug Administration)
Feb 15, 2009; ... After a year-long review of data from the ENHANCE trial that showed no significant difference in the changes in carotid artery thickness between patients treated with ezetimibe and simvastatin, vs. simvastatin alone, the Food and Drug administration has concluded that patients should not ...
Correction.(Correction notice)
Feb 15, 2009 ... In "Low-Dose Colchicine Effective for Acute Gout" (Jan. 15, 2009, p. 12), the total ...
Of pens, mugs, and transparency.(Physician Payments Sunshine Act of 2008)(Editorial)
Feb 15, 2009; ... With the continuing public push for more transparency from government and corporations, three pharmaceutical companies have decided to begin online registries in 2009 that list payments to physicians who perform service to the company as educational speakers, clinical trial principal ...
Funding by industry biases research.(Does pharmaceutical industry funding bias research?)
Feb 15, 2009; ... Industry-sponsored studies, when published in peer-reviewed journals, are four times more likely to be favorable to the sponsor's drug, device, or treatment than are non-industry sponsored studies, according to a meta-analysis of 30 studies (BMJ 2003;326:1167-71). An analysis ...
Non-industry funded research can be biased, too.(Does pharmaceutical industry funding bias research?)
Feb 15, 2009; ... For almost 100 years, industry has been a powerful motivating force in the creation of new technology and the underwriting of scientific research. But in the last 2 decades, there has been a campaign to decry industry funding, claiming that such funding is tainting research. It ...
Combination score flags stroke risk after TIA.(NEUROLOGY)(transient-ischemic-attack)
Feb 15, 2009; ... CHICAGO--A low ABC[D.sup.2] score identified transient-ischemic-attack patients at low risk for having an early disabling stroke, but it was suboptimal at identifying more minor strokes in a prospective, multicenter study of 1,667 patients. Early diffusion-weighted MRI (DWMRI) ...
Many adults turn to CAM for chronic pain relief.(NEUROLOGY)(complementary and alternative medicine)
Feb 15, 2009; ... About 38% of adults and nearly 12% of children in the United States used some type of complementary or alternative medicine therapy in 2007, according to survey data released by the Centers for Disease Control and Prevention and the National Institutes of Health. Adults ...
Permanently disabling MS attacks uncommon.(NEUROLOGY)(multiple sclerosis)(Brief article)
Feb 15, 2009; ... SALT LAKE CITY--The risk of permanent disability from a multiple sclerosis attack is extremely rare and does not appear to be tied to drug holidays, data on more than 1,000 MS patients showed. A catastrophic attack of multiple sclerosis is feared by patients and physicians ...
Severe, sudden acne calls for initial prednisone.(DERMATOLOGY)
Feb 15, 2009; ... LAS VEGAS--Profoundly severe, sudden-onset acne in adolescents should be treated right away, Dr. Fred Ghali said. These patients exhibit inflammatory and ulcerative acne lesions, often with large, nodular cysts, Dr. Ghali said at a dermatology seminar sponsored by Skin Disease ...
Dapsone gel can now be used for acne.(DERMATOLOGY)
Feb 15, 2009; ... LAS VEGAS--After years of delay, topical dapsone gel 5% can now be prescribed for patients with mild to moderate acne, marking the first new chemically based drug treatment for acne in a decade. A sulfone drug, Aczone 5% gel has anti-inflammatory and antimicrobial properties ....
Think efficacy, toxicity when treating psoriasis.(DERMATOLOGY)
Feb 15, 2009; ... PARIS--Nonbiologic systemic drugs can be effective choices for the treatment of psoriasis if they are chosen properly, according to Dr. Jonathan Barker. Traditional systemic drugs work but are not always effective, and are often associated with considerable toxicity, he said at ...
Value of skin cancer screenings lacks evidence.(DERMATOLOGY)
Feb 15, 2009; ... The U.S. Preventive Services Task Force still cannot recommend for or against whole-body skin examination by a primary care physician or by patient self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general ...
Letrozole beats tamoxifen in breast cancer trial: a switch back to tamoxifen for the remainder of their 5 years would not compromise their outcome.(WOMEN'S HEALTH)
Feb 15, 2009; ... SAN ANTONIO -- Updated results of the landmark Breast International Group 1-98 trial suggest that overall survival in breast cancer patients is superior with 5 years of adjuvant letrozole, compared with tamoxifen. The 13% reduction in mortality risk in the letrozole (Femara) ...
Gail model inaccurate in women with atypical hyperplasia.(WOMEN'S HEALTH)(Report)
Feb 15, 2009; ... SAN ANTONIO--The widely used Gail model proved no better than a coin toss in predicting breast cancer risk in individual women with atypical hyperplasia on a benign breast biopsy, a case-control study has shown. "The Gail model couldn't separate who was going to go on to breast ...
Lobular involution may protect against breast Ca.(WOMEN'S HEALTH)(breast cancer)(Report)
Feb 15, 2009; ... SAN ANTONIO--Young women with a benign breast biopsy showing complete lobular involution are at below-average risk of future breast cancer, according to a large prospective Mayo Clinic study. This finding--that lobular involution constitutes a novel protective factor against ...
Gamma imaging can identify occult breast Ca.(WOMEN'S HEALTH)(breast cancers )(Report)
Feb 15, 2009; ... CHICAGO--Breast-specific gamma imaging can detect additional breast cancers missed by mammography and physical examination in women with newly diagnosed breast cancer. In a retrospective study in 159 women with at least one biopsy-proven cancer, follow-up breast-specific gamma ...
Breast Ca survival tied to hormone therapy.(WOMEN'S HEALTH)
Feb 15, 2009; ... SAN ANTONIO--Breast cancer patients who used menopausal hormone therapy before their diagnosis had a reduced breast cancer mortality, compared with never-users of hormone therapy, in the large epidemiologic California Teachers Study. Users of estrogen plus progestin hormone ...
IBD better understood, still a clinical challenge.(GASTROENTEROLOGY)(inflammatory bowel disease )(Disease/Disorder overview)
Feb 15, 2009; ... FORT LAUDERDALE, FLA.--Despite greater understanding of genetic influences and phenotypic manifestations and the availability of multiple immunomodulatory medications, inflammatory bowel disease continues to pose significant clinical challenges. "Classically, in inflammatory ...
AAA screen warranted in men with TIA or stroke.(CARDIOVASCULAR MEDICINE)(abdominal aortic aneurysm)(transient ischemic attack )(Report)
Feb 15, 2009; ... CHICAGO--One of the every nine men over age 59 years with a diagnosis of stroke or transient ischemic attack had an abdominal aortic aneurysm in a prospective study of 499 patients. Among all patients admitted for stroke or TIA, the prevalence of abdominal aortic aneurysm (AAA) ...
Intake of non-soy legumes tied to lower cholesterol.(CARDIOVASCULAR MEDICINE)
Feb 15, 2009; ... NEW-ORLEANS--A diet that includes regular consumption of non-soy legumes provides clinically meaningful lipid lowering in hypercholesterolemic individuals, a meta-analysis indicates. The meta-analysis included 298 dyslipidemic adults not on lipid-lowering drugs who participated ...
Genetic factors, PPIs may alter effectiveness of clopidogrel.(CARDIOVASCULAR MEDICINE)
Feb 15, 2009; ... The Food and Drug Administration said that Sanofi-Aventis and Bristol-Myers Squibb Co. have agreed to conduct studies to better characterize the effectiveness of clopidogrel (Plavix) in patients with certain genetic factors. The two manufacturers also said they will lead clinical trials to ...
Eating fruits and vegetables improves endothelial function.(CARDIOVASCULAR MEDICINE)
Feb 15, 2009; ... NEW ORLEANS--Every portion of fruits and vegetables eaten per day improves vascular endothelial function by an additional 6.2% in dose-dependent fashion. This finding from a randomized, controlled study provides a mechanistic explanation for the previously reported lower rates ...
Depression plus comorbidities not targeted.(PSYCHIATRY)
Feb 15, 2009; ... RIO GRANDE, P.R.--Primary care physicians don't appear to treat depression any more aggressively in patients who have medical comorbidities, compared with other patients, despite mounting evidence showing that depression may lead to worse medical outcomes. The conclusions were ...
In mentally Ill, CVD more deadly than suicide.(PSYCHIATRY)(Brief article)
Feb 15, 2009; ... CHICAGO--Death due to cardiovascular disease dwarfs suicide as a cause of total years of potential life lost among patients with major mental illness, according to a five-state study. Even though suicide is less common than cardiovascular disease, it tends to occur at a younger ...