Internal Medicine News back issues from March 2009:
Experts divided on FDA review of tests.(NEWS)(Food and Drug Administration)
Mar 01, 2009; ... Whether or not the Food and Drug Administration falls short in regulating diagnostic tests for cancer and other diseases depends on whom you ask. Talk to a pathologist who performs diagnostic tests, and you may hear that everything is generally okay. "Clinical labs ...
Guidelines focus on using opioids for chronic pain: screening and assessment tools available.(NEWS)
Mar 01, 2009; ... New guidelines on opioid treatment of chronic noncancer pain address the burgeoning use of opioids for this indication and provide evidence-based recommendations geared toward both primary care physicians and subspecialists. Released by the American Pain Society (APS) and the ...
Economic stimulus law will strengthen health it.(NEWS)
Mar 01, 2009; ... The newly enacted economic stimulus law will infuse tens of billions of dollars into the health care sector, providing incentives for using health information technology, increasing funds for primary care training, and launching initiatives in comparative effectiveness research. ...
Vital signs.(Statistical table)(Brief article)
Mar 01, 2009 ... <Pre> The Nation's Health Care Dollar: Where It Went in 2007 Hospitals 31% Physicians and clinics 21% Prescription drugs 10% Administration 7% Nursing homes6% Other 25% Note: ...
FDA to require risk Strategy for some opioids.(NEWS)(Food and Drug Administration)
Mar 01, 2009; ... A risk-management plan will be required to address the ongoing problems of inappropriate prescribing, misuse, abuse, and accidental overdoses of certain opioid medications, the Food and Drug Administration recently announced. The agency announced that letters had been sent to 16 ...
Primary care needs real change.(EDITORIAL)
Mar 01, 2009; ... For "real change" to be more than a political sound bite, the new administration in Washington will need vision and courage to promote and sustain high-quality and affordable health care. Part of that vision will need to be a strong primary care workforce. Our system of medical ...
Time for hard choices.(EDITORIAL)
Mar 01, 2009; ... When it comes to health care reform, one thing no one argues about is that costs will need to be cut. If President Obama and Congress want to insure more people, the money will have to be spent more efficiently. Unfortunately, however, cutting costs, especially physician ...
Boys and girls should be vaccinated.(Is universal vaccination of boys the next step in fighting HPV?)
Mar 01, 2009; ... Widespread immunization of girls and boys against the human papillomavirus could fully eradicate types 16 and 18 of the virus. If we miss half the equation by leaving the boys out of our vaccination strategy, that type of public health success will not be possible. The benefits ...
The evidence needs time to mature.(Is universal vaccination of boys the next step in fighting HPV?)
Mar 01, 2009; ... The issue of immunizing males against HPV often comes down to whether they should receive the vaccine to protect females. Doing so is honorable and even reasonable, but at this point there is little evidence suggesting that this is cost effective. Early cost-benefit analyses of ...
Look for rheumatic disease in ILD patients.(PULMONARY MEDICINE)(interstitial lung disease)(Report)
Mar 01, 2009; ... SAN FRANCISCO--Clinicians detected underlying rheumatic disease in 17 of 28 patients referred to a multidisciplinary clinic for interstitial lung disease. The evaluations changed the diagnosis in 11 of the 28 patients, including 4 of 15 who had been referred for idiopathic ...
Expert offers natural ways to treat respiratory diseases.(PULMONARY MEDICINE)(Report)
Mar 01, 2009; ... SAN DIEGO--Taking an integrative holistic medical approach to treating respiratory disease requires addressing the patient's environment, immune system balance, and emotional health. At a meeting sponsored by the Scripps Center for Integrative Medicine and the American Board of ...
With foot checks, walking safe for diabetics.(ENDOCRINOLOGY)(Report)
Mar 01, 2009; ... RIO GRANDE, P.R.--Exercise does not increase foot ulcer rates in adults with diabetic peripheral neuropathy, based on data from 79 adults aged 50 years and older. The American Diabetes Association recommends moderate physical activity for people with diabetes, but the ...
Heredity strongly influences insulin clearance.(ENDOCRINOLOGY)(Report)
Mar 01, 2009; ... Insulin clearance is a highly heritable trait that has now been tracked to specific regions of two chromosomes, a finding that may have important implications for risk assessment in diabetes, polycystic ovary syndrome, and metabolic syndrome. Although it has been "virtually ...
Midlife diabetes diagnosis doubles dementia risk.(ENDOCRINOLOGY)(Report)
Mar 01, 2009; ... A midlife diagnosis of diabetes increases the risk of developing Alzheimer's disease and vascular dementia, based on results of a twin study including more than 13,000 individuals. Previous studies have shown that people with diabetes are at increased risk for dementia, but ...
Return to normal glucose tolerance reaps CV benefits.(ENDOCRINOLOGY)(cardiovascular)(Report)
Mar 01, 2009; ... Patients who revert from impaired to normal glucose tolerance, especially those who do so via intensive lifestyle modification, can significantly reduce their cardiovascular risk factors, according to an analysis of data from the Diabetes Prevention Program. The Diabetes ...
U.S. prevalance of diabetes and prediabetes reaches new high.(ENDOCRINOLOGY)(Survey)
Mar 01, 2009; ... More than 40% of American adults aged 20 years and older have hyperglycemic conditions, according to review of data from the 2005-2006 National Health and Nutrition Examination Survey. In this study, Catherine Cowie, Ph.D., of the National Institutes of Health and her colleagues ...
Physical activity can affect genetic tendency to obesity.(ENDOCRINOLOGY)(Report)
Mar 01, 2009; ... Individuals who are genetically predisposed to obesity can prevent weight gain by being physically active, according to findings from a Finnish study of young adult twins. The investigation involved more than 4,000 monozygotic and dizygotic twins, aged 22-27 years (average age ...
First FDA-approved chemo agent turns 60.(ONCOLOGY)(Food and Drug Administration)
Mar 01, 2009; ... "The response of the first patient was as dramatic as that of the first mouse. ... Within 48 hours after the initiation of therapy, a softening of the tumor masses was detected. It soon became obvious that this was not just wishful thinking."--Alfred Gilman, Ph.D., "The Initial Clinical ...
IVF regimen linked to ovarian cancer risk.(WOMEN'S HEALTH)(in vitro fertilization)(Report)
Mar 01, 2009; ... SAN ANTONIO--Ovarian stimulation for in vitro fertilization was linked to an increased risk of ovarian cancer 15 years later in a large cohort study that followed thousands of women in the Netherlands. Compared with a control group of women who had fertility problems but did not ...
Many Mexican Americans postpone breast exam.(WOMEN'S HEALTH)(Report)
Mar 01, 2009; ... An alarming 51% of women failed to seek out medical care after detecting a change in their breasts through self-examination, in a study of 314 Mexican American women with invasive breast cancer. The most common method of breast cancer detection was self-exam (68%), which ...
Family history tied to triple-negative breast ca.(WOMEN'S HEALTH)(cancer)(Report)
Mar 01, 2009; ... Having a family history of breast cancer was associated with a significant 2.2-fold increased risk of triple-negative breast cancer in Hispanic women, but not in black women, according to preliminary data from a study of 466 patients. Moreover, Hispanic women were six times more ...
Oncovue genetic test beats Gail model in identifying high breast cancer risk.(WOMEN'S HEALTH)(Report)
Mar 01, 2009; ... SAN ANTONIO--The investigational OncoVue breast cancer risk test provided a 2.4-fold improvement over the Gail model in accurately identifying women at elevated risk of breast cancer in a blinded validation study. This is the third independent study demonstrating that the ...
MammaPrint gauges risk in HER2-positive breast cancer patients.(WOMEN'S HEALTH)(Human Epidermal growth factor Receptor 2)(Report)(Brief article)
Mar 01, 2009; ... San Antonio--The 70-gene MammaPrint prognosis signature independently identifies a genomic low-risk subgroup of HER2-positive early-breast cancer patients likely to have a good long-term clinical outcome, even without adjuvant trastuzumab and chemotherapy. Dr. Michael Knauer of ...
Impact of PPIs on clopidogrel activity uncertain.(CARDIOVASCULAR MEDICINE)(Clinical report)
Mar 01, 2009; ... NEW ORLEANS--A possible interaction between proton pump inhibitors and the antiplatelet drug clopidogrel remains a potential concern and became a muddled issue when findings from two independent studies produced diametrically opposed results. A review of more than 16,000 ...
Depression underdiagnosed in nursing homes.(GERIATRICS)(Report)
Mar 01, 2009; ... NATIONAL HARBOR, MD.--Weight loss, verbally abusive behavior, and moderate pain were all significant predictors of a new diagnosis of depression among established nursing home residents in a longitudinal analysis. Although studies have shown that depression affects 20%-55% of ...
'Oldest old' have less serious mental illness.(GERIATRICS)(Survey)
Mar 01, 2009; ... NATIONAL HARBOR, MD.--Long-term care residents aged 85 and older are less likely than younger residents to have a serious mental illness, more likely to have dementia, and equally likely to have depression or anxiety. Up to 80% of long-term care (LTC) residents have diagnosable ...
Colonoscopy quality varies by specialty, volume.(GASTROENTEROLOGY)
Mar 01, 2009; ... ORLANDO--Provider specialty and procedure volume influence polyp detection, biopsy rates, and other measures of colonoscopy quality, according to a study of routine clinical practice. "Over 14 million colonoscopies are performed in the U.S. These are performed by providers with ...
Ceftaroline noninferior to vancomycin/aztreonam.(INFECTIOUS DISEASE)(Report)
Mar 01, 2009; ... WASHINGTON--The investigational antibiotic ceftaroline was found to be effective against a range of gram-positive and gram-negative organisms that can cause complicated skin and skin structure infections, according to data from a phase III noninferiority study of more than 600 patients. ...
Monitoring vancomycin.(THE EFFECTIVE PHYSICIAN)
Mar 01, 2009; ... Background Vancomycin has a reputation for potential nephro- and ototoxicity and is increasingly used in the inpatient setting. The American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists have ...
Court shields billing records.(POLICY & PRACTICE)(Brief article)
Mar 01, 2009; ... An appeals court has ruled against the release of Medicare billing records, which was sought by the group Consumers' Checkbook so that it could grade physicians on quality. The nonprofit had filed a Freedom of Information Act request for all 2004 Medicare claims from physicians in several ...
IOM Report: HIPAA Is inadequate.(POLICY & PRACTICE)
Mar 01, 2009; ... The government's main health-privacy rule doesn't adequately protect people's health information, yet it hinders important health research, a report from the Institute of Medicine concluded. The privacy rule, stemming from the Health Insurance Portability and Accountability Act (HIPAA), is ...
Many people go without drugs.(POLICY & PRACTICE)(Brief article)
Mar 01, 2009; ... More children and working-age adults are failing to take needed prescription medications because of cost concerns, according to a national study by the Center for Studying Health System Change. In 2007, 1 in 7 Americans under age 65 years reported not filling a prescription in the previous ...
FDA on high-risk list.(POLICY & PRACTICE)(United States. Food and Drug Administration)(Brief article)
Mar 01, 2009; ... The Food and Drug Administration faces significant challenges that compromise its ability to protect Americans from unsafe and ineffective products, the Government Accountability Office said in adding the FDA to its biennial "high-risk" list. The GAO gives that label to government ...
Poll: affordability is tops.(POLICY & PRACTICE)(Survey)(Brief article)
Mar 01, 2009; ... Making health insurance more affordable trumps improving quality and expanding coverage among the public's priorities for health care reform, according to a new poll. The survey from the Kaiser Family Foundation and the Harvard School of Public Health found that most people believe that ...
Humana supports ID cards.(POLICY & PRACTICE)(Identification cards)(Brief article)
Mar 01, 2009; ... Humana has become the first health insurer to publicly support the Medical Group Management Association's drive to get standardized, machine-readable insurance cards into people's wallets by next January. "Our goal is to continue working with MGMA and the industry to eliminate waste, ...
Liability can prompt docs to avoid nursing homes.(PRACTICE TRENDS)
Mar 01, 2009; ... NATIONAL HARBOR, MD.--Fears about liability appear to be one of several factors undercutting the ability and desire of physicians to provide care in nursing homes. That conclusion comes from a study funded jointly by the Southern Illinois University School of Law, the California ...
Community medicine in Kenya's Rift Valley.(WORLD WIDE MED)(Interview)
Mar 01, 2009; ... Dr. Seth Sullivan traces his interest in global health to his senior year in high school, when he served as a French interpreter to a surgical team working in Haiti. The experience inspired Dr. Sullivan to pursue medicine, and to provide care for people in underserved areas. "I ...
State laws vary on seizure-impaired driving.(PRACTICE TRENDS)
Mar 01, 2009; ... SEATTLE--States vary widely as to whether they legally require physicians to report patients whose driving may be impaired because of seizures, and whether they provide reporting physicians any legal protection, a new study shows. Physicians across specialties often encounter ...
HHS finalizes plans for transition to ICD-10.(PRACTICE TRENDS)(International Classification of Disease)(Health and Human Services )
Mar 01, 2009; ... In less than 5 years, physicians and other health care providers will be required to begin using a new system of code sets to report health care diagnoses and procedures. Under a final rule published in the Federal Register last month, the Health and Human Services department is ...
CMS clarifies bariatric surgery coverage for Medicare patients with diabetes.(PRACTICE TRENDS)(Centers for Medicare and Medicaid Services)(Brief article)
Mar 01, 2009; ... The Centers for Medicare and Medicaid Services has made it official: Medicare beneficiaries with type 2 diabetes and a body mass index less than 35 kg/[m.sup.2] will not receive coverage for bariatric surgery. The announcement finalizes a CMS proposal issued last November. ...
Indications.(Quotation)
Mar 01, 2009; ... Thinking About Golf "Dude, where's my cart?" "It's in the guest bedroom, sir, exactly where you left it." "Right! That was one helluva round." "Really sir, and does one crash into the house after a good round or a bad one?" "It was ...
Zoster vaccination faces obstacles.(NEWS)
Mar 15, 2009; ... ATLANTA -- About half of internists and family physicians stock and administer the herpes zoster vaccine in their offices, but most administer it to very few of their eligible patients, citing cost and reimbursement hurdles as major barriers. Those findings come from a survey of ...
New data verify clopidogrel-PPI interaction risk: danger identified in three recent reports.(NEWS)(proton-pump inhibitor)
Mar 15, 2009; ... Increasing evidence that treatment with a proton-pump inhibitor can reduce the efficacy of clopidogrel in patients with coronary disease in a clinically meaningful and dangerous way may prompt cardiology groups to rethink current recommendations on using the two drugs together. ...
[HbA.sub.1c] gains legitimacy for diagnosis of diabetes.(NEWS)
Mar 15, 2009; ... The way that diabetes is diagnosed in the United States is about to change. Later this year, an expert panel organized by the American Diabetes Association will issue a report making a person's blood level of glycosylated hemoglobin ([HbA.sub.1c]) an accepted method of ...
Annual national health expenditure has risen ninefold since 1980.(VITAL SIGNS)
Mar 15, 2009 ... Note: Based on data from the Centers for Medicare and Medicaid ...
Gardasil prevents warts, HPV infection in males.(NEWS)
Mar 15, 2009; ... ATLANTA -- The human papillomavirus vaccine reduced rates of persistent infections and genital warts caused by HPV strains 6, 11, 16, and 18 in a Merck-sponsored study of 4,065 males aged 16-26 years. The findings were presented by Dr. Richard M. Haupt at a meeting of the ...
No tie seen Between MCV4, Guillain-Barre syndrome.(NEWS)(meningococcal conjugate vaccine)
Mar 15, 2009; ... ATLANTA -- The jury is still out regarding a potential link between the quadrivalent meningococcal conjugate vaccine and Guillain-Barre syndrome, but new data from the Centers for Disease Control and Prevention provide some reassurance. In October 2006, the CDC published data ...
FDA recommends changes for next flu vaccine.(NEWS)(United States Food and Drug Administration)
Mar 15, 2009; ... SILVER SPRING, MD. -- The influenza B strain in the current influenza vaccine in the United States should be replaced for the 2009-2010 influenza vaccine, according to a preliminary recommendation by a federal advisory panel, which based its decision on data on circulating viruses ...
FDA issues alert on zonisamide-induced acidosis.(NEWS)(United States Food and Drug Administration)(Brief article)
Mar 15, 2009; ... Serum bicarbonate levels should be checked in patients before initiating treatment with the antiepileptic drug zonisamide because of an association between the drug and metabolic acidosis, according to an alert issued by the Food and Drug Administration. Serum bicarbonate should ...
Online Care: promises and perils.(Editorial)
Mar 15, 2009; ... On Jan. 15, 2009, Hawaii became the first state to offer a comprehensive, computer-based, round-the-clock, interactive program for patients seeking medical services. Patients can buy consultation time from a properly credentialed physician who may offer advice, referral, diagnosis, and/or ...
Data indicate an increase in prevalence.(Is there a food allergy epidemic?)
Mar 15, 2009; ... Current estimates from various countries suggest that up to 5%-8% of children and 2%-19% of adults have food allergies. Substantial proportions are allergic to cow's milk, eggs, seafood, or peanuts--and these are just a few of the many foods we eat. If you are not impressed by ...
Inconsistency of diagnosis may explain it.(Is there a food allergy epidemic?)
Mar 15, 2009; ... Several factors may be giving the appearance of an increase in the prevalence of food allergy. On the professional front, these allergies are often being diagnosed by a variety of nonallergists, such as general practitioners and emergency department physicians; hence, the ...
Hippocampal atrophy: biomarker for early AD? Hippocampal volume in patients with AD is typically two standard deviations below normal.(NEUROLOGY)(Alzheimer's disease)
Mar 15, 2009; ... CHICAGO -- Volumetric reduction of the hippocampus has emerged as a promising noninvasive imaging bio-marker for prodromal and early stages of Alzheimer's disease, according to a study of 373 patients. The hippocampus was the site of the most dramatic changes in patients with ...
Disparities in stroke treatment seen for men, women.(NEUROLOGY)
Mar 15, 2009; ... SAN DIEGO -- Women have strokes more often than men, but they are significantly less likely to receive the best available treatment, according to two studies presented at the International Stroke Conference. In a meta-analysis of 18 studies involving more than 2.3 million men ...
Four factors help predict prostate cancer risk.(UROLOGY)
Mar 15, 2009; ... A Dutch study of 5, 176 men found four factors to be helpful in predicting a man's risk of developing prostate cancer: serum prostate-specific antigen, a previous negative biopsy of the prostate, family history of prostate cancer, and prostate volume. "PSA assessments combined ...
Herbal options exist for erectile dysfunction.(UROLOGY)
Mar 15, 2009; ... SAN DIEGO -- Before you recommend a treatment for erectile dysfunction, make sure to rule out underlying factors that may contribute to the condition. "Treat the whole person. Try to take care of other medical problems they might have," Dr. Edward (Lev) Linkner advised at a ...
New lupus drugs remain elusive after 50 years.(RHEUMATOLOGY)(Report)
Mar 15, 2009; ... FORT LAUDERDALE, FLA. -- The saga of mycophenolate mofetil for lupus exemplifies the difficulties in developing new drugs for a condition with such protean manifestations and inconsistent course, for which there has not been a new drug approved for 50 years. "An important ...
Dyslipidemia common in patients with lupus and RA.(RHEUMATOLOGY)(rheumatoid arthritis)
Mar 15, 2009; ... FORT LAUDERDALE, FLA. -- Patients with systemic lupus erythematosus and rheumatoid arthritis should be considered in a cardiovascular risk category equivalent to that of patients with diabetes, with aggressive management of risk factors, particularly dyslipidemia, according to experts. ...
Aldosterone blockers lower BP in obese patients.(CARDIOLOGY)(blood pressure)
Mar 15, 2009; ... NEW YORK. -- Two aldosterone receptor-blocking drugs--spironolactone and eplerenone--have almost overnight become important, second-line antihypertensive drugs for obese patients. "Aldosterone receptor blockers were never on the list [of major antihypertensive drug choices], and ...
Drug-eluting stents cut mortality in diabetes.(CARDIOLOGY)(Report)
Mar 15, 2009; ... NEW ORLEANS -- Diabetic patients treated with drug-eluting stents showed impressive reductions in mortality, acute MI, and repeat revascularization during the subsequent 3 years compared with bare-metal stent recipients in a large real-world Massachusetts registry featuring mandatory ...
At-home INR monitoring safe for patients on warfarin.(CARDIOLOGY)(international normalized ratio)(Report)
Mar 15, 2009; ... NEW ORLEANS -- Patients taking warfarin who regularly self-tested their level of anticoagulation at home had outcomes that were at least as good as, and in some cases better than, patients who were monitored by regular monthly visits to an anticoagulation clinic. This good ...
Rosuvastatin slashed stroke risk in JUPITER.(CARDIOLOGY)(Justification for Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin)(Report)
Mar 15, 2009; ... SAN DIEGO -- Patients with normal lipid levels but elevated C-reactive protein showed a 48% reduction in the risk of stroke when taking rosuvastatin, according to a study presented at the International Stroke Conference. These results came from a planned additional analysis of ...
Technique can classify lesions during colonoscopy.(GASTROENTEROLOGY)(Report)
Mar 15, 2009; ... SAN FRANCISCO -- Confocal laser endomicroscopy accurately classifies lesions found during colonoscopy according to their malignant potential, the results of a prospective cohort study show. "Confocal laser endomicroscopy is a promising tool for in vivo microscopic imaging of ...
Biomarkers tied to colorectal cancer in smokers.(GASTROENTEROLOGY)(Report)
Mar 15, 2009; ... San Francisco -- Older women who smoke have an elevated risk of colorectal cancer, but they have a particularly high risk of cancers containing certain molecular features, a large prospective study has found. Former and current smokers were much more likely than never smokers ...
Endoscopic mucosal resection can cut costs.(GASTROENTEROLOGY)
Mar 15, 2009; ... ORLANDO -- With an average cost just over $2,000, endoscopic mucosal resection of colorectal lesions can be an effective and less expensive alternative to surgery, according to a recent study. Endoscopic mucosal resection (EMR) is a standard technique useful for resection of ...