Internal Medicine News back issues from May 2009:
Subspecialists wary of medical homes.
May 01, 2009; ... BALTIMORE -- Subspecialists need not worry that their salaries will decline as a result of efforts to increase the salaries of primary care physicians and thereby attract more medical students to the field, according to Dr. Jeffrey Harris, president of the American College of Physicians. ...
FTC rule requires practices to guard against ID theft: 'Red Flags Rule' in effect as of May 1.(Federal Trade Commission)
May 01, 2009; ... Physicians and health care organizations must now implement a formal identity theft prevention program to protect their patients under a little-known set of regulations called the "Identity Theft Red Flags Rule." The rule--issued by the Federal Trade Commission (FTC) in 2007 but ...
Debut of 5-in-1 polypill spurs therapeutic debate.
May 01, 2009; ... ORLANDO -- The multiplicity of reactions to a new drug treatment concept has helped put the "poly" in the polypill. The idea of broadly administering a single, daily capsule containing five drugs proven to cut cardiovascular risk finally had its first field test on more than ...
Compliance with Red Flags Rule starts with putting someone in charge.(Brief article)
May 01, 2009; ... Physician practices that are seeking to comply with the "Red Flags Rule" can begin by appointing someone who will be the compliance officer for the identity-theft prevention program, said Sai Huda, an expert in financial services regulation. The next step is to conduct an ...
Medicaid gets majority of health funding in the American Recovery and Reinvestment Act of 2009.(VITAL SIGNS)(Table)(Brief article)
May 01, 2009 ... <Pre> Medicaid Gets Majority of Health Funding in the American Recovery and Reinvestment Act of 2009 (billions of dollars) Medicaid matching rate increase $86.6 (57%) Other Medicaid$3.2 (2%) COBRA$24.7 (17%) Health information ...
Second female condom approved.(NEWS FROM THE FDA)(Brief article)
May 01, 2009 ... The second-generation Reality female condom has been approved by the Food and Drug Administration. The FDA approved the first female condom, the Reality Female Condom (FC1), in 1993. Since the, 165 million have been sold in 145 countries, said Mary Ann Leeper, Ph.D., senior ...
Combo Rx approved for depression.(NEWS FROM THE FDA)
May 01, 2009 ... The FDA's recent approval of Eli Lilly's olanzapine/fluoxetine combination drug Symbyax for recalcitrant depression has been hailed as an important advance in the management of patients with major depressive disorder who do not respond to multiple standard therapies. But experts advise ...
Efalizumab withdrawal imminent.(NEWS FROM THE FDA)(Brief article)
May 01, 2009 ... The psoriasis drug efalizumab (Raptiva) is being rapidly phased off the U.S. market, and as of June 8 will no longer be available to patients, according to an FDA statement. Practitioners should not initiate efalizumab treatment in new patients, according to the FDA. The ...
CV safety OK with saxagliptin.(NEWS FROM THE FDA)
May 01, 2009 ... Cardiovascular safety data for the investigational diabetes drug saxagliptin are sufficient to rule out unacceptable excess risk in the population studied, but the manufacturer should conduct longer postmarketing studies in patients at higher risk for cardiovascular events, a federal ...
Mixed votes on liraglutide safety.(NEWS FROM THE FDA)(Brief article)
May 01, 2009 ... The majority of a federal advisory panel has agreed that the available cardiovascular safety data on the antidiabetic drug liraglutide were adequate to rule out an unacceptable increase in cardiovascular risk when compared with other diabetes drugs. The panel split, however, on ...
Refractory epilepsy drug reviewed.(NEWS FROM THE FDA)(Brief article)
May 01, 2009 ... The FDA's Peripheral and Central Nervous System Drugs Advisory Committee voted 24-0 in favor of approving vigabatrin for patients with epilepsy refractory to several other anticonvulsants, Panel members included caveats that reflected the significant risk of visual loss that has ...
Panel recommends dronedarone.(NEWS FROM THE FDA)(Brief article)
May 01, 2009 ... An FDA panel recommended 10-3 that dronedarone, an analogue of amiodarone, be approved for treating patients with nonpermanent atrial fibrillation, with recommendations that the label include a boxed warning cautioning against use of the drug in patients with hearth failure. ...
Are you ready for the Red Flags Rule?(Editorial)
May 01, 2009; ... By now, you are probably aware of the Fair and Accurate Credit Transactions (FACT) Act of 2003 and its "Identity Theft Red Flags Rule" which requires creditors to establish a program to prevent identity theft. (See story on p. 1.) Enforcement starts this month, so if you haven't taken any ...
Recruitment and consent pose difficulties.(POINT/COUNTERPOINT)
May 01, 2009; ... Is it appropriate to include Alzheimer's disease patients in non-AD clinical research? The short answer is that it is up to the individual and his or her family members, but the larger answer is essentially no. Clinical research in Alzheimer's disease (AD) is ...
With appropriate consent, trials are beneficial.(POINT/COUNTERPOINT)(Brief article)
May 01, 2009; ... Some patients with early AD have capacity to provide their own informed consent, but it is common practice in AD studies to obtain consent from a legally authorized representative, usually a close relative, and an assent from the patient. Although imperfect, guidelines and processes have ...
Unapproved narcotic gets reprieve from FDA.(GERIATRICS)
May 01, 2009; ... The Food and Drug Administration has backed off from a warning letter it sent to several manufacturers and decided to allow an unapproved version of high-concentrate morphine sulfate oral solution to remain on the market. Objections from pain specialists, hospice workers, and ...
Palliative oxygen may not be worth the additional cost.(GERIATRICS)
May 01, 2009; ... AUSTIN, TEX. -- Palliative oxygen was no better than air delivered by nasal cannulae for relieving dyspnea or improving quality of life in a study of 239 non-or mildly hypoxemic patients with terminal illness. During the first 24 hours, patients in the [O.sub.2] Breathe Trial ...
Outdoor summer jobs double risk of skin Ca.(DERMATOLOGY)(skin cancer)(Report)
May 01, 2009; ... SAN FRANCISCO -- People who worked at outdoor summer jobs as teenagers for 3 years or more had twice the risk of developing malignant melanoma later in life as those who did not, according to a case-control study by Dr. Darrell S. Rigel of New York University Medical Center. The ...
Watchman heart device lowers stroke risk in atrial fibrillation patients.(CARDIOVASCULAR MEDICINE)(Report)
May 01, 2009; ... ORLANDO -- A left atrial appendage occlusion device called the Watchman strikingly outperformed warfarin in preventing hemorrhagic strokes in patients with atrial fibrillation in a pivotal phase III clinical trial. On other key efficacy end points, the device showed statistical ...
Clopidogrel plus aspirin cuts vascular events.(CARDIOVASCULAR MEDICINE)(Report)
May 01, 2009; ... Adding clopidogrel to aspirin therapy significantly reduces the risk of stroke and other major vascular events in patients who have atrial fibrillation and are not candidates for anticoagulation therapy with a vitamin K antagonist, according to Dr. Stuart Connolly of the Population Health ...
Increased stroke risk seen in women with early menopause.(CARDIOVASCULAR MEDICINE)(Report)
May 01, 2009; ... SAN DIEGO -- Women who reach menopause before the age of 42 years are twice as likely to suffer a stroke in later life as are women who reach menopause after age 42, according to a new analysis of data from the Framingham Heart Study presented at the International Stroke Conference. ...
Dronedarone for atrial fib impresses in meta-analysis.(CARDIOVASCULAR MEDICINE)(atrial fibrillation)(Report)
May 01, 2009; ... ORLANDO -- The novel multi-channel-blocking antiarrhythmic agent dronedarone cut the risk of cardiovascular hospitalization or all-cause mortality by 24% in a meta-analysis of five placebo-controlled, randomized trials involving 6,157 patients with atrial fibrillation or atrial flutter. ...
TBI linked to adverse neurologic outcomes.(NEUROLOGY)(traumatic brain injury)(Report)
May 01, 2009; ... Soldiers returning from Iraq and Afghanistan who have suffered severe or moderate traumatic brain injury are at increased risk for certain neurodegenerative symptoms such as Alzheimer-type dementia and parkinsonism, according to an Institute of Medicine report. The IOM also ...
Opioids for noncancer pain.(THE EFFECTIVE PHYSICIAN)(Report)
May 01, 2009; ... Background The use of chronic opioid therapy (COT) has increased substantially over the last 20 years for noncancer pain. The American Pain Society and the American Academy of Pain Medicine released clinical guidance in 2009 to assist clinicians with the difficult therapeutic ...
Group appointments improve asthma outcomes.(PULMONARY MEDICINE)(Brief article)
May 01, 2009; ... WASHINTON -- Group drop-in appointments reduce emergency department visits and rescue medicine use in adult patients with asthma, according to the results of a small study. ED and hospital use was reduced 40%, and the average use of rescue medication decreased by half over a ...
Exhaled nitric oxide may be asthma measure.(PULMONARY MEDICINE)(Report)(Brief article)
May 01, 2009; ... WASHINGTON -- Measures of exhaled nitric oxide levels may add another dimension to the evaluation of asthma, based on data from a study presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. Fractional exhaled nitric oxide (FeNO) may be "a ...
BMI affects asthma control, not Tx response.(PULMONARY MEDICINE)(body mass index)(Brief article)
May 01, 2009; ... WASHINGTON -- Heavier people may have worse asthma control than do their lighter counterparts, but they are not significantly less likely to respond to treatment, based on data from a pair of studies presented at the annual meeting of the American Academy of Allergy, Asthma, and ...
Statins tied to few hospital visits for asthma.(PULMONARY MEDICINE)(Report)(Brief article)
May 01, 2009; ... WASHINGTON -- The use of statins was associated with a 33% reduction in the risk of emergency department visits and hospitalizations among adult asthma patients in a retrospective study. Statin use during the previous 12 months was independently associated with a significant 33% ...
CA 125 plus ultrasound detects early ovarian Ca.(WOMEN'S HEALTH)(cancer antigen 125)(Report)
May 01, 2009; ... Large-scale screening for ovarian cancer with a combination of transvaginal ultrasound and cancer antigen 125 is a feasible strategy that can accurately identify early cancers, a large U.K. trial of almost 203,000 women concluded. The combination approach carried a sensitivity ...
ROMA tool more sensitive than RMI to predict ovarian Ca.(WOMEN'S HEALTH)(risk of ovarian malignancy algorithm)(Report)
May 01, 2009; ... SAN ANTONIO -- A novel algorithm has been shown to be more sensitive than a widely used risk of malignancy index for predicting epithelial ovarian cancers in women who present with a pelvic mass or ovarian cyst. The Risk of Ovarian Malignancy Algorithm (ROMA) stratifies women at ...
Rethinking silicone vs. saline breast implants.(WOMEN'S HEALTTH)(Report)
May 01, 2009; ... Scottsdale, ARIZ. -- Silicone or saline? With 550,000 breast augmentations performed each year in the United States, it's a question physicians and surgeons get asked a lot. Today, most women choose silicone. Indeed, silicone gel breast implants have dominated the ...
CA 125 level predicts survival in ovarian cancer patients.(WOMEN'S HEALTH)
May 01, 2009; ... San Antonio -- Elevated cancer antigen 125 levels measured after surgery but before chemotherapy are an independent prognostic indicator of recurrence and worse survival in women with high-risk, early-stage epithelial ovarian cancer, according to results of a Gynecologic Oncology Group ...
Tuberculosis decreasing, but rate of decline slows.(INFECTIOUS DISEASES)(Report)
May 01, 2009; ... The tuberculosis rate in the United States continues to decline, but the pace of the decline has slowed since 2000--and the rate of infection among racial/ethnic minorities and foreign-born individuals continues to be disproportionately high. Those were among the findings of a ...
New Web site promotes adult immunization.(INFECTIOUS DISEASES)(www.adultvaccination.com )
May 01, 2009; ... The National Foundation for Infectious Diseases has unveiled a Web site that takes a multi-pronged approach to increasing the rate of adult vaccination in the United States. Revealed during a Webcast for reporters, www.adultvaccination.com provides information for patients, ...
White House starts HIV awareness campaign.(INFECTIOUS DISEASES)
May 01, 2009; ... WASHINGTON -- The Obama administration has launched the first major U.S. initiative against HIV/AIDS in more than a decade. The 5-year campaign, "Act Against AIDS," is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, ...
Heart problems can occur early in anorexia.(ADOLESCENT HEALTH)(Report)
May 01, 2009; ... LOS ANGELES -- Significant cardiac abnormalities were detected in nearly a third of adolescent girls hospitalized for the first time with anorexia nervosa in a San Francisco study, raising questions about whether detailed cardiac workups may be warranted early in the course of the disease ....
Vitamin D tied to hypertension, hyperglycemia.(ADOLESCENT HEALTH)(Report)
May 01, 2009; ... Low serum levels of vitamin D were linked to increased blood pressure, hyperglycemia, and obesity in an analysis of more than .3,500 American teenagers, a link previously seen in adults. In addition, the prevalence of vitamin D deficiency has increased among all Americans, based ...
USPSTF recommends depression screening for all teens.(ADOLESCENT HEALTH)(united states preventive services task force)(Report)
May 01, 2009; ... A new recommendation from the U.S. Preventive Services Task Force endorses the need for routine screening of all adolescents for clinical depression. The task force recommended that physicians screen adolescent patients aged 12-18 years for major depressive disorder provided ...
Medicaid a better payer than medicare for EHRs.(PRACTICE TRENDS)(electronic health record)
May 01, 2009; ... While Medicare is almost always, a better payer than Medicated, one notable exception is the health information technology funding contained in the Recovery Act. For physicians applying for incentive money to purchase electronic health record (EHR) systems, "Medicaid is a little ...
Bristol-Myers Squibb fined.(POLICY & PRACTICE)(Brief article)
May 01, 2009; ... Bristol-Myers Squibb Co. will pay $2.1 million--the largest fine allowed by law--for failing to report an agreement it reached with Apotex Inc. on generic competition for its blockbuster cardiovascular drug Plavix (clopidogrel), the Federal Trade Commission said. Bristol-Myers Squibb ...
Massachusetts clinics are busy.(POLICY & PRACTICE)(Brief article)
May 01, 2009; ... Community health centers in Massachusetts saw a significant increase in their patient load from 2005 to 2007, as the state implemented its health reform law, according to a study from the Kaiser Family Foundation. The 34 federally qualified clinics, which provide comprehensive primary care ...
FDA warns on Internet ads.(POLICY & PRACTICE)(Brief article)
May 01, 2009; ... The Food and Drug Administration has warned 14 drug makers against using brief Internet ads to promote drugs, saying the ads are misleading because they fail to provide full information about risks and indications. The ads typically appear on search engines, such as Google, as "sponsored ...
FDA seeks data on older devices.(POLICY & PRACTICE)(Brief article)
May 01, 2009; ... The FDA has ordered manufacturers of 25 class III medical devices that were approved before 1976 to submit safety and effectiveness data to the agency by Aug. 7. The devices include an intra-aortic balloon and its control system, a ventricular bypass assist device, generators, materials ...
Issues of drug class pending.(POLICY & PRACTICE)(Brief article)
May 01, 2009; ... Logistical and cost issues must be addressed before a behind-the-counter class of nonprescription drugs can be established officially in the United States, the Government Accountability Office said in a report on so-called BTC drugs. The GAO stressed that pharmacists must be ready to ...
EMR applications rise.(POLICY & PRACTICE)(electronic medical record)(Brief article)
May 01, 2009; ... As of the March 31 deadline, 64 companies had applied for certification of their electronic medical record (EMR) products, one-third more than had applied by the same time last year, the Certification Commission for Healthcare Information Technology reported. Nearly 40% of the applications ...
Move to primary care scary for some Ca patients.(PRACTICE TRENDS)(cancer )(Report)
May 01, 2009; ... HOLLYWOOD, FLA. -- Many people experience fear, anxiety, and depression during the transition from cancer patient to survivor, according to a panel of oncologists, survivors, patient advocates, and others at the annual conference of the National Comprehensive Cancer Network. ...
Some cancer survivors can't afford needed medical care.(PRACTICE TRENDS)(Report)
May 01, 2009; ... Slightly more than 2 million cancer survivors in the United States forego necessary medical care because of cost concerns, and Hispanics and African Americans are twice as likely to do so, new research suggests. Using the annual National Health Interview Survey database for ...
Friendship fosters medical project in Uganda.(WORLD WIDE MED)(Interview)
May 01, 2009; ... Dr. Kevin E. Hunt was taking premed classes at Loyola University in Chicago when he met Father Samuel Okori, who was serving as a priest in Dr. Hunt's parish. The two men struck up a friendship, and Father Okori invited Dr. Hunt to travel with him to the Lira Diocese in Uganda, to assess ...
Palliative care certificate program faces delay.(PRACTICE TRENDS)
May 01, 2009; ... AUSTIN, TEX. -- The release of the long-awaited Joint Commission-sponsored palliative care certificate program has been put on hold in order to complete a strategic planning process, Dr. Diane Meier said at the annual meeting of the American Academy of Hospice and Palliative Medicine. ...
Move over, Elgin marbles.(INDICATIONS)(Brief article)
May 01, 2009; ... As much as we at the Bureau of Indications like to think that we answer to no one, it's not true. We are just the innermost doll in a corporate matryoshka, with the big mama doll being Elsevier. You may have seen that name on the spine of your textbooks in medical school or on the masthead ...
We've heard of barflys, but ED-flys?(INDICATIONS)(emergency department)(Brief article)
May 01, 2009; ... They do everything big in Texas, and it looks like emergency department use is no exception. A report from the nonprofit Integrated Care Collaboration showed that just nine people made 2,678 visits to Austin-area hospital emergency departments from 2003 to 2008, according to the Austin ...
Health reform must boost primary care.
May 15, 2009; ... PHILADELPHIA -- With health care reform efforts gaining momentum in Congress, the American College of Physicians is pushing for changes in physician reimbursement and training that would help expand the nation's primary care workforce. At its annual meeting, the ACP released two ...
AUA guidelines back PSA testing starting at age 40: risk of overdetection remains a concern.(American Urological Association)(prostate-specific antigen testing)(Report)
May 15, 2009; ... CHICAGO--New guidelines on prostate-specific antigen testing issued by the American Urological Association support the continued use of the test in conjunction with digital rectal examination as a strategy for detecting prostate cancer, measuring risk over time, and monitoring the ...
2009-H1N1 outbreak poses challenge for fall.(influenza A virus subtype)(Report)
May 15, 2009 ... Even as the rate of new 2009-H1N1 infections dwindles in the Northern Hemisphere, health officials are bracing for the influenza's potential reemergence this fall. At press time, the House Appropriations Committee had approved $2.05 billion in emergency supplemental funding to ...
Internal medicine getting closer to gender parity.(VITAL SIGNS)
May 15, 2009 ... Note: Age distribution if for 107, 171 male and 50,848 female internists, including ...
CHTs help small practices use medical home approach.(community health teams)
May 15, 2009; ... PHILADELPHIA -- Community health teams can bring the patient-centered medical home approach to small practices that otherwise would not be able to afford care coordinators. The idea behind community health teams (CHTs) is that the care coordination professionals--such as nurse ...
New annals editor sees online media as the journal's future.(Dr. Christine Laine editor of Annals of Internal Medicine)(www.youtube.com/InternalMedicineNews)(Brief article)
May 15, 2009; ... PHILADELPHIA -- Creating an expanded electronic presence for the Annals of Internal Medicine will be the major challenge for Dr. Christine Laine. Dr. Laine was named the journal's new editor during the annual meeting of the organization that publishes Annals of Internal Medicine ...
COPD web site promotes evidence-based care.(NEWS)(chronic obstructive pulmonary disease)(www.copd.acpoline.org)
May 15, 2009; ... PHILADELPHIA -- A Web site devoted to information about chronic obstructive pulmonary disease was launched by the American College of Physicians during its annual meeting in late April. The Web site, which includes separate sections for primary care physicians and for patients, ...
Insurers profit from banking, at our expense.(Editorial)(Editorial)
May 15, 2009; ... If you think the country's largest health insurance company is in the health care business, guess again. As WellPoint testified to the Federal Reserve Board, its core insurance business should be considered financial services; ergo, it's really a bank. What about the doctors and nurses who ...
More sudden deaths in triathlons than marathons.(CARDIOVASCULAR MEDICINE)(Report)
May 15, 2009; ... ORLANDO -- The risk of sudden death during a triathlon is two-to threefold greater than in running a marathon, according to the first large-scale mortality study of participants in the popular swim-bike-run events. The risk appears to be essentially confined to the swim ...
Warfarin's real impact less than in trials.(Report)
May 15, 2009; ... ORLANDO -- Warfarin was not nearly as effective in the real world as it has been in clinical trials for reducing the risk of stroke in patients with atrial fibrillation, in a review of about 50,000 patients. Analysis of the same database also showed that fewer than half of the ...
Vitamin K for excessive anticoagulation.(MINDFUL PRACTICE)(Case study)
May 15, 2009; ... The Problem A 61-year-old man with a history of atrial fibrillation on anticoagulation with warfarin, hypertension, and type 2 diabetes mellitus presents to you with an international normalized ratio of 5.8. He has had an INR in the range of 2.0-3.0 on 5 mg of warfarin daily, ...
Diabetes drug improves lipoatrophy in HIV.(INFECTIOUS DISEASES)(Report)
May 15, 2009; ... MONTREAL -- A drug approved for use in diabetes may reverse HIV-associated lipoatrophy and insulin resistance, a study has shown. In a randomized, controlled trial of 71 HIV-positive patients with documented peripheral fat wasting, patients who received 4 mg of the ...
Hepatitis C coinfection complicates HIV care.(INFECTIOUS DISEASES)(Report)
May 15, 2009; ... MONTREAL--HIV patients who are coinfected with the hepatitis C virus have significantly higher rates of health care utilization and disability days than do those with HIV alone. The findings, according to lead investigator Benjamin Linas of Boston's Massachusetts General ...
Lymphogranuloma venereum cases increasing.(INFECTIOUS DISEASES)(Report)(Brief article)
May 15, 2009; ... MAUI, HAWAII -- Lymphogranuloma venereum is making a comeback, and this time around the STD looks nothing like it did during residency training. The new clinical picture of lymphogranuloma venereum (LGV) is proctitis in slightly older gay men, Dr. Theodore Rosen explained at the ...