Internal Medicine News back issues from June 2009:
Coalition aims to cut growth in costs.(NEWS)
Jun 01, 2009; ... Leaders of several health care and labor organizations who met with President Obama proposed ideas to reduce the growth in health care costs by up to $2 trillion over the next decade. In a letter sent to the president, the six organizations--the American Medical Association, the ...
Dutasteride shown to lower risk of prostate cancer: agent lowered risk by 23.5% at 4 years.(NEWS)
Jun 01, 2009; ... CHICAGO--Dutasteride, prescribed for benign prostatic hyperplasia, reduced the risk of prostate cancer by 23.5% over 4 years in a randomized trial of at-risk men. The drug's effects were consistent across key baseline subgroups and at 2- and 4-year follow-up, reported Dr. Gerald ...
Hypertension improves with combo intervention.(NEWS)
Jun 01, 2009; ... MIAMI BEACH--A combination of home blood pressure monitoring plus a tailored behavioral intervention delivered by a nurse significantly improved control of hypertension, compared with usual care, in a study of 636 patients. In contrast, either intervention alone did not ...
Health care reform options include primary care boost.(NEWS)
Jun 01, 2009; ... The health care reform package being crafted in Congress could include Medicare payment bonuses to primary care physicians and general surgeons, according to policy options released by leaders of the Senate Finance Committee. The 52-page paper is a first look at the proposals ...
Vital signs.(NEWS)(physicians' earnings)(Brief article)
Jun 01, 2009 ... Physicians in Private Hospitals and Practices Earned Over $78 per hour Note: Data are ...
Novel diabetes drug approved.(NEWS FROM THE FDA)(Cycloset)(Brief article)
Jun 01, 2009 ... Cycloset, a quick-release oral formulation of bromocriptine mesylate, was recently approved by the Food and Drug Administration as a treatment for type 2 diabetes, according to the manufacturers, VeroScience and S2 Therapeutics Inc. Cycloset is taken by mouth once daily in the ...
Warning issued on testosterone gels.(NEWS FROM THE FDA)(Brief article)
Jun 01, 2009 ... Two prescription topical testosterone gels will now include a boxed warning following confirmed adverse effects in eight children, the FDA announced. The children did not have the gel directly applied, but rather incurred secondary exposure through contact with the application ...
TNF blocker wins approvals.(NEWS FROM THE FDA)(tumor necrosis factor-alpha antagonist Golimumab)(Centocor Ortho Biotech Inc.)(Brief article)
Jun 01, 2009 ... Golimumab, the first once-monthly, injectable tumor necrosis factor-alpha antagonist, was approved for treating adults with moderately to severely active rheumatoid arthritis, active psoriatic arthritis, and active ankylosing spondylitis, based on data from five studies of more than 2,500 ...
New botulinum product approved.(NEWS FROM THE FDA)(Dysport by Ipsen)(Brief article)
Jun 01, 2009 ... Dysport (abobotulinum toxin A) has been approved for the treatment of cervical dystonia and glabellar lines, bringing competition to Botox (botulinum toxin type A). Ipsen will market Dysport in the United States for the therapeutic indication (cervical dystonia), while Medicis ...
Hydroxycut recalled for liver risks.(NEWS FROM THE FDA)(Iovate Health Sciences Inc.)(Brief article)
Jun 01, 2009 ... Reports of severe liver injuries--including one fatality--associated with Hydroxycut brand dietary supplements have prompted a nationwide product recall. The products are marketed as weight-loss aids, energy enhancers, low-carbohydrate diet aids, and diuretics. The 23 reports ...
Warnings strengthened for pain drugs.(NEWS FROM THE FDA)(Brief article)
Jun 01, 2009 ... The FDA is requiring manufacturers to place more prominent warning labels on certain over-the-counter drug products to alert consumers to the potential risks of liver injury from acetaminophen and stomach bleeding from NSAIDs. Many consumers may not be aware of the risks, and ...
Botulinum toxin labels updated.(NEWS FROM THE FDA)(Brief article)
Jun 01, 2009 ... The FDA will require all botulinum toxin manufacturers to add boxed warnings to the label that address the potential for paralysis-like symptoms resulting from the toxin's distant spread. The drug has been associated with an unexpected loss of strength, dysphagia, loss of ...
Panel votes in favor of AF device.(NEWS FROM THE FDA)(Watchman for atrial fibrillation)(Brief article)
Jun 01, 2009 ... More than half of a federal advisory panel voted in favor of approving a device designed to reduce the risk of stroke in people with nonvalvular atrial fibrillation, but the recommendation was contingent on certain conditions, including physician certification and postmarketing studies. ...
Data needed on cognitive-enhancing drugs.(Editorial)
Jun 01, 2009; ... If we had drugs that would make people smarter, wouldn't that benefit society? And would using drugs in this way be a bad thing? The reality is: We do have such drugs. And, more and more, we are hearing accounts of normal people taking agents to enhance their mental acuity and ...
Herbal pharmacopeia is 'wild west'.(LETTERS)(Letter to the editor)
Jun 01, 2009 ... We write to protest what we perceive as editorial irresponsibility in Internal Medicine News' near-promotional presentation of herbs to treat erectile dysfunction ("Herbal Options Exist for Erectile Dysfunction," March 15, 2009, p. 15). The herbal pharmacopeia as marketed in the ...
Keeping it confidential.(LETTERS)(Letter to the editor)
Jun 01, 2009; ... Dr. S.Y. Tan makes several good points regarding how physicians' communication methods and skills can mitigate against the subsequent initiation of a malpractice lawsuit (Law & Medicine, "Communication and Malpractice," April 15, 2009, p. 37). However, I must point out that his ...
Botox benefits overactive bladder patients.(UROLOGY)
Jun 01, 2009; ... CHICAGO--Patients with idiopathic overactive bladder refractory to anticholinergics reported significant improvements in health-related quality of life, symptom severity, and satisfaction for at least 24 weeks after treatment with botulinum neurotoxin type A (Botox) in a randomized trial ...
Prostate cancer risk lower in digoxin users.(UROLOGY)
Jun 01, 2009; ... DENVER--Men on digoxin were roughly one-quarter less likely to be diagnosed with prostate cancer than digoxin nonusers, according to findings from the Health Professionals Follow-Up Study. The longer the duration of digoxin use, the lower the risk of prostate cancer. Indeed, men ...
NASH treatments controversial, unproven.(GASTROENTEROLOGY)(nonalcoholic steatohepatitis)
Jun 01, 2009; ... SAN DIEGO -- Treating nonalcoholic steatohepatitis is difficult territory for clinicians because no therapy has been proved effective, Dr. Arthur J. McCullough said at a meeting on chronic liver disease sponsored by Scripps Clinic. "All therapies I consider emerging, because, at ...
Diabetes may increase risk of liver cancer.(GASTROENTEROLOGY)(Brief article)
Jun 01, 2009; ... DENVER--Diabetes appears to be an independent risk factor for hepatocellular carcinoma, with the risk rising as duration of the endocrine disease increases, according to an ongoing, prospective case-control study. Also, the magnitude of risk for HCC seems to vary with the type ...
25 years later, HIV/AIDS still an epidemic.(INFECTIOUS DISEASES)
Jun 01, 2009; ... WASHINGTON -- The two researchers credited with discovering HIV in 1984, Dr. Robert C. Gallo and Dr. Luc A. Montagnier, came together in a "Global Call to Action" to remind the world on the 25th anniversary of their discovery that HIV/AIDS remains one of the largest global health threats. ...
Outbreak highlights low flu vaccination rates.(INFECTIOUS DISEASES)
Jun 01, 2009; ... CHICAGO -- Even if history records the 2009-H1N1 influenza epidemic as mild, its appearance highlights the need to improve seasonal-flu vaccination rates among the elderly and the health care workers who take care of them, said speakers during an influenza symposium. Vaccination ...
Test flu specimen to determine treatment for elderly.(INFECTIOUS DISEASES)
Jun 01, 2009; ... CHICAGO -- The 2009-H1N1 influenza epidemic has mostly affected young people so far, but health professionals should take care to protect the vulnerable elderly from infection, Dr. Stefan Gravenstein said during an influenza symposium at the annual meeting of the American Geriatrics ...
Teach patients the sexual side effects of SSRIs.(PSYCHIATRY)(selective serotonin reuptake inhibitors)
Jun 01, 2009; ... PENTAGON CITY, VA. -- Educating depressed patients about the sexual side effects of selective serotonin reuptake inhibitors could mitigate their experiences with those side effects, results of a study of 92 adults who were first-time users of the medication show. Many physicians ...
Pruritus diagnosis tied to psychopathology.(PSYCHIATRY)(Brief article)
Jun 01, 2009; ... SAN FRANCISCO--Patients with pruritus are twice as likely to have a co-morbid psychiatric diagnosis as those with other dermatologic diagnoses, according to a large epidemiologic study. This is driven largely by the strong association between pruritus and comorbid anxiety ...
Emerging thyroid ca therapies show promise.(ENDOCRINOLOGY)
Jun 01, 2009; ... Kinase inhibitors and antiangiogenic drugs may offer the first real hope of treating differentiated metastatic thyroid cancer, and seem to be especially effective in tumors exhibiting the B-type Raf kinase mutation. Although such tumors are uncommon, there are no effective ...
Thyroid carcinoma recommendations updated.(ENDOCRINOLOGY)
Jun 01, 2009; ... HOLLYWOOD, FLA.--The National Comprehensive Cancer Network has updated its thyroid carcinoma guidelines to add consideration of small molecule kinase inhibitors in metastatic disease treatment, refine diagnosis and treatment strategies based on fine-needle aspiration, and provide new ...
Lower normal TSH range may help detect hypothyroidism.(ENDOCRINOLOGY)(thyroid-stimulating hormone)
Jun 01, 2009; ... Philadelphia--A lower normal range for thyroid-stimulating hormone would help physicians detect and treat more cases of occult hypothyroidism, Dr. Leonard Wartofsky said at the annual meeting of the American College of Physicians. Based on common thyroid-stimulating hormone ...
NCCN offers updated breast cancer guidelines: genetic counseling is now advised for women with DCIS and a high risk for hereditary breast cancer.(WOMEN'S HEALTH)(National Comprehensive Cancer Network)(ductal carcinoma in situ)
Jun 01, 2009; ... HOLLYWOOD, FLA.--New recommendations in breast cancer guidelines rank preferred adjuvant chemotherapy regimens and offer guidance on local therapy for women who present with stage IV breast cancer, according to an update presented at the annual conference of the National Comprehensive ...
Aromatase inhibitors may hasten bone loss in osteopenia.(WOMEN'S HEALTH)
Jun 01, 2009; ... WASHINGTON -- Aromatase inhibitors are associated with small but significant levels of additional bone loss in osteopenic women who take the drugs for hormone-sensitive breast cancer, according to a study of 104 women. After just 1 year of aromatase inhibitor therapy, these ...
No CV benefit from rosuvastatin in dialysis.(NEPHROLOGY)(cardiovascular)
Jun 01, 2009; ... While rosuvastatin significantly improved the lipid profile of patients with end-stage renal disease, those improvements did not translate into a decrease in the combined rate of heart attack, stroke, or cardiovascular death, a large randomized, controlled trial has confirmed. ...
Exercise lowers risk of death in HF patients.(CARDIOVASCULAR MEDICINE)(heart failure)
Jun 01, 2009; ... ORLANDO -- Heart failure patients who engage in aerobic activity can lower their risk of all-cause mortality or hospitalization, according to a new secondary analysis of data from a major National Heart, Lung, and Blood Institute-sponsored randomized trial. "It appears that only ...
CRT beneficial in mild heart failure.(CARDIOVASCULAR MEDICINE)(cardiac resynchronization)
Jun 01, 2009; ... ORLANDO -- Cardiac resynchronization therapy improves key clinical outcomes in patients with mild heart failure, a randomized trial has shown. In the European cohort of the Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction (REVERSE) trial, patients ...
Heart failure: hospital management 2009.(THE EFFECTIVE PHYSICIAN)(Report)
Jun 01, 2009; ... Background The American College of Cardiology recently published a focused update of their 2005 guideline for the diagnosis and management of heart failure in adults. One of the major changes incorporated in this guideline was a review of inpatient care for adults with heart ...
Will Plavix be the pharmacogenetic exemplar?(GENETICS IN YOUR PRACTICE)
Jun 01, 2009; ... Pharmacogenetics is the use of a patient's genetic information to inform the selection or dosing of medications. In general, pharmacogenetics involves "gene-drug" pairs, where DNA sequence variants of the gene are linked either to variation in the drug's metabolism or to alterations in the ...
Registry fails to find adverse PPI-Clopidogrel interaction.(GENETICS IN YOUR PRACTICE)(proton-pump inhibitor)
Jun 01, 2009; ... ORLANDO -- Patients with coronary disease who combine clopidogrel with a proton-pump inhibitor risk clinical consequences that remain unclear but are of concern, several reports indicate. The most recent report, on 535 patients from the University of Pittsburgh who received ...
Revise workflow when launching EMR system.(PRACTICE TRENDS)(electronic medical record)
Jun 01, 2009; ... Philadelphia--Installing an electronic medical record system at a primary care practice is a perfect time to also revamp the tasks the office staff performs. Having all staff members "work at the top of their licensure" is the guiding principle advocated by Dr. Cephus D. V. ...
IOM issues 16 conflict of interest recommendations.(PRACTICE TRENDS)(Institute of Medicine)
Jun 01, 2009; ... Physicians should stop accepting gifts or meals from industry representatives, according to a report from the Institute of Medicine that offers 16 recommendations aimed at limiting financial conflicts of interest in medicine. While some relationships with industry are ...
Part a to go broke in 2017.(POLICY & PRACTICE)(Brief article)
Jun 01, 2009; ... The Medicare Hospital Insurance Trust Fund will run out of money in 2017-2 years earlier than predicted last year--in part because the fund is collecting fewer payroll taxes during the recession, trustees of the fund announced in their annual report. If lawmakers don't make changes in the ...
Mental heath parity comments due.(POLICY & PRACTICE)(Mental Health Parity and Addiction Equity Act of 2008 )(Brief article)
Jun 01, 2009; ... The federal government is seeking public comments before implementing a law that demands broader insurance coverage for mental health benefits. The Mental Health Parity and Addiction Equity Act of 2008 requires that health plans use the same rules for cost-sharing and visit limits in ...
Families can't afford insurance.(POLICY & PRACTICE)(Brief article)
Jun 01, 2009; ... The majority of uninsured American families cannot afford to buy non-group health insurance, according to a study from the Agency for Healthcare Research and Quality. The study measured families' median net worth--their savings plus other assets, minus debt--rather than just family income ....
Medical homes are challenging.(POLICY & PRACTICE)(Brief article)
Jun 01, 2009; ... Transforming a primary care practice into a patient-centered medical home (PCMH) requires "epic whole-practice reimagination and redesign," according to researchers who reported on one of the first demonstrations of the PCMH model. The results of the 2-year pilot project, which was ...
HHS launches lupus campaign.(POLICY & PRACTICE)(United States Department of Health and Human Services)(Brief article)
Jun 01, 2009; ... The Department of Health and Human Services, in cooperation with the American College of Rheumatology and other health care organizations, has launched a national advertising campaign to educate women about lupus. "Despite its prevalence in the United States, lupus is ...
New Web site pushes reform.(POLICY & PRACTICE)('Voices of Physicians' campaign of the Doctors for America)(Brief article)
Jun 01, 2009; ... Doctors for America, a new grassroots physician organization, is launching a campaign to get physicians' voices heard on health care reform. The "Voices of Physicians" campaign has collected and published comments from doctors nationwide at www.voicesofphysicians.org. The 11,000-member ...
Health reform plan to be released in June.(PRACTICE TRENDS)
Jun 01, 2009; ... WASHINGTON -- The three committees with jurisdiction over health care in the House of Representatives will make their health reform "framework" public by early June, Rep. Henry Waxman (D-Calif.) said at a forum sponsored by the policy analysis firm Avalere Health. Rep. Waxman, ...
Residency redux with a Foreign twist.(GLOBAL PERSPECTIVES ON MEDICAL PRACTICE)(Mark Delman)(Interview)
Jun 01, 2009; ... The difference in the public's perception of doctors made a strong impression on Dr. Mark Delman during an 8-month locum tenens experience in New Zealand. "Going through an internal medicine residency in the United States, you get used to a lot of difficult interactions with ...
National health service corps to get overhaul.(PRACTICE TRENDS)
Jun 01, 2009; ... WASHINGTON -- With $2.5 billion in Recovery Act funding, major changes are in the works for the National Health Service Corps. And according to new Health Resources and Services Administration director Mary Wakefield, Ph.D., R.N., the money comes just in time. Last ...
Indications.(Psycho Donuts and treadmill desk)
Jun 01, 2009; ... Deep-Fried Controversy The next stop on our tour of the world's medically themed restaurants is Psycho Donuts in Campbell, Calif. "We bid a fond farewell to the tired, round ring of lameness," says the shop's Web site (www.psycho-donuts.com), but not to nurse impersonators ...
Analysis supports HT combo therapy.(NEWS)( hypertension)(Report)
Jun 15, 2009; ... SAN FRANCISCO -- A new analysis supports a controversial study that challenged the favored role of diuretics in combination therapy for hypertension, but some experts remain skeptical. Dr. Kenneth Jamerson, lead investigator of the Avoiding Cardiovascular Events Through ...
Panel calls Hb[A.sub.1c] preferred way to diagnose diabetes: threshold set at value of 6.5% or above.(NEWS)(hemoglobin )(Report)
Jun 15, 2009; ... NEW ORLEANS -- An international committee of experts has endorsed the use of the hemoglobin [A.sub.1c] assay to diagnose diabetes, at a level of 6.5% or above. The 21-member international committee, chaired by Dr. David M. Nathan, was appointed by the American Diabetes ...
New commissioner aims to open FDA's 'black box'.(NEWS)
Jun 15, 2009; ... In one of her first public acts at the Food and Drug Administration, new commissioner Dr. Margaret Hamburg announced that the agency aims to be more transparent about its daily work and decision-making process. "Over the years, complaints have been made about FDA's lack of ...
Top 10 U.S. pharmaceutical products by sales in 2008.(VITAL SIGNS)(Statistical table)(Brief article)
Jun 15, 2009 ... <Pre> VITAL SIGNS Top 10 U.S. Pharmaceutical Products by Sales in 2008 (in billions) Lipitor (atorvastatin) $7.8 Nexium (esomeprazole) $5.9 Plavix (clopidogrel)$4.9 Advair Diskus (fluticasone/salmeterol) $4.4 ...
Biyearly zoledronic acid gets nod for bone loss prevention.(NEWS)(Brief article)
Jun 15, 2009; ... The Food and Drug Administration has approved biyearly dosing of the osteoporosis drug zoledronic acid (Reclast) for the prevention of bone loss in postmenopausal women, making it the first bisphosphonate in its class to get the nod for a 2-year indication. The approval is based ...
Experts clash over combo pill for hypertension.(NEWS)(Report)
Jun 15, 2009; ... SAN FRANCISCO -- There is no consensus on whether starting hypertension treatment with a fixed-dose combination pill is the best approach, a topic debated at the annual meeting of the American Society of Hypertension. The Seventh Report of the Joint National Committee on ...
Hyperinsulinemia a risk factor for breast cancer.(NEWS)(Report)
Jun 15, 2009; ... Denver -- New data from the Women's Health Initiative indicate that hyperinsulinemia is an independent risk factor for breast cancer. This observation goes a long way toward explaining the well-established association between obesity and increased breast cancer risk, Marc J ....
Feds offer free software for data exchange.(NEWS)(Brief article)
Jun 15, 2009; ... The federal government has released free software that will enable health care organizations to exchange information over the Nationwide Health Information Network in the near future. The Nationwide Health Information Network (NHIN) is under development as a "network of ...
Guidelines warn against NSAIDs for elderly.(NEWS)(nonsteroidal anti-inflammatory agents)
Jun 15, 2009; ... CHICAGO -- An updated guideline addressing persistent pain in older people takes a tough stance on the use of nonsteroidal anti-inflammatory drugs. The American Geriatrics Society (AGS) guideline recommends that acetaminophen be considered for initial and ongoing treatment of ...
Should living organ donors receive financial incentives?(POINT/COUNTERPOINT)(Report)
Jun 15, 2009 ... The right incentives may resolve moral issues The number of people with kidney failure is increasing. By 2010, it's expected to be 591,000, with more than 80,000 patients waiting for a kidney transplant. This state of affairs is responsible for several unintended but ...
Technology can improve diabetes compliance.(ENDOCRINOLOGY)(Report)
Jun 15, 2009; ... WASHINGTON -- It ain't easy being diabetic. Life is filled with additional responsibilities: the linger sticks, the glucose monitoring, hemoglobin [A.sub.1c] testing, foot and eye exams. So how can things be made easier for diabetes patients and their physicians? One ...
Depression doubles risk for diabetic foot ulcers.(ENDOCRINOLOGY)(Report)
Jun 15, 2009; ... MONTREAL -- Major depression is associated with a twofold increase in the risk of incident diabetic foot ulcers, according to the results of a large, prospective, population-based cohort study. The findings suggest strong benefits in screening for and treating depression to ...
Depressed diabetes patients have higher 10-year mortality.(ENDOCRINOLOGY)(Report)
Jun 15, 2009; ... LONG BEACH, CALIF. -- People with diabetes have far higher scores on a depression scale than do those without diabetes, according to a large epidemiologic study. Furthermore, depression is associated with increased 10-year mortality in people with diabetes, but not in those ...
Daily weighing helps maintain weight loss.(ENDOCRINOLOGY)(Report)
Jun 15, 2009; ... New York -- Daily self-weighing helps people who have recently lost weight maintain their lower weight. People who are trying to maintain weight loss need to "learn to use scale information [the same way] a patient with diabetes uses blood-sugar monitoring," Rena R. Wing, Ph.D., ...
Use of meal replacement products increases weight loss.(ENDOCRINOLOGY)(Report)
Jun 15, 2009; ... PHILADELPHIA -- For patients trying to lose weight, meal replacement products boost the odds of success, according to Dr. Robert F. Kushner, a professor in the department of medicine at Northwestern University, Chicago. In a recent study, the most important predictors of ...
Flu vaccine may not be effective in the elderly.(INFECTIOUS DISEASES)(Report)
Jun 15, 2009; ... CHICAGO -- Trivalent inactivated influenza vaccine may not elicit a clinically adequate antibody response in elderly adults, pilot data suggest. Based on blood assays taken before and 4 weeks after administration of the Fluarix 2007/2008 formula, 88% of 71 community-dwelling ...
Screening colonoscopy not helpful after age 70.(GASTROENTEROLOGY)(Report)
Jun 15, 2009; ... MIAMI BEACH -- The use of colonoscopy to screen for colorectal cancer may cause net harm if continued beyond age 70, according to a clinical- and cost-effectiveness study. Fecal occult blood testing, on the other hand, remained both effective and cost-effective up until age 80 years. ...