Family Practice News articles from February 2008

Family Practice News archives from February 2008

The medical home embeds psychiatry.(Mental Health)(Grant Family Medicine)
February 1, 2008... [ILLUSTRATION OMITTED] Dr. Robert Skully and Ms. Pat Martin are training their residents to meet patients' mental health care needs within the medical home. Under the model at the Grant Family Medicine residency program in Columbus,...

Added calcium may raise MI risk in older women: physicians clash on need to alter practice.(Cardiovascular Medicine)(Clinical report)
February 1, 2008... Calcium supplementation significantly increased the risk of a myocardial infarction among healthy, postmenopausal women, compared with those taking placebo in a secondary analysis of an osteoporosis study. Physicians should consider this...

Ezetimibe fails to rein in atherosclerotic advance.(Cardiovascular Medicine)
February 1, 2008... Results from a controversial study assessing ezetimibe's ability to slow atherosclerotic progression when added to a high-dose statin regimen have cardiologists split on whether the findings signaled a flawed study or a flawed drug. The...

Projected aggregate physician and clinical service expenditures in the U.S.(VITAL SIGNS)(Table)(Brief article)
February 1, 2008... Projected Aggregate Physician and Clinical Service Expenditures in the U.S. (in billions of dollars) 2006 $447.0 2008 -- 2010 -- 2012 -- 2014 -- 2016 $819.9 Note; Based on the 2005 version of the...

FDA advises against cold remedies.(News)(Food and Drug Administration)
February 1, 2008... The Food and Drug Administration has released a public health advisory strongly recommending against the use of over-the-counter cough and cold products in children and infants aged under 2 years, but will not issue recommendations until the...

PAD is rising among asymptomatic Americans, and in women especially.(News)
February 1, 2008... ORLANDO -- The prevalence of peripheral artery disease in asymptomatic adults is increasing in the United States, according to data that were collected on more than 5,000 people by the National Health and Nutrition Examination Survey (NHANES)...

ESA risks in patients with cancer are under review.(NEWS FROM THE FDA)
February 1, 2008... More evidence associating erythropoiesis-stimulating agents with increased tumor growth and mortality in patients with cancer is being reviewed at the Food and Drug Administration and could result in additional action by the agency. The...

Natalizumab gets the nod for use in selected Crohn's patients.(NEWS FROM THE FDA)
February 1, 2008... The Food and Drug Administration's approval of natalizumab for the treatment of moderate to severe Crohn's disease in selected patients includes the requirement that the drug will be administered only through a restricted distribution program,...

Derma-Smoothe/FS.(New & Approved)(Hill Dermaceuticals Inc.)(Drug overview)
February 1, 2008... Derma-Smoothe/FS (fluocinolone acetonide topical body oil, 0.01%, Hill Dermaceuticals Inc.) The Food and Drug Administration approved Derma-Smoothe/FS (fluocinolone acetonide) Topical Oil, 0.01% for treatment of moderate to severe atopic...

Omnaris nasal spray.(New & Approved)(Drug overview)
February 1, 2008... Omnaris Nasal Spray (ciclesonide nasal spray, Nycomed) The FDA approved Omnaris (ciclesonide) Nasal Spray for treatment of seasonal allergic rhinitis in patients aged 6-11 years. * Recommended Dosage: The recommended 200 mcg per day is...

Guidelines focus on palliative care at end of life.(News)
February 1, 2008... Palliative care at the end of life should focus on the assessment and alleviation of symptoms of pain, shortness of breath, and depression, according to new guidelines released by the American College of Physicians. "The ACP's drawing a...

Part D boosts drug utilization, drives up nation's health tab.(News)
February 1, 2008... WASHINGTON -- The nation spent $2 trillion, or $7,000 per person, on health care in 2006. Although that was a small increase from the previous year, America's prescription drug tab increased by 8.5%, fueled largely by the new Medicare Part D...

Diabetes education needs reevaluation.(Editorial)
February 1, 2008... With the incidence of diabetes increasing, especially type 2 diabetes in children and adolescents, there is a renewed interest in how to manage diabetes care. It is even more critical because many with diabetes can't achieve metabolic goals...

Challenges of being a single dad.(Letters)(Letter to the editor)
February 1, 2008... I really have been able to identify almost to the letter with Dr. Michael A. Volz and his experience as a single parent ("Being a Single Dad Is Ongoing Struggle," Letters, Dec. 15, 2007, p. 8). I have three children and have struggled to...

Vasopressin antagonists effective for hyponatremia.(Cardiovascular Medicine)(conivaptan and satavaptan)
February 1, 2008... SAN FRANCISCO -- Satavaptan and conivaptan seem effective in treating dilutional hyponatremia, a frequent consequence of heart failure and of renal failure. Data supporting the efficacy of the vasopressin receptor antagonists for this...

Pioglitazone may lower cardiovascular risk in CKD patients.(Cardiovascular Medicine)(Clinical report)
February 1, 2008... Treatment with pioglitazone might help lower the risk of cardiovascular events in patients with chronic kidney disease, the results of a large study suggest. "CKD, as defined by a glomerular filtration rate of less than 60 mL/min per 1.73...

Coronary calcium flags young men at cardiac risk.(Cardiovascular Medicine)
February 1, 2008... ORLANDO -- Coronary artery calcium identified young men at relatively high risk for a coronary heart disease event even when their Framingham risk score was low, in a study with more than 1,600 men. The new findings "challenge the notion...

Continuous glucose monitoring holds potential.(Metabolic Disorders)
February 1, 2008... COLUMBUS, OHIO -- Real-time continuous glucose monitoring is likely to become the standard of care for the treatment of type 1 diabetes within the next 5-10 years, but for now it's best to reserve the technology for selected patients, Dr. Irl...

Moderate exercise improves metabolic syndrome in adults.(Metabolic Disorders)
February 1, 2008... Moderate-intensity exercise that was equivalent to walking about 12 miles over an average of 170 minutes per week significantly improved features of the metabolic syndrome even without dietary modification in a study of 171 overweight adults....

Men's Osteopenia Dx unlikely to change at 3 years.(Metabolic Disorders)
February 1, 2008... HONOLULU -- Men diagnosed with osteopenia through dual-energy x-ray absorptiometry are unlikely to have a change in diagnosis at a 3-year follow-up DXA test, according to a study presented in a poster at the annual meeting of the American...

Bazedoxifene nips postmenopausal osteoporosis risk.(Metabolic Disorders)
February 1, 2008... HONOLULU -- Bazedoxifene is effective in preventing osteoporosis in postmenopausal women, according to the results of a 2-year, phase III, placebo-controlled trial presented at the annual meeting of the American Society for Bone and Mineral...

History, low BMD raise long-term fracture risk.(bone mineral density)
February 1, 2008... Low bone mineral density and a prevalent vertebral fracture were long-term independent predictors of an increased risk of vertebral fractures in women aged 65-99 who were followed for almost 15 years. Previous studies have shown links...

Assessment tool helps classify CAP severity.(Infectious Diseases)(community-acquired pneumonia)
February 1, 2008... CHICAGO -- A simple severity-assessment tool for community-acquired pneumonia accurately identified patients needing intensive respiratory or inotropic support in a multicenter validation study. SMART-COP was developed as part of the...

Petting zoos, swimming pools bring infectious diarrhea closer to home.(Infectious Diseases)
February 1, 2008... SAN FRANCISCO -- Go beyond the usual questions about travel to other countries or the keeping of nontraditional pets, when asking parents about potential environmental exposures to diarrhea-causing agents, Dr. Sarah S. Long said at the annual...

Asthmatic children bear the brunt of the influenza burden.(Infectious Diseases)(Clinical report)
February 1, 2008... The influenza-related hospitalization rates of young children with asthma were four times greater than those of children without asthma, and outpatient visits attributable to influenza were about twice as likely among those with asthma,...

Chest radiographs may be overused in severe CAP.(Infectious Diseases)(community-acquired pneumonia)
February 1, 2008... CHICAGO -- Routine follow-up chest radiography may not be appropriate for patients with severe community-acquired pneumonia who clinically respond to initial antibiotic therapy, according to a multicenter study presented at the Interscience...

Database for RSV.(Infectious Diseases)(respiratory syncytial virus)(Brief article)
February 1, 2008... A redesigned Web site from the Centers r Disease Control and Prevention now provides data that has been gathered on respiratory syncytial virus (RSV) in the U.S., thus allowing parents and physicians to track the locations of virus outbreaks in...

Approach to C. difficile must change.(Infectious Diseases)(Clostridium)
February 1, 2008... SAN FRANCISCO -- Community-onset Clostridium difficile infection that is not antibiotic related has emerged as a multinational problem that can be life threatening, said Dr. Sarah S. Long, chief of infectious diseases at St. Christopher's...

Olive, whey products may help soothe psoriasis.(Skin Disorders)
February 1, 2008... Two new natural products--one containing olive polyphenols and the other a proprietary combination of whey proteins--can reduce the symptom burden and appearance of mild to moderate psoriasis. Both products were recently introduced in the...

Practice hosts after-hours psychological services.(Mental Health)
February 1, 2008... SAN FRANCISCO -- When primary care physicians head home at the end of the day in one New York practice, mental health providers reopen the doors to children and families who need their help. Offering the after-hours office space to mental...

Self-management tool helps patients navigate depression.(Mental Health)
February 1, 2008... Family physician Patrice Ranger estimates that she sees about 10 depressed patients a week at the student health services clinic at the Simon Fraser University campus in Burnaby, B.C. That's about 10% of her practice. However, she can help...

Mental health care gaps recast PCPs as 'reluctant' psychiatrists.(Mental Health)
February 1, 2008... VANCOUVER, B.C. -- Primary care physicians in community health centers say they are practicing "reluctant psychiatry" because mentally ill patients with chronic diseases often have nowhere else to turn for care, Dr. Carol Darr reported in a...

Histology necessary for endometriosis diagnosis.(Women's Health)(International Pelvic Pain Society)
February 1, 2008... SAN DIEGO -- When it comes to diagnosing endometriosis, visual inspection is not enough, Dr. Georgine Lamvu said at the annual meeting of the International Pelvic Pain Society. "We need to be more careful to use excisional biopsies during...

Response to hormonal therapy doesn't point to endometriosis.
February 1, 2008... WASHINGTON -- Response to hormonal therapy does not accurately predict whether a patient has endometriosis, Dr. Todd R. Jenkins reported at the annual meeting of the AAGL. Laparoscopy has long been the standard for diagnosing...

Prostate cancer therapy breaks deemed risky.(Men's Health)
February 1, 2008... LOS ANGELES -- For men with low-risk prostate cancer, skipping more than two sessions of radiotherapy beyond their scheduled weekends off can have long-term consequences, investigators found when they reviewed nearly 1,800 patients treated from...

Cialis gets approved for once-daily use.(Men's Health)
February 1, 2008... The erectile dysfunction drug Cialis (tadalafil) has been approved by the Food and Drug Administration for once-daffy use in 2.5-mg and 5-mg doses, the drug's manufacturer announced. "This low-dose daily treatment option of Cialis may be...

Gastric bypass also cuts cancer, diabetes, heart disease mortality.(Obesity)
February 1, 2008... Severely obese individuals who opt to have gastric bypass surgery not only reduce their waistlines, they reduce their long-term total mortality as well, Utah researchers have reported. Rates of death from diabetes, coronary artery disease,...

Federal program aims to prevent obesity in girls.(Obesity)
February 1, 2008... Physicians can now turn to a free federally-developed program that provides the tools to educate parents and caregivers on how to help their young adolescent daughters make small and specific behavior changes to maintain a healthy weight and...

Families lose weight with fat, sugar, carbs intake counseling.(Obesity)
February 1, 2008... A family dietary program that offered monthly nutritional counseling and online computer support helped parents and children cut their daily intake of fat and sugar. Although the counseling lasted for only 8 months, changes were sustained...

Biologics in pipeline for juvenile idiopathic arthritis.(Musculoskeletal Disorders)(Medical condition overview)
February 1, 2008... BOSTON -- Treatment options for children with juvenile idiopathic arthritis might soon expand, with safety and efficacy now having been demonstrated for two additional biologic agents--even in patients who have failed to respond to methotrexate...

Changes in synovial volume could predict progression of osteoarthritis.(Musculoskeletal Disorders)(Clinical report)
February 1, 2008... FORT LAUDERDALE, FLA. -- Early screening of synovial fluid volume changes using magnetic resonance imaging could identify patients at risk for progressive knee osteoarthritis, according to interim findings of an ongoing study. Synovial...

Life expectancy no better in RA patients, despite new therapies.(Musculoskeletal Disorders)(Medical condition overview)
February 1, 2008... Rheumatoid arthritis patients have not experienced a decline in mortality, despite dramatically increased life expectancy in the general population and newer, more aggressive arthritis treatments. This stagnation is contributing to a...

Early asthma tied to bacteria in neonatal airways.(Pulmonary Medicine)
February 1, 2008... Infants whose airways are colonized by one or more of three bacterial species are significantly more likely to develop asthma by 5 years of age than are other children. Dr. Hans Bisgaard and his colleagues from the Copenhagen University...

Inner-city preschoolers with asthma should be evaluated every 3 months.(Pulmonary Medicine)
February 1, 2008... A study of preschool-age, inner-city children with asthma found marked fluctuations in the degree of asthma control within 3 months, suggesting that frequent evaluations of asthma control in this population may be warranted, investigators...

Elective C-section linked to respiratory morbidity.(Pulmonary Medicine)
February 1, 2008... Elective cesarian section increases by up to fourfold the risk of respiratory morbidity in babies delivered at 37-39 weeks of gestation, compared with babies delivered vaginally or by emergency C-section at the same gestational age. That...

Contrast medium eased small bowel blockages.(Digestive Disorders)
February 1, 2008... MONTREAL -- FOE patients with adhesive small bowel obstruction, a water-soluble contrast medium produces significantly better outcomes than conservative treatment, according to a study presented at a meeting sponsored by the International...

Diagnostic criteria devised for adult autoimmune enteropathy.(Digestive Disorders)
February 1, 2008... Five criteria for diagnosing autoimmune enteropathy are now available thanks to a compilation of 15 patients at the Mayo Clinic, which has more than doubled the number of cases in the published literature. The researchers found that only...

Mild, acute pancreatitis resolves well with a normal diet.(Digestive Disorders)
February 1, 2008... PHILADELPHIA -- An early return to a normal diet was not harmful and might even have expedited the hospital discharge of patients with mild, acute pancreatitis in a randomized, prospective study with 62 patients. "Early feeding appears...

Stroke risk after TIA lowest at specialized centers.(Geriatric Medicine)
February 1, 2008... The risk of a stroke within 7 days of a transient ischemic attack was lowest when patients were treated by specialist stroke services on an emergency basis, according to a systematic review and meta-analysis that included 10,126 TIA patients....

Toolkit helps guide elderly on the Web.(Geriatric Medicine)(Helping Older Adults Search for Health Information Online: A Toolkit for Trainers)(Brief article)
February 1, 2008... The National Institute on Aging is offering a free curriculum, "Helping Older Adults Search for Health Information Online: A Toolkit for Trainers." Instructors can use this curriculum to teach elderly people how to find health information on...

Evidence supports concern over nonfocal TNAs.(Geriatric Medicine)
February 1, 2008... Adults who suffered transient neurological attacks with nonfocal symptoms were at increased risk of developing major vascular disease and dementia in a study of more than 6,000 adults aged 55 years and older. The findings challenge the...

Bipolar, depression symptoms cluster in epilepsy.(Clinical Rounds)
February 1, 2008... PHILADELPHIA -- Symptoms of bipolar disorder are prevalent among patients with epilepsy, and are highly associated with depressive symptoms in these patients, an analysis of 54 epilepsy patients at a tertiary care center shows. In a poster...

Vitamin E, lutein shave cataract risk.(Clinical Capsules)(Brief article)
February 1, 2008... Higher intakes of the antioxidants vitamin E and lutein were associated with a 14%-18% lower risk of cataract in the Women's Health Study, according to William G. Christen, Sc.D., of Brigham and Women's Hospital, Boston, and his associates. ...

Smoking raises the odds for AMD.(Clinical Capsules)(age-related macular degeneration)(Brief article)
February 1, 2008... Smoking might raise the odds of developing age-related macular degeneration by nearly 50% over the long term, and it might also be associated with the cumulative progression of AMD in the Beaver Dam Eye Study, said Dr. Ronald Klein and...

Air quality matter in lung function.(Clinical Capsules)(Brief article)
February 1, 2008... Improving air quality, particularly by reducing particulate-matter pollution, attenuates the normal age-related decline in lung function in adults, according to Sara H. Downs, Ph.D., of the University of Basel (Switzerland) and associates in...

Clones and the human food chain.(Genomic Medicine)
February 1, 2008... Primary care providers are asked often about issues that aren't strictly related to diagnoses and treatments, and increasingly, the question of food safety arises (think contaminated spinach and bovine growth hormone). Enter another link...

States rapidly adopting cystic fibrosis screening in newborns.(Clinical Rounds)
February 1, 2008... SALT LAKE CITY -- Twenty-nine states required newborn cystic fibrosis screening as of this past summer, and more states are likely to do so soon, Dr. Michael Rock said at the annual meeting of the North American Society for Pediatric...

Group to Study the genetics of serious adverse drug events.(Clinical Rounds)
February 1, 2008... A group of eight of the largest drug manufacturers has formed a consortium to study the genetics of serious adverse drug reactions. The Serious Adverse Events Consortium will work closely with the Food and Drug Administration on the...

Expert offers tips for effective opioid prescribing.(Clinical Rounds)
February 1, 2008... SAN DIEGO -- A good way to ensure a balanced approach to opioid prescribing is to follow the key principles of the Model Policy for the Use of Controlled Substances for the Treatment of Pain, Dr. Edward Michna advised at the annual meeting of...

Vitamin D inadequacy might have a role in chronic pain.(Clinical Rounds)
February 1, 2008... SAN FRANCISCO -- In what may be the first study of the prevalence of vitamin D inadequacy in patients seeking treatment for chronic pain, those who were on opioids used significantly higher doses and had been taking opioids significantly longer...

Pain catastrophizing worsens disability from osteoarthritis.(Clinical Rounds)
February 1, 2008... FORT LAUDERDALE, FLA. -- Pain catastrophizing and pain-related fear are associated with increased disability and worse physical functioning among overweight patients with osteoarthritis, according to a study presented at the World Congress on...

Medicare payment creates uncertainty for the future.(Practice Trends)
February 1, 2008... Doubt and low morale are rampant in many primary care practices in light of the uncertainty surrounding Medicare physician payment rates this year. While members of Congress averted a 10% cut in the Medicare physician fee schedule,...

Wealthy, insured patients get free drug samples over poor, uninsured.(Practice Trends)(Brief article)
February 1, 2008... Poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples, according to a study by physicians from Cambridge Health Alliance and Harvard Medical School. The study found that, in 2003, 12% of...

Low-income seniors helped.(Policy & Practice)(Brief article)
February 1, 2008... The Centers for Medicare and Medicaid Services has proposed new rules that would allow more low-income Medicare beneficiaries to remain in their current prescription drug plan without having to pay a premium. Each year, CMS recalculates the...

Coverage improves health.(Policy & Practice)(Brief article)
February 1, 2008... Uninsured adults 55-64 years old, particularly those with cardiovascular disease or diabetes, saw their health improve significantly once they became eligible for Medicare, a study from Harvard Medical School, Boston, reported. The study looked...

Grant funds medical home study.(Policy & Practice)(Brief article)
February 1, 2008... The American College of Physicians has received a $225,000 grant from the Commonwealth Fund to study the cost of providing a patient-centered medical home. The grant, part of the Commonwealth Fund's Patient-Centered Primary Care Initiative,...

Retiree benefits can be cut.(Policy & Practice)(Brief article)
February 1, 2008... A new federal regulation will allow employers to provide more limited health care benefits for retirees who are eligible for Medicare. The rule, which the Equal Employment Opportunity Commission released in late December, responds to a court of...

Expanded INR monitor coverage.(Policy & Practice)(international normalized ratio)(Brief article)
February 1, 2008... CMS is considering expanding coverage for home prothrombin time (international normalized ratio) monitoring. Currently, monitoring is limited to patients with mechanical heart valves. The agency proposes to expand coverage of monitoring to...

Judge overturns Rx info law.(Policy & Practice)(Brief article)
February 1, 2008... A federal judge has overturned a Maine law that would have restricted medical data companies' access to physician prescribing information. In a decision that relied heavily on a previous ruling in New Hampshire, U.S. District Judge John...

Medicare's final outpatient rule boosts device payments.(Practice Trends)
February 1, 2008... The Centers for Medicare and Medicaid Services will increase payments for outpatient services by an average of 3.8% in 2008, with most of the neurologic, cardiac, and gynecologic procedures covered under the payment system being slated for...

Criteria for coverage of sleep apnea devices may be eased.(Practice Trends)
February 1, 2008... Medicare may soon begin providing coverage for continuous positive airway pressure devices for beneficiaries who have been diagnosed with obstructive sleep apnea using unattended home monitoring. The coverage proposal is an expansion of...

Survey shows wide support for individual insurance mandate.(Practice Trends)
February 1, 2008... Most Americans favor a continuation of the employer-based health insurance system and say that they believe health insurance costs should be shared among individuals, employers, and the government, according to the results of a survey conducted...

Study: emergency on-call coverage is unraveling.(Practice Trends)
February 1, 2008... Emergency on-call coverage from specialist physicians is "unraveling" at hospitals across the country, resulting in delayed treatment, patient transfers, permanent injuries, and even death, according to a study from the Center for Studying...

Inspector general faults specialty hospital EDs.(Practice Trends)
February 1, 2008... Physician-owned specialty hospitals are largely unprepared to handle emergencies and should be more closely tracked by the government to ensure that they comply with Medicare rules, according to a report from the Inspector General of the...

Protect e-mail to minimize medicolegal liability.(Practice Trends)
February 1, 2008... SAN FRANCISCO -- Give e-mail correspondence with patients the same care and attention you'd give to paper records, faxes, or phone calls in order to minimize medicolegal liability, Dr. Jeffrey L. Brown advised. Physicians should be...

A matter of privilege.(LAW & MEDICINE)
February 1, 2008... The case of Russell Adkins, M.D. v. Arthur Christie et al. may not sound very exciting on its face, but could be a significant one for practicing physicians because of its potential effect on peer review. Dr. Adkins, an African American,...

It's not always easy to live up to one's medical ideals.(Practice Trends)
February 1, 2008... WASHINGTON -- Easier said than done. That may be the take-away message from a study that revealed gaps between physicians' attitudes and behavior when it comes to standards of professionalism. A national survey of 3,500 primary care and...

HIPAA privacy rule may impede research, fail to protect subjects.(Practice Trends)
February 1, 2008... The Health Insurance Portability and Accountability Act's privacy rule has stymied clinical research by making it more expensive and time consuming, according to data from a national survey of more than 1,500 epidemiologists. The Institute...

Know your responsibilities in handling Vaccine Information.(Practice Trends)
February 1, 2008... SAN FRANCISCO -- If you're not giving parents a copy of a Vaccine Information Statement every time they accept or reject a child's immunization, you're not meeting your obligations under the National Vaccine Injury Compensation Program and...

MedPAC recommends a 1.1% fee increase for 2009.(Practice Trends)
February 1, 2008... WASHINGTON -- The Medicare Payment Advisory Commission has voted to recommend that Congress increase Medicare physician fees by 1.1% in 2009. The recommendation will be included in MedPAC's Final report to Congress next month but was...

IOM committee charged to fix resident hours.(Practice Trends)(Institute of Medicine)
February 1, 2008... WASHINGTON -- Five years after the establishment of across-specialty rules to limit resident work hours, the issue of trainee schedules in teaching hospitals is again under the microscope as a continuing threat to patient safety--and this time...

Health care stakeholders bullish on grants.(Practice Trends)
February 1, 2008... Participants in several hospital and physician-related quality organizations are sanguine that almost $16 million in grants from the Robert Wood Johnson Foundation will hasten development of national cost and quality measures, as well as...

Cupid's all-natural fix, guaranteed.(INDICATIONS)(anti-impotence agents)(Brief article)
February 1, 2008... Valentine's Day is nearly upon us, and the Bureau of Indications would like to pass along some recent warnings from the Food and Drug Administration. According to a press release, use of the following supposedly "all-natural" erectile...

Till rehab do us part.(INDICATIONS)(Brief article)
February 1, 2008... Spouses who report discordant drug use--meaning one uses and one does not--are the least satisfied with their marriages, leading researchers to conclude that the best way to get high while married is secretly, according to a recent report in...