Family Practice News articles from May 2007

Family Practice News archives from May 2007

Depression screen worthwhile in CAD.(Cardiovascular Medicine)
May 1, 2007... ORLANDO -- Depression is not a proven risk factor for coronary artery disease events, but the data available now are compelling enough to warrant screening patients with coronary disease for depression and treating it when it's diagnosed. ...

Top 10 prescriptions by U.S. sales.(VITAL SIGNS)(Statistical table)(Brief article)
May 1, 2007... Top 10 Prescriptions by U.S. Sales (in billions of dollars) Lipitor $8.6 Nexium $5.1 Advair diskus $3.9 Aranesp $3.9 Prevacid $3.5 Epogen $3.2 Zocor $3.1 Enbrel ...

Older LDL agent may find new role in diabetes care: [HbA.sub.1c] dropped half a percentage point.(Metabolic Disorders)
May 1, 2007... SEATTLE -- The LDL-lowering agent colesevelam also lowers blood glucose levels significantly in type 2 diabetes patients already on oral diabetes medication, according to two studies presented at the annual meeting of the American Association...

Controversial study links HT to ovarian cancer risk.(News)
May 1, 2007... An additional 1,000 women may have died from ovarian cancer linked to hormone therapy during a 15-year period in the United Kingdom, according to the results of an enormous, but controversial, epidemiologic study. After 6.5 million...

FDA panel rejects Merck's Arcoxia.(News)(arthritis drugs)
May 1, 2007... GAITHERSBURG, MD. -- Safety concerns about Merck's Arcoxia (etoricoxib) led the Food and Drug Administration's Arthritis Drugs Advisory Committee to vote 20-1 against approval of the COX-2 inhibitor. In presentations to the FDA and at...

Updated syncope guidelines emphasize history.(News)(American College of Emergency Physicians)
May 1, 2007... MAUI, HAWAII -- The American College of Emergency Physicians' newly revised guidelines for evaluating patients with syncope play down age as a risk factor and emphasize the need to get a cardiac history, Dr. James V. Quinn explained at a...

FDA deems antiemetic suppositories ineffective.(News)
May 1, 2007... Tigan and other suppository drug products that contain trimethobenzamide hydrochloride have not been shown to be effective for nausea and vomiting and should no longer be marketed, says the Food and Drug Administration. The FDA announced...

Physicians have another year to get their NPI.(News)(National Provider Identifiers regulation from Centers for Medicare and Medicaid Services )(Brief article)
May 1, 2007... Physicians and other health care providers who fail to comply with the May 23 deadline to acquire and start using National Provider Identifiers will not be penalized if they can show they deployed a "contingency plan," the Centers for Medicare...

Fluoroquinolones nixed for treating gonorrhea.(News)
May 1, 2007... Fluoroquinolones should no longer be used for the treatment of gonorrhea in the United States, the Centers for Disease Control and Prevention has concluded. The recommendation is based on new evidence suggesting that the prevalence of...

Lipitor, HepaGam B.(New & Approved)
May 1, 2007... Lipitor (atorvastatin, Pfizer Inc.) The lipid-lowering drug approved for five new indications in adults with coronary heart disease; namely, to reduce the risk of these five cardiovascular events: nonfatal myocardial infarction, fatal and...

'Ethics police' enforce draconian rules.(Letters)(Letter to the editor)
May 1, 2007... The self-appointed "ethics police" have taken to a new extreme the topic of pharmaceutical sales promotions to physicians ("Schools Put the Kibosh on Gifts From Drug Reps," Jan. 1, 2007, p. 45). Despite the assertions in the article,...

NPI Web site has problems.(Letters)(Letter to the editor)
May 1, 2007... The article on the National Provider Identifier sounds more like a sales pitch for the Centers for Medicare and Medicaid Services than a balanced report ("Sign Up Soon for National Provider Identifier," Feb. 15, 2007, p. 44). The NPI Web...

Problems with vaccine mandates.(Letter to the editor)
May 1, 2007... Government should be involved in health care advocacy, but I disagree with legislative fiat ("Caution Urged on State HPV Vaccine Mandates," Feb. 1, 2007, p. 4). That would deprive individuals of making their own informed choices. We can...

Chronic pain management belongs in primary care.(Guest Editorial)
May 1, 2007... The treatment of chronic pain belongs squarely within the domain of primary care, but it may take some extra effort to incorporate it into our practice. As primary care physicians, we are the ones who follow patients over long periods of...

Is portable home monitoring the future of sleep apnea diagnosis? It's more equitable, accessible, and cost effective.(Point/Counterpoint)
May 1, 2007... Obstructive sleep apnea affects an estimated 3 million American adults. It causes significant morbidity and mortality. Effective treatment options exist. All of this makes the current long delays in diagnosis via polysomnography (PSG) performed...

Is portable home monitoring the future of sleep apnea diagnosis? It could reduce access to diagnostic expertise.(Point/Counterpoint)
May 1, 2007... Many issues need to be explored further before a national portable sleep monitoring policy can be implemented. Paramount among these is determining the validity, reliability, and accuracy of data collection using portable sleep monitoring. We...

Citalopram, but not psychotherapy, lifts depression in cardiac patients.(Cardiovascular Medicine)
May 1, 2007... The addition of citalopram to the clinical management of depression in people with established coronary artery disease decreases the symptoms, reported Dr. Francois Lesperance and his associates in the Canadian Cardiac Randomized Evaluation of...

Depression speeds atherosclerosis after coronary bypass surgery.(Cardiovascular Medicine)(Clinical report)
May 1, 2007... ORLANDO -- Patients who were depressed after coronary artery bypass surgery were significantly more likely to have atherosclerotic disease progression within their grafted vessels during follow-up, in a post hoc analysis of data from over 1,300...

Nicotine patches seem to be safe in cardiac patients.(Cardiovascular Medicine)(Brief article)
May 1, 2007... NEW ORLEANS -- Nicotine patches are safe for smokers with coronary artery disease and stress-induced myocardial ischemia, according to results of the first randomized, placebo-controlled, multicenter clinical trial to examine this issue. ...

Adult-onset asthma doubles women's heart risks.(Cardiovascular Medicine)
May 1, 2007... ORLANDO -- Adult-onset asthma was linked to an almost twofold increased rate of coronary heart disease or stroke in women in a study with more than 15,000 people. The mechanism behind this association is unknown but may be explained by an...

Hyperuricemia may elevate hypertension risk.(Cardiovascular Medicine)
May 1, 2007... ORLANDO -- Hyperuricemia was an independent risk factor for the development of hypertension in a post hoc analysis of data collected on more than 3,000 men. Future studies will need to address whether reducing a high serum level of uric...

Psychosocial risk factors weigh on heart patients.(Cardiovascular Medicine)(Brief article)
May 1, 2007... WASHINGTON -- Psychosocial risk factors contribute a level of risk for cardiovascular events in clinically symptomatic women that is similar to the traditional major risk factors, Thomas Rutledge, Ph.D., reported at the annual meeting of the...

Incidentally found thyroid nodules oft malignant.(Metabolic Disorders)
May 1, 2007... CHICAGO -- A high rate of malignancy was found in a retrospective review of incidentally discovered thyroid nodules among patients with a history of other cancers, Dr. Scott M. Wilhelm reported at the annual meeting of the Central Surgical...

Vitamin D deficiency occurs even when marker is 'normal'.(Metabolic Disorders)
May 1, 2007... TAMPA -- Vitamin D deficiency is highly prevalent, even in patients whose 25-hydroxyvitamin D levels are within the "normal" range, Dr. Robert P. Heaney said at the annual meeting of the International Society for Clinical Densitometry. ...

Euthyroid function can steer metabolic syndrome.(Metabolic Disorders)(Brief article)
May 1, 2007... People with low normal thyroid function are at elevated risk for components of the metabolic syndrome, according to the first large, community-based study of this population. Previous research showed an association between overt...

Exclusive breast-feeding inhibits HIV transmission.(Infectious Diseases)
May 1, 2007... LOS ANGELES -- Exclusive breast-feeding has now been convincingly shown to be associated with less transmission of HIV from infected mother to child than is breast-feeding that is sometimes supplemented with formula, Dr. Hoosen Coovadia said at...

Mumps outbreak points to system weaknesses.(Infectious Diseases)
May 1, 2007... KANSAS CITY, MO. -- The resurgence of mumps in 2006 was unexpected but provided the medical community with some valuable lessons, two infectious disease experts reported at the National Immunization Conference sponsored by the Centers for...

Vaccine mix-up risk rises with greater product availability.(Infectious Diseases)
May 1, 2007... MIAMI BEACH -- Inadvertent misadministration can occur with several new vaccines that are commonly used, Dr. Larry Picketing said at the annual Masters of Pediatrics conference sponsored by the University of Miami. Confusion has occurred...

Nontoxic approach to head lice dries them up.(Skin Disorders)
May 1, 2007... MONTREAL -- A product that dehydrates, rather than poisons, head lice should be available soon in the United States to fill a gap widened by parental concerns about the toxicity of existing treatments, Dr. Ian Landells, said at Dermatology...

Plantar wart patients report satisfaction with bleomycin.(Skin Disorders)
May 1, 2007... WASHINGTON -- Intralesional bleomycin should continue to be a therapeutic option for treating plantar warts, Dr. William Stebbins said in a poster presentation at the annual meeting of the American Academy of Dermatology. The efficacy of...

Bipolar disorder differs according to age, gender.(Mental Health)
May 1, 2007... NEW YORK -- Significant differences are apparent in the rates of mania and types of externalizing comorbidity between children, adolescents, and adults with bipolar disorder, Dr. Gabrielle A. Carlson reported at a psychopharmacology update...

Online autism registry opens door on research.(Mental Health)
May 1, 2007... Decades ago, researchers banded together to help fight childhood leukemia and, in doing so, transformed the disease from a virtual death sentence to one that the vast majority of children survive. Researchers at Baltimore's Kennedy Krieger...

Not all anogenital HPV infections need treatment.(Women's Health)
May 1, 2007... HOUSTON -- Although most clinicians treat all anogenital human papillomavirus infections, nontreatment is something to consider in certain cases, Dr. Peter J. Lynch said at a conference on vulvovaginal diseases jointly sponsored by Baylor...

Pigmented vulvar lesions often require biopsy.(Women's Health)(Brief article)
May 1, 2007... HOUSTON -- Biopsy should be considered more frequently for pigmented lesions that appear on the vulva, compared with elsewhere on the body, because in this location they are particularly tricky to identify by appearance alone, Dr. Libby Edwards...

Algorithm addresses late postpartum headache.(Women's Health)
May 1, 2007... SAN FRANCISCO -- Evaluating persistent headache that presents more than 24 hours after delivery requires a stepwise, multidisciplinary approach, Dr. Caroline Stella said at the annual meeting of the Society for Maternal-Fetal Medicine. ...

Should hormone treatment be started early in response to rising prostate-specific-antigen levels? Why wait?(Point/Counterpoint)
May 1, 2007... A raging controversy exists regarding the use of early vs. delayed hormone therapy and the use of chemotherapy for patients with rising prostate-specific-antigen levels after failed local therapy, or stage D1.5 disease. Biochemical failure...

Should hormone treatment be started early in response to rising prostate-specific-antigen levels? What's the hurry?(Point/Counterpoint)
May 1, 2007... It is important to look at the data and try to make the most rational decisions that we can make. Most of our current data on the use of hormones for rising PSA are derived from explanatory (phase I and phase II) trials. There have been some...

Early therapy is not helpful for recurrent prostate cancer.(Men's Health)
May 1, 2007... Available evidence does not support the early use of androgen-deprivation therapy in men whose prostate cancer recurs after treatment, according to clinical practice guidelines issued by the American Society of Clinical Oncology. In...

DXA offers window on fat, muscle.(Obesity)(dual energy x-ay absorptiometry)
May 1, 2007... TAMPA, FLA. -- Dual-energy x-ay absorptiometry is an excellent method to measure and monitor body composition changes in obese patients undergoing weight loss and to assess body composition in athletes, Dr. Mary K. Oates reported at the annual...

Age-related bariatric approach needed for teens.(Obesity)
May 1, 2007... Bariatric surgery in adolescents, while still uncommon, has dramatically increased in the United States in the past decade, according to a recent study. And the trend may require an age-tailored approach. "Because the long-term metabolic...

Young kids get a boost from strength training.(Musculoskeletal Disorders)
May 1, 2007... QUEBEC CITY -- Children as young as 6 years can benefit from carefully supervised strength training, which can lay the foundation for an athletic future, either in competition or as part of a healthy lifestyle, said Avery Faigenbanm, Ed.D., at...

Dextrose shots may jump start healing in tendinopathies.(Musculoskeletal Disorders)
May 1, 2007... QUEBEC CITY -- Hyperosmolar dextrose injected into ailing tendons may cause tissue damage that triggers a healing response, reported Michael Ryan, a doctoral candidate at the University of British Columbia in Vancouver. Mr. Ryan and his...

Therapy still dicey as gout's incidence more than doubles.(Musculoskeletal Disorders)
May 1, 2007... DESTIN, FLA. -- The incidence of gout is on the rise, and lifestyle factors are largely to blame, Dr. N. Lawrence Edwards said at the annual Rheumatology on the Beach. For example, one study showed that between 1977-1978 and 1995-1996, the...

Not all physicians have heeded warnings about cardiac risks of pain medications.(Musculoskeletal Disorders)
May 1, 2007... Physicians need a stronger message about the cardiac risks of treating chronic pain with anti-inflammatory drugs, both traditional NSAIDs and cyclooxygenase-2 inhibitors, according to Dr. Elliott M. Antman and his colleagues. "We believe...

Early surgery best for some shoulder dislocations.(Sports Medicine)
May 1, 2007... QUEBEC CITY -- Athletic patients under age 30 years with a first-time shoulder dislocation might benefit from early surgical repair rather than conservative therapy, said Dr. Robert McCormack at the joint annual meeting of the Canadian Academy...

Tennis elbow responds to isokinetic training.(Sports Medicine)
May 1, 2007... For individuals with chronic tennis elbow, rehabilitation based on isokinetic eccentric exercises appears to produce better results than conventional rehabilitation after about 9 weeks, according to a recent study. Dr. Jean-Louis Croisier...

Push diet, exercise: consider glitazones for NASH.(Digestive Disorders)(nonalcoholic steatohepatitis )
May 1, 2007... MIAMI BEACH -- All patients with nonalcoholic steatohepatitis, as well as those at risk for developing the condition, should be counseled about the importance of diet and exercise, while more aggressive therapy should be considered in those who...

Type 2 diabetes nearly doubles Parkinson's risk.(Clinical Rounds)(Brief article)
May 1, 2007... Type 2 diabetes appears to almost double the risk of developing Parkinson's disease, Dr. Gang Hu and colleagues reported. Their prospective study included more than 51,000 Finnish men and women who were followed for a mean of 18 years. Type...

Ulcerative colitis, Crohn's linked.(Clinical Capsules)
May 1, 2007... Patients who present with nonbloody diarrhea or weight loss upon initial diagnosis of ulcerative colitis should undergo a more extensive work-up, because both symptoms confer a significantly increased risk of change in diagnosis to Crohn's...

Diabetics at risk for MCI.(Clinical Capsules)(mild cognitive impairment)(Brief article)
May 1, 2007... Patients with type 2 diabetes are at risk for amnestic mild cognitive impairment, which is thought to be a precursor of Alzheimer's disease, reported Dr. Jose A. Luchsinger and his associates at Columbia University, New York. Diabetes is...

Caffeine, smoking, and Parkinson's.(Clinical Capsules)(Brief article)
May 1, 2007... Caffeine consumption seems to protect against the development of Parkinson's disease, and smoking has been confirmed as another protective factor, but NSAID use doesn't seem to be protective, according to Dana B. Hancock of Duke University,...

Dashboards, Detroit, and DNA.(Genomic Medicine)
May 1, 2007... Most physicians have probably noticed the increasing attention given by popular culture to genetics and biotechnology. From the New York Times to Newsweek magazine to CNN, CSI, or author Michael Crichton, topics such as stem cells, cloning,...

Medicare pay-for-reporting program tied to a bonus.(Practice Trends)
May 1, 2007... Starting July 1, physicians who report on selected quality measures will have a chance to earn a small bonus payment from Medicare. The program, called the Physician Quality Reporting Initiative, was mandated by Congress and offers...

Abortion procedure ban upheld.(Policy & Practice)(Brief article)
May 1, 2007... The U.S. Supreme Court last month narrowly upheld the controversial ban on so-called partial-birth abortions, marking the first time the court has forbidden a specific abortion procedure. The 5-4 decision said that the Partial Birth Abortion...

Retail clinics replacing PCPs.(Policy & Practice)(primary care physicians )(Brief article)
May 1, 2007... More than 1 in 10 retail medical clinic users said the clinics have mostly or completely replaced their primary care physicians for the types of treatments offered at such facilities, according to a study from Market Strategies Inc., a research...

Penalized by high deductible plans.(Policy & Practice)(Brief article)
May 1, 2007... High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults 45-64 years, those...

Negotiation could save $30 billion.(Policy & Practice)(Brief article)
May 1, 2007... Legislation that would allow Medicare to use its bulk purchasing power to negotiate for lower prescription drug prices under Part D could save U.S. taxpayers and seniors more than $30 billion annually, an advocacy group reported. The Institute...

Cuts would harm seniors.(Policy & Practice)(Brief article)
May 1, 2007... Three-fourths of physicians said they believe that seniors will be harmed if Congress cuts the Medicare Advantage program, and most doctors said lawmakers should cut other programs or raise taxes rather than cut Medicare Advantage, according to...

Changing MD demographics.(Policy & Practice)(female physicians number rising, medical)(Brief article)
May 1, 2007... A major demographic shift is underway in medicine as female physicians become more numerous, and this trend will influence how medical groups recruit and retain physicians throughout their career cycles, according to the 2006 Retention Survey...

Part D cancer patients need help to pick plans.(Practice Trends)
May 1, 2007... WASHINGTON -- Physicians treating older cancer patients must actively help them choose Medicare Part D prescription drug plans with formularies that best cover current medications as well as future needs, said health care consultant Mary...

Childbirth is a top expense for illegal immigrants.(Practice Trends)(Brief article)
May 1, 2007... WASHINGTON -- The first study of emergency Medicaid expenditures for illegal immigrants shows that childbirth is the most expensive component. However, at least in North Carolina, that expense amounted to less than 1% of the state's Medicaid...

Providers unaware of shift in opioid regulations.(Practice Trends)
May 1, 2007... NEW ORLEANS -- Get educated about state and federal regulations and policies on the prescription of controlled substances, advised David Joranson, director of the Pain and Policy Studies Group at the University of Wisconsin Paul P. Carbone...

Screening tool identifies patients' health literacy: data show that patient education materials are often too advanced for the average patient to understand.(Practice Trends)
May 1, 2007... PHOENIX -- Three brief screening questions enable physicians to spot patients lacking the literacy skills necessary to understand and act upon health care information, Lorraine S. Wallace, Ph.D., said at a congress sponsored by the Association...

Alternative models of care.(The Office)
May 1, 2007... After 15 years of managing a fulltime-equivalent panel of 2,000 patients for the University of California, San Diego Medical Group, Dr. Martin C. Schulman was burned out and frustrated at not being able to fully address the needs of his...

Johnny Walker--or reefer madness?(Indications)(Reef sandal company produces flip flops to store alcohol)(Brief article)
May 1, 2007... The Reef sandal company is now producing flip-flops with a polyurethane storage compartment hidden in the sole of each sandal, capable of storing 1 oz. of alcoholic beverage, the Baltimore Examiner reports. The sole of each sandal features the...

French fete famished fashion.(Indications)(thin fashion models used for showcasing dangers of excessive dieting)(Brief article)
May 1, 2007... Reuters reports that the French Ministry of Health, unlike its counterpart in Spain, has declined to ban overly thin fashion models and will seek instead to publicize the dangers of excessive dieting. Quote of the week, from designer and...

Boxers may have been smart once.(Indications)(brain damage in boxing)(Brief article)
May 1, 2007... Perhaps you were unconvinced by the legions of ex-pugilists writing novels and earning doctoral degrees, but boxing really does cause brain damage, say Swedish researchers who presented their findings at the annual meeting of the American...

Somebody text 911!(Indications)(cell phones don't interfere electronic medical devices)(Brief article)
May 1, 2007... The Mayo Clinic Proceedings in its March issue reports that mobile phones do not interfere with electronic medical devices. Dr. David Hayes and colleagues tested cell phones on nearly 200 hospital-based devices for a 5-month period and found no...

Yankee shortstop.(Indications)(condoms distributed for free in New York)(Brief article)
May 1, 2007... Although New York City has been distributing free condoms to its residents since 1971, this year the prophylactics come packaged in wrappers evoking the symbols on a New York subway map, according to the New York Times. The municipal government...

Ovaries optional in PCOS.(Indications)(polycystic ovary syndrome)(Brief article)
May 1, 2007... An essay published recently in the journal Medical Hypotheses suggests men should be considered candidates for the diagnosis of polycystic ovary syndrome (PCOS). Dr. Razelle Kurzrock of the University of Texas M.D. Anderson Cancer Center,...

Childhood caries warrant FP action.(Clinical Rounds)(family practitioners)
May 15, 2007... A significant increase in the prevalence rates of dental caries in the primary teeth of children aged 2-5 years has experts urging primary care providers to reevaluate their role in preventing such outcomes. In 1988-1994, 240% of children...

Suicide warning on antidepressants applies to adults: risk in 18- to 24-year-olds added to labels.(News)
May 15, 2007... The warnings of an increased risk for suicidality in pediatric patients that appear on the labels of antidepressants should be expanded to include young adults aged 18-24 years but should include a statement saying that depression also is...

Resistance to daily aspirin therapy seen in diabetics.(News)
May 15, 2007... NEW ORLEANS -- Diabetic patients exhibit a higher prevalence of aspirin resistance at a dosage of 81 mg/day than do nondiabetics with coronary artery disease, Dr. Paul A. Gurbel said at the annual meeting of the American College of Cardiology....

Sertraline led antidepressant sales in 2006.(VITAL SIGNS)(Statistical table)(Brief article)
May 15, 2007... Sertraline 22% Venlafaxine 21% Bupropion 18% Escitalopram 18% Duloxetine 9% Others 11% Notes: Table made from pie chart. Notes: Numbers do not add up to 100 because of rounding. Based on the...

Combo antihypertensive backed for initial therapy.(NEWS FROM THE FDA)
May 15, 2007... ROCKVILLE, MD. -- A Food and Drug Administration advisory panel unanimously recommended that the combination antihypertensive product irbesartan and hydrochlorothiazide (HCTZ) be approved as a first-line treatment for hypertension. At a...

First pandemic avian influenza vaccine approved for stockpile.(NEWS FROM THE FDA)
May 15, 2007... The Food and Drug Administration has approved the first vaccine in the United States that could be used in the event of an avian influenza virus pandemic. The approval, announced April 17, is for active immunization against influenza...

Altabax, Keppra.(NEW & APPROVED)(drug approvals)
May 15, 2007... Altabax (retapamulin ointment 1%, GlaxoSmithKline) The FDA approved Altabax (retapamulin ointment 1%) for topical treatment of impetigo caused by susceptible strains of Staphylococcus aureus or Streptococcus pyogenes in patients 9 months...

Data back 13-g/dL limit for hemoglobin in CKD.(News)
May 15, 2007... ORLANDO -- New evidence about the potential hazards of high hemoglobin levels in patients with chronic kidney disease is prompting the National Kidney Foundation to narrow the target range for hemoglobin levels. According to a draft update...

Part D hassles persist, but prescription drug program improves.(News)
May 15, 2007... SAN DIEGO -- In the second year of Medicare Part D implementation, physicians continue to struggle with prior authorization requests and other problems, Dr. Kay M. Mitchell said at the annual meeting of the American College of Physicians. ...

What's driving epoetin dosing?(News)
May 15, 2007... It remains unclear why nephrologists "prescribe so much more epoetin, and make such dubious dosing decisions" at for-profit chains, compared with nonprofit facilities, Dr. Daniel W. Coyne said in an editorial comment about the study of dialysis...

Preventing the next tragedy.(Guest Editorial)
May 15, 2007... The Virginia Tech murder rampage showed us the inescapable horror and pain inflicted by a lonely, isolated young man who was apparently beyond the reach of the mental health system and who several students and professors at the university...

Residencies for the real world.(Letters)(Letter to the editor)
May 15, 2007... That some family practice residencies are making their programs more practical to better prepare their graduates for the real world of medicine is long overdue ("Residencies Strive to Mirror Practice," March 15, 2007, p. 1). Most residents...

Correction.(Correction notice)
May 15, 2007... The photograph for "ECG Benched for Sports Screening" (FAMILY PRACTICE NEWS, April 1, p. 1) should have shown auscultation being performed against the skin.

Need for preprocedure antibiotics questioned: "Maintaining good oral health and hygiene appears to be more protective than prophylactic antibiotics.'.(Cardiovascular Medicine)
May 15, 2007... MOST patients with heart conditions don't need to take antibiotics to reduce the risk of infection prior to a dental procedure, according to revised American Heart Association guidelines. The new guidelines represent a change from previous...