Family Practice News articles from November 2007

Family Practice News archives from November 2007

Limits advised for OTC cold drugs.(News)(over-the-counter)
November 1, 2007... [ILLUSTRATION OMITTED] SILVER SPRING, MD. -- The Food and Drug Administration is expected to issue interim recommendations to the public about the use of over-the-counter cough and cold products in children, in response to the advisory...

Most respondents believe lower salary will keep med students away from primary care.(VITAL SIGNS)(Survey)(Brief article)
November 1, 2007... Most Respondents Believe Lower Salary Will Keep Med Students Away From Primary Care Yes 94% No 2% Don't know 4% Note: Based on a 2007 survey of 302 family practice and internal medicine physicians who...

FPs await fixes to TRICARE referral, payment systems: low reimbursement limits access to care.(Practice Trends)(family physicians)
November 1, 2007... It's been a year since the American Academy of Family Physicians struck a deal with TRICARE, under which the AAFP agreed to encourage its members to see patients from the U.S. military health plan in exchange for less bureaucracy and better...

Cervical cancer guidelines tweaked for select women.(News)
November 1, 2007... MINNEAPOLIS -- The American Society for Colposcopy and Cervical Pathology has issued new consensus guidelines on the management of women with abnormal cervical screening tests and cervical intraepithelial neoplasia, emphasizing changes for...

Lumiracoxib deemed 'not approvable' for OA pain.(NEWS FROM THE FDA)(osteoarthritis)
November 1, 2007... The Food and Drug Administration has issued a "not approvable" letter on the cydooxygenase-2 inhibitor lumiracoxib for osteoarthritic pain. "Now that we have the FDA's decision, we will start the discussions with them as soon as possible...

Possible link between atrial fib, bisphosphonates is scrutinized.(NEWS FROM THE FDA)(atrial fibrillation)
November 1, 2007... The Food and Drug Administration will seek data for an "in-depth evaluation" of atrial fibrillation for the entire bisphosphonate class of drugs as well as continue to monitor any spontaneous postmarketing reports of the heart rhythm disorder,...

Lamisil oral granules, norditropin cartridges.(New & Approved)
November 1, 2007... Lamisil Oral Granules (terbinafine HCl, Novartis Pharmaceuticals Corp.) The Food and Drug Administration approved Lamisil Oral Granules, a new pediatric formulation of terbinafine HCl, for the treatment of tinea capitis in children 4 years...

FDA warns of pancreatitis risk with Byetta.(News)
November 1, 2007... The Food and Drug Administration has issued an alert on exenatide (Byetta), warning that the agency has received 30 postmarketing reports of acute pancreatitis in patients taking the drug. Exenatide is approved as adjunctive therapy to improve...

Longer influenza immunization season urged.
November 1, 2007... WASHINGTON -- For the second year in a row, federal officials and professional societies are urging health care providers to administer influenza vaccination beyond the traditional months of October and November. A record number of doses...

Congress, White House eye SCHIP compromises.(News)
November 1, 2007... Congress and the Bush administration headed back to the negotiating table in mid-October after the House of Representatives failed to override President Bush's veto of the State Children's Health Insurance Program reauthorization legislation....

Let's support the Medical Homes Act.(Guest Editorial)
November 1, 2007... In the wake of the latest failed attempt to reauthorize the State Children's Health Insurance Program, let's focus on the bigger picture. Forthcoming legislation would have the power to change the SCHIP reauthorization debate. That...

Treatment options for MRSA.(Letters)(methicillin-resistant Staphylococcus aureus )
November 1, 2007... As medical director for Homeless Health Care Los Angeles, where I run a clinic at a needle exchange on Skid Row, and as a staff physician at the free Venice Family Clinic, where 25% of our patients are homeless, I treat wounds and abscesses on...

Be clear on 'life' and 'death'.(Letters)
November 1, 2007... Thank you for publishing the interesting exchange between Dr. Robert Sade and Dr. Michael A. Grodin on organ donation after cardiac arrest--misnamed "cardiac death" in the article ("Should organ donation after cardiac death be promoted and...

Outpatient use of beta-blockers to be measured.(Cardiovascular Medicine)
November 1, 2007... WASHINGTON -- The National Committee for Quality Assurance will begin reporting in earnest next year on how many myocardial infarction patients are receiving beta-blockers 6 months after hospital discharge, as recommended by the American Heart...

Generic carvedilol receives green light from FDA.(Cardiovascular Medicine)(Food and Drug Administration)(Clinical report)
November 1, 2007... The first generic formulations of the beta-blocker carvedilol (Coreg) have been approved by the Food and Drug Administration for treating hypertension, mild to severe chronic heart failure, and left ventricular dysfunction following a...

Aliskiren may be safe, effective in heart failure.(Cardiovascular Medicine)(Clinical report)
November 1, 2007... VIENNA -- Treatment with the direct renin inhibitor aliskiren was safe and effective for improving surrogate measures of heart failure when used on top of an optimal regimen in a phase II study with about 300 patients with moderately severe...

CABG relieves angina better than PCI.(Cardiovascular Medicine)(coronary artery bypass grafting)(percutaneous coronary intervention )
November 1, 2007... Coronary artery bypass grafting was more effective at relieving angina, and required fewer repeat revascularization procedures, than did percutaneous coronary interventions, according to investigators who conducted a review of randomized...

Anemia tied to worse acute coronary syndrome outcomes.(Cardiovascular Medicine)
November 1, 2007... VIENNA -- Anemia was a significant risk factor for worse outcomes in patients with acute coronary syndrome in a post hoc analysis of almost 14,000 patients enrolled in a recent trial. Despite this evidence of anemia's risk, it's premature...

Statins appear to boost heart failure survival.(Cardiovascular Medicine)(Clinical report)
November 1, 2007... VIENNA -- Treatment with a statin was linked with better survival among patients with heart failure or left ventricular dysfunction in results from three independent studies reported at the annual congress of the European Society of Cardiology....

Perioperative risks rise with cessation of statins.(Cardiovascular Medicine)(Brief article)
November 1, 2007... VIENNA -- Stopping statins for a few days during and after major vascular surgery was linked with a significant rise in cardiovascular events at one center, according to a poster at the annual congress of the European Society of Cardiology. ...

Moderate drinking tied to lower fasting glucose.(Metabolic Disorders)
November 1, 2007... AMSTERDAM -- Initiation of moderate daily alcohol consumption among patients with type 2 diabetes results in decreased fasting plasma glucose levels, particularly among patients with worse control at baseline, Iris Shai, Ph.D., reported at the...

Formula links [HbA.sub.1c] to average plasma glucose.(Metabolic Disorders)
November 1, 2007... AMSTERDAM -- Data from an international trial have yielded a formula that accurately converts hemoglobin Ale values to an estimated average blood glucose. The results of the [A.sub.1c]Derived Average Glucose (ADAG) study, comprising 4...

Carbs often undercounted by diabetic patients.(Metabolic Disorders)
November 1, 2007... AMSTERDAM -- Patients with type 1 diabetes often underestimate the amount of carbohydrates in their meals, Dr. Guido Freckmann reported at the annual meeting of the European Association for the Study of Diabetes. The ability to accurately...

Comprehensive care a burden, some diabetics say.(Metabolic Disorders)(Clinical report)
November 1, 2007... Many patients with diabetes might prefer to have some risk of minor complications from the condition than to live life saddled with the rigors of comprehensive diabetes management, according to a survey conducted by researchers at the...

Symlin pens to be available for select patients.(Metabolic Disorders)(Brief article)
November 1, 2007... The glucose-lowering drug pramlintide will now be available in pens, but not for patients not using premeal bolus insulin. Last month the Food and Drug Administration said Amylin could begin marketing the SymlinPen 60 and the SymlinPen 120...

Fighting needle fear in diabetes helps compliance.(Metabolic Disorders)
November 1, 2007... Needle fear can complicate many doctor-patient relationships, but in the case of patients with insulin-dependent diabetes, fear of needles can become a serious barrier to compliance. Studies show that up to one-quarter of people with...

Gardasil, Zostavax shots: questions and answers.(Infectious Diseases)
November 1, 2007... MONTEREY, CALIF. -- Although most physicians are familiar with the basic facts concerning the newly introduced Gardasil and Zostavax vaccines, patients still have many questions about their use. Zostavax, a 14-fold concentrated version of...

Thimerosal not linked to cognitive performance.(Infectious Diseases)
November 1, 2007... A study of 1,047 children found no evidence of a causal association between exposure to ethylmercury from the preservative thimerosal in vaccines during the prenatal, neonatal, or first 7 months of life and neuropsychological outcomes at ages...

Otitis media 'superbug' holds implications for adults and kids.(Infectious Diseases)
November 1, 2007... A strain of Streptococcus pneumoniae that is resistant to all antibiotics approved to treat acute otitis media in children has been identified as an otopathogen, according to the findings of a study. The multidrug-resistant serotype 19A...

'Fungal Fridays' and other tips for onychomycosis.(Skin Disorders)(Case study)
November 1, 2007... CORONADO, CALIF. -- A patient who has abnorrnal-looking nails with a normal plantar and web surface is unlikely to have onychomycosis, Dr. Boni E. Elewski said at the annual meeting of the Pacific Dermatologic Association. The presence of...

Warning labels on tanning beds to be scrutinized by FDA.(Skin Disorders)
November 1, 2007... The Food and Drug Administration soon will begin to scrutinize the warning labels on tanning beds, under a new federal law signed by the president in late September. The Tanning Accountability and Notification Act was included in the Food...

Little guides pediatric melanocytic lesion choices.(Skin Disorders)
November 1, 2007... MONTEREY, CALIF. -- Melanocytic tumors of unknown malignant potential represent some of the most difficult cases in pediatric dermatology, since little agreement exists about their diagnostic criteria, management, or outcome. "They cause...

Clue into suicide risk among elderly patients.(Mental Health)
November 1, 2007... PHILADELPHIA -- Suicide is more common among the elderly, particularly older men, than it is in other demographic groups in the United States, Patrick Arbore, Ed.D., said at a conference sponsored by the American Society on Aging. In...

Personality disorders may worsen with age.(Mental Health)
November 1, 2007... PHILADELPHIA -- Personality disorders may appear to worsen with advancing age, although the prevalence remains stable with about 10%-20% of people age 65 or older having a personality disorder, Erlene Rosowsky, Psy.D., said at a conference...

Urinary incontinence risk higher in women with obesity, diabetes.(Women's Health)
November 1, 2007... AMSTERDAM -- Women who are obese, have diabetes. or both should be asked about symptoms of urinary incontinence and other pelvic floor disorders. That is the take-home message from two recent studies, one presented in a poster at the...

Advice on fish intake in pregnancy sparks debate.(Women's Health)
November 1, 2007... A coalition that advocates for healthy pregnancies came under criticism after issuing an advisory urging pregnant women to eat more fish, based on an evidence review that received financial support from the fisheries industry. In a...

HIV-positive patients struggle with overweight.(Obesity)
November 1, 2007... SAN DIEGO -- In the 1980s, patients with HIV/AIDS commonly lost an excessive amount of weight, a process known as wasting. But today, these patients are becoming just as overweight and obese as the general population of the United States, Dr....

Suicide, CHD deaths elevated after gastric bypass.(Obesity)
November 1, 2007... Researchers have found "a substantial excess" in deaths attributable to suicide and to coronary heart disease among patients who have undergone bariatric surgery, according to a report. This descriptive study was not designed to ascertain...

Appendectomy deemed safe during pregnancy.(Digestive Disorders)
November 1, 2007... TORONTO -- Laparoscopic appendectomy in pregnant patients is as safe as open appendectomy and has several advantages, according to a review presented at the annual meeting of the Canadian Association of Thoracic Surgeons. A retrospective study...

Antibiotics resolve some appendicitis.(Digestive Disorders)
November 1, 2007... MONTREAL -- Antibiotic therapy is largely successful for treating acute, nonperforated appendicitis, but unlike surgery, it carries a risk of recurrence, according to long-term follow-up on the first randomized comparison of both treatments,...

CT colonography refines screening for neoplasia.(Digestive Disorders)
November 1, 2007... Detection rates for advanced colorectal neoplasia were similar in a comparison of screening computed tomographic colonography versus conventional colonoscopy, but the numbers of polypectomies and complications were significantly lower with CT...

Anticoagulants, polyp size affect postpolypectomy risks.(Digestive Disorders)
November 1, 2007... WASHINGTON -- Large polyp size and the use of anticoagulants significantly raised the risk of delayed postpolypectomy hemorrhage, but aspirin and a history of hypertension did not, according to findings presented at the annual Digestive Disease...

Colorectal neoplasms appear more common in heart disease.(Digestive Disorders)(Clinical report)
November 1, 2007... Colorectal neoplasms are nearly twice as common in patients newly diagnosed as having coronary artery disease than in those found not to have CAD based on coronary angiography, results of a cross-sectional study suggest. The prevalence of...

If treatment fails, think inclusion body myositis.(Musculoskeletal Disorders)
November 1, 2007... BOSTON -- Failure to respond to standard immunosuppressant therapy may be the first sign that a patient's apparent polymyositis actually is inclusion body myositis, according to Dr. Chester Oddis of the University of Pittsburgh. The most...

Canadian rules distinguish breaks from sprains.(Musculoskeletal Disorders)(Brief article)
November 1, 2007... STANFORD, CALIF. -- The Ottawa Ankle Rules for children and adolescents can take some of the guesswork out of evaluating ankle injuries and cut down on the number of needless x-rays of sprains. "Is it broken? Is it not broken? In the...

Eccentric training rivals Achilles tendon brace.(Sports Medicine)(Clinical report)
November 1, 2007... A pneumatic brace was as effective as eccentric training in resolving chronic Achilles tendon pain in a study that randomized 100 patients. The investigators hypothesized that the brace, a device known as the AirHeel, probably does work to...

Specialists reject CT for lung cancer screening.(Pulmonary Medicine)(computed tomography)
November 1, 2007... In a controversial move, the American College of Chest Physicians has formally recommended against the use of low-dose helical CT scanning for general lung cancer screening, even in high-risk populations, except in the context of clinical...

Urinary incontinence screening practices vary.(Clinical Rounds)
November 1, 2007... HOLLYWOOD, FLA. -- Although most primary care physicians recognize the importance of diagnosis and treatment of urinary incontinence, routine screening is not always done, according to survey results presented at the annual meeting of the...

Use caution when presribing dopamine agonists.(Clinical Rounds)(Brief article)
November 1, 2007... Following government warnings in both the United States and Britain about the cardiac risks associated with dopamine agonists in the management of Parkinson's disease, the British Society of Endocrinology recommends continuing the agents for...

Identifying intracranial, intraorbital sinusitis in children helps outcomes.(Clinical Rounds)
November 1, 2007... SAN DIEGO -- Children with intracranial complications of sinusitis are significantly older and have longer hospitalizations and more neurologic sequelae, compared with those who have intraorbital complications of sinusitis, Dr. Veronica K....

Family history goes cutting edge.(Genomic Medicine)
November 1, 2007... News flash, November 22, 2007: Inexpensive, noninvasive genetic test detects two-to threefold risk increase for diabetes, cardiovascular disease, stroke, colorectal cancer, breast cancer, and ovarian cancer. In some individuals the test...

Premature adrenarche in girls.(Clinical Capsules)(Brief article)
November 1, 2007... Prepubertal girls with premature adrenarche have an increased prevalence of childhood metabolic syndrome, which may be due mainly to their overweight and hyperinsulinism, according to a study. The findings suggest that providers might be...

Tonsillectomy outcomes.(Clinical Capsules)(Brief article)
November 1, 2007... Intracapsular tonsillectomy has lower rates of delayed hemorrhage, severe hemorrhage, and rehospitalization for pain or other complications than does traditional electrodissection tonsillectomy, according to a report (Arch. Otolaryngol. Head...

Diabetes control disparities.(Clinical Capsules)(Brief article)
November 1, 2007... The disparity in glycemic control between white Americans and those of other ethnic groups may be related to issues such as medication nonadherence and diabetes-related emotional stress, said Dr. Michele Heisler of the Veterans Affairs Ann...

Edwards outlines plans for Tort, universal health care.(Practice Trends)(John Edwards)
November 1, 2007... WASHINGTON -- According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on... the malpractice attorneys. The former senator from North...

Medicare cuts may cause layoffs.(Policy & Practice)(Brief article)
November 1, 2007... The impending 9.9% cut in the Medicare physician fee schedule likely will result in staff and infrastructure cutbacks by medical group practices, according to a poll taken by the Medical Group Management Association. Of 613 group practice...

Partisan views on health reform.(Policy & Practice)
November 1, 2007... While 82% of Democrats agreed that "'it is the government's duty to ensure that all Americans have adequate health care coverage," only 47% of Republicans agreed with that statement, according to a WSJ.com/Harris Interactive online survey of...

Social Programs eat federal funds.(Policy & Practice)(Brief article)
November 1, 2007... Social Security, Medicare, and Medicaid combined take up almost half of the federal government's nondefense, nonintelligence spending in 2005, according to the latest edition of the Census Bureau's Consolidated Federal Funds Report, which...

Put health records in the Vault.(Policy & Practice)(Microsoft Corp. launches website HealthVault )(Brief article)
November 1, 2007... Microsoft has launched HealthVault, a Web site where consumers can post and maintain their personal health records. Individuals can input their health and medical data on the free site and give permission for their health care providers to...

Medicare plans resume marketing.(Policy & Practice)
November 1, 2007... All seven of the private fee-for-service Medicare plans that voluntarily suspended marketing last summer (INTERNAL MEDICINE NEWS, Sept. 1, p. 50) have been found to be compliant with Centers for Medicare and Medicaid Services requirements and...

Choosing a credit card company.(The Office)
November 1, 2007... Accepting credit cards in your office--both for capturing charges immediately at the time of service and for billing residual balances--has huge advantages. But how do you arrange for credit card processing at your office at the best possible...

Ambulatory surgery coverage to expand.(Practice Trends)
November 1, 2007... Starting next year, federal health programs will cover any procedure done at an ambulatory surgery center, with few but defined exclusions, according to final regulations released by the Centers for Medicare and Medicaid Services. The...

Race cars crash, Journal reports.(Indications)(Brief article)
November 1, 2007... An article in the British Journal of Sports Medicine reported that professional Formula 1 and MotoGP motorbike racing is "inherently dangerous." The authors recommended "innovative clothing" to "'selectively defend key anatomical structures"...

Helium-hogging MRIs ruin birthdays.(Indications)(Brief article)
November 1, 2007... As a worldwide helium shortage worsens, many groups are blaming MRI machines--which use helium gas to cool their powerful magnets--for hogging the resource, reported the CBC, a Canadian news outlet. About one-fifth of the world's helium supply...

Beer makes you smart.(Indications)(Brief article)
November 1, 2007... Moderate alcohol consumption may enhance cognition, according to research published in the Journal of Neuroscience. In a study, rats were fed liquid diets containing varying amounts of alcohol. Some had no alcohol at all; some had a moderate...

One in three use inhalers incorrectly.(Pulmonary Medicine)
November 15, 2007... [ILLUSTRATION OMITTED] CHICAGO -- Nearly one-third of patients with asthma or chronic obstructive pulmonary disease incorrectly used their dry powder inhalers in a study of 224 patients reported at the annual meeting of the American...

Warfarin can safely prevent stroke in AF patients over 75: prior RCT trials involved younger patients.(News)
November 15, 2007... VANCOUVER, B.C. -- Thrombo-prophylaxis using warfarin produced a "huge, highly significant, 50% reduction" in death and major disability from stroke in elderly patients with a history of atrial fibrillation, roundly outperforming aspirin...

Vitamin E may slow heart disease in select diabetics.(Metabolic disorders)
November 15, 2007... ORLANDO -- Vitamin E has finally fulfilled its promise as an antioxidant that can slow the progression of cardiovascular disease. Patients with diabetes who also had the haptoglobin 2-2 genotype and who were treated with 400 IU of vitamin E...

Top diagnoses by family physicians in 2007.(VITAL SIGNS)(Table)(Brief article)
November 15, 2007... Hypertension * 9.8% Diabetes, uncomplicated 3.6% Hyperlipidemia * ([dagger]) 3.5% Chronic sinusitis * 2.9% Acute upper respiratory infection...

Potency specifications tightened for levothyroxine medications.(NEWS FROM THE FDA)
November 15, 2007... The Food and Drug Administration has tightened the potency specifications required for levothyroxine sodium products, mandating that they cannot lose more than 5% of their baseline potency by the time they reach their expiration date. The...

Ultrasound agents tied to fatal cardiac events.(NEWS FROM THE FDA)
November 15, 2007... Microbubble ultrasound contrast agents used in patients with suboptimal echocardiograms have been linked to serious cardiopulmonary reactions and several deaths, according to the Food and Drug Administration. The agency issued a notice on...

Medihoney wound dressings, Azor.(New & Approved)
November 15, 2007... Medihoney Dressings (active Manuka honey absorbent dressing, Derma Sciences Inc.) A honey-based wound dressing that "provides a moist environment conducive to wound healing," indicated for moderate to heavily exuding wounds such as...

Report pools data on cancer and diet, lifestyle.(News)
November 15, 2007... WASHINGTON -- A new comprehensive evidence-based report issued by an international expert panel provides an unprecedented analysis supporting the preventability of cancer by way of diet, exercise, and avoidance of obesity. Developed over a...

Medicare payments slated for 10% cut in 2008.(News)
November 15, 2007... Unless Congress steps in, the Centers for Medicare and Medicaid Services will reduce payments to physicians by about 10% beginning in January 2008, a slightly deeper fee cut than had been proposed earlier in the year. Federal estimates...

Sophisticated bloggers can conceal patient identity.(Do physician bloggers compromise patient privacy?)
November 15, 2007... I write a doctor's blog (www.talesfromthewomb.blogspot.com) and I post in the open. I write fictionalized medical events, discuss studies relevant to neonatal outcomes, and, on occasion, will even muddy myself with both politics and evolution....

Blogging about patients is never safe or acceptable.(Do physician bloggers compromise patient privacy?)
November 15, 2007... Physicians who write about their patients in blogs violate the law and the Hippocratic oath, regardless of whether they blog anonymously or take steps to conceal the identities of their patients. Patients require and indeed have a right to...

Dealing with the physician shortage.(Letters)(Letter to the editor)
November 15, 2007... I am an international medical graduate and have been working in an underserved region of the United States for the last 5 years ("More Residency Slots May Ease Physician Shortage" Sept. 1, 2007, p. 48). I know several international medical...

Mixed message on retail clinics.(Letters)(Letter to the editor)
November 15, 2007... The American Academy of Family Physicians is sending a mixed message to the public regarding retail health clinics. The Congress of Delegates recently passed a resolution stating that the AAFP "does not endorse retail health care clinics...

Correction.(Letters)(Correction notice)
November 15, 2007... In The Office column, "Open Access Scheduling" (FAMILY PRACTICE NEWS, Oct. 1, p. 44), Dr. Antonucci's first name is Jean.

Epicardial fat might point to cardiovascular risks.(Cardiovascular Medicine)
November 15, 2007... NEW ORLEANS -- The fat that surrounds the heart is associated with cardiac abnormalities, including low stroke volume and cardiac output, that are independent of body mass index, a study has found. The finding casts doubt on the widespread...

Cardiac rehab measures aim to boost referrals.(Cardiovascular Medicine)
November 15, 2007... Medical societies have jointly issued new performance measures for cardiac rehabilitation that are expected to increase the number of patients referred to rehab services. The measures also promote a safe exercise environment for those patients,...

Cardiac screening for diabetics still controversial.(Cardiovascular Medicine)
November 15, 2007... The question of whether all asymptomatic diabetic patients should be routinely screened for coronary artery disease--and if so, how--is still open, according to a consensus statement from the American Diabetes Association. "Although the...

Subclinical hypothyroidism tied to heart issues.(Metabolic Disorders)(Clinical report)
November 15, 2007... NEW YORK -- Subclinical hypothyroidism with a thyroid-stimulating hormone level of 10-20 mU/L was associated with an almost twofold risk of heart failure in a study of more than 3,000 older adults. The findings, presented by Dr. Douglas...

Blood glucose tested daily in two-thirds of adult diabetics.(Metabolic Disorders)
November 15, 2007... Nearly two-thirds of adults with diabetes in the United States perform self-monitoring of blood glucose at least daily, the Centers for Disease Control and Prevention reported. The data come from the Behavioral Risk Factor Surveillance...