Internal Medicine News articles from February 2009

Internal Medicine News archives from February 2009

Amyloid theory sputters for AD.(NEWS)(Alzheimer's disease)(Report)
February 1, 2009... The amyloid hypothesis isn't dead, but it seems to be limping a bit in the race for an Alzheimer's cure. Some researchers who predicted 5 years ago that an antiamyloid disease-modifying therapy was imminent are now reevaluating that...

Breast cancer decline linked to HT cessation: new WHI data affirm hormonal link.(NEWS)(hormone therapy)(Report)
February 1, 2009... SAN ANTONIO - Two new statistical analyses of Women's Health Initiative data persuasively indicate that the recent abrupt decline in breast cancer incidence in the United States is attributable to a dramatic drop in the use of...

Myelodysplastic syndrome 'severely underestimated'.(NEWS)(Report)
February 1, 2009... SAN FRANCISCO -- Myelodysplastic syndrome is far more common than previous estimated, and patients with this blood disorder tend to be older and sicker than the general Medicare population, based on an analysis of claims by more than 1.7...

Most states allow deductions for health savings account contributions.(VITAL SIGNS)
February 1, 2009... Note: 2008 data from Thomson West's Health Policy Tracking Service. Source: Kaiser Family Foundation

Oral contraceptives linked to vascular stiffness.(NEWS)(Report)
February 1, 2009... NEW ORLEANS -- The use of an oral contraceptive for at least 10 years was associated with increased carotid and femoral pulse wave velocity, a marker of increased vascular damage and arterial stiffness, in a study of about 1,300 women. "In...

Epilepsy drug warnings to add suicidal ideation.(NEWS)
February 1, 2009... The Food and Drug Administration has directed physicians to inform patients taking anticonvulsant medications that the drugs have the potential to increase suicidal thoughts and behavior. Families and caregivers should also be notified of...

CV risk studies encouraged for diabetes drugs.(NEWS)(cardiovascular diseases)
February 1, 2009... The Food and Drug Administration has issued new guidance to manufacturers of type 2 diabetes therapies seeking more information on how the products may increase or decrease the risk of cardiovascular comorbidities. The agency mailed...

IOM outlines ways to improve adolescent care.(NEWS)(Institute of Medicine)
February 1, 2009... Health care services for adolescents are fragmented, leaving gaps in care that "safety-net" resources cannot fill, especially for those who are uninsured or vulnerable to risky behavior or poor health, according to a report issued by the...

Suicidality report: more harm than good?(Editorial)
February 1, 2009... For years, we've had scientifically sound data telling us that patients with epilepsy have an increased risk of depression. But the recent federal warning of an increased risk of suicidal ideation in patients on antiepileptic drugs is based on...

Pain relievers.(Cartoon)
February 1, 2009... "That's my diagnosis--but HEY, what do I know?"

Seeking Rx for e-prescribing.(LETTERS)(Letter to the editor)
February 1, 2009... My practice has implemented Sure-Scripts in preparation for the 2009 Medicare bonus for e-prescribing ("Medicare Bonus to Push E-Prescribing Beginning in 2009," Nov. 15, 2008, p. 1). However, I have not been able to find out how to...

Skepticism about ezetimibe persists.(LETTERS)(Letter to the editor)
February 1, 2009... Your article on ezetimibe and cancer missed a crucial point ("Cancer Concerns Over Ezetimibe Linger for Some," Oct. 1, 2008, p. 6). The SEAS trials reported an increase in total cancer, and especially in fatal cancers. In a thinly disguised...

'Self-embedding' of foreign objects reported.(ADOLESCENT HEALTH)
February 1, 2009... Chicago -- Radiologists have reported cases of self-mutilation by adolescents involving the deliberate embedding of foreign objects such as paper clips, staples, and pieces of glass into soft tissues of the arms, hands, feet, and ankles. ...

Teenage menstruation: what's normal and what's not?(ADOLESCENT HEALTH)
February 1, 2009... STANFORD, CALIF. -- A teenage patient complains of "heavy" menstrual periods. Her mother mentions that her daughter never gets periods during soccer season. Should you evaluate the girl for abnormal uterine bleeding? Or is a bit of...

Endoscopic resection of Barrett's safe, effective.(GASTROENTEROLOGY)
February 1, 2009... ORLANDO -- Endoscopic mucosal resection of Barrett's esophagus can provide a safe and effective alternative to esophagectomy, according to a retrospective study of long-term clinical experience at the University of Chicago Medical Center. ...

Guidelines survey psoriatic arthritis treatments.(RHEUMATOLOGY)(Report)
February 1, 2009... FORT LAUDERDALE, FLA. -- An international group of dermatologists and rheumatologists has published new recommendations for the treatment of the heterogeneous manifestations of psoriatic arthritis, but they caution that randomized data remain...

After years of decline, RA on the rise among women.(RHEUMATOLOGY)(rheumatoid arthritis)
February 1, 2009... SAN FRANCISCO -- An unexpected, significant uptick in rheumatoid arthritis incidence among women may point to increased exposure to hormonal and environmental risk factors, although investigators remain unsure of a clear explanation. "What...

Fitness can reduce mortality in diabetes.(ENDOCRINOLOGY)(Report)
February 1, 2009... MUNICH -- Middle-aged men with type 2 diabetes can reduce their long-term mortality risk by roughly 14% for each 1-MET increase they achieve in peak exercise capacity through improved physical fitness, according to a large epidemiologic study....

Glycemia management in type 2 diabetes.(THE EFFECTIVE PHYSICIAN)
February 1, 2009... Background Last month, a consensus panel representing the American Diabetes Association and European Association for the Study of Diabetes published revised recommendations for management of hyperglycemia in patients with type 2 diabetes...

Weekly exenatide improves multiple CV risks.(ENDOCRINOLOGY)(cardiovascular diseases)(Report)
February 1, 2009... NEW ORLEANS -- Exenatide, in a novel once-weekly formulation, resulted in simultaneous improvements in blood pressure, lipid levels, and body weight as well as glycemic control in a year-long study in 241 type 2 diabetic subjects. These...

Emergence of C. gattii in Northwest kills four.(INFECTIOUS DISEASES)(Cryptococcus gattii)
February 1, 2009... WASHINGTON -- Cryptococcus gattii, a meningitis-causing fungus previously confined to tropical and subtropical climates outside of the United States, has caused severe illness in at least 19 individuals--of whom 4 died--in the Pacific Northwest...

Antipsychotics may boost Alzheimer's mortality.(NEUROLOGY)
February 1, 2009... Antipsychotics appeared to increase the risk of death in patients with Alzheimer's disease, especially if taken for more than 12 months, in a randomized controlled trial. Nursing home patients with Alzheimer's who continued taking the...

Genetics in your practice 2008: year of the GWAS.(MEDICAL GENETICS)(genome-wide association studies)
February 1, 2009... Finding a needle in a haystack is a favorite metaphor of geneticists for describing the process of connecting a disease to a gene or genetic marker. For many years, gene hunters have used family-based linkage studies of large,...

Hibiscus tea lowers BP in clinical trial.(CARDIOVASCULAR MEDICINE)(blood pressure)
February 1, 2009... NEW ORLEANS -- Quaffing three cups of hibiscus tea daily for 6 weeks resulted in a mean 7.2-mm Hg reduction in systolic blood pressure in mildly hypertensive or prehypertensive adults in a randomized, double-blind, placebo-controlled trial. ...

Metabolic syndrome ups PAD risk in women.(CARDIOVASCULAR MEDICINE)(peripheral artery disease)
February 1, 2009... NEW ORLEANS -- Women with metabolic syndrome have an increased risk of developing symptomatic peripheral artery disease, mediated mainly by the syndrome's associated inflammation and endothelial activation, according to a study of more than...

Policy & practice.(PRACTICE TRENDS)
February 1, 2009... FDA Posts Guidance on Handouts The Food and Drug Administration has issued updated guidance for manufacturers that distribute journal articles or other scientific publications concerning off-label uses for their FDA-approved drugs,...

MedPAC proposes 1.1% fee increase for 2010.(PRACTICE TRENDS)(Medicare Payment Advisory Commission)
February 1, 2009... WASHINGTON -- Medicare advisers unanimously voted to recommend increasing physician fees by 1.1% next year, while expressing dismay that their June 2008 recommendation to boost primary care pay has not yet been acted upon. The Medicare...

CMS will expand coverage for initial PET scans.(PRACTICE TRENDS)(Centers for Medicare and Medicaid Services, positron emission tomography)
February 1, 2009... Medicare officials are preparing to expand the coverage of positron emission tomography for initial diagnostic testing in individuals with suspected solid tumors. Under a proposed national coverage determination issued by the Centers for...

CT colonography endorsed, with caveats.(PRACTICE TRENDS)(computed tomographic )
February 1, 2009... BALTIMORE -- A panel of Medicare advisers has tentatively expressed support for the use of computed tomographic colonography to screen for colorectal cancer in average-risk Medicare beneficiaries. Based on an overview of existing evidence...

Buoyed by faith in Niger: global perspectives on medical practice.(WORLD WIDE MED)(Kate Venable)(Interview)
February 1, 2009... "I just can't seem to stay in the U.S.," Dr. Kate Venable said. A love for the poor and a strong Christian faith combined to inspire her to plan a medical career practicing overseas. Dr. Venable first felt called to overseas medical mission...

Medicare PHR test launched in two states.(PRACTICE TRENDS)(personal health records, Arizona and Utah)
February 1, 2009... Medicare and Medicaid beneficiaries living in Arizona and Utah are among the first to test-drive a pilot program that lets them access their personal health records online. They also can add pertinent information such as their medications,...

Indications.
February 1, 2009... Hallucination Nation... British researchers report that a high intake of caffeine--more than the equivalent of seven cups of instant coffee a day--may cause you to hear voices and see things that aren't there. The authors from Durham...

Survivor care key after breast cancer.(NEWS)
February 15, 2009... Breast cancer survivors are more likely to receive recommended care when they see both an oncology specialist and a primary care physician, data from a study of trends in survivor care between 1998 and 2002 in nearly 24,000 survivors suggest....

Third treatment for fibromyalgia gets FDA approval: milnacipran to be available by March.(NEWS)(United States Food and Drug Administration)
February 15, 2009... Milnacipran, a norepinephrine-serotonin reuptake inhibitor, has been approved by the Food and Drug Administration for the management of fibromyalgia in adults, the third drug approved for this indication. Approval was based on the results...

Online tool makes family history a living document.(NEWS)
February 15, 2009... A revised high-tech tool from the Department of Health and Human Services may make filling out a pre-exam checklist in the doctor's office obsolete, if doctors and patients will use it. "We know that a large percentage of our risk for...

Vital signs.(women physicians)(Statistical table)(Brief article)
February 15, 2009... Percentage of Physicians Who Are Women (Active physicians by specialty, 2007) Geriatric medicine 43.7% Endocrinology, diabetes, and metabolism 35.2% Rheumatology 32.9%...

Good physical health boosts survival after breast cancer.(NEWS)
February 15, 2009... SAN ANTONIO--Breast cancer survivors with poor physical health, particularly those with limited physical activity, have a worse prognosis than those with adequate physical health, based on the results of a study of almost 3,000 survivors...

Americans' mental health needs unmet, report says.(NEWS)(National Survey on Drug Use and Health)
February 15, 2009... Just 45% of the 24 million U.S. citizens who experienced serious psychological distress in the past year received any kind of mental health services for their symptoms, a new national report has found. Young adults bore much of the burden...

The nation's health care is 'poor,' ACP says.(NEWS)(American College of Physicians)
February 15, 2009... Expansion of the primary care workforce is necessary to improve the "poor" state of the nation's health care, according to Dr. Jeffrey P. Harris, president of the American College of Physicians. "We have too many uninsured. We have too few...

Advisory says use topical anesthetic with caution.(NEWS)
February 15, 2009... The use of topical lidocaine products to mitigate pain during mammograms and other medical tests has the potential to cause life-threatening events, according to a public health advisory issued by the Food and Drug Administration. "Before...

Ranolazine label has new claims, fewer restrictions.(NEWS)
February 15, 2009... The Food and Drug Administration has approved a revised indication and several label additions for the angina drug ranolazine, including a statement that the drug reduced hemoglobin [A.sub.1c] in people with diabetes. The indication is...

FDA review backs ezetimibe and simvastatin combination.(NEWS)(United States Food and Drug Administration)
February 15, 2009... After a year-long review of data from the ENHANCE trial that showed no significant difference in the changes in carotid artery thickness between patients treated with ezetimibe and simvastatin, vs. simvastatin alone, the Food and Drug...

Correction.(Correction notice)
February 15, 2009... In "Low-Dose Colchicine Effective for Acute Gout" (Jan. 15, 2009, p. 12), the total low dose of colchicine that was given to 74 patients should have been stated as 1.8 mg.

Of pens, mugs, and transparency.(Physician Payments Sunshine Act of 2008)(Editorial)
February 15, 2009... With the continuing public push for more transparency from government and corporations, three pharmaceutical companies have decided to begin online registries in 2009 that list payments to physicians who perform service to the company as...

Funding by industry biases research.(Does pharmaceutical industry funding bias research?)
February 15, 2009... Industry-sponsored studies, when published in peer-reviewed journals, are four times more likely to be favorable to the sponsor's drug, device, or treatment than are non-industry sponsored studies, according to a meta-analysis of 30 studies...

Non-industry funded research can be biased, too.(Does pharmaceutical industry funding bias research?)
February 15, 2009... For almost 100 years, industry has been a powerful motivating force in the creation of new technology and the underwriting of scientific research. But in the last 2 decades, there has been a campaign to decry industry funding, claiming that...

Combination score flags stroke risk after TIA.(NEUROLOGY)(transient-ischemic-attack)
February 15, 2009... CHICAGO--A low ABC[D.sup.2] score identified transient-ischemic-attack patients at low risk for having an early disabling stroke, but it was suboptimal at identifying more minor strokes in a prospective, multicenter study of 1,667 patients. ...

Many adults turn to CAM for chronic pain relief.(NEUROLOGY)(complementary and alternative medicine)
February 15, 2009... About 38% of adults and nearly 12% of children in the United States used some type of complementary or alternative medicine therapy in 2007, according to survey data released by the Centers for Disease Control and Prevention and the National...

Permanently disabling MS attacks uncommon.(NEUROLOGY)(multiple sclerosis)(Brief article)
February 15, 2009... SALT LAKE CITY--The risk of permanent disability from a multiple sclerosis attack is extremely rare and does not appear to be tied to drug holidays, data on more than 1,000 MS patients showed. A catastrophic attack of multiple sclerosis is...

Severe, sudden acne calls for initial prednisone.(DERMATOLOGY)
February 15, 2009... LAS VEGAS--Profoundly severe, sudden-onset acne in adolescents should be treated right away, Dr. Fred Ghali said. These patients exhibit inflammatory and ulcerative acne lesions, often with large, nodular cysts, Dr. Ghali said at a...

Dapsone gel can now be used for acne.(DERMATOLOGY)
February 15, 2009... LAS VEGAS--After years of delay, topical dapsone gel 5% can now be prescribed for patients with mild to moderate acne, marking the first new chemically based drug treatment for acne in a decade. A sulfone drug, Aczone 5% gel has...

Think efficacy, toxicity when treating psoriasis.(DERMATOLOGY)
February 15, 2009... PARIS--Nonbiologic systemic drugs can be effective choices for the treatment of psoriasis if they are chosen properly, according to Dr. Jonathan Barker. Traditional systemic drugs work but are not always effective, and are often associated...

Value of skin cancer screenings lacks evidence.(DERMATOLOGY)
February 15, 2009... The U.S. Preventive Services Task Force still cannot recommend for or against whole-body skin examination by a primary care physician or by patient self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous...

Letrozole beats tamoxifen in breast cancer trial: a switch back to tamoxifen for the remainder of their 5 years would not compromise their outcome.(WOMEN'S HEALTH)
February 15, 2009... SAN ANTONIO -- Updated results of the landmark Breast International Group 1-98 trial suggest that overall survival in breast cancer patients is superior with 5 years of adjuvant letrozole, compared with tamoxifen. The 13% reduction in...

Gail model inaccurate in women with atypical hyperplasia.(WOMEN'S HEALTH)(Report)
February 15, 2009... SAN ANTONIO--The widely used Gail model proved no better than a coin toss in predicting breast cancer risk in individual women with atypical hyperplasia on a benign breast biopsy, a case-control study has shown. "The Gail model couldn't...

Lobular involution may protect against breast Ca.(WOMEN'S HEALTH)(breast cancer)(Report)
February 15, 2009... SAN ANTONIO--Young women with a benign breast biopsy showing complete lobular involution are at below-average risk of future breast cancer, according to a large prospective Mayo Clinic study. This finding--that lobular involution...

Gamma imaging can identify occult breast Ca.(WOMEN'S HEALTH)(breast cancers )(Report)
February 15, 2009... CHICAGO--Breast-specific gamma imaging can detect additional breast cancers missed by mammography and physical examination in women with newly diagnosed breast cancer. In a retrospective study in 159 women with at least one biopsy-proven...

Breast Ca survival tied to hormone therapy.(WOMEN'S HEALTH)
February 15, 2009... SAN ANTONIO--Breast cancer patients who used menopausal hormone therapy before their diagnosis had a reduced breast cancer mortality, compared with never-users of hormone therapy, in the large epidemiologic California Teachers Study. Users...

IBD better understood, still a clinical challenge.(GASTROENTEROLOGY)(inflammatory bowel disease )(Disease/Disorder overview)
February 15, 2009... FORT LAUDERDALE, FLA.--Despite greater understanding of genetic influences and phenotypic manifestations and the availability of multiple immunomodulatory medications, inflammatory bowel disease continues to pose significant clinical...

AAA screen warranted in men with TIA or stroke.(CARDIOVASCULAR MEDICINE)(abdominal aortic aneurysm)(transient ischemic attack )(Report)
February 15, 2009... CHICAGO--One of the every nine men over age 59 years with a diagnosis of stroke or transient ischemic attack had an abdominal aortic aneurysm in a prospective study of 499 patients. Among all patients admitted for stroke or TIA, the...

Intake of non-soy legumes tied to lower cholesterol.(CARDIOVASCULAR MEDICINE)
February 15, 2009... NEW-ORLEANS--A diet that includes regular consumption of non-soy legumes provides clinically meaningful lipid lowering in hypercholesterolemic individuals, a meta-analysis indicates. The meta-analysis included 298 dyslipidemic adults not on...

Genetic factors, PPIs may alter effectiveness of clopidogrel.(CARDIOVASCULAR MEDICINE)
February 15, 2009... The Food and Drug Administration said that Sanofi-Aventis and Bristol-Myers Squibb Co. have agreed to conduct studies to better characterize the effectiveness of clopidogrel (Plavix) in patients with certain genetic factors. The two...

Eating fruits and vegetables improves endothelial function.(CARDIOVASCULAR MEDICINE)
February 15, 2009... NEW ORLEANS--Every portion of fruits and vegetables eaten per day improves vascular endothelial function by an additional 6.2% in dose-dependent fashion. This finding from a randomized, controlled study provides a mechanistic explanation...

Depression plus comorbidities not targeted.(PSYCHIATRY)
February 15, 2009... RIO GRANDE, P.R.--Primary care physicians don't appear to treat depression any more aggressively in patients who have medical comorbidities, compared with other patients, despite mounting evidence showing that depression may lead to worse...

In mentally Ill, CVD more deadly than suicide.(PSYCHIATRY)(Brief article)
February 15, 2009... CHICAGO--Death due to cardiovascular disease dwarfs suicide as a cause of total years of potential life lost among patients with major mental illness, according to a five-state study. Even though suicide is less common than cardiovascular...

Altered technique may avert injuries in runners.(SPORTS MEDICINE)
February 15, 2009... RIO GRANDEL, P.R.--Injury rates among recreational runners were significantly reduced after they adopted a running technique called ChiRunning, according to results of a survey of 2,500 runners. Previous research has suggested that injuries...

Joint Space narrowing predicts cartilage loss.(RHEUMATOLOGY)
February 15, 2009... Knees with joint space narrowing lost more cartilage over a year than did knees without joint space narrowing, based on imaging results from a study of 80 adults with knee osteoarthritis. Previous research has shown that radiography can...

Foot orthotics for patellofemoral pain.(MINDFUL PRACTICE)(Case study)
February 15, 2009... The Problem A 53-year-old physician presents to you for evaluation of a 1-month history of new-onset knee pain. She reports knee pain when walking up and down stairs on medical rounds and after prolonged sitting ("movie-goers sign"). She...

Blacks, women had higher STD rates in 2007.(INFECTIOUS DISEASES)(sexually transmitted disease)
February 15, 2009... The rates of three major sexually transmitted diseases in the United States in 2007 continued to follow a nearly decade-long climb that has disproportionately affected minorities and women, according to a report issued by the Centers for...

Single-day famciclovir found as effective as 3-day valacyclovir.(INFECTIOUS DISEASES)
February 15, 2009... WASHINGTON--Single-day famciclovir therapy was similar in safety and efficacy to a 3-day course of valacyclovir in the first head-to-head comparison of the two oral medications for the treatment of recurrent genital herpes. Previous data...

UnitedHealth to close database, pay $350M.(PRACTICE TRENDS)(UnitedHealth Group Inc.)
February 15, 2009... As part of an agreement with New York Attorney General Andrew Cuomo, UnitedHealth Group has agreed to shut down a national billing database used by health plans to determine reimbursements to members who use out-of-network physician services....

Policy & practice.(PRACTICE TRENDS)(United States Food and Drug Administration, Centers for Medicare and Medicaid Services, tobacco control, Singulair, medical home and insurance cards)
February 15, 2009... FDA Launches Safety Program The Food and Drug Administration launched a pilot program aimed at ensuring the safety of drugs produced outside the United States. The agency said it plans to select 100 companies that volunteer to participate...

Shortage of gastroenterologists predicted by 2020.(PRACTICE TRENDS)
February 15, 2009... Within a decade, the United States won't have enough gastroenterologists to meet the demand for colorectal cancer screenings, given its burgeoning elderly population, a new study has found. If the national screening rates remain stable, the...

Res ipsa loquitur.(LAW & MEDICINE)
February 15, 2009... Question: Twenty minutes into an otherwise routine endoscopic examination, the patient sustained a stroke, which left him with cognitive loss and hemiparesis. The etiology was later established to be air embolism. A lawsuit asserts obvious...

For the love of dogs.(THE REST OF YOUR LIFE)(Donna Chester)
February 15, 2009... When Dr. Donna Chester steps onto the dog agility obstacle course with Penny, her 3-year-old papillon, she brings a team approach to the task ahead. It's them against the course timer. That sense of alliance isn't lost on Penny,...

SCHIP law will cover more children, services.(PRACTICE TRENDS)(State Children's Health Insurance Program)
February 15, 2009... Nearly 11 million low-income children will receive health coverage under the reauthorization and expansion of the State Children's Health Insurance Program, which was recently signed into law by President Barack Obama. The legislation...

Brits queued, yanks rude.(INDICATIONS)
February 15, 2009... Since February is "National write a poem about the Titanic month," here's a poem about the Titanic: The story begins with the Titanic The Brits were polite and didn't panic Yanks lacked a stiff upper lip And didn't go down...