Internal Medicine News articles from June 2007

Internal Medicine News archives from June 2007

Coalition aims to fight Cardiac Arrest.(News)
June 1, 2007... DENVER -- The Heart Rhythm Society and a disparate collection of 29 other organizations have joined forces to create the Sudden Cardiac Arrest Coalition to advocate for increased research and education regarding the killer of more than 250,000...

Teamwork training may help improve inpatient safety: good communication can prevent errors.(News)
June 1, 2007... WASHINGTON -- Patient safety problems in hospitals often stem from a lack of teamwork and poor communication, James Battles, Ph.D., said at a conference sponsored by the National Patient Safety Foundation. "In health care, if we don't have...

HARMM criteria signal increased melanoma risk.(News)(Report)
June 1, 2007... PHOENIX -- Analysis of more than 350,000 reports from skin cancer screenings has identified five melanoma risk factors that can flag candidates for total skin examinations, Dr. Darrell S. Rigel reported at a clinical dermatology conference...

Palliative care reduces inpatient costs.(News)
June 1, 2007... SEATTLE -- Hospital-based palliative care can save as much as nearly $7,000 per patient admission, a figure that could add up to total savings of $1.3 million per year for a 300- to 350-bed hospital, according to an analysis of data from eight...

Consumer payments projected to be largest part of national health expenditure in 2007.(VITAL SIGNS)(Table)(Brief article)
June 1, 2007... Consumer Payments Projected to Be Largest Part of National Health Expenditure in 2007 Consumer payments 46% Federal payments 34% State and local payments 13% Other private funds 7% Total: $2,263.3 billion...

First pandemic avian influenza vaccine approved.(News)
June 1, 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 is for active immunization against influenza disease caused by the H5N1...

Reclast Injection.(NEW & APPROVED)
June 1, 2007... Reclast Injection (zoledronic acid, Novartis Pharmaceuticals) An intravenously administered bisphosphonate approved for the treatment of Paget's disease of bone in men and women. A different dosage (4 mg) of zoledronic acid (Zometa)...

Altabax.(NEW & APPROVED)(Drug overview)(Brief article)
June 1, 2007... Altabax (retapamulin ointment 1%, GlaxoSmithKline) A topical antibiotic approved for treatment of impetigo caused by susceptible strains of Staphylococcus aureus or Streptococcus pyogenes in patients aged 9 months and older. Altabax is...

Death rate higher in cancer patients on Aranesp.(News)
June 1, 2007... LOS ANGELES -- A randomized, double-blind, placebo-controlled study of the use of darbepoetin alfa (Aranesp) in patients with cancer-related anemia produced disappointing results, Dr. John A. Glaspy reported during the annual meeting of the...

Bone guidelines will focus on fracture risk.(News)
June 1, 2007... Updated guidelines slated for release this year should make it easier for physicians and patients to manage osteoporosis and make informed treatment decisions, according to Dr. Bess Dawson-Hughes, director of the bone metabolism laboratory at...

Making the move to Quality Reporting.(Guest editorial)
June 1, 2007... On July 1, Medicare will launch its Physician Quality Reporting Initiative. Physicians who choose to submit quality data will be paid a bonus equivalent to 1.5% of their total Medicare billing for the period July 1 to Dec. 31, 2007. Physicians...

Many breast exams are unnecessary.(LETTERS)(Letter to the editor)
June 1, 2007... I wholeheartedly agree with the view that clinicians need to individualize their recommendations for early mammogram ("Early Mammogram Has Pros and Cons," April 1, 2007, p. 1). I would, however, go several steps further to suggest that the...

Cross protection may help in pandemic.(LETTERS)(Letter to the editor)
June 1, 2007... The article about influenza vaccine coverage refers to a statement by Dr. Anthony Fauci that "one promising finding is that there appears to be good degree of cross protection' from the vaccination of animals and/or humans, although clinical...

Vaccine mandates are dangerous.(LETTERS)(Letter to the editor)
June 1, 2007... I take great exception to Dr. Amesh Adalja's assertions that it is puritanical to disagree with a mass prescription to immunize all girls against HPV ("Puritanical Ideas Are Perilous," Letters, April 1, p. 11). First of all, universal...

HPV vaccine mandate is Ill conceived.(LETTERS)(Letter to the editor)
June 1, 2007... As a Christian board-certified internist who has diagnosed and treated gynecological diseases for 27 years, I am vehemently opposed to the ill-conceived and profit-driven implementation of state-mandated human papillomavirus (HPV) vaccination...

What is the best way to manage Barrett's esophagus and high-grade dysplasia?(POINT/COUNTERPOINT)
June 1, 2007... Anything less than esophagectomy is risky. The risk of high-grade dysplasia becoming esophageal cancer within 5 years is somewhere between 16% and 80%, depending on which study you read. Although 16% is the low number in this wide range, it...

Tailor rosacea treatment to patient symptoms.(Dermatology)(Clinical report)
June 1, 2007... AMELIA ISLAND, FLA. -- Medical therapies work well for the treatment of the inflammatory lesions of rosacea, whereas physical modalities appear to be the most effective for the telangiectasia and macular erythema that arc often associated with...

New assay helps in the diagnosis of urticaria.(Dermatology)
June 1, 2007... KEYSTONE, COLO. -- A new in vitro diagnostic assay that detects antibodies responsible for about 40% of chronic idiopathic urticaria is now available, Dr. Mark Boguniewicz said at a meeting on allergy/clinical immunology, asthma, and pulmonary...

Melanonychia striata lacks diagnostic criteria.(Dermatology)
June 1, 2007... AMELIA ISLAND, FLA. -- Every case of melanonychia striata must be evaluated individually, Dr. Richard K. Scher said at a symposium sponsored by the Dermatology Foundation. Longitudinal bands of pigmentation in nails are among the trickiest...

Elevated melanoma risk found in men with breast cancer.(Dermatology)(Brief article)
June 1, 2007... MIAMI BEACH -- Men with breast cancer have about a threefold increased likelihood of developing secondary melanoma, according to a recent study. Evidence of a link between breast cancer and later melanoma implies a shared genetic etiology...

Individualized drug management is key in elderly.(Geriatrics)
June 1, 2007... SAN DIEGO -- When treating elderly patients, don't treat a drug side effect with another medication unless you absolutely have to, Dr. Peter A. Boling advised at the annual meeting of the American College of Physicians. Although...

Warfarin underprescribed in elderly AF patients.(Geriatrics)(Atrial fibrillation)
June 1, 2007... CARMEL, CALIF. -- Many clinicians underprescribe warfarin in elderly patients with atrial fibrillation because of the perceived risks of anticoagulation therapy results from a study of Department of Veterans Affairs patients showed. ...

Hospice patients are not receiving full benefit of inhaled medications.(Geriatrics)
June 1, 2007... SALT LAKE CITY -- Hospice practitioners are not adequately trained in the use of inhaled medications, according to a study presented at the annual meeting of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative...

Mentally impaired adults benefit from exercise.(Geriatrics)(Brief article)
June 1, 2007... CARMEL, CALIF. -- Cognitively impaired older adults who participate in exercise rehabilitation programs have similar strength and endurance outcomes as their cognitively intact peers, results from a large meta-analysis showed. The data...

Migraine survey can guide evaluation, therapy.(Neurology)(Survey)
June 1, 2007... BOSTON -- A new five-question survey for patients on the efficacy and tolerability of their migraine drugs should help physicians quickly discover any problems with treatment, according to Dr. Richard B. Lipton, who led the group of...

Stenting safe in high-risk endarterectomy patients.(Neurology)
June 1, 2007... NEW ORLEANS -- Carotid artery stenting in high-risk candidates for endarterectomy is working well as the procedure diffuses out into real-world clinical practice, with steadily improving outcomes as operators in the community gain greater...

Clinical effects of carotid stent depend in part on its design.(Neurology)
June 1, 2007... HOLLYWOOD, FLA. -- The design and composition of carotid stents can have a major effect on the stents' clinical impact, according to the results from two separate studies. Specifically, treatment with open cell and large-cell carotid...

Undiagnosed anxiety worsens major depression.(Psychiatry)
June 1, 2007... ST. LOUIS -- Patients with major depressive disorders should be screened for comorbid anxiety disorders, including panic disorder, obsessive-compulsive disorder, social phobia, posttraumatic stress disorder, and general anxiety disorder, Dr....

Medicare won't cover VNS for depression.(Psychiatry)
June 1, 2007... The Centers for Medicare and Medicaid Services has determined that it will not cover vagus nerve stimulation for treatment-resistant depression. The therapy, marketed by Cyberonics Inc. of Houston, has been successful in epilepsy but has...

FDA approves 13 generic Ambien formulations.(Psychiatry)(Food and Drug Administration)(Brief article)
June 1, 2007... Just days after the patent expired on the trade formulation of the insomnia drug Ambien, the Food and Drug Administration announced that 13 generic drug manufacturers had received approval for generic formulations of immediate-release zolpidem...

Legal fallout could restrict rights of mentally ill.(Psychiatry)
June 1, 2007... SANTA FE, N.M. -- The mass murders at Virginia Tech could turn the public against the mentally ill and, in turn, lead to harsher laws restricting their rights, lawyers and psychiatrists warned at the annual meeting of the American College of...

Binge drinking tied to intimate partner violence.(Psychiatry)(Report)(Brief article)
June 1, 2007... MIAMI -- Victims of intimate partner violence are more than twice as likely to binge drink than those who have not been victimized, Dr. Nicole Flowers reported in a poster at the annual meeting of the American College of Preventive Medicine....

Atherosclerosis boosts mortality in RA patients: patients diagnosed with rheumatoid arthritis should also undergo screening for peripheral atherosclerosis.(Rheumatology)
June 1, 2007... NEW ORLEANS -- Patients with rheumatoid arthritis and peripheral arterial atherosclerosis are about twice as likely to die as are rheumatoid arthritis patients with no sign of peripheral atherosclerosis, based on a study of more than 2,400...

Hepatitis B reactivation can occur with biologic treatment.(Rheumatology)
June 1, 2007... NEW YORK -- Reactivation of hepatitis B virus is an underrecognized hazard of immunosuppressive therapy in patients with rheumatic disease, Dr. Leonard H. Calabrese said at a rheumatology meeting sponsored by New York University. Although...

Dextrose injections may trigger healing in tendons.(Rheumatology)(Report)
June 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...

Free lupus CD-ROM.(FYI)
June 1, 2007... "Lupus Information for You and Your Patients" is a free CD-ROM from the National Institute of Arthritis and Musculoskeletal and Skin Diseases that includes PDF files of selected patient education brochures, professional educational resources,...

Doctor-patient partner guide.(FYI)(Brief article)
June 1, 2007... The American Medical Association and the AARP (formerly the American Association of Retired Persons) have joined forces to produce a free downloadable pamphlet that outlines shared responsibilities for physicians and patients. The goal of the...

Training, information on Drug Abuse.(FYI)(Brief article)
June 1, 2007... The National Institute on Drug Abuse has launched four Centers of Excellence for Physician Information. The new Centers for Excellence--which will be located at academic medical institutions throughout the country--will target primary care...

Fact sheet on pain management.(FYI)(Brief article)
June 1, 2007... The Substance Abuse and Mental Health Services Administration has published a new fact sheet on providing pain management while avoiding psychological dependence on opioids. To order free copies of "Pain Management Without Psychological...

Online tutorial on patient safety.(FYI)(Brief article)
June 1, 2007... The Food and Drug Administration's MedWatch Program is offering an online tutorial to present its goals of safety information dissemination and adverse event reporting. The course takes about I hour to complete and includes a video...

Rx drugs disposal guide.(FYI)(Brief article)
June 1, 2007... New guidelines on the proper disposal of unused, unneeded, or expired prescription drugs were recently released by the White House Office of National Drug Control Policy, the Department of Health and Human Services, and the Environmental...

Public diabetes prevention initiative.(FYI)(Brief article)
June 1, 2007... The American Diabetes Association (ADA) has launched CheckUpAmerica, which is aimed at people who are at risk of type 2 diabetes and heart disease. The initiative encourages people older than 40 years to have regular checkups and take steps to...

Hypothermia booklet for the elderly.(FYI)
June 1, 2007... "Stay Safe in Cold Weather" is an easy-to-read booklet on hypothermia, aimed at elderly adults with limited reading skills. The free 12-page publication from the National Institute on Aging explains what hypothermia is, how it can be prevented,...

Targeting underage drinking.(FYI)(Brief article)
June 1, 2007... Acting Surgeon General Kenneth Moritsugu issued a call to action against underage drinking that spells out recommendations for government, school officials, parents, and young people to address and confront the problem. Copies are available...

Tool for radiation emergencies.(FYI)
June 1, 2007... The Department of Health and Human Services has released a downloadable tool for diagnosing and treating patients in the case of a mass casualty radiation event. The toolkit provides physicians with information on the possible types of...

Depression information for seniors.(FYI)(Brief article)
June 1, 2007... The National Institute of Health's Senior Health Web site has added information on depression. Seniors can research causes, risk factors, symptoms, and treatments for depression. The Web site includes a page on frequently asked questions. For...

Web-based EMR service.(PRODUCTS)
June 1, 2007... A new Web site is offering an Internet-based electronic medical records system that needs no special software purchase. Subscription plans vary and are available at an annual or monthly rate. Visit www.docpatient.com for more information.

Drug for rare blood disorder.(PRODUCTS)(Brief article)
June 1, 2007... Soliris (eculizumab) is indicated for the treatment of paroxysmal nocturnal hemoglobinuria. The drug suppresses immunologic destruction of red blood cells, which is the most common characteristic of the disease. For more information, visit...

Software for assessing fall risk.(PRODUCTS)
June 1, 2007... The CAPS Lite can help assess older patients' risk of falling by using software that analyzes vestibular, visual, and proprioceptive-somatosensory balance systems in under a minute. More information about the product, from Vestibular...

Germicidal wipes.(PRODUCTS)
June 1, 2007... Super Sani-Cloth Germicidal Disposable Wipes now kill rotavirus, human corona-virus, extended-spectrum [beta]-lactamase-producing Escherichia coli and Burkholderia cepacia, in addition to more than a dozen other microorganisms. The wipes are...

New Twinrix dosing schedule.(PRODUCTS)(Brief article)
June 1, 2007... The Food and Drug Administration has approved an accelerated dosing schedule for Twinrix (Hepatitis A [inactivated] and Hepatitis B [recombinant] vaccine). Three doses can now be administered at 0, 7, and 21-30 days, followed by a booster at 12...

Conception Kit.(PRODUCTS)
June 1, 2007... Fertility prediction tools, three FDA-approved cervical caps, and semen collectors are all available in the new 3-month Conception Kit for couples having problems becoming pregnant. For more information on the Conceivex Inc. Conception Kit,...

Injection port for drug self-delivery.(PRODUCTS)
June 1, 2007... The I-Port device allows adults and children to inject insulin and other medications without repeated skin punctures. The device is 1.5 inches in diameter and 0.33 inch tall, which allows it to be worn discreetly under clothing. For more...

Home fertility tests.(PRODUCTS)
June 1, 2007... Fertell will be available this summer for home assessment of key elements of male and female fertility. The male test measures concentration of motile sperm; the female test measures day 3 follicle-stimulating hormone in the urine. The kits,...

Tool for identifying billing codes.(PRODUCTS)
June 1, 2007... The ICD-9/CPT reference helps physicians quickly identify procedural and diagnostic billing codes. Users can search 20,000 routinely updated codes by category, keyword, or code. For more information visit www.epocrates.com/products/coder.

Obstructive sleep apnea linked to risk of atrial fibrillation before age 65.(Cardiovascular Medicine)(Clinical report)
June 1, 2007... SCOTTSDALE, ARIZ. -- Obesity and obstructive sleep apnea are independent risk factors for atrial fibrillation in patients younger than 65 years of age, but not in older patients, according to a retrospective cohort study of 3,542 people who had...

Adult-onset asthma boosts women's cardiovascular risk.(Cardiovascular Medicine)
June 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...

FDA panel backs Avalide as first-line HT therapy.(Cardiovascular Medicine)
June 1, 2007... ROCKVILLE, MD. -- A Food and Drug Administration advisory panel unanimously recommended that the combination antihypertensive product irbesartan and hydrochlorothiazide be approved as a first-line treatment for hypertension. The...

Depression tied to worse heart failure outcomes.(Cardiovascular Medicine)
June 1, 2007... NEW ORLEANS -- Depression is common among patients with heart failure and is independently associated with poor outcomes, Dr. Aldo P. Maggioni said at the annual meeting of the American College of Cardiology. He presented a retrospective...

Analysis ties rosiglitazone to increased MI risk.(Cardiovascular Medicine)(myocardial infarction)(Report)
June 1, 2007... Rosiglitazone may be associated with an increased risk of myocardial infarction, according to the results of a meta-analysis of 42 published and unpublished randomized trials. Patients who received rosiglitazone (Avandia) were 43% more...

Herpes zoster vaccine safe in 50- to 59-year-olds.(Infectious Diseases)
June 1, 2007... BALTIMORE -- The herpes zoster vaccine is as immunogenic in adults aged 50-59 as it is in those aged 60 and older, Santosh C. Sutradhar, Ph.D., reported at a conference on vaccine research sponsored by the National Foundation for Infectious...

Use clinical judgment to augment CAP guidelines.(Infectious Diseases)(community-acquired pneumonia)
June 1, 2007... MONTREAL -- New guidelines for the management of community-acquired pneumonia provide an excellent framework for site-of-care decisions, but they must be augmented with a good dose of clinical judgment, according to Glenn Tillotson, Ph.D. ...

Biologic marker can help tailor antibiotic use in CAP.(Infectious Diseases)(community-acquired pneumonia)
June 1, 2007... MONTREAL -- In community-acquired pneumonia, overuse of broad-spectrum antibiotics can be curbed with the help of biologic markers such as procalcitonin, according to Dr. Jean Chastre of the Hopital de la Pitie-Salpetriere, Paris. Blood...

Appropriate antibiotic important in COPD with pneumonia.(Infectious Diseases)(Chronic obstructive lung disease)
June 1, 2007... MONTREAL -- Exacerbations of chronic obstructive pulmonary disease may need more aggressive therapy when they co-occur with pneumonia, according to Dr. Charles Chan, professor of medicine at the University of Toronto and head of respirology at...

Mix-ups are occurring among several vaccines.(Infectious Diseases)
June 1, 2007... MIAMI BEACH -- Inadvertent misadministration can occur with several new vaccines that are commonly used, Dr. Larry Pickering said at the annual Masters of Pediatrics conference sponsored by the University of Miami. One potential source of...

Allergies to other drugs may predict penicillin allergy.(Infectious Diseases)(Brief article)
June 1, 2007... SAN DIEGO -- People who report allergies to other drugs were more than 27 times as likely to report a penicillin allergy as people who reported no other drug allergies, Dr. Andrea J. Apter reported in a poster presentation at the annual meeting...

FDA warning ties linezolid use to mortality from catheter infections.(Infectious Diseases)(Food and Drug Administration)
June 1, 2007... The Food and Drug Administration has issued an alert about a higher rate of deaths associated with the antibiotic linezolid in a recent study of patients with catheter-related bloodstream infections. For patients infected with gram-positive...

Endoscopic mucosal resection useful for Barrett's.(Gastroenterology)
June 1, 2007... WASHINGTON -- Endoscopic mucosal resection seems to be safe and effective for Barrett's esophagus with high-grade dysplasia or intramucosal adenocarcinoma, and may help patients avoid an esophagectomy, according to a small study presented at a...

Three biomarkers tied to esophageal ca risk.(Gastroenterology)
June 1, 2007... LOS ANGELES -- A combination of three biomarkers may reliably predict which patients with Barrett's esophagus will progress to esophageal adenocarcinoma, Dr. Patricia L. Blount reported at the annual meeting of the American Association for...

LN ratio may predict survival in pancreatic ca.(Gastroenterology)
June 1, 2007... WASHINGTON -- A retrospective look at the Surveillance, Epidemiology, and End Results database indicates that too few nodes are being evaluated in some patients with pancreatic cancer, which may result in understaging, Dr. Mark Slidell said at...

Acute pancreatitis.(THE EFFECTIVE PHYSICIAN)(Disease/Disorder overview)
June 1, 2007... Background Acute pancreatitis causes an estimated 210,000 hospitalizations in the United States annually, with overall mortality around 5%. The American College of Gastroenterology recently published updated guidelines for diagnosis and...

Cost sharing lowers Medicare mammogram rates.(Practice Trends)
June 1, 2007... TORONTO -- Copayments exceeding $10 or coinsurance of more than 10% is associated with lower rates of breast cancer screening, Dr. Amal Trivedi said at the annual meeting of the Society of General Internal Medicine. Across all study years,...

Physicians advise use of registry data for PQRI.(Practice Trends)(Physician Quality Reporting Initiative)
June 1, 2007... BALTIMORE -- Outcomes registries, not claims data, should be the base for the Physician Quality Reporting Initiative next year, physicians and their representatives said at a forum held in May by the Centers for Medicare and Medicaid Services....

CMS urged to improve efficiency.(POLICY & PRACTICE)(Brief article)
June 1, 2007... Medicare patients who see an "outlier generalist," a physician who treats a disproportionate share of overly expensive patients, were more likely to have been hospitalized, more likely to have been hospitalized multiple times, and more likely...

Overcrowded hospitals riskier?(POLICY & PRACTICE)(Brief article)
June 1, 2007... Hospitals that operate at or over their capacity might be at increased risk of adverse events that injure patients, according to a study led by investigators from Massachusetts General Hospital (MGH) and Brigham and Woman's Hospital, both in...

N.H. Rx law struck down.(POLICY & PRACTICE)(New Hampshire )(Brief article)
June 1, 2007... A federal judge in New Hampshire has struck down a state law banning commercial use of provider-identifiable prescription information, finding that it "unconstitutionally restricted speech." Judge Paul Barbadoro ruled in favor of health...

IT bill would aid small practices.(POLICY & PRACTICE)(information technology )(Brief article)
June 1, 2007... Seeking to help physicians who might like to adopt health information technology (HIT) systems but cannot afford the investment, Reps. Charlie Gonzalez (D-Tex.) and Phil Gingrey (R-Ga.) have introduced legislation that would provide grants,...

Debridement restrictions lifted.(POLICY & PRACTICE)(Brief article)
June 1, 2007... The American Academy of Family Physicians (AAFP) said it has succeeded in its drive to remove restrictive language from a Medicare carrier's draft local coverage determination on wound care. The restriction would have affected physicians in...

Adults disregard MDs' orders.(POLICY & PRACTICE)(Doctor of Medicine)(Survey)(Brief article)
June 1, 2007... In a recent survey. 44% of U.S. adults said that they or an immediate family member have ignored a doctor's course of treatment or sought a second opinion because they felt the doctor's orders were unnecessary or overly aggressive. Most adults...

Medicare nixes expanded coverage of carotid stents.(Practice Trends)
June 1, 2007... Officials at the Centers for Medicare and Medicaid Services have reversed a proposal to expand coverage for carotid artery stenting in asymptomatic patients. Instead, Medicare will continue to cover percutaneous transluminal angioplasty of...

States take the initiative to expand health coverage to the uninsured.(Practice Trends)
June 1, 2007... SAN DIEGO -- The pressure is building to expand health insurance coverage, and right now the states are taking the lead, Jack Ginsburg said at the annual meeting of the American College of Physicians. The issue of covering the uninsured is...

Medicare proposes policy revisions for clinical trials.(Practice Trends)(Brief article)
June 1, 2007... Clinical trials may have to conform to new procedural and reporting requirements for Medicare beneficiary participants to be reimbursed, if revisions to the Clinical Trial Policy national coverage determination are implemented. Changes...

Low-cost system handles patient phone calls.(REINVENTING YOUR PRACTICE)
June 1, 2007... Patient phone calls are a necessity, and a potential liability, which every practice must deal with, but Dr. S. Germain Cassiere said keeping track of calls is no longer a nightmare. He has created software, called MessageTracker, to make...

Reminders raise mammogram compliance rate.(Practice Trends)(Brief article)
June 1, 2007... WASHINGTON -- E-mail may be a convenient way to remind patients about routine health screening, but when it comes to mammograms, it's no more effective than the good old-fashioned postcard, according to researchers from the Mayo Clinic in...