Internal Medicine News articles from June 2008

Internal Medicine News archives from June 2008

ACP backs effort to rate treatments.(American College of Physicians)
June 1, 2008... WASHINGTON -- The American College of Physicians, saying it is time for patients, physicians, and policy makers to consider the economic impact of health care choices along with their clinical impact, has issued a call for the creation of a...

Low Vitamin D tied to poor prognosis in breast cancer: significant differences seen at 10 year.(Clinical report)
June 1, 2008... Vitamin D deficiency at the time of breast cancer diagnosis is common and is associated with a significantly increased risk of metastasis and mortality, according to data from a study of 512 women with newly diagnosed breast cancer. The...

Medicare adds options to Quality Reporting Initiative.
June 1, 2008... Physicians now have nine different options for submitting quality data to Medicare under the Physician Quality Reporting Initiative. The new options include three ways to submit claims-based data and six registry-based methods for...

Women's health web site unveiled.(Website overview)(Brief article)
June 1, 2008... Women's Health Resources is a one-stop Web resource with the latest information on significant topics in women's health research from scientific journals and other peer-reviewed sources. The site is offered by the National Library of...

FDA approves smaller implantable ventricular assist device.
June 1, 2008... The Food and Drug Administration has approved an implantable ventricular assist device that is markedly smaller than previously available devices and is the first that can be used in smaller adults, which will make this technology available to...

Parkinson's patch recall is hard for some patients.(Clinical report)
June 1, 2008... The recent recall of the rotigotine patch used in early Parkinson's disease has been difficult for some patients, according to Dr. Irene Litvan, director of the movement disorder program at the University of Louisville (Ky.). Patients...

FDA approves generic versions of ropinirole.(Brief article)
June 1, 2008... The Food and Drug Administration has approved generic formulations of ropinirole for the treatment of restless legs syndrome but not for Parkinson's disease, the other approved indication for the drug. Generic ropinirole hydrochloride...

Patanase nasal spray, Relistor.(NEW & APPROVED)(Drug overview)
June 1, 2008... Patanase Nasal Spray (olopatadine HCI, Alcon Inc.) An [H.sub.1]-receptor antagonist approved by the Food and Drug Administration for the relief of symptoms of seasonal allergic rhinitis in patients aged 12 years and older. *...

Transplant drugs under scrutiny.(NEWS FROM THE FDA)
June 1, 2008... Recent actions by the Food and Drug Administration have called attention to potential safety issues involving drugs used to prevent organ rejection and treat diabetic skin ulcers; expanded the indications for drugs used to treat anemia,...

Label expanded for ESA.(NEWS FROM THE FDA)
June 1, 2008... The Food and Drug Administration on May 5 expanded the indication for the erythropoietin-stimulating agent darbepoetin alfa to include its use as therapy for new chronic renal failure patients who are not on dialysis. Under the expanded...

Combo migraine drug gets go-ahead.(NEWS FROM THE FDA)(Brief article)
June 1, 2008... GlaxoSmithKline and developmental partner Pozen have received marketing approval for a combination drug for short term treatment of migraine attacks with or without aura in adults, ending a nearly 3-year regulatory review process. ...

Amitiza indication expanded.(NEWS FROM THE FDA)(Brief article)
June 1, 2008... The chronic idiopathic constipation drug Amitiza (lubiprostone) was approved by the Food and Drug Administration for irritable bowel syndrome with constipation in women 18 years and older, making it the only prescription drug available for...

Advair use extended for COPD.(NEWS FROM THE FDA)
June 1, 2008... The Food and Drug Administration approved expanded use of the asthma drug Advair to reduce exacerbations of chronic obstructive pulmonary disease. Inhaled Advair, taken by way of the manufacturer GlaxoSmithKline's Diskus device, combines...

Becaplermin tied to cancer risk.(NEWS FROM THE FDA)
June 1, 2008... The risk of death from cancer may be increased in patients prescribed becaplermin (Regranex) more than three times, according to a statement issued by the Food and Drug Administration. Becaplermin is made by Johnson & Johnson's Ethicon...

All practicing MDs should recertify.(LETTERS)(Letter to the editor)
June 1, 2008... I agree with Dr. Christine K. Cassel's assertion that the American Board of Internal Medicine is committed to improving and supporting a certification process "that reflects what physicians are doing in practice" and facilitates efforts in...

Boards miss key traits, intangibles.(LETTERS)(Letter to the editor)
June 1, 2008... Dr. Jerome Arnett Jr. expressed poignant criticisms about the American Board of Internal Medicine ("Is the ABIM the Only Stakeholder?" Letters, April 15,2008, p.8). Being boarded is not a guarantee of competence, and it requires excessive...

ACP's bold defense of science.(LETTERS)(Letter to the editor)
June 1, 2008... I applaud the American College of Physicians for its recently published position on the utilization of medical marijuana ("Medical Marijuana Gets ACP's Okay," March 15, 2008, p. 1). The college's bold defense of scientific inquiry and...

Medical marijuana = easy cash?(LETTERS)(Letter to the editor)
June 1, 2008... I recently visited Lake Tahoe. Medical marijuana clinics there charge cash for brief visits. This means no insurance forms ("Medical Marijuana Gets ACP's Okay," March 15,2008, p.1). Headaches and high heel pain qualify for a prescription....

AAP should stick to science.(LETTERS)(Letter to the editor)
June 1, 2008... The American Academy of Pediatrics' stand on adolescent sexuality is unscientific and impractical ("Policy on Adolescent Contraception Updated," Feb. 1, 2008, p.6). Pontification is no way to address a biologic phenomenon governed by...

Correction.(Correction notice)
June 1, 2008... In the March 15 issue, p. 15, in the article, "HT Thrombosis Risk Tied to Coagulation Factors," the fifth paragraph should have read: Other factors that were found to be associated with an elevated venous thrombosis risk in the presence of HT...

Redefine diabetes to lower costs of care.(GUEST EDITORIAL)(Clinical report)
June 1, 2008... Here's a solution to the enormous cost of caring for diabetes: Give the diagnosis to 54 million more people. Diabetes per se is not what cost the United States $174 billion last year. Poorly controlled diabetes and its resulting...

Stepping up to fight STDs in teens.(GUEST EDITORIAL)(Report)
June 1, 2008... Like many health care providers, I was taken aback by the data from the Centers for Disease Control and Prevention population-based study showing that, overall, one in four 14-to 19-year-olds tested positive for at least one sexually...

Screen teens for abuse of inhalants.(Adolescent Health)(Report)
June 1, 2008... WASHINGTON -- The drugs of choice for children aged 12 and 13 years are inhalants, surpassing pain relievers, marijuana, and any other illegal drug, with 3.4% of 12-year-olds and 4.8% of 13-year-olds using in the past year. This is...

Developmental factors play role in teen drinking: 'drinking problems of youths have their beginnings well before alcohol use is initiated,' researchers find.(Adolescent Health)(Report)
June 1, 2008... A complex mixture of biologic, psychological, and social evidence suggests that alcohol consumption in children and adolescents is a developmental issue, based on data from several studies. Studying the developmental components of underage...

Teen confidante important after family violence.(Adolescent Health)
June 1, 2008... CHICAGO -- Adolescents exposed to long-term intimate partner violence against their mothers can reduce their own risk of depression by relying less on negative coping strategies and more on emotional disclosure to a confidante, according to...

Controversial sunscreen ingredient ubiquitous.(Dermatology)
June 1, 2008... Exposure to the sunscreen ingredient benzophenone-3 is "widespread in the U.S. general population," according to a study from the Centers for Disease Control and Prevention. "This high level of detection most likely resulted from routine...

Acne vulgaris gets two new treatment options.(Dermatology)(Clinical report)
June 1, 2008... WAIKOLOA, HAWAII -- In a regulatory turnaround, it looks like physicians will gain ready access to dapsone gel 5% for the treatment of acne vulgaris after all, Dr. David M. Pariser said at the annual Hawaii dermatology seminar sponsored by Skin...

Diet gaining legitimacy as potential factor in acne.(Dermatology)
June 1, 2008... WAIKOLOA, HAWAII -- Most physicians, taught that diet is unrelated to the pathogenesis of acne vulgaris, dismiss as folklore the frequent questions posed by patients and family members as to whether eating greasy foods or chocolate or other...

Lymph node dissection overlooked in melanoma.(Dermatology)(Report)
June 1, 2008... CHICAGO -- Only half of close to 3,000 patients with a positive sentinel lymph node biopsy underwent a completion lymph node dissection in a controversial retrospective analysis of 47,643 patients with invasive melanoma that suggests common...

Adherence to guidelines improves melanoma outcomes.(Dermatology)(Clinical report)
June 1, 2008... CHICAGO -- Adherence to national cancer treatment guidelines was associated with decreased local and regional recurrence, improved disease-free and overall survival, and decreased treatment-associated morbidity in a study of 327 clinically...

'Closed-loop' insulin delivery is within reach.(Endocrinolosy)
June 1, 2008... COLUMBUS, OHIO -- A fully functional external "closed-loop" insulin delivery system for patients with diabetes is still down the road, but the availability of continuous glucose monitoring has brought that long-held goal within sight. ...

Fetuin-A is risk factor for type 2 diabetes in elderly.(Endocrinology)(Report)
June 1, 2008... COLORADO SPRINGS -- Serum fetuin-A level is an independent risk factor for subsequent development of diabetes in the well-functioning elderly, Dr. Joachim H. Ix said at a conference of the American Heart Association. The burning issue now...

Choose the right patients for continuous monitors.(Endocrinology)
June 1, 2008... COLUMBUS, OHIO -- Real-time continuous glucose monitoring is likely to become the standard of care for the treatment of type 1 diabetes within the next 5-10 years, but for now it's best to reserve the technology for selected patients, Dr. Irl...

Timing important when calibrating glucose monitors.(Endocrinology)
June 1, 2008... SAN FRANCISCO -- The physiological lag between glucose levels in the blood and in interstitial fluid can wreak havoc in continuous glucose monitoring if the lag isn't considered when calibrating the monitors, according to Dr. Howard A. Wolpert....

Integrated care works best against mental illness.(Psychiatry)
June 1, 2008... Patients with serious mental disorders will be best served when psychiatrists start thinking like primary care physicians, and primary care physicians start thinking like psychiatrists, experts said at a forum on integrating physical and mental...

Study: integrating mental and physical care serves patients and saves money.(Psychiatry)
June 1, 2008... Treatment at an integrated behavioral/physical health care clinic not only reduced emergency department admissions among patients with serious mental illness but also saved a health care company $32,000 per patient in psychiatric care costs....

Institute of medicine details geriatric care ills.(Geriatrics)
June 1, 2008... WASHINGTON -- The U.S. health workforce, including physicians, is "woefully unprepared" to deal with the coming onslaught of aging Americans, according to an Institute of Medicine panel that cited poor training and perverse payment incentives...

Screen for geriatric syndromes in diabetic elderly.(Geriatrics)
June 1, 2008... SAN FRANCISCO -- Managing blood sugar, lipids, and blood pressure levels in elderly patients with diabetes is important, but don't forget to address their quality of life, Dr. Hermes Florez said at a meeting sponsored by the American Diabetes...

Diabetes linked to risk, not cause, of Parkinson's.(Geriatrics)(Report)
June 1, 2008... WASHINGTON -- A history of type 2 diabetes was associated with a 34% higher risk of new-onset Parkinson's disease in older men, but diabetes did not appear to cause Parkinson's, according to data from the Physicians' Health Study. Data...

Type 2 diabetes doesn't affect risk of late-life Alzheimer's.(Geriatrics)(Alzheimer's disease)(Report)
June 1, 2008... WASHINGTON -- Type 2 diabetes did not increase the risk of onset or progression of Alzheimer's disease in older adults, according to results from a study of more than 700 individuals presented in a poster at the annual meeting of the American...

Older patients' stoicism hinders pain management.(Geriatrics)(Report)
June 1, 2008... ORLANDO -- Despite a high prevalence of chronic pain in older adults, adherence to pain medications is low--fueled largely by patients' stoicism, beliefs about pain and aging, and concerns about safety and addiction, according to Dr. Stephen...

Managing pain with Methadone can be complex.(Neurology)
June 1, 2008... TAMPA -- Methadone is an excellent choice for pain management as long as the drug's prescribing complexities are understood, said two experts at the annual meeting of the American Academy of Hospice and Palliative Medicine and the Hospice and...

Fentanyl buccal tablets effective for breakthrough pain.(Neurology)(Report)
June 1, 2008... ORLANDO -- Fentanyl buccal tablets effectively and safely relieved breakthrough cancer pain in opioid-tolerant cancer patients, according to a multicenter open-label trial presented at the annual meeting of the American Academy of Pain...

Ten minutes of exercise reduces chronic pain.(Neurology)(Clinical report)
June 1, 2008... ORLANDO -- A physical conditioning program that consisted of just 10 minutes a day of walking on a treadmill at a moderate pace for 3 weeks significantly improved measures of pain perception, aerobic capacity, depression, and anxiety in chronic...

RNA in diagnosis and therapy.(GENETICS IN YOUR PRACTICE)(Clinical report)
June 1, 2008... Ribonucleic acid, or RNA, is often overlooked in discussions of genetics and genomics. Depending on when you last formally studied biology and genetics, you may still think of RNA as a simple messenger that is the intermediary between a gene's...

Newsletter covers FDA drug safety.(Brief article)
June 1, 2008... The Food and Drug Administration has launched its new online Drug Safety Newsletter. The quarterly publication provides information for health care professionals about selected postmarketing drug safety reviews from the Center for Drug...

Extra test boosts cardio assessment.(Cardiovascular Medicine)(Clinical report)
June 1, 2008... CHICAGO -- The Framingham Risk Score failed to identify a substantial number of people who were at risk for cardiovascular disease events on the basis of their ankle-brachial index, in a review of more than 1,700 asymptomatic people. An...

Warfarin gene tests described.(Cardiovascular Medicine)(Brief article)
June 1, 2008... The American Medical Association has issued the brochure "Personalized Health Care Report 2008: Warfarin and Genetic Testing," which outlines the gene variations that affect warfarin metabolism and response, and describes the genetic tests...

Resistant hypertension.(THE EFFECTIVE PHYSICIAN)
June 1, 2008... Background Resistant hypertension is defined as blood pressure that remains above goal despite the simultaneous use of three antihypertensives from different medication classes. The American Heart Association recently released a guideline...

Ratio of sodium to potassium affects CV risk.(Cardiovascular Medicine)(Clinical report)
June 1, 2008... COLORADO SPRINGS -- The dietary intake ratio of sodium to potassium bears a much stronger association with subsequent development of cardiovascular disease than does consumption of either alone, according to new findings from the Trials of...

Dengue fever is increasing in Texas and Florida.(Infectious Diseases)(Report)
June 1, 2008... MIAMI -- From 1977 to 2004, there were 3,806 suspected cases of dengue imported to the United States, according to the Centers for Disease Control and Prevention. "Many more cases probably go unreported each year because surveillance in...

Bubonic plague was surprise culprit.(Infectious Diseases)
June 1, 2008... WAIKOLOA, HAWAII -- An infamous, deadly disease that killed a large portion of the population of Europe in medieval times can still make rare and disruptive appearances in the modern emergency department. Speaking at a symposium on...

Neuropsychiatric events added to flu drug's label.(Infectious Diseases)(Brief article)
June 1, 2008... Information about neuropsychiatric events associated with zanamivir in people being treated for influenza was added to the warnings and precautions section of the antiviral drug's label. The addition reflects postmarketing reports of...

Bariatric surgery leads to bone density decrease: 'we can really do a lot for these patients by just making sure we minimize their risk of falling'.(Gastroenterology)(Clinical report)
June 1, 2008... SAN FRANCISO -- Weight loss after bariatric surgery induces a drop in bone mineral density and increases the risk for falls and fractures, but it's unclear whether most of theses changes are clinically significant, Dr. Brian N. Sabowitz said....

Bariatric outcomes tied to surgeon and hospital volume.(Gastroenterology)
June 1, 2008... Three-year data on surgical patients in Pennsylvania support using surgeon and hospital volume as part of the credentialing process for bariatric surgery centers of excellence, according to a study of 14,716 patients who underwent bariatric...

Senate targets industry payments to physicians.(Practice Trends)
June 1, 2008... WASHINGTON -- Drug and device manufacturers came under scrutiny at a recent hearing of the Senate Special Committee on Aging, during which witnesses said payments to high-profile physicians appear to be more of a marketing strategy than an...

Medicare commission flags rising hospice costs.(Practice Trends)
June 1, 2008... WASHINGTON--Staggering growth in the popularity of hospice services--and in the rise of for-profit hospice providers--has caught the attention of the Medicare Payment Assessment Commission. At their recent meeting, MedPAC commissioners...

FDA hiring experts.(POLICY & PRACTICE)(Brief article)
June 1, 2008... The Food and Drug Administration has begun a multiyear hiring initiative and plans to fill more than 1,300 positions within the next several months--nearly triple the number hired during the period spanning 2005 to 2007, the FDA said. The...

RUC recommendations submitted.(American Medical Association/Specialty Society Relative Value Scale Update Committee)(POLICY & PRACTICE)(Brief article)
June 1, 2008... The American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) has submitted recommendations on the new Medicare medical home demonstration project to the Centers for Medicare and Medicaid Services. The RUC...

Report: food safety in crisis.(POLICY & PRACTICE)(Brief article)
June 1, 2008... Approximately 76 million Americans--one in four--are sickened by foodborne illnesses every year, and of these, an estimated 325,000 are hospitalized and 5,000 die, according to a report from the advocacy group Trust for America's Health....

GAO: prioritize infection control.(Government Accountability Office)(POLICY & PRACTICE)(Brief article)
June 1, 2008... The federal government is not doing enough to prevent hospital-acquired infections, and the Department of Health and Human Services needs to identify priorities and establish greater consistency in reporting rates, the U.S. Government...

Insurance cost rises fast.(POLICY & PRACTICE)(Brief article)
June 1, 2008... Americans who get health insurance for their families through their jobs have seen their premiums increase 10 times faster than their incomes in recent years, according to an analysis of government data. The study, supported by the Robert Wood...

Part D helps adherence.(POLICY & PRACTICE)(Brief article)
June 1, 2008... The Medicare Part D drug benefit has made it less likely that elderly beneficiaries will forego basic needs such as food or housing in order to pay for medications, a study published in JAMA found. In addition, the study found a small but...

Inspired to promote health care in Haiti.(WORLD WIDE MED GLOBAL PERSPECTIVES ON MEDICAL PRACTICE)(Interview)
June 1, 2008... During a break from an exhausting day of her residency in Atlanta, Dr. Charmaine Lewis stepped into a downtown church near the hospital where she worked in search of some inspiration--and found a new focus. People at the church were passing out...

Indications.
June 1, 2008... Red Hot Chile Seniors? When it comes to entitlement programs, who can beat Lo Prado, a working-class suburb of Chile's capital city, Santiago? There, the mayor is handing out free 50mg Viagra pills to senior citizens who are doctor...

House calls would save Medicare 5%.(News)
June 15, 2008... WASHINGTON -- A group of roving physicians wants to offer Medicare a money-back guarantee the program can't refuse. Members of the American Academy of Home Care Physicians, a 10-year-old specialty society with nearly 1,000 members, met...

Studies challenge benefit of intensive glycemic control; macrovascular event rates not reduced.(News)
June 15, 2008... SAN FRANCISCO -- Lowering hemoglobin [A.sub.1C] levels below currently recommended levels did not reduce the risk of macrovascular events in high-risk patients with established type 2 diabetes in two large studies, and significantly increased...

Genetic nondiscrimination act will protect patients.(News)
June 15, 2008... Patients will soon be able to undergo genetic testing without fear of discrimination from either their health insurers or their employers, thanks to a new law signed in May by President Bush. The Genetic Information Nondiscrimination Act...

Tight glucose control in doubt.(News)
June 15, 2008... SAN FRANCISCO -- Intensively lowering blood glucose levels did not significantly reduce cardiovascular risk in older patients with poorly controlled diabetes whose blood pressures and cholesterol levels were well controlled, a major long-term...

Rosiglitazone safety supported by VA Diabetes study.(News)(Brief article)
June 15, 2008... Three secondary safety analyses of data from the VA Diabetes Trial found neutral effects or protection against cardiovascular events with use of the thiazolidinedione rosiglitazone, contrary to previous findings. "We feel that...

Celecoxib protects against colorectal adenoma 2 years out.(News)
June 15, 2008... SAN DIEGO -- Celecoxib reduced the incidence of advanced colorectal adenomas by 41% at 5 years in highrisk patients who took the controversial COX-2 inhibitor for 3 years in a cancer prevention trial before stopping it because of cardiovascular...

Earlier intervention for infertility recommended.(News)
June 15, 2008... NEW ORLEANS -- The definition of infertility has been revised to encourage earlier evaluation of women aged over 35 years who are having difficulty conceiving. The new definition will be published in the June issue of Fertility and...

A lawyer's take on medical issues.(LETTERS)(Letter to the editor)
June 15, 2008... Both of the medical experts discussed by Miles J. Zaremski, J.D., later had complaints filed against them with their specialty medical societies by the defendant physicians against whom they had testified ("Expert Witnesses Under Fire," Law &...

Enhance reflects limited population.(LETTERS)(Letter to the editor)
June 15, 2008... I treat my patients to goal numbers. The ENHANCE study findings only show me that in an unfortunate genetic group, not treating to goal does not result in any benefit ("After ENHANCE, Next Step on Vytorin Weighed," Feb. 15, 2008, p. 30, and...

Top 10 reasons reform won't happen soon.(ADVISER'S VIEWPOINT)
June 15, 2008... Although I am a strong and consistent supporter of health care reform, I may have become a bit jaded from the unsuccessful efforts I've witnessed over the past 20 years. To address this subject coherently, we must begin by explaining what...

Metabolic surgery holds hope for people with diabetes.(Guest editorial)
June 15, 2008... Imagine that a new patient comes to your clinic: a 42-year-old man with new-onset diabetes. He is taking oral hypoglycemic agents for his diabetes and is on a low-salt diet for mild hypertension. He has had an appendectomy and hernia repair in...

Suicidality overlooked in diagnosis of depression.(Psychiatry)
June 15, 2008... SAN FRANCISCO -- In a randomized trial involving actors portraying patients with major depression, internists and family physicians usually failed to ask these patients about suicidality, even when they correctly made the depression diagnosis,...

Personality disorder influences alcohol relapse.(Psychiatry)(Clinical report)
June 15, 2008... TORONTO -- The impact of stressful life events on alcohol relapse varied depending on personality disorder subtype and history of alcohol use in an analysis of data from the Collaborative Longitudinal Study of Personality Disorders, Dr....

Hypermobility increases risk of osteoporosis.(Rheumatology)
June 15, 2008... Patients with hypermobility have a significant and often unappreciated risk of osteoporosis. The prevalence of osteopenia and osteoporosis is very high in this cohort, said Dr. Eric P. Gall, chief of rheumatology and allergy at the Chicago...

Lupus patients have extremely low levels of vitamin D.(Rheumatology)
June 15, 2008... NEW YORK -- Patients with lupus have "dramatically" low serum levels of the biologically active form of vitamin D, a deficiency that may contribute to the pathological processes involved in their disease, Dr. Peter E. Lipsky said at a...

Treating pain improves cognition in the elderly: it is not always appreciated that pain can increase anxiety, depression, and cognitive impairment.(Geriatrics)
June 15, 2008... ORLANDO -- Pain is a comorbid condition too often overlooked in the setting of geriatric psychiatry, despite the potential for better mental health outcomes when it is treated, Dr. Jordan F. Karp said at the annual meeting of the American...

No links found between statin use and memory loss.(Geriatrics)
June 15, 2008... SALT LAKE CITY -- Despite case reports of memory problems linked to the use of statins in older people, data from the large studies of statins to date find no apparent association. "Why are memory problems showing [up] in case studies, yet...

Gabapentin slashes risk of postherpetic neuralgia.(Dermatology)(Clinical report)
June 15, 2008... WAIKOLOA, HAWAII -- A week oral antiviral therapy combined with 4-8 weeks of gabapentin markedly reduces the postherpetic neuralgia rate in patients with herpes zoster, Dr. Stephen K. Tyring reported. "We've followed 138 patients out to 6...

'Ugly duckling' sign could aid detection of melanoma.(Dermatology)
June 15, 2008... WAIKOLOA, HAWAII -- The "ugly duckling" sign showed impressive sensitivity for melanoma when applied by physicians as well as non-medically trained individuals for rating melanocytic lesions, according to Dr. Ashfaq A. Marghoob. The...