Internal Medicine News articles from March 2009

Internal Medicine News archives from March 2009

Experts divided on FDA review of tests.(NEWS)(Food and Drug Administration)
March 1, 2009... Whether or not the Food and Drug Administration falls short in regulating diagnostic tests for cancer and other diseases depends on whom you ask. Talk to a pathologist who performs diagnostic tests, and you may hear that everything is...

Guidelines focus on using opioids for chronic pain: screening and assessment tools available.(NEWS)
March 1, 2009... New guidelines on opioid treatment of chronic noncancer pain address the burgeoning use of opioids for this indication and provide evidence-based recommendations geared toward both primary care physicians and subspecialists. Released by...

Economic stimulus law will strengthen health it.(NEWS)
March 1, 2009... The newly enacted economic stimulus law will infuse tens of billions of dollars into the health care sector, providing incentives for using health information technology, increasing funds for primary care training, and launching initiatives in...

Vital signs.(Statistical table)(Brief article)
March 1, 2009... The Nation's Health Care Dollar: Where It Went in 2007 Hospitals 31% Physicians and clinics 21% Prescription drugs 10% Administration 7% Nursing homes 6% Other 25% ...

FDA to require risk Strategy for some opioids.(NEWS)(Food and Drug Administration)
March 1, 2009... A risk-management plan will be required to address the ongoing problems of inappropriate prescribing, misuse, abuse, and accidental overdoses of certain opioid medications, the Food and Drug Administration recently announced. The agency...

Primary care needs real change.(EDITORIAL)
March 1, 2009... For "real change" to be more than a political sound bite, the new administration in Washington will need vision and courage to promote and sustain high-quality and affordable health care. Part of that vision will need to be a strong primary...

Time for hard choices.(EDITORIAL)
March 1, 2009... When it comes to health care reform, one thing no one argues about is that costs will need to be cut. If President Obama and Congress want to insure more people, the money will have to be spent more efficiently. Unfortunately, however,...

Boys and girls should be vaccinated.(Is universal vaccination of boys the next step in fighting HPV?)
March 1, 2009... Widespread immunization of girls and boys against the human papillomavirus could fully eradicate types 16 and 18 of the virus. If we miss half the equation by leaving the boys out of our vaccination strategy, that type of public health success...

The evidence needs time to mature.(Is universal vaccination of boys the next step in fighting HPV?)
March 1, 2009... The issue of immunizing males against HPV often comes down to whether they should receive the vaccine to protect females. Doing so is honorable and even reasonable, but at this point there is little evidence suggesting that this is cost...

Look for rheumatic disease in ILD patients.(PULMONARY MEDICINE)(interstitial lung disease)(Report)
March 1, 2009... SAN FRANCISCO--Clinicians detected underlying rheumatic disease in 17 of 28 patients referred to a multidisciplinary clinic for interstitial lung disease. The evaluations changed the diagnosis in 11 of the 28 patients, including 4 of 15...

Expert offers natural ways to treat respiratory diseases.(PULMONARY MEDICINE)(Report)
March 1, 2009... SAN DIEGO--Taking an integrative holistic medical approach to treating respiratory disease requires addressing the patient's environment, immune system balance, and emotional health. At a meeting sponsored by the Scripps Center for...

With foot checks, walking safe for diabetics.(ENDOCRINOLOGY)(Report)
March 1, 2009... RIO GRANDE, P.R.--Exercise does not increase foot ulcer rates in adults with diabetic peripheral neuropathy, based on data from 79 adults aged 50 years and older. The American Diabetes Association recommends moderate physical activity for...

Heredity strongly influences insulin clearance.(ENDOCRINOLOGY)(Report)
March 1, 2009... Insulin clearance is a highly heritable trait that has now been tracked to specific regions of two chromosomes, a finding that may have important implications for risk assessment in diabetes, polycystic ovary syndrome, and metabolic syndrome....

Midlife diabetes diagnosis doubles dementia risk.(ENDOCRINOLOGY)(Report)
March 1, 2009... A midlife diagnosis of diabetes increases the risk of developing Alzheimer's disease and vascular dementia, based on results of a twin study including more than 13,000 individuals. Previous studies have shown that people with diabetes are...

Return to normal glucose tolerance reaps CV benefits.(ENDOCRINOLOGY)(cardiovascular)(Report)
March 1, 2009... Patients who revert from impaired to normal glucose tolerance, especially those who do so via intensive lifestyle modification, can significantly reduce their cardiovascular risk factors, according to an analysis of data from the Diabetes...

U.S. prevalance of diabetes and prediabetes reaches new high.(ENDOCRINOLOGY)(Survey)
March 1, 2009... More than 40% of American adults aged 20 years and older have hyperglycemic conditions, according to review of data from the 2005-2006 National Health and Nutrition Examination Survey. In this study, Catherine Cowie, Ph.D., of the National...

Physical activity can affect genetic tendency to obesity.(ENDOCRINOLOGY)(Report)
March 1, 2009... Individuals who are genetically predisposed to obesity can prevent weight gain by being physically active, according to findings from a Finnish study of young adult twins. The investigation involved more than 4,000 monozygotic and...

First FDA-approved chemo agent turns 60.(ONCOLOGY)(Food and Drug Administration)
March 1, 2009... "The response of the first patient was as dramatic as that of the first mouse.... Within 48 hours after the initiation of therapy, a softening of the tumor masses was detected. It soon became obvious that this was not just wishful...

IVF regimen linked to ovarian cancer risk.(WOMEN'S HEALTH)(in vitro fertilization)(Report)
March 1, 2009... SAN ANTONIO--Ovarian stimulation for in vitro fertilization was linked to an increased risk of ovarian cancer 15 years later in a large cohort study that followed thousands of women in the Netherlands. Compared with a control group of women...

Many Mexican Americans postpone breast exam.(WOMEN'S HEALTH)(Report)
March 1, 2009... An alarming 51% of women failed to seek out medical care after detecting a change in their breasts through self-examination, in a study of 314 Mexican American women with invasive breast cancer. The most common method of breast cancer...

Family history tied to triple-negative breast ca.(WOMEN'S HEALTH)(cancer)(Report)
March 1, 2009... Having a family history of breast cancer was associated with a significant 2.2-fold increased risk of triple-negative breast cancer in Hispanic women, but not in black women, according to preliminary data from a study of 466 patients. ...

Oncovue genetic test beats Gail model in identifying high breast cancer risk.(WOMEN'S HEALTH)(Report)
March 1, 2009... SAN ANTONIO--The investigational OncoVue breast cancer risk test provided a 2.4-fold improvement over the Gail model in accurately identifying women at elevated risk of breast cancer in a blinded validation study. This is the third...

MammaPrint gauges risk in HER2-positive breast cancer patients.(WOMEN'S HEALTH)(Human Epidermal growth factor Receptor 2)(Report)(Brief article)
March 1, 2009... San Antonio--The 70-gene MammaPrint prognosis signature independently identifies a genomic low-risk subgroup of HER2-positive early-breast cancer patients likely to have a good long-term clinical outcome, even without adjuvant trastuzumab and...

Impact of PPIs on clopidogrel activity uncertain.(CARDIOVASCULAR MEDICINE)(Clinical report)
March 1, 2009... NEW ORLEANS--A possible interaction between proton pump inhibitors and the antiplatelet drug clopidogrel remains a potential concern and became a muddled issue when findings from two independent studies produced diametrically opposed results....

Depression underdiagnosed in nursing homes.(GERIATRICS)(Report)
March 1, 2009... NATIONAL HARBOR, MD.--Weight loss, verbally abusive behavior, and moderate pain were all significant predictors of a new diagnosis of depression among established nursing home residents in a longitudinal analysis. Although studies have...

'Oldest old' have less serious mental illness.(GERIATRICS)(Survey)
March 1, 2009... NATIONAL HARBOR, MD.--Long-term care residents aged 85 and older are less likely than younger residents to have a serious mental illness, more likely to have dementia, and equally likely to have depression or anxiety. Up to 80% of...

Colonoscopy quality varies by specialty, volume.(GASTROENTEROLOGY)
March 1, 2009... ORLANDO--Provider specialty and procedure volume influence polyp detection, biopsy rates, and other measures of colonoscopy quality, according to a study of routine clinical practice. "Over 14 million colonoscopies are performed in the U.S....

Ceftaroline noninferior to vancomycin/aztreonam.(INFECTIOUS DISEASE)(Report)
March 1, 2009... WASHINGTON--The investigational antibiotic ceftaroline was found to be effective against a range of gram-positive and gram-negative organisms that can cause complicated skin and skin structure infections, according to data from a phase III...

Monitoring vancomycin.(THE EFFECTIVE PHYSICIAN)
March 1, 2009... Background Vancomycin has a reputation for potential nephro- and ototoxicity and is increasingly used in the inpatient setting. The American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society...

Court shields billing records.(POLICY & PRACTICE)(Brief article)
March 1, 2009... An appeals court has ruled against the release of Medicare billing records, which was sought by the group Consumers' Checkbook so that it could grade physicians on quality. The nonprofit had filed a Freedom of Information Act request for all...

IOM Report: HIPAA Is inadequate.(POLICY & PRACTICE)
March 1, 2009... The government's main health-privacy rule doesn't adequately protect people's health information, yet it hinders important health research, a report from the Institute of Medicine concluded. The privacy rule, stemming from the Health Insurance...

Many people go without drugs.(POLICY & PRACTICE)(Brief article)
March 1, 2009... More children and working-age adults are failing to take needed prescription medications because of cost concerns, according to a national study by the Center for Studying Health System Change. In 2007, 1 in 7 Americans under age 65 years...

FDA on high-risk list.(POLICY & PRACTICE)(United States. Food and Drug Administration)(Brief article)
March 1, 2009... The Food and Drug Administration faces significant challenges that compromise its ability to protect Americans from unsafe and ineffective products, the Government Accountability Office said in adding the FDA to its biennial "high-risk" list....

Poll: affordability is tops.(POLICY & PRACTICE)(Survey)(Brief article)
March 1, 2009... Making health insurance more affordable trumps improving quality and expanding coverage among the public's priorities for health care reform, according to a new poll. The survey from the Kaiser Family Foundation and the Harvard School of Public...

Humana supports ID cards.(POLICY & PRACTICE)(Identification cards)(Brief article)
March 1, 2009... Humana has become the first health insurer to publicly support the Medical Group Management Association's drive to get standardized, machine-readable insurance cards into people's wallets by next January. "Our goal is to continue working with...

Liability can prompt docs to avoid nursing homes.(PRACTICE TRENDS)
March 1, 2009... NATIONAL HARBOR, MD.--Fears about liability appear to be one of several factors undercutting the ability and desire of physicians to provide care in nursing homes. That conclusion comes from a study funded jointly by the Southern Illinois...

Community medicine in Kenya's Rift Valley.(WORLD WIDE MED)(Interview)
March 1, 2009... Dr. Seth Sullivan traces his interest in global health to his senior year in high school, when he served as a French interpreter to a surgical team working in Haiti. The experience inspired Dr. Sullivan to pursue medicine, and to provide care...

State laws vary on seizure-impaired driving.(PRACTICE TRENDS)
March 1, 2009... SEATTLE--States vary widely as to whether they legally require physicians to report patients whose driving may be impaired because of seizures, and whether they provide reporting physicians any legal protection, a new study shows. ...

HHS finalizes plans for transition to ICD-10.(PRACTICE TRENDS)(International Classification of Disease)(Health and Human Services )
March 1, 2009... In less than 5 years, physicians and other health care providers will be required to begin using a new system of code sets to report health care diagnoses and procedures. Under a final rule published in the Federal Register last month, the...

CMS clarifies bariatric surgery coverage for Medicare patients with diabetes.(PRACTICE TRENDS)(Centers for Medicare and Medicaid Services)(Brief article)
March 1, 2009... The Centers for Medicare and Medicaid Services has made it official: Medicare beneficiaries with type 2 diabetes and a body mass index less than 35 kg/[m.sup.2] will not receive coverage for bariatric surgery. The announcement finalizes a...

Indications.(Quotation)
March 1, 2009... Thinking About Golf "Dude, where's my cart?" "It's in the guest bedroom, sir, exactly where you left it." "Right! That was one helluva round." "Really sir, and does one crash into the house after a good round or a bad one?"...

Zoster vaccination faces obstacles.(NEWS)
March 15, 2009... ATLANTA -- About half of internists and family physicians stock and administer the herpes zoster vaccine in their offices, but most administer it to very few of their eligible patients, citing cost and reimbursement hurdles as major barriers....

New data verify clopidogrel-PPI interaction risk: danger identified in three recent reports.(NEWS)(proton-pump inhibitor)
March 15, 2009... Increasing evidence that treatment with a proton-pump inhibitor can reduce the efficacy of clopidogrel in patients with coronary disease in a clinically meaningful and dangerous way may prompt cardiology groups to rethink current...

[HbA.sub.1c] gains legitimacy for diagnosis of diabetes.(NEWS)
March 15, 2009... The way that diabetes is diagnosed in the United States is about to change. Later this year, an expert panel organized by the American Diabetes Association will issue a report making a person's blood level of glycosylated hemoglobin...

Annual national health expenditure has risen ninefold since 1980.(VITAL SIGNS)
March 15, 2009... Note: Based on data from the Centers for Medicare and Medicaid Services' Office of the Actuary. Source: Health Affairs 2009;28:246-61

Gardasil prevents warts, HPV infection in males.(NEWS)
March 15, 2009... ATLANTA -- The human papillomavirus vaccine reduced rates of persistent infections and genital warts caused by HPV strains 6, 11, 16, and 18 in a Merck-sponsored study of 4,065 males aged 16-26 years. The findings were presented by Dr....

No tie seen Between MCV4, Guillain-Barre syndrome.(NEWS)(meningococcal conjugate vaccine)
March 15, 2009... ATLANTA -- The jury is still out regarding a potential link between the quadrivalent meningococcal conjugate vaccine and Guillain-Barre syndrome, but new data from the Centers for Disease Control and Prevention provide some reassurance. In...

FDA recommends changes for next flu vaccine.(NEWS)(United States Food and Drug Administration)
March 15, 2009... SILVER SPRING, MD. -- The influenza B strain in the current influenza vaccine in the United States should be replaced for the 2009-2010 influenza vaccine, according to a preliminary recommendation by a federal advisory panel, which based its...

FDA issues alert on zonisamide-induced acidosis.(NEWS)(United States Food and Drug Administration)(Brief article)
March 15, 2009... Serum bicarbonate levels should be checked in patients before initiating treatment with the antiepileptic drug zonisamide because of an association between the drug and metabolic acidosis, according to an alert issued by the Food and Drug...

Online Care: promises and perils.(Editorial)
March 15, 2009... On Jan. 15, 2009, Hawaii became the first state to offer a comprehensive, computer-based, round-the-clock, interactive program for patients seeking medical services. Patients can buy consultation time from a properly credentialed physician who...

Data indicate an increase in prevalence.(Is there a food allergy epidemic?)
March 15, 2009... Current estimates from various countries suggest that up to 5%-8% of children and 2%-19% of adults have food allergies. Substantial proportions are allergic to cow's milk, eggs, seafood, or peanuts--and these are just a few of the many foods we...

Inconsistency of diagnosis may explain it.(Is there a food allergy epidemic?)
March 15, 2009... Several factors may be giving the appearance of an increase in the prevalence of food allergy. On the professional front, these allergies are often being diagnosed by a variety of nonallergists, such as general practitioners and emergency...

Hippocampal atrophy: biomarker for early AD? Hippocampal volume in patients with AD is typically two standard deviations below normal.(NEUROLOGY)(Alzheimer's disease)
March 15, 2009... CHICAGO -- Volumetric reduction of the hippocampus has emerged as a promising noninvasive imaging bio-marker for prodromal and early stages of Alzheimer's disease, according to a study of 373 patients. The hippocampus was the site of the...

Disparities in stroke treatment seen for men, women.(NEUROLOGY)
March 15, 2009... SAN DIEGO -- Women have strokes more often than men, but they are significantly less likely to receive the best available treatment, according to two studies presented at the International Stroke Conference. In a meta-analysis of 18...

Four factors help predict prostate cancer risk.(UROLOGY)
March 15, 2009... A Dutch study of 5, 176 men found four factors to be helpful in predicting a man's risk of developing prostate cancer: serum prostate-specific antigen, a previous negative biopsy of the prostate, family history of prostate cancer, and prostate...

Herbal options exist for erectile dysfunction.(UROLOGY)
March 15, 2009... SAN DIEGO -- Before you recommend a treatment for erectile dysfunction, make sure to rule out underlying factors that may contribute to the condition. "Treat the whole person. Try to take care of other medical problems they might have,"...

New lupus drugs remain elusive after 50 years.(RHEUMATOLOGY)(Report)
March 15, 2009... FORT LAUDERDALE, FLA. -- The saga of mycophenolate mofetil for lupus exemplifies the difficulties in developing new drugs for a condition with such protean manifestations and inconsistent course, for which there has not been a new drug approved...

Dyslipidemia common in patients with lupus and RA.(RHEUMATOLOGY)(rheumatoid arthritis)
March 15, 2009... FORT LAUDERDALE, FLA. -- Patients with systemic lupus erythematosus and rheumatoid arthritis should be considered in a cardiovascular risk category equivalent to that of patients with diabetes, with aggressive management of risk factors,...

Aldosterone blockers lower BP in obese patients.(CARDIOLOGY)(blood pressure)
March 15, 2009... NEW YORK. -- Two aldosterone receptor-blocking drugs--spironolactone and eplerenone--have almost overnight become important, second-line antihypertensive drugs for obese patients. "Aldosterone receptor blockers were never on the list [of...

Drug-eluting stents cut mortality in diabetes.(CARDIOLOGY)(Report)
March 15, 2009... NEW ORLEANS -- Diabetic patients treated with drug-eluting stents showed impressive reductions in mortality, acute MI, and repeat revascularization during the subsequent 3 years compared with bare-metal stent recipients in a large real-world...

At-home INR monitoring safe for patients on warfarin.(CARDIOLOGY)(international normalized ratio)(Report)
March 15, 2009... NEW ORLEANS -- Patients taking warfarin who regularly self-tested their level of anticoagulation at home had outcomes that were at least as good as, and in some cases better than, patients who were monitored by regular monthly visits to an...

Rosuvastatin slashed stroke risk in JUPITER.(CARDIOLOGY)(Justification for Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin)(Report)
March 15, 2009... SAN DIEGO -- Patients with normal lipid levels but elevated C-reactive protein showed a 48% reduction in the risk of stroke when taking rosuvastatin, according to a study presented at the International Stroke Conference. These results came...

Technique can classify lesions during colonoscopy.(GASTROENTEROLOGY)(Report)
March 15, 2009... SAN FRANCISCO -- Confocal laser endomicroscopy accurately classifies lesions found during colonoscopy according to their malignant potential, the results of a prospective cohort study show. "Confocal laser endomicroscopy is a promising tool...

Biomarkers tied to colorectal cancer in smokers.(GASTROENTEROLOGY)(Report)
March 15, 2009... San Francisco -- Older women who smoke have an elevated risk of colorectal cancer, but they have a particularly high risk of cancers containing certain molecular features, a large prospective study has found. Former and current smokers...

Endoscopic mucosal resection can cut costs.(GASTROENTEROLOGY)
March 15, 2009... ORLANDO -- With an average cost just over $2,000, endoscopic mucosal resection of colorectal lesions can be an effective and less expensive alternative to surgery, according to a recent study. Endoscopic mucosal resection (EMR) is a...

Tamoxifen/anastrozole sequence ups survival.(WOMEN'S HEALTH)(Report)
March 15, 2009... SAN ANTONIO -- Adjuvant endocrine therapy with 2 years of tamoxifen, followed by 3 years of the aromatase inhibitor anastrozole, conferred a 22% reduction in overall mortality, compared with 5 years of tamoxifen alone in breast cancer patients...

Testosterone for low libido after menopause.(MINDFUL PRACTICE)(Clinical report)
March 15, 2009... The Problem A 51-year-old female physician presents to you for follow-up of impaired fasting glucose, hypertension, migraine, and allergies. Her body mass index is 32 kg/[m.sup.2], and her blood glucose level is 112 mg/dL. Her blood...

Menopause differs among ethnic groups.(WOMEN'S HEALTH)
March 15, 2009... LAKE BUENA VISTA, FLA. -- Menopause symptoms vary significantly by ethnic group, based on data emerging from a longitudinal study. Acculturation of women immigrants to the United States and socioeconomic status are two of the factors that...

Less-stringent [HbA.sub.1c] goal may be appropriate.(ENDOCRINOLOGY)
March 15, 2009... NEW YORK -- Physicians need to be judicious in choosing a treatment goal for controlling glycemia in patients with type 2 diabetes, three studies have shown. It may not always be necessary or appropriate to focus on treating a patient to...

Hep a vaccine advised for adoptee contacts.(INFECTIOUS DISEASE)(Hepatitis A)(Brief article)
March 15, 2009... ATLANTA -- Hepatitis A vaccination should be given to all previously unvaccinated nontraveling individuals who will be in close personal contact with an internationally adopted child, the Advisory Committee on Immunization Practices of the...

Earlier may be better for starting HIV treatment.(INFECTIOUS DISEASE)
March 15, 2009... MONTREAL -- Mounting evidence suggests a substantial survival benefit associated with immediate initiation of antiretroviral therapy in adults with HIV, compared with deferred treatment, investigators reported at the Conference on Retroviruses...

Weight, diabetes linked to impaired cognition in HIV.(INFECTIOUS DISEASE)
March 15, 2009... MONTREAL -- Weight control and treatment with antiretroviral drugs that are less likely to induce type 2 diabetes could reduce the risk of neurocognitive impairment associated with HIV infection, suggest study findings presented at the...

Non-AIDS-defining cancer rates still high in HIV patients.(INFECTIOUS DISEASE)
March 15, 2009... MONTREAL -- Although the rates of AIDS-defining cancers have declined significantly among people with HIV infection since the advent of antiretroviral therapy, the rates of non-AIDS-defining cancers--particularly those associated with an...

National insurance exchange proposed by panel.(PRACTICE TRENDS)
March 15, 2009... A national health insurance exchange that would allow individuals to choose among private plans or a new nationwide public plan is the cornerstone of an expert panel's proposal to cover nearly all Americans within 2 years and slow the growth of...

RAC program rollout is back on schedule.(PRACTICE TRENDS)(Recovery Audit Contractor)(Brief article)
March 15, 2009... The controversial Medicare Recovery Audit Contractor program is continuing as planned after federal officials cleared up contracting disputes. The rollout of the permanent, national Recovery Audit Contractor (RAC) program is proceeding,...

Health care costs are growing slice of GDP.(PRACTICE TRENDS)(gross domestic product)
March 15, 2009... WASHINGTON -- Even as the economic downturn causes private health spending to slow, public sector health spending is rising, according to a federal analysis. An estimated 3.4 million people may lose private health insurance coverage in...

Boston limits tobacco sales.(POLICY & PRACTICE)(Brief article)
March 15, 2009... Boston has banned tobacco-product sales at pharmacies--becoming the second city to do so--and on college campuses. The Boston Public Health Commission's board of health also banned new permits for smoking bars, such as hookah and cigar bars,...

Metabolic Drugs Top List.(POLICY & PRACTICE)(Brief article)
March 15, 2009... Medications that affect a person's metabolism by lowering cholesterol, controlling diabetes, and trimming weight accounted for $38 billion of the $208 billion that American adults spent on drugs in 2006, according to a report on prescription...

Most unemployed lack coverage.(POLICY & PRACTICE)(Brief article)
March 15, 2009... More than half of low-income workers who have lost their jobs in the recession also have lost their health insurance, according to a report from advocacy group Families USA. The report, which focuses on workers with annual incomes below 200% of...

Court upholds calorie rule.(POLICY & PRACTICE)(Brief article)
March 15, 2009... A federal appeals court has upheld New York City's rule requiring chain restaurants to provide calorie information on their printed and posted menus. The New York State Restaurant Association had asked the United States Court of Appeals for the...

AMA sues Aetna, CIGNA.(POLICY & PRACTICE)(American Medical Association)(Brief article)
March 15, 2009... The American Medical Association and several state medical associations have filed separate class-action lawsuits against insurers Aetna Health Inc. and CIGNA, each suit claiming that the company used faulty data to un-dercompensate physicians....

Reminders effective for screening.(POLICY & PRACTICE)(Brief article)
March 15, 2009... Mailed reminders to patients do work in prompting colorectal cancer screening, and electronic reminders to physicians may increase screening among some patients, a study in the Archives of Internal Medicine indicated. The researchers randomly...

Budget sets aside $634 billion for health reform.(PRACTICE TRENDS)
March 15, 2009... President Barack Obama has made health care a top priority in his first budget proposal by setting aside $634 billion over the next decade to begin reforming the health care system and expanding health care coverage to all Americans. The...

Factual and proximate causation.(LAW & MEDICINE)(medical negligence)
March 15, 2009... Question: An internist prescribed increasing doses of cholestyramine for a patient with hypercholesterolemia with resulting constipation. The constipation worsened after codeine was used to relieve abdominal pain. A month, later, the patient...