Internal Medicine News articles from November 2008

Internal Medicine News archives from November 2008

Experts respond to Barrett's guidelines.(News)
November 1, 2008... ORLANDO -- Screening strategies and treatment approaches for Barrett's esophagus, addressed in clinical practice guidelines released earlier this year by the American College of Gastroenterology, continued to trigger discussion during the...

Vital signs.
November 1, 2008... Internists Spent More Than 36 Hours Per Week in Direct Patient Care in 2007 Mean clinical hours per week Hospitalist: internal medicine (n = 755) 41.8 General ob.gyn. (n =...

Subclinical thyroid dysfunction tied to increased mortality; data support 'more aggressive strategy.(News)(Clinical report)
November 1, 2008... CHICAGO -- Subclinical hyperthyroidism significantly increases the risks of both cardio vascular and all-cause mortality, according to findings from a prospective cohort study. Subclinical hypothyroidism was similarly an independent risk...

HHS guidelines specify physical activity goals.(News)(Department of Health and Human Services)
November 1, 2008... Adults who engage in at least 2.5 hours of moderate-intensity aerobic exercise each week and children who are physically active for 1 hour a day can realize "substantial" health benefits, according to guidelines from the U.S. Department of...

Food product allergen labels due for overhaul.(NEWS FROM THE FDA)
November 1, 2008... College Park, MD. -- Efforts to improve the confusing, inconsistent, and often misleading statements on food packages that indicate a food allergen may be present in the product are underway at the Food and Drug Administration. ...

FDA panel backs lasofoxifene for osteoporosis indication.(NEWS FROM THE FDA)
November 1, 2008... Rockville, MD. -- The majority of a federal advisory panel agreed that the benefits of treatment with lasofoxifene, a selective estrogen receptor modulator, would probably outweigh the risks in some postmenopausal women with osteoporosis. ...

TNF blockers to carry stronger infection warning.(News)(tumor necrosis factor)
November 1, 2008... The Food and Drug Administration has announced that it will require warnings about fungal infections in the labels of tumor necrosis factor-[alpha] blockers be strengthened to reflect reports of histoplasmosis and other opportunistic fungal...

Certain groups of patients can benefit.(Subclinical hypothyroidism: Is there a benefit to treatment?)
November 1, 2008... Subclinical hypothyroidism, defined as a thyroid-stimulating hormone (TSH) elevation of between 5 and 10 mIU/L and normal free thyroxine (FT4) level, constitutes early hypothyroidism and presents with mild symptoms. But it is not an entirely...

Little evidence of benefit exists.(Subclinical hypothyroidism: Is there a benefit to treatment?)
November 1, 2008... Although treating patients with SCH may improve some lipid profiles, there is scanty evidence that it benefits quality of life, cardiovascular health, or mortality. But giving thyroxine to the millions of Americans with questionably...

Revisiting AMD and vitamins.(LETTERS)(Letter to the editor)
November 1, 2008... I understand the methodology by which Dr. Jon O. Ebbert and Dr. Eric G. Tangalos arrived at their conclusion to suggest that no benefit would be gained from nutritional supplementation in age-related macular degeneration ("Vitamins for...

What is normal thyroid function?(Editorial)(Case study)
November 1, 2008... There "s been a lot of talk these days about "subclinical" thyroid disease, what it means, and who should be treated. So much discussion, in fact, that not only are physicians confused, but also our patients, who read everything on the Internet...

Multiple large-vessel events common in Behcet's.(Rheumatology)(Clinical report)
November 1, 2008... PARIS -- Fully one-quarter of patients with Behcet's syndrome who experience a large-vessel vascular event will have another within 5 years--and the second is typically more severe than the first. This was among the most striking findings...

Step up foot care in psoriatic arthritis patients.(Rheumatology)
November 1, 2008... PARIS -- When it comes to psoriatic arthritis, don't forget the feet. The foot is a neglected area of the body in patients with psoriatic arthritis. The burden of foot pain and deformity is high and the level of foot care provision is low,...

HPV vaccine's safety trumps concerns about sex.(Adolescent Health)(Clinical report)
November 1, 2008... Safety, not sexuality, was a key factor in the reluctance of mothers to have their teenage daughters vaccinated against human papilloma virus, according to results of a survey. The Centers for Disease Control and Prevention's Advisory...

Look for PCOS in teens with oligomenorrhea.(Adolescent Health)(polycystic ovary syndrome)(Brief article)(Clinical report)
November 1, 2008... NEWPORT BEACH, CALIF. -- Most adolescent girls with infrequent menstruation have treatable polycystic ovary syndrome. A prospective observational study of 229 patients compared 111 adolescents with oligomenorrhea and 118 with secondary...

Youth with diabetes have more CV risk factors.(Adolescent Health)(Clinical report)
November 1, 2008... ROME -- Youth with type 2 diabetes had an average of nearly three cardiovascular risk factors each, compared with just one among healthy controls, in an analysis of 295 participants in a large, multicenter, case-control study. The data...

[beta]-cell abnormalities predict type 2 diabetes in obese teens.(Adolescent Health)(Clinical report)
November 1, 2008... LOS ANGELES -- Impaired [beta]-cell function appears to be one of the earliest signs of type 2 diabetes risk in obese adolescents, according to a study of 60 obese but otherwise healthy teens. Over a 3-year period, 14 (23%) of the teens had...

Among adolescents, black females have highest prevalence of overweight.(DATA WATCH)(Statistical table)(Brief article)
November 1, 2008... Among Adolescents, Black Females Have Highest Prevalence of Overweight Males aged 12-19 years Females aged 12-19 years Blacks 17.7% 23.8% Mexican Americans 20.0% ...

Model predicts pain in patients with dementia.(Geriatrics)(Clinical report)
November 1, 2008... Nursing home residents with dementia are at risk for undiagnosed, underestimated, and undermanaged pain as a result of having difficulty communicating, but an ongoing study suggests that objective assessment of a resident's health status can...

Chemotherapy beneficial in BRCA1/2 carriers.(Women's Health)(Clinical report)
November 1, 2008... Stockholm -- Adjuvant chemotherapy appears critical to overcoming adverse prognostic factors for recurrence and survival in women with BRCAl or BRCA2 breast cancer, according to a large prospective study presented at the annual meeting of the...

Molecular imaging needs lower radiation dose.(Women's Health)
November 1, 2008... A new way to image breast tumors with a nuclear tracer has shown promise as a more sensitive screen than is conventional mammography in women with dense breasts, who account for about a quarter of all women older than age 40. Molecular...

Single mammogram plus CAD comparable to double reading.(Women's Health)(computer-aided detection)
November 1, 2008... Computer-aided detection technology helped a single reader of screening mammography films detect as many cancers as would two readers, but the jury is still out on whether adding such technology to routine screening is cost effective overall,...

Merck drops taranabant, cites psychiatric effects.(Endocrinology)(Clinical report)
November 1, 2008... Pharmaceutical manufacturer Merck & Co. has stopped developing taranabant, a weight-loss drug, because of concerns over psychiatric side effects, the company announced last month. "Available phase III data showed that both efficacy and...

ACP guidelines address osteoporosis therapy.(Endocrinology)(American College of Physicians)(Clinical report)
November 1, 2008... A new set of osteoporosis treatment guidelines from the American College of Physicians streamlines evidence-based recommendations, potentially making them more useful for busy physicians. The committee that created the document mined...

Annual zoledronic acid dose reduces back pain disability.(Endocrinology)(Clinical report)
November 1, 2008... Washington -- A yearly dose of zoledronic acid significantly reduced the number of days of disability because of back pain in older women with osteoporotic fractures, based on data from the HORIZON Pivotal Fracture study. "Osteoporotic...

Suicide risk 15 times higher for PTSD patients.(Psychiatry)(posttraumatic stress disorder)
November 1, 2008... BARCELONA -- The risk of attempting suicide increases by up to 15 times for patients with posttraumatic stress disorder, compared with those in the general population, a national French mental health survey has found. Although the survey...

Cognitive therapies beat antidepressant for PTSD.(Psychiatry)(Post-traumatic stress disorder)(Clinical report)
November 1, 2008... Barcelona -- When given within a month of the precipitating event, cognitive therapy and prolonged exposure therapy are equally effective at decreasing the incidence of posttraumatic stress disorder--and both strategies are significantly more...

Extended-release quetiapine maintained antianxiety effects.(Psychiatry)
November 1, 2008... Phoenix -- The extended-release form of quetiapine, an atypical antipsychotic, worked better than placebo to maintain the antianxiety effects of short-term treatment with the drug in a year-long study of 432 patients. Extended-release (XR)...

Skipping elevator at work can lower CV risk.(Cardiovascular Medicine)(cardiovascular )
November 1, 2008... MUNICH -- "No thanks, I'll take the stairs instead." This was the cry that rang through the corridors of University Hospital, Geneva, last year as physicians and nurses participating in the Geneva stair study eschewed elevators in favor of...

Concomitant antiplatelet/NSAID use requires caution.(Cardiovascular Medicine)
November 1, 2008... Identifying and treating the potentially life-threatening problem of gastrointestinal complications in patients who use the combination of antiplatelet therapy and NSAIDs are the focus of a new scientific statement by the American College of...

Hypertension vigilance called for in diabetics.
November 1, 2008... New York -- Patient-centered management and early, aggressive treatment of hypertension are necessary in patients with diabetes to address the sevenfold mortality increase in this patient population, according to an updated guidance from the...

Low Vitamin D seen as factor in tuberculosis.(Infectious Diseases)(Clinical report)
November 1, 2008... Kyoto, JAPAN -- The rationale for proposed clinical trials of vitamin D supplementation as adjunctive therapy in tuberculosis--and perhaps in a wide-ranging assortment of other diseases--has origins stretching as far back as the tuberculosis...

FDA approves rapid test to detect Flu.(Infectious Diseases)(Food and Drug Administration )
November 1, 2008... The Food and Drug Administration approved a new test that can diagnose human influenza infections, including the highly pathogenic influenza A (H5N1) virus, and produce results within 4 hours. The device, known as the Human Influenza Virus...

Ample supply of tamiflu available for 2008-2009 season.(Infectious Diseases)(Brief article)
November 1, 2008... A sufficient amount of the prescription antiviral medication oseltamivir will be available throughout the United States during the upcoming flu season, according to a statement released by its manufacturer, Roche. Oseltamivir (Tamiflu) can...

MRSA types different in hospital and community.(Infectious Diseases)(methicillin-resistant Staphylococcus aureus)
November 1, 2008... SANTA BARBARA, CALIF. -- Community-acquired methicillin-resistant Staphylococcus aureus is unlike its hospital-acquired cousin epidemiologically, clinically, and genetically, an infectious disease specialist explained. "It is a different...

DNA-based colon ca screen 80% sensitive.(Gastroenterology)(deoxyribonucleic acid)(cancer)(Clinical report)
November 1, 2008... PHILADELPHIA -- A newly available, noninvasive screening test for colorectal cancer based on detecting a cancer-specific form of DNA had a sensitivity and specificity of greater than 80% in studies with a total of 363 people. The...

Chronic hepatitis B.(THE EFFECTIVE PHYSICIAN)(Clinical report)
November 1, 2008... Background Chronic hepatitis B virus (HBV) infection remains a major public health risk. The Centers for Disease Control and Prevention has released recommendations to guide management of patients with this common viral illness. ...

Medication confirmed as first choice for GERD.(Gastroenterology)(gastroesophageal reflux disease)
November 1, 2008... Antisecretory drug therapy should be the first-line treatment for gastroesophageal reflux disease, with antireflux surgery offered only to those whose symptoms are not controlled by medication or who can't tolerate the drugs, according to a new...

A colonoscopy screen every 5 years may be safe.(Gastroenterology)(Clinical report)
November 1, 2008... For patients at average risk for colorectal cancer whose initial screening colonoscopy reveals no abnormalities, an interval of 5 years or longer before the next exam appears to be safe. The 5-year risk of colorectal cancer in such patients...

Community-level efforts target health disparities.(Practice Trends)
November 1, 2008... Washington -- Simple yet targeted efforts to improve minority patients' access to health care are growing in communities across the nation. Often, language is the first component that needs to be addressed. The first step in Expecting...

Short-term service in Fiji yields long-term benefits.(GLOBAL PERSPECTIVES ON MEDICAL PRACTICE)(Interview)
November 1, 2008... Dr. Howard Homier, an internist in solo practice in Carmichael, Calif, knows firsthand that short-term services can have long-term benefits when it comes to practicing medicine overseas in underserved areas. "I have volunteered at a...

Mass. Medicaid waiver extended.(POLICY & PRACTICE)(Brief article)
November 1, 2008... The Centers for Medicare and Medicaid Services has granted Massachusetts a 3-year, $21.2 billion Medicaid waiver that will allow the state to continue to expand access to care through its health reform law. The agreement represents a $4.3...

Cephalon pays $425 million.(POLICY & PRACTICE)(Brief article)
November 1, 2008... Cephalon Inc. has agreed to pay more Indian $425 million to settle claims that it inappropriately marketed three drugs for off label uses, according to the U.S. Justice Department. The settlement will resolve civil and criminal complaints...

Consumers like flat Rx pricing.(POLICY & PRACTICE)(Brief article)
November 1, 2008... Pharmacy customers who take advantage of flat-rate generic prescription drug prices have higher levels of satisfaction than those who don't, according to the second annual J.D. Power and Associates National Pharmacy Study. Nearly one-fourth of...

Nationwide RAC launched.(POLICY & PRACTICE)(Brief article)
November 1, 2008... CMS has launched its national recovery audit contractor program as part of its "aggressive new steps to find and prevent waste, fraud and abuse in Medicare." The new RACs, which will be paid on a contingency fee basis, soon will begin to...

Many drug studies unpublished.(POLICY & PRACTICE)(Brief article)
November 1, 2008... Studies on new prescription drugs are less likely to be published if they conclude that the medication is ineffective, researchers reported in the journal PLoS Medicine. The researchers found that only 43% of all clinical trials submitted to...

Florida files Vioxx suit.(POLICY & PRACTICE)
November 1, 2008... Florida Attorney General Bill McCollum has sued Merck & Co. on behalf of state agencies he said were damaged by "the company's allegedly deceptive marketing and promotion" of Vioxx. The lawsuit follows a 3-year investigation of Merck's...

HHS committee calls for medical home funding.(Practice Trends)(Health and Human Services )
November 1, 2008... Support for the concept of the patient-centered medical home continues to grow, with the latest nod coming from the federal Advisory Committee on Training in Primary Care Medicine and Dentistry. The committee, which provides policy advice...

Health insurance premiums rose 5% in 2008.(Practice Trends)(Survey)(Brief article)
November 1, 2008... The average employer-sponsored health insurance premium rose 5% from 2007 to 2008, with average premiums for family coverage reaching $12,680, according to a report from the Kaiser Family Foundation and the Health Research and Educational...

CMS puts drug acquisition program on hold.(Practice Trends)
November 1, 2008... Medicare officials have pulled the plug at least temporarily on their Competitive Acquisition Program for Part B drugs. The program was put on hold because of "contractual issues" with the successful vendor bidders for the 2009 cycle of...

Document warnings before firing bad employees.(Practice Trends)
November 1, 2008... MIAMI -- A "progressive discipline" system of warnings and suggestions for improvement before firing an underperforming employee maximizes chances of winning a wrongful termination lawsuit, according to a labor and employee attorney. In...

CME may slip without commercial funding.(Practice Trends)(continuing medical education)
November 1, 2008... Washington -- Without pharmaceutical industry funding, continuing medical education is in danger of faltering, said a group of CME providers, several physicians, and a medical journal editor at a forum held this fail. The forum--designed...

Drugmakers to disclose payments.(Practice Trends)
November 1, 2008... Two pharmaceutical companies will begin publicly disclosing how much each pays physicians. Eli Lilly & Co. was the first company to step forward, followed a day later by Merck & Co. Lilly is starting a registry that will compile...

When the (only a) moment is right.(INDICATIONS)(Brief article)
November 1, 2008... Despite long being popularly perceived as a major concern for men, premature ejaculation did not have an evidence-based definition until earlier this year, when the International Society for Sexual Medicine (ISSM) presented the conclusion of a...

From the national enquirer dept.(INDICATIONS)(Brief article)
November 1, 2008... A Greek girl, aged 9 years, was recently taken to a hospital with stomach pains. Doctors at Larissa General Hospital in central Greece surgically removed a 2-inch-long growth, and the girl made a full recovery. Upon biopsy, however, the doctors...

From the big brother research dept.(INDICATIONS)(Brief article)
November 1, 2008... Speaking of markets and consumers, a couple of West Coast firms are adapting brain-scanning technology to gain insight into how people react to advertisements, computer games, and even presidential candidates. The companies use EEG sensors to...

From the that 70s lifesaver dept.(INDICATIONS)
November 1, 2008... Last but not least, in mind-bending research, the world recently learned that the Bee Gees still rule. Yes, their iconic 1977 disco smash "Stayin' Alive" has been shown to help heart patients do just that, according to research presented at the...

Prostate cancer treatment guides.(FYI)(Brief article)
November 1, 2008... The Agency for Healthcare Research and Quality has released two new plain-language guades on the treatment of prostate cancer. The guide for clinicians is titled "Treatments for Clinically Localized Prostate Cancer," and the publication aimed...

Youth substance use awareness.(FYI)(Brief article)
November 1, 2008... A report from the 2006 National Survey on Drug Use and Health has found that youth substance use is higher among one-parent households, particularly father-child pairs, than it is in two-parent households. Awareness of youth substance use in...

Videos on helping heavy drinkers.(FYI)(Brief article)
November 1, 2008... The National Institute on Alcohol Abuse and Alcoholism has released "Video Cases: Helping Patients Who Drink Too Much." This course for clinicians demonstrates strategies that can be used to screen patients for heavy drinking and to help them...

Pain relievers.(Cartoon)
November 1, 2008... "Can I come along? I need cheaper prescription drugs."

PPV immunization urged for smokers.(News)(pneumococcal polysaccharide vaccination)
November 15, 2008... ATLANTA -- Cigarette smoking in adults aged 19-64 years should be considered an indication for 23-valent pneumococcal polysaccharide vaccination, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention...

Vital signs.
November 15, 2008... Projected U.S. Health Expenditures (in trillions of dollars) Note: Based on 2006 National Health Expenditures data. Source: Centers for Medicare and Medicaid Services

Medicare bonus to push e-prescribing beginning in 2009: average reward pegged at $2,000-$3,000.(News)
November 15, 2008... BOSTON -- "E-prescribing saves lives, it saves money, and it's time we implement it," according to Health and Human Services Secretary Mike Leavitt. Streamlining the bloated health care system "is an economic imperative for our country. We...

Bisphosphonates not tied to atrial fib, FDA finds.(News)(Food and Drug Administration)
November 15, 2008... A Food and Drug Administration safety review of bisphosphonates has not found a clear association between bisphosphonate therapy and atrial fibrillation, the agency announced. "Based on the data available at this time, health care...

Medicare rule gives 1.1% raise, plus bonuses: incentives include 2% for PQRI and 2% for electronic prescribing.(News)
November 15, 2008... Physicians will have the potential to gain as much as a 5.1% increase in their Medicare payments next year, according to a final rule issued by the Centers for Medicare and Medicaid Services. The projected pay raise is a combination of the...

ICD-10 transition could carry big price tag for physicians.(News)
November 15, 2008... The federal government's plan to transition from the ICD-9-CM diagnosis and procedure code set to the ICD-10 by 2011 could cost physicians big bucks, according to a cost analysis commissioned by the Medical Group Management Association and...

HPV vaccine not tied to serious adverse events.(News)
November 15, 2008... ATLANTA -- Postlicensure safety monitoring by three national vaccine safety systems indicates that, in the more than 2 years since the human papillomavirus vaccine was licensed, serious adverse events have been rare and have not been...

P4P isn't the only tool in the drawer.(GUEST EDITORIAL)(pay-for-performance )
November 15, 2008... Health care policy makers' enthusiastic embrace of pay-for-performance as the dominant strategy to improve quality and rein in health care costs needs to be weighed against questions about whether P4P would produce more positive effects than...

Electrophysiologists cannot meet the demand.(POINT/COUNTERPOINT)
November 15, 2008... Even as a card-carrying electrophysiologist, I think this is a good idea. In 2007, about 23,000 patients with new atrial fibrillation (AF) underwent ablation. That's around 10% of new AF patients per year. We're not even close to meeting...

Interventionalists lack the training and skills.(POINT/COUNTERPOINT)
November 15, 2008... I'm not convinced. You have to know how to use these tools. Otherwise, there are going to be some problems. Electrophysiologists should be doing these procedures. One has to do a complete electrophysiologic evaluation to look for...

Treat multiple sclerosis early to boost outcomes.(Neurology)(Report)
November 15, 2008... Starting treatment for multiple sclerosis when the first suggestive neurologic event occurred led to better outcomes in disease progression and long-term cognitive function, compared with patients whose initial treatment was deferred, based on...

Multiple sclerosis improved with low-dose naltrexone.(Neurology)
November 15, 2008... Adding low-dose naltrexone to the existing drug treatment of patients with multiple sclerosis led to significant improvements in pain, mental health, and cognitive function during 8 weeks of treatment in a controlled study with 60 patients. ...

Sexual side effects 'silent issue' in cancer care: sexual impact is little explored in women with gynecologic cancers, although 100% will be affected.(Women's Health)(Report)
November 15, 2008... GOTEBORG, SWEDEN -- Virtually every woman treated for a gynecologic cancer has sexual problems during or after therapy. Yet sexual consequences are rarely addressed by clinicians or investigators. Sexual dysfunction is "the silent issue,"...

Pessary use improves sexual function in pelvic organ prolapse.(Women's Health)
November 15, 2008... Savannah, Ga. -- Pessary use appears to improve sexual function in women treated for pelvic organ prolapse or urinary incontinence, based on analysis of a prospective cohort study involving 80 women. "Sexually active women who are affected...

Best practices in: chronic inflammatory demyelinating polyradiculoneuropathy in the internal medicine setting.(Case study)
November 15, 2008... Clinical Scenario Robert is a 55-year-old male who has been under your care for moderate obesity, type 2 diabetes, and hypertension. You last saw him 3 months ago for a change in his diabetes regimen. At the current visit, you note...

Weight loss helps with incontinence in obesity.(Women's Health)
November 15, 2008... CHICAGO -- Obese and overweight women with urinary incontinence may be able to manage their condition by losing weight and maintaining the weight loss. The more weight a woman had lost by the end of the 18-month Program to Reduce...

Incontinence not more likely with bacteriuria.(Women's Health)(Brief article)
November 15, 2008... SAVANNAH, GA. -- Urinary incontinence symptoms do not appear to be more prevalent or more severe in women with bacteriuria, based on a study of 530 urogynecology patients seen at one institution. Dr. Mary P. Fitzgerald, of the obstetrics...

Prolapse progression linked to higher weight.(Women's Health)
November 15, 2008... CHICAGO -- The most effective way for women to prevent the progression of pelvic organ prolapse might be to maintain a healthy weight, a retrospective analysis of data on 16,000 women has suggested. Being overweight or obese at baseline was...

Colpocleisis effective for pelvic organ prolapse.(Women's Health)
November 15, 2008... NEW ORLEANS -- Colpocleisis successfully resolves pelvic organ prolapse, and patient satisfaction rates are extremely high 1 year after surgery, according to a cohort study of 153 patients. Colpocleisis is a "time-honored procedure," having...

St. John's wort meta-analysis shows some benefit.(Psychiatry)
November 15, 2008... St. John's wort was more effective than placebo and just as effective as standard antidepressants in treating depression, a Cochrane analysis of 29 studies of almost 5,500 adults with major depression showed. The meta-analysis also found...

Novel sleep drug cuts chronic insomnia without rebound.(Psychiatry)
November 15, 2008... CHICAGO -- The novel investigational sleep agent eplivanserin improves sleep continuity in patients with chronic primary insomnia without causing next-day drowsiness or rebound insomnia upon discontinuation, clinical trials show. ...

Bisphosphonates not tied to atrial fib, FDA review finds.(News)(Food and Drug Administration)
November 15, 2008... The Food and Drug Administration's safely review of bisphosphonates has not found a clear association between treatment with a bisphosphonate and atrial fibrillation, the agency recently announced. "Based on the data available at this time,...

Brain stimulation device cleared for depression.(News)
November 15, 2008... The Food and Drug Administration has cleared a noninvasive device that delivers magnetic stimulation to the brain for treating depression in adults, according to Neuronetics Inc., the manufacturer of the device. The FDA cleared the...