Internal Medicine News articles from October 2008

Internal Medicine News archives from October 2008

Tracer aids breast cancer detection.(News)
October 1, 2008... A novel imaging technique appears to be better than standard mammography at detecting breast cancer in high-risk women with dense breast tissue, according to findings from a study involving 940 women. Molecular breast imaging detected three...

Vital signs.
October 1, 2008... Retail Drug Prescriptions Filled at Pharmacies in 2007 (per capita) Note: Data are generated by Verispan, which collects data from a panel of retail pharmacies, third-party payers, and data providers. Source: Kaiser Family...

UKPDS data show benefits of glucose control at 30 years: metformin, insulin have a 'legacy effect.'.(News)(United Kingdom Prospective Diabetes Study )
October 1, 2008... ROME--Sustained improvements in diabetes-related end points were achieved with early rather than delayed use of intensive glucose control in patients with newly diagnosed type 2 diabetes, according to results from a landmark diabetes study...

Vitamin C intake tied to lower hip fracture risk.(News)(Clinical report)
October 1, 2008... MONIREAL--Consumption of vitamin C at sufficiently high levels is associated with nearly a 50% decrease in the risk of hip and nonvertebral osteoporotic fractures in elderly men and women, according to a 15- to 17-year follow-up of participants...

Pain reliever may avoid hypertensive effects.(News)(Clinical report)
October 1, 2008... PARIS--Naproxcinod, a novel pain reliever being developed for osteoarthritis, resulted in significantly lower blood pressure than did naproxen in a pivotal phase III clinical trial. This finding holds the key to the drug's seemingly bright...

FDA posts reports of ongoing drug investigations.(News)(United States. Food and Drug Administration)
October 1, 2008... The Food and Drug Administration has posted on its Web site the first quarterly report of drugs identified as having "potential safety issues" that are under evaluation, in order to keep health care professionals and the public informed about...

Cancer concerns over ezetimibe linger for some.(News)
October 1, 2008... MUNICH--Many experts have been reassured that the signal of a cancer risk that was reported last July for treatment with the lipid-lowering drug ezetimibe probably was the result of chance, but other cardiologists have lingering concerns. ...

More restrictions placed on rabies vaccine because of supply problems.(News)
October 1, 2008... Health care providers who prescribe post-exposure rabies prophylaxis must confer with public health officials and obtain a confirmation code from the state health department before they can order doses of the vaccine, because the only rabies...

Beware of fructose confusion.(LETTERS)
October 1, 2008... I only recently become aware of an article titled "Kidney Risk May Rise With High Fructose Consumption" (March 1, 2008, p. 42), which was sent to me by a colleague who knows of the research done in my laboratory and others comparing various...

Obama: preserve what works, improve what doesn't.(ELECTION 2008: PHYSICIANS' PERSPECTIVES)
October 1, 2008... As doctors, you know well what ails our health care system. Are there any among us who have not cared for a patient without health insurance? Who hasn't noticed that the cost of care has risen so high that many can no longer afford the care we...

McCain: control costs, ensure access.(ELECTION 2008: PHYSICIANS' PERSPECTIVES)
October 1, 2008... For the past several months I have closely followed the health care policies of Sen. John McCain (R-Ariz). I am impressed how the senator places the individual--patient and physician--at the center of this policy. The McCain plan is not simply...

Eliminate the negatives about glucose monitoring.(Endocrinology)
October 1, 2008... WASHINGTON--"It's almost as if [health care providers] have a secret strategy for discouraging people" from monitoring their blood glucose levels, according to William Polonsky, Ph.D. To help his colleagues avoid these negative behaviors,...

Fewer diabetic women achieve LDL, BP targets.(Endocrinology)(Low density lipoproteins)(blood pressure )(Clinical report)
October 1, 2008... WASHINGTON--Significantly fewer diabetic women than men achieved target LDL cholesterol and blood pressure levels despite equivalent medication prescriptions in a study of 211 underserved inner-city and rural patients. Evidence suggests...

Free 2008 diabetes pocket guide.(Endocrinology)(Brief article)
October 1, 2008... The National Diabetes Education Program is offering Diabetes Numbers at-a-Glance (for nonpregnant adults). This reference card lists current recommendations on diagnosis and treatment of prediabetes and diabetes, American Diabetes...

Nephropathy, mortality cut by glucose, blood pressure control.(Endocrinology)(Clinical report)
October 1, 2008... ROME New or worsening nephropathy was reduced by 33% with intensive glucose management and routine blood pressure lowering, compared with standard care, according to the latest findings from the Action in Diabetes and Vascular Disease: Preterax...

Intensive glucose control not protective in older diabetics.(Endocrinology)(Clinical report)
October 1, 2008... ROME--Eye and renal complications were no less frequent in older, difficult-to-treat patients with type 2 diabetes who were randomized to intensive rather than standard glucose control in the Veterans Affairs Diabetes Trial. Furthermore,...

Metabolic syndrome may hasten 'neuroaging'.(Endocrinology)(Clinical report)
October 1, 2008... Mid-Atlantic Bureau CHICAGO--Older people with metabolic syndrome are significantly more likely to experience depression and deficits in cognition and function as they age than are their healthier peers. The presence of metabolic...

Booklet for pregnant diabetic women.(Endocrinology)(Brief article)
October 1, 2008... A 44-page guide to pregnancy for women with preexisting diabetes is offered by the National Institute of Diabetes and Digestive and Kidney Diseases. "For Women with Diabetes: Your Guide to Pregnancy" (DM-269) outlines a diabetes care plan,...

Weight loss easier with meal replacements.(Endocrinology)
October 1, 2008... WASHINGTON--What is a safe, drugfree, and effective method for treating obesity and its comorbidities in patients with diabetes or those who are at risk for it? Tell them to try prepackaged, nutritionally balanced, and calorie-controlled meal...

Spanish-language diabetes pill guide.(Endocrinology)(Brief article)
October 1, 2008... A new guide, "Pastillas para la diabetes tipo 2: guia para adultos," offers information for patients in Spanish on 10 generic and 13 brand-name oral diabetes medications. The data are based on a recent report from the Agency for Healthcare...

Abuse-deterrent morphine blocks euphoria.(Psychiatry)
October 1, 2008... TORONTO-A new formulation of extended-release morphine that contains sequestered naltrexone does not provide a sense of euphoria when crushed and taken orally, a study has found. This limits its appeal for recreational use, as the rapid...

Drug selectively inhibits hedonic responses.(Psychiatry)(Brief article)(Clinical report)
October 1, 2008... TORONTO-Long-term treatment with extended-release naltrexone selectively inhibited the hedonic response associated with drinking alcohol while sparing the experience of pleasure associated with other activities such as reading and listening to...

Teen use of most illegal drugs drops.(Psychiatry)
October 1, 2008... WESHINGTON--The rate of illicit drug use among adolescents and young adults stayed relatively the same in 2007, showing mild decreases in use for many drugs, according to the results of the 2007 National Survey on Drug Use and Health. But...

Illicit fentanyl kills 1,000 over 2 years.(Psychiatry)
October 1, 2008... At least 1,000 people died in a 2-year period from an overdose of an illegally manufactured non-pharmaceutical fentanyl that hit the streets sometime in 2006, according to a survey of U.S. surveillance data. It was the largest-ever...

Smoking cessation rate in England increased after public smoking ban.(Psychiatry)(Brief article)
October 1, 2008... As many as 400,000 smokers have quit their habit as a result of England's ban on smoking in public places, according to a cancer charity. Cancer Research UK said the Smoking Toolkit Study it supports at University College London found that...

Deep brain stimulation aids resistant depression: DBS may modulate the activity of the brain circuit that malfunctions in cases of severe depression.(Psychiatry)
October 1, 2008... BARCELONA -- Deep brain stimulation of the subcallosal cingulate gyrus significantly improved the symptoms of treatment-resistant depression, both by suppressing activation of that area and remotely activating other brain regions involved in...

Nortriptyline may beat SSRIs for depression in Parkinson's.(Psychiatry)(selective serotonin reuptake inhibitor )(Clinical report)
October 1, 2008... PHOENIX--Nortriptyline was more effective than paroxetine or placebo in treating depression in patients with Parkinson's disease, an 8-week pilot study of 52 patients found. The study, while small, is the largest placebo-controlled trial of...

Radiation accessible to both rural, urban women.(Women's Health)
October 1, 2008... Rural women with breast cancer are just as likely as their urban counterparts to get postsurgery radiation therapy, which contradicts the prevailing belief that mastectomies are more common in rural areas because access to radiation therapy is...

Radiation less likely after lumpectomy in blacks.(Women's Health)
October 1, 2008... WAHSINGTON--Black women who undergo lumpectomy to treat early-stage breast cancer are less likely than are their white counterparts to receive standard postoperative radiation therapy, results of a large study suggest. The findings, which...

Older women benefit from MRI breast screening.(Women's Health)(Magnetic resonance imaging)
October 1, 2008... Orlando Bureau CHICAGO--Magnetic resonance imaging can detect cancer that is missed by mammography and physical examination in women aged 70 years or older, a retrospective single-institution study suggests. Among 159 elderly women...

Combination treatment improved control in COPD.(Pulmonary Medicine)
October 1, 2008... TORONTO--Patients with chronic obstructive pulmonary disease treated with a combination of formoterol and tiotropium required less rescue medication than did those treated with tiotropium alone. The Global Initiative for Chronic Ob-...

The effective physician: Allergic Rhinitis.(Pulmonary Medicine)
October 1, 2008... Background The Joint Task Force on Practice Parameters, representing the major American allergy-immunology professional societies, has issued revised guidelines on the diagnosis and management of rhinitis. The goal of these guidelines is...

Lung function measures may predict sleep apnea.(Pulmonary Medicine)
October 1, 2008... BALTIMORE--Two measures of lung function--a higher forced expiratory volume in 1 second/forced vital capacity ratio and lower total lung capacity--may predict the presence of obstructive sleep apnea in chronic pulmonary disease patients,...

Lung function continues to improve after gastric bypass.(Pulmonary Medicine)(Brief article)
October 1, 2008... PHILADELPHIA--The pulmonary function of gastric bypass patients temporarily drops in the immediate postoperative period but significantly improves in various functional parameters beginning at 3 months and lasting through at least 1 year,...

Watch fluid intake, heat illnesses in young athletes.(Sports Medicine)
October 1, 2008... VANCOUVER, B.C.--Fluid maintenance issues and heat illnesses are especially important in young athletes, who "are uniquely vulnerable to fluid loss," according to Dr. Michele LaBotz. Fluid depletion compromises their athletic performance...

Amenorrheic athletes have altered leptin and ghrelin levels.(Sports Medicine)
October 1, 2008... SAN FRANCISCO--Athletic teenage girls who are amenorrheic have higher ghrelin and lower leptin levels than do athletic girls who are eumenorrheic or girls who are nonathletic, according to a small study. The findings could help tease out...

Direct-to-consumer genetic analysis.(GENETICS IN YOUR PRACTICE)
October 1, 2008... Have you ever ordered a genetic test to assess a patient's future risk of developing a disease? Are you prepared for a patient to walk into your office with such information already in hand? Direct-to-consumer genetic analysis is now...

When to resume activity after mono is a clinical decision.(Clinical Rounds)
October 1, 2008... VANCOUVER, B.C. --Physical findings, laboratory values, and imaging results are of little use in determining when it is safe for young athletes with infectious mononucleosis to return to play. Ultimately, the decision on how long to keep them...

Diabetes + celiac disease = dietary difficulties.(Gastroenterology)
October 1, 2008... KEYSTONE, COLO. -- Many type 1 diabeitc patients with comorbid celiac disease say the celiac disease is actually the harder of the two to deal with, according to a presentation at a conference on the management of diabetes in youth. The...

Colonoscopy without sedation had high acceptance rates.(Gastroenterology)
October 1, 2008... SAN DIEGO--One third of veterans offered colonoscopy without sedation agreed to the procedure, which was conducted safely and successfully with high levels of patient satisfaction, according to results of a prospective study presented at the...

Efficacy of raltegravir sustained at nearly 2 years.(Infectious Diseases)
October 1, 2008... MEXICO CITY -- When raltegravir (Isentress) is used as part of combination antiretroviral therapy in treatment-naive patients infected with HIV, its efficacy is sustained and similar to that of efavirenz (Sustiva) and it appears to have a...

Mortality gap has narrowed for HIV-infected patients.(Infectious Diseases)(human immunodeficiency virus)
October 1, 2008... Mortality rates of people infected with HIV now approach those of the general population, at least for the first 5 years of the infection, according to a large multinational study. The gap in mortality rates between people with HIV...

HIV/AIDS diagnoses rising in young black men in most states.(Infectious Diseases)
October 1, 2008... From 2001 through 2006, the number of HIV/AIDS diagnoses among men who have sex with men increased by nearly 9% in 33 states, with particularly high increases among black men and Asian/Pacific Islanders under the age of 25 years, according to...

Fish oil cuts heart failure morbidity, mortality.(Cardiovascular Medicine)(Clinical report)
October 1, 2008... MUNICH -- Supplementation with a single daily low-dose fish oil capsule in patients with chronic heart failure resulted in modest but clinically meaningful reductions in mortality and cardiovascular hospitalization in a nearly 7,000-patient...

Statin therapy offers no benefit in chronic heart failure.(Cardiovascular Medicine)(Clinical report)
October 1, 2008... MUNICH -- Rosuvastatin at 10 mg per-day had no impact on clinical outcomes in patients with chronic heart failure in a large clinical trial. Results of the GISSI-HF trial, in which 4,574 Italian patients with chronic heart failure were...

Data watch.(Statistical table)(Brief article)
October 1, 2008... Number of People Buying Statins Increased by Nearly 88% Over 5 Years 2000 15.8 million 2005 29.7 million Note: Based on prescriptions purchased in an outpatient setting. Source: Agency for Healthcare Research and Quality

U.S. falling short on key health care indicators.(Practice Trends)
October 1, 2008... Access to care has declined significantly since 2003, with 42% of all working-age adults either uninsured or underinsured in 2007, according to a national health system scorecard from the Commonwealth Fund, which found that health care system...

Demo helps define what makes a medical home.(Practice Trends)
October 1, 2008... If patient-centered medical homes are to be the new standard in care, fee-for-service practices will have to convert to the new model. Dr. Richard Baron and his four-physician practice in Philadelphia are part of a growing contingent...

Privacy should be main criterion for personal health records.(Practice Trends)
October 1, 2008... Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended. Adequate security and...

Medical home demo seeks four coordinating centers.(Practice Trends)(Brief article)
October 1, 2008... The Commonwealth Fund is gearing up to turn 50 safety net clinics into models of the patient-centered medical home. The demonstration project, called the Safety Net Medical Home Initiative, will run for 5 years with the goal of creating an...

Trinkets out, 'educational' gifts ok under new code.(Practice Trends)
October 1, 2008... The free pens and mugs adorned with the names of commonly prescribed drugs are soon to be a thing of the past, thanks to a new set of voluntary guidelines from the Pharmaceutical Research and Manufacturers of America. But the real impact...

Media influences tobacco use.(POLICY & PRACTICE)(Brief article)
October 1, 2008... Media communications--including movies, advertising, and news--play a key role in shaping tobacco use, according to a lengthy report from the National Cancer Institute. The report noted that cigarettes are among the most heavily marketed...

Tobacco control support drops.(POLICY & PRACTICE)(Brief article)
October 1, 2008... Budgets for tobacco control programs in most states are either staying level or declining, despite increases in payments from the 1997 Tobacco Master Settlement Agreement, designed to compensate states for some of the cost of smoking-related...

Grants to doctors in hurricanes.(POLICY & PRACTICE)(Brief article)
October 1, 2008... The AMA Foundation's Health Care Recovery Fund will provide grants of up to $2,500 to physicians in places declared disaster areas by the Federal Emergency Management Agency, and the foundation is accepting donations to help physicians who have...

'Free' Rx samples expensive.(POLICY & PRACTICE)(Brief article)
October 1, 2008... Free drug samples provided to physicians by pharmaceutical companies actually could cost uninsured patients more in the long run, because those patients are prescribed brand-name drugs rather than generics, according to a study done by...

Tools' usefulness limited.(POLICY & PRACTICE)(Brief article)
October 1, 2008... Although health plans are developing tools to help consumers compare price and quality information across hospitals and physicians, the tools' pervasiveness and usefulness are limited, according to a study by the Center for Studying Health...

Many reach 'doughnut hole'.(POLICY & PRACTICE)(Brief article)
October 1, 2008... One in four Medicare Part D enrollees who filled prescriptions in 2007 reached the gap in coverage known as the "doughnut hole," and most remained in the doughnut hole for the rest of the year, according to an analysis from the Kaiser Family...

Internist abroad: hospitalist practice in New Zealand.(WORLD WIDE MED)(Interview)
October 1, 2008... Dr. Clark Parrish is an internal medicine physician with an outsider's perspective on hospital-based medicine. Although Dr. Parrish currently practices as a partner in the former Madrona Medical Group in Bellingham, Wash., now known as...

WHO recommends steps to reduce global health inequities.(Practice Trends)(Brief article)
October 1, 2008... Improving living conditions, reducing income disparities, and measuring the effects of specific steps to reduce inequities in health care all are necessary to eliminate the effects that deprivation has on global public health, the World Health...

Physician groups protest timeline for ICD-10.(Practice Trends)(International Classification of Diseases)(Chronology)
October 1, 2008... Officials at the Centers for Medicare and Medicaid Services plan to replace the ICD-9-CM diagnosis and procedure code set with a significantly expanded set of codes--the ICD-10--by Oct. 1, 2011. But physician groups are calling the agency's...

Regulation of off-label drugs warrants attention.(Practice Trends)
October 1, 2008... PHILADELPHIA -- The Food and Drug Administration needs to change the way it regulates promotion of off-label drug use, according to the chair of the department of health policy and public health at the University of the Sciences in...

Indications.(Clinical report)
October 1, 2008... Whoa, That's Heavy, Man When 29 young men in Leipzig, Germany, last year presented with possible poisoning symptoms--stomach cramps, nausea, anemia, and fatigue--public health doctors and officials were puzzled. But there were quite a few...

Pain relievers.(Cartoon)
October 1, 2008... "With today's technology, why can't you do my colonoscopy over the Internet?"

Site offers skin cancer info for Seniors.(FYI)(www.nihseniorhealth.gov.)(Brief article)
October 1, 2008... The National Institute of Health's Senior Health Web site has added information on skin cancer. Seniors can research causes, risk factors, screening, diagnosis, and treatments. The Web site includes a page on frequently asked questions. For...

Multiple-language CD from NIAMS.(FYI)(The National Institute of Arthritis and Musculoskeletal and Skin Diseases)
October 1, 2008... The National Institute of Arthritis and Musculoskeletal and Skin Diseases is offering "Easy-to-Read Health Information on Bones, Muscles, joints, and Skin," for consumers. The CD-ROM contains print-friendly copies of NIAMS publications in...

Clinician's guide on osteoporosis.(FYI)(National Osteoporosis Foundation )(Brief article)
October 1, 2008... The National Osteoporosis Foundation is offering a "Clinician's Guide to Prevention and Treatment of Osteoporosis." The guide helps health care providers assess fracture risk and treat patients with low bone mass or osteoporosis. New...

Doctors in demand at health centers.(News)(Report)
October 15, 2008... Experts are calling for an infusion of about 10,000 primary care physicians into medically underserved areas over the next several years, even as medical students' interest in primary care has waned. The nation's community health centers,...

Little financial reward from PQRI.(VITAL SIGNS)(Physician Quality Reporting Initiative)(Statistical table)(Survey)(Brief article)
October 15, 2008... How has your practice's involvement in the 2007 and/or 2008 PQRI program affected total physician compensation? Reduced 5.7% No change 72.7% Increased 11.7% Don't know 9.8% Notes: Survey responses from 264...

HT, stroke risk up after hypertension during pregnancy: large study confirms previous findings.(News)(Clinical report)
October 15, 2008... WASHINGTON -- Women who had hypertension during pregnancy are at increased risk for hypertension and stroke after 40 years of age, based on follow-up data from more than 4,000 women. The findings suggest that clinicians should ask patients...

Law requires equality for mental health coverage.(NEWS)
October 15, 2008... After a 12-year fight led by mental health advocates, patients, families, clinicians, and a handful of members of Congress, approximately 113 million Americans will soon have equality of coverage between their benefits for physical health care...

Flu vaccine for physicians, staff is 'ethical responsibility'.(News)
October 15, 2008... WASHINGTON -- It is "unconscionable for health care workers who do not have a medical contraindication to not receive the flu vaccine," Dr. Julie L. Gerberding, director of the Centers for Disease Control and Prevention, said at a press...

Expanded cancer prevention claim approved for Gardasil.(News)(Brief article)
October 15, 2008... The human papilloma virus vaccine, Gardasil, has been approved for a new claim: preventing vaginal and vulvar cancer caused by HPV types 16 and 18 in females aged 9-26, the Food and Drug Administration announced. The approval is based on...

Promotions for ADHD drugs earn warning.(News)(attention-deficit/hyperactivity disorder)
October 15, 2008... The Food and Drug Administration has warned five manufacturers of drugs for attention-deficit/hyperactivity disorder against using what it terms "false or misleading" promotional materials that overstate the drugs' efficacy and downplay risks....

Incidence of NSAID-related liver toxicity climbs fast in California.(News)(Nonsteroidal anti-inflammatory agents)(Brief article)
October 15, 2008... PARIS -- Serious liver toxicity associated with the use of NSAIDs showed a sevenfold jump in incidence in a recent 10-year period in California. The explanation for this alarming trend is speculative, but one key factor might be the steady...

Adviser Meier awarded MacArthur fellowship.(News)(Diane E. Meier)(Brief article)
October 15, 2008... Dr. Diane E. Meier, a member of the editorial advisory board of INTERNAL MEDICINE NEWS, has been named a 2008 MacArthur Fellow in recognition of her pioneering work in palliative care. Dr. Meier is 1 of 25 individuals--including 4...

Prevention goes a long way in medicine and in law.(Guest editorial)
October 15, 2008... Nothing's worse than having the first appointment of your day interrupted by an unexpected--and unpleasant--surprise. Instead of a young woman who is running a fever or a middle-aged, man concerned about his blood pressure, you are faced...

Resist burdensome preauthorization.(LETTERS)(Letter to the editor)
October 15, 2008... Dr. N.S. Damle was too gentle in his criticisms regarding imaging preauthorization programs ("Paying for Advanced Medical Imaging," Guest Editorial, Sept. 1, 2008, p. 9). These programs represent an intrusive, unpaid burden for practicing...

Health care is not a commodity.(LETTERS)(Letter to the editor)
October 15, 2008... Dr. Steven Kreisman argues that the assumption of health care as a "right" is a morally untenable premise that is responsible for the current quagmires of the American health care system ("Health Care Must Be Earned," Letters, Aug. 1, 2008, p....

The effective management of chronic constipation and IBS-C.(BEST PRACTICES IN)(Irritable bowel syndrome with constipation)(Disease/Disorder overview)
October 15, 2008... Chronic constipation (CC) is one of the most common gastrointestinal (GI) disorders in the United States, affecting ~14.7% of the population. (1), (2) Irritable bowel syndrome with constipation (IBSC) affects ~1% to 4% of the North American...

Thinking outside the box in atopic dermatitis.(Dermatology)(Clinical report)
October 15, 2008... CHICAGO -- Despite bone-chilling temperatures and the risk of frostbite, patients who underwent experimental whole-body cryotherapy for atopic dermatitis said they were willing to do it again. This Finnish experience with whole-body...

CV problems often go unrecognized in psoriasis.(Dermatology)(Cardiovascular diseases)(Clinical report)
October 15, 2008... PARIS -- Patients with moderate to severe psoriasis are at increased risk for cardiovascular disorders and diabetes, but the problems often go undiagnosed, according to an analysis of three clinical trials. "There was a substantial number...

VA declares ALS linked to military service.(Neurology)(Amyotrophic lateral sclerosis)(Department of Veterans Affairs)
October 15, 2008... Veterans with amyotrophic lateral sclerosis can now receive services and equipment from the Department of Veterans Affairs without having to prove that their condition is connected to their military service. The VA established a...

RBC distribution width may predict stroke death.(Neurology)(Red blood cell )
October 15, 2008... NEW ORLEANS -- Red blood cell distribution width appears to be a significant predictor of stroke mortality, according to data obtained from the third National Health and Nutrition Examination Survey. An analysis of data from 480...

Ear-nerve stimulator promising for chronic pain.(Neurology)
October 15, 2008... In 2005 Dr. Robert Bonakdar was searching through PubMed in preparation for a lecture he was about to deliver to physicians on the nonpharmacologic treatment of chronic pain. He came across two randomized, controlled trials that described a...