Internal Medicine News articles from September 2007

Internal Medicine News archives from September 2007

New Orleans still lacks health care.(News)
September 1, 2007... Two years after Hurricane Katrina's floodwaters submerged much of New Orleans, the city's relatively few open health care facilities and diminished corps of physicians are struggling to serve a smaller, but just as needy, population. It's...

Top 10 drugs prescribed by internists in 2006.(VITAL SIGNS)(Brief article)
September 1, 2007... Top 10 Drugs Prescribed by Internists in 2006 Percentage of prescriptions Lipitor (atorvastatin) 3.0% Lisinopril 2.4% Hydrocodone/APAP 2.0% Atenolol 2.0%...

One measure for overall glycemia to guide patient care: 'obtuse concept' of Hb[A.sub.1c] to be sidelined.(News)
September 1, 2007... If all goes as expected, the number of ways in which a diabetes patient's overall glucose control is expressed will soon increase to three but essentially boil down to just one concept: average glucose. New joint guidelines from the...

Trastuzumab may benefit HER2-negative patients.(Women's Health)
September 1, 2007... CHICAGO -- Some patients with HER2-negative breast cancer may benefit from trastuzumab therapy, judging from findings from two studies presented at the annual meeting of the American Society of Clinical Oncology. A retrospective analysis...

PPIs not tied to heart risk, FDA says.(News)
September 1, 2007... New data supplied by AstraZeneca, maker of the prescription proton pump inhibitors Prilosec (omeprazole) and Nexium (esomeprazole), do not suggest that either drug poses an increased risk for cardiovascular events in patients with severe...

Disaster planning is still lacking.(News)
September 1, 2007... Public health systems need more federal funding to respond to day-to-day emergencies and mass casualty events, according to disaster preparedness recommendations released by a coalition of 18 health organizations. The coalition, led by the...

European SLE guidelines found to fall short.(News)(systemic lupus erythematosus)
September 1, 2007... The first-ever attempt to develop "comprehensive management guidelines" for systemic lupus erythematosus resulted in 12 recommendations--some potentially controversial--from a European task force. European League Against Rheumatism (EULAR)...

Greens, NSAIDs may prevent squamous cancer.(News)
September 1, 2007... AMSTERDAM -- Adoption of a diet rich in leafy green vegetables and the regular use of NSAIDs are evidence-based supplementary measures available to patients with prior skin cancer to reduce their risk of future episodes, Dr. Adele C. Green said...

TZDs given black box warning on heart failure.(News)(thiazolidinediones)
September 1, 2007... The labels of all thiazolidinediones will carry a black box warning about the risk of heart failure emphasizing that these drugs may "cause or exacerbate congestive heart failure in some patients," according to the Food and Drug Administration....

CryoCor Cardiac Cryoablation System.(NEW & APPROVED)
September 1, 2007... CryoCor Cardiac Cryoablation System (Cryocor Inc.) A cryoablation device approved for the ablation of isthmus-dependent right atrial flutter in patients aged 18 years and older. This is the first cryoablation device approved for atrial...

Selzentry.(NEW & APPROVED)
September 1, 2007... Selzentry (maraviroc, Pfizer Inc.) A CCR5 coreceptor antagonist approved for use in combination with other anti-retroviral drugs for treating adults infected with only CCR5-tropic HIV-1 and who have evidence of viral replication and...

Physicians as terrorists.(GUEST EDITORIAL)
September 1, 2007... The failed car bomb attacks in London and Glasgow have startled many. One of the biggest surprises is that the alleged would-be terrorists are physicians or medical students--people who take an oath to save lives. But throughout human history,...

Should hormone treatment be started early in response to rising PSA levels?(POINT/COUNTERPOINT)(patient-stimulated anxiety)
September 1, 2007... Why wait? A raging controversy exists regarding the use of early vs. delayed hormone therapy and the use of chemotherapy for patients with rising prostate-specific antigen levels after failed local therapy, or stage D1.5 disease. ...

Reimbursement system is unfair.(LETTERS)(Letter to the editor)
September 1, 2007... It sounds like the American Board of Internal Medicine is prepared to make a sweet deal with the insurance companies to increase the number of internists taking the boards by tying payment fees to board certification ("New Certificate Option...

Lowering LDL cholesterol is key.(LETTERS)(Letter to the editor)
September 1, 2007... I have a pearl for Dr. Jon O. Ebbert and Dr. Eric G. Tangelos ("Reducing Microalbuminuria in Diabetics on ACE Inhibitor Therapy," Mindful Practice, July 15, 2007, p. 21). The most effective way of reducing microalbuminuria is to profoundly...

'Pay for performance' anxiety.(LETTERS)(Letter to the editor)
September 1, 2007... Pay for performance? First let me do what I think the patient needs. A non-MD tells me over the phone that a CT scan or MRI isn't indicated. A mail-order prescription plan tells me I can't use a drug because I didn't try OTC medication first....

Correction.(Correction notice)
September 1, 2007... Our report, "Standard Hepatitis C Treatment Highly Effective" (July 1, 2007, p. 42), stated the study findings incorrectly. The first sentence should have been replaced with this: WASHINGTON--Findings from the largest-ever study of the standard...

Pain relievers.(Opinion)(Cartoon)
September 1, 2007... Give it to me in layman's terms... dollars and cents.

Novel diabetes drugs block glucose reabsorption.(Endocrinology)
September 1, 2007... CHICAGO -- Suppressing the reabsorption of glucose in the kidney is the novel mechanism for an investigational new class of diabetes drugs. Early data presented at the annual scientific sessions of the American Diabetes Association suggest...

Diabetic retinopathy regresses with pegaptanib.(Endocrinology)
September 1, 2007... CHICAGO -- Intravitreal pegaptanib appeared to induce regression of proliferative diabetic retinopathy in a small pilot study presented at the annual scientific sessions of the American Diabetes Association. Pegaptanib sodium (Macugen),...

Diabetic eye disease in the U.S. projected to triple by 2050.(Endocrinology)
September 1, 2007... CHICAGO -- Diabetic eye disease is expected to triple in the United States by the year 2050, investigators from the Centers for Disease Control and Prevention reported at the annual scientific sessions of the American Diabetes Association. ...

Guidelines steer focus from glucose to lifestyle.(Endocrinology)
September 1, 2007... Diabetes management is becoming less "glucocentric" than it used to be, according to Dr. Helena W. Rodbard. Dr. Rodbard is the chairperson of the task force that wrote the new clinical practice guidelines on the management of diabetes...

Manage stress for better prostatectomy outcomes.(Urology)
September 1, 2007... CHICAGO -- Just 2 hours of teaching men with prostate cancer how to self-manage their stress improves their ability to cope with their fears of undergoing radical prostatectomy. Moreover, the effects of learning how to manage their stress...

Factors tied to poor prostate ca outcome in blacks.(Urology)
September 1, 2007... CHICAGO -- African American men were significantly more likely to have prostate cancer at needle biopsy than were white men in a study reported by Dr. William Dale at the annual meeting of the American Society of Clinical Oncology. One of...

Postsurgery prognostic tools give inaccurate predictions.(Urology)
September 1, 2007... CHICAGO -- Prognostic tools that are commonly used to predict postsurgical outcomes in patients with prostate cancer dramatically underestimate the efficacy of surgery, according to Dr. Brant Inman, of the Mayo Clinic, Rochester, Minn. ...

Circulating tumor cells may be better marker than PSA.(Urology)(prostate-specific antigen)
September 1, 2007... CHICAGO -- An assay to calculate circulating tumor cells may be superior to PSA as a surrogate marker for survival in men treated for castration-refractory prostate cancer, according to a study presented at the annual meeting of the American...

Older women, Asians, blacks at higher risk of OSA.(Pulmonary Medicine)(obstructive sleep apnea)
September 1, 2007... SCOTTSDALE, ARIZ. -- Obstructive sleep apnea is often associated with obesity, especially in men, but other patients are also vulnerable, Dr. Brian A. Boehlecke advised at a meeting on sleep medicine sponsored by the American College of Chest...

Sleep-disordered breathing best tested in lab.(Pulmonary Medicine)(Brief article)
September 1, 2007... SAN FRANCISCO -- Although patients undergoing in-home polysomnography spend more time supine and more time in rapid eye movement sleep than did patients studied in a sleep laboratory, the in-home technique underestimates measures of...

Clues to missed PE often found in vital signs.(Pulmonary Medicine)(pulmonary embolism)
September 1, 2007... SAN DIEGO -- More than 400,000 cases of pulmonary thromboembolism are missed by doctors every year in the United States. Over the past few years, it has become clearer why many of those cases are missed and how they could be diagnosed, Dr....

Exercise guidelines emphasize health maintenance: the aerobic activity should be in addition to routine activities of daily living, such as casual walking.(Sports Medicine)
September 1, 2007... Exercise experts have clarified what qualifies as the minimum level of physical activity for maintaining health and lowering the risk of disease in older and younger adults as well as in middle-aged adults with chronic conditions in updated...

The benefits of resistance training know no age limit.(Sports Medicine)
September 1, 2007... Elderly persons in nursing homes can benefit from resistance training, as can patients with heart failure, according to an update on resistance exercise issued by the American Heart Association. The update follows up AHAs first scientific...

Tonsillectomy linked with breast cancer risk.(Women's Health)(Brief article)
September 1, 2007... LOS ANGELES -- Women who have had a tonsillectomy are 50% more likely to develop breast cancer, but only if they are premenopausal, according to a poster presentation by Ted Brasky at the annual meeting of the American Association for Cancer...

Serial screening combo may flag early ovarian ca.(Women's Health)(cancer)
September 1, 2007... CHICAGO -- Frequent serum CA125 testing in tandem with transvaginal sonography may be an effective screening method to detect ovarian cancer early in women at increased risk of the disease. When serial CA125 levels were analyzed using the...

Endometriosis-related ca risk not tied to parity.(Women's Health)(cancer)(Brief article)
September 1, 2007... LYON, FRANCE -- The increased risk of cancer seen in patients with endometriosis is unrelated to parity, according to a large study--the first to examine this association. "Endometriosis and nulliparity did not combine to give a higher...

'Timing' hypothesis fails to save estrogen therapy.(Women's Health)
September 1, 2007... ORLANDO -- The "timing" hypothesis is a misguided effort to keep estrogen therapy an option for reducing heart disease risk in perimenopausal and postmenopausal women, Dr. Elizabeth Barrett-Connor said at a conference on cardiovascular disease...

Diabetes doubles arthroplasty infection rate.(Rheumatology)(Brief article)
September 1, 2007... DALLAS -- Diabetic patients have a more than twofold increased risk of infection following elective hip or knee arthroplasty, Dr. Jeffrey L. Glasheen reported at the annual meeting of the Society of Hospital Medicine. Moreover, development...

Fever after hip, knee surgery may not signal infection.(Rheumatology)(Brief article)
September 1, 2007... DALLAS -- Postoperative fever is extremely common in patients undergoing elective hip or knee surgery--and it's seldom associated with infection, Dr. Josiah K. Halm reported at the annual meeting of the Society of Hospital Medicine. ...

Charlson score may predict early postop mortality.(Rheumatology)(Brief article)
September 1, 2007... DALLAS -- The Charlson Comorbidity Index may have clinical utility as an independent predictor of postoperative infection and 30-day mortality in geriatric patients undergoing hip surgery, Dr. Lisa L. Kirkland reported at the annual meeting of...

Radiation exposure.(THE EFFECTIVE PHYSICIAN)
September 1, 2007... The growth of radiographic imaging has raised concerns about the acute and cumulative exposure of patients to radiation. The American College of Radiology recently released a white paper outlining the extent of this issue and potential...

Secondary cachexia often has multiple causes.(Clinical Rounds)
September 1, 2007... CHICAGO -- Primary cachexia in patients with advanced cancer is frequently exacerbated by secondary complications that decrease energy intake, according to data presented in a poster at the annual meeting of the American Society of Clinical...

0.3% Differin gel.(PRODUCTS)(Brief article)
September 1, 2007... The Food and Drug Administration has approved adapalene (Differin) gel 0.3% for the treatment of acne. Differin gel was previously only available in a 0.1% formulation. For more information, visit www.differin.com.

Enjuvia for vaginal dryness.(PRODUCTS)(Brief article)
September 1, 2007... Enjuvia (synthetic conjugated estrogens, B) is approved for the treatment of moderate to severe vaginal dryness and pain with intercourse, which are symptoms of vulvar and vaginal atrophy associated with menopause. Enjuvia is also approved in a...

Noninvasive central pressure monitor.(PRODUCTS)(SphygmoCor)(Brief article)
September 1, 2007... The SphygmoCor system is available for assessment of the blood pressure waveform at the ascending aorta. Applications include cardiovascular risk evaluation and ICU monitoring. The system also can be used for a simple assessment of sympathetic...

Home-based fertility screening.(PRODUCTS)
September 1, 2007... The first at-home fertility screening test for men and women, Fertell enables couples to assess key elements of fertility earlier in the process, and facilitates earlier professional care when there are results outside the normal range. The...

Lipid profile device.(PRODUCTS)
September 1, 2007... CardioChek PA is a diagnostic device that can measure a patient's lipid profile in the office or waiting room in less than 2 minutes. It is cleared by the Food and Drug Administration for use in adults. For more information, visit...

Estradiol spray to treat menopause.(PRODUCTS)
September 1, 2007... Evamist (estradiol transdermal spray) has been approved by the Food and Drug Administration for the treatment of moderate to severe vasomotor symptoms caused by menopause. The spray is delivered in metered doses. For more information, contact...

Diabetic retinopathy detection.(PRODUCTS)
September 1, 2007... Retasure enables primary care physicians to detect retinopathy at an early stage. The physician uses a digital fundus camera to capture nondilated, high-resolution retinal images. The images are transmitted over a secure network to an...

'Smart' brace for stroke victims.(PRODUCTS)
September 1, 2007... The e100 NeuroRobotic System has been cleared by the FDA for marketing as a portable elbow brace. No electrical stimulation or surgery is required. The device is designed to help people relearn how to move impaired upper limbs. When a patient's...

First artificial cervical disk.(PRODUCTS)
September 1, 2007... The Food and Drug Administration has approved the Prestige cervical disk for treating cervical degenerative disk disease. The disk, manufactured by Memphis-based Medtronic Sofamor Danek, is used to replace the impaired natural disk during...

Urinary flow measuring system.(PRODUCTS)
September 1, 2007... Installed in a standard toilet, with no awkward chair, the FloPoint Elite Uroflow System measures and records a patient's pattern of urinary flow, allowing physicians to assess bladder function and diagnose abnormalities in voiding patterns....

Office lab chemistry analyzer.(PRODUCTS)
September 1, 2007... The Data Pro Plus is a compact, automated benchtop analyzer designed for routine diagnostic laboratory use in physician offices. It has a throughput of up to 230 tests per hour, onboard reagent management, and unlimited storage capacity for...

Lifestyle can rectify some prehypertension.(Cardiovascular Medicine)(Clinical report)
September 1, 2007... NEW ORLEANS -- Therapeutic lifestyle changes are effective for lowering blood pressure in individuals with prehypertension, but obese individuals may not derive maximum benefit, according to findings from a prospective study of nearly 2,500...

'Stop Sudden Cardiac Arrest' Web site.(Cardiovascular Medicine)(www.stopcardiacarrest.org)(Brief article)
September 1, 2007... The Sudden Cardiac Arrest Coalition has launched a Web site with extensive information on SCA for public health advocates, the medical community, and the public, as well as links to more than 30 member organizations. The site supports the...

Combo drug lowers refractory HT.(Cardiovascular Medicine)(hypertention)(Clinical report)
September 1, 2007... CHICAGO -- Nearly three-fourths of patients with uncontrolled hypertension on monotherapy achieved national blood pressure targets on a fixed-dose combination of amlodipine and valsartan that will soon be available, Dr. Joseph L. Izzo Jr....

Unstable angina, non-STEMI get new guidelines.(Cardiovascular Medicine)(non-ST segment elevation myocardial infarction)
September 1, 2007... Early invasive and conservative strategies for managing unstable angina or non-ST-segment-elevation myocardial infarction both received endorsements in the first guidelines on the topic from the American College of Cardiology and the American...

Value of presurgery revascularization is still unresolved.(Cardiovascular Medicine)(Clinical report)
September 1, 2007... BALTIMORE -- The jury remains out on the safety and efficacy of coronary revascularization for very high-risk patients before they have major vascular surgery. A pilot study that randomized 101 adult patients to revascularization or...

Diabetics with CKD benefit from atorvastatin.(Cardiovascular Medicine)
September 1, 2007... CHICAGO -- Intensive lipid lowering with high-dose atorvastatin significantly reduced the incidence of major cardiovascular events in coronary patients who have both type 2 diabetes and chronic kidney disease, Dr. James Shepherd reported at the...

Supplemental olive oil may cut Cardiac Risk in diabetes.(Cardiovascular Medicine)
September 1, 2007... BARCELONA -- Additional supplementation of olive oil in the diets of patients with type 2 diabetes may reduce their risk of cardiac problems, according to research presented at an international congress on prediabetes and metabolic syndrome....

Waist circumference predicts risk of cardiovascular events.(Cardiovascular Medicine)
September 1, 2007... BARCELONA -- Although body mass index is a poor predictor of mortality from myocardial infarction in patients with diabetes, this measure should not be discounted altogether, Dr. Jonathan Shaw said at an international congress on prediabetes...

Episodic amiodarone flops for atrial fibrillation.(Cardiovascular Medicine)(Clinical report)
September 1, 2007... DENVER -- Episodic amiodarone therapy is a losing strategy for maintenance of sinus rhythm in patients with persistent atrial fibrillation, according to the first randomized trial comparing this approach to continuous amiodarone. "Episodic...

Claudication drug may cut cerebrovascular events.(Cardiovascular Medicine)(Clinical report)
September 1, 2007... BALTIMORE -- Treatment with the claudication drug cilostazol was linked to a significant drop in the rate of cerebrovascular events in a post hoc analysis of data collected from more than 1,400 patients with peripheral artery disease. ...

Echinacea may protect against the common cold.(Infectious Diseases)(Report)
September 1, 2007... Users of echinacea supplements in clinical trials reduced their odds of developing the common cold by more than half, according to findings from a meta-analysis of 14 published, randomized, placebo-controlled trials. When patients in the...

Logistics pose an obstacle for flu antiviral Rx.(Infectious Diseases)
September 1, 2007... MONTREAL -- Although influenza vaccination continues to be underutilized, it is a success story compared with the use of influenza antiviral medications, experts agreed at an international conference on community-acquired pneumonia. ...

American ginseng for prevention of respiratory illness.(ALTERNATIVE MEDICINE)
September 1, 2007... History and Rationale for Use Nearly 300 years ago, the first descriptions of Asian Panax ginseng reached the West from China, and shortly thereafter another member of this genus, Panax quinquefolius, was identified in Canada. This plant...

Crohn disease drug backed, with restrictions.(Gastroenterology)
September 1, 2007... GAITHERSBURG, MD. -- A federal advisory panel has recommended that the immune modulator natalizumab be approved to treat moderate to severe Crohn disease under highly restrictive conditions. Because of the serious risks associated with this...

Early PET predictive in Barrett-related cancer.(Gastroenterology)(positron emission tomography)
September 1, 2007... COLORADO SPRINGS -- The early metabolic response to induction chemotherapy as assessed by fluorodeoxyglucose-PET just 2 weeks into the treatment of patients with locally advanced Barrett cancer reliably distinguishes those who will have low...

Research stretches survival for GIST patients.(Gastroenterology)(gastrointestinal stromal tumors)
September 1, 2007... LAS VEGAS -- Gastrointestinal stromal tumors, long an enigma, are revealing their secrets and their vulnerabilities in the face of revolutionary discoveries about their origins, speakers said at a multidisciplinary general session of the spring...

Comorbidity, warfarin use boost colonoscopy complications.(Gastroenterology)
September 1, 2007... WASHINGTON -- Patients who are sicker, who are taking warfarin, and whose polyps are removed by snare with cautery are at higher risk for complications following screening or surveillance colonoscopy, according to an analysis presented at the...

Practice self-assessment promotes patient safety.(Practice Trends)
September 1, 2007... WASHINGTON -- Health information technology's greatest potential contribution to patient safety lies in areas related to record keeping and record retrieval, David N. Gans said at a conference sponsored by the National Patient Safety...

Leaders back payment reform.(POLICY & PRACTICE)(Survey)(Brief article)
September 1, 2007... The vast majority (95%) of key public officials, analysts, and executives say fundamental health care payment reform is needed, and 75% support Medicare reform that would pay "medical homes" for care coordination, according to the latest...

Publix to offer free antibiotics.(POLICY & PRACTICE)(Brief article)
September 1, 2007... Publix Super Markets will offer seven oral antibiotics free of charge at its 684 pharmacy locations, the Lakeland, Fla.-based store chain announced. The antibiotics included in the program--amoxicillin, cephalexin, sulfamethoxazole/trimethoprim...

FDA, DoD to share data.(POLICY & PRACTICE)(Food and Drug Administration)(Department of Defense)(Brief article)
September 1, 2007... The Department of Defense will share data and expertise with the Food and Drug Administration related to the review and use of FDA-regulated drugs, biologics, and medical devices in an effort to identify potential concerns and recognize...

Bill would improve import safety.(POLICY & PRACTICE)(Brief article)
September 1, 2007... User fees on imported food and drug shipments would fund additional personnel to inspect shipments both at the border and at FDA laboratories under legislation proposed by the chairman of the House Energy and Commerce Committee. Funds from the...

GAO finds Medicaid decline.(POLICY & PRACTICE)(Brief article)
September 1, 2007... A law requiring most U.S. citizens applying for Medicaid coverage to document their citizenship has caused eligible citizens to lose Medicaid coverage, and the law costs far more to administer than it saves, according to two government...

R.I. to begin information exchange.(POLICY & PRACTICE)(Brief article)
September 1, 2007... Rhode Island is one step closer to a health information system that will allow physicians to access patient health data from a variety of sources. The state has chosen Electronic Data Systems Corp. and its subcontractor, InterSystems Corp., to...

EMR adoption faces hurdles of time, cost.(Practice Trends)(electronic medical record)
September 1, 2007... SEATTLE -- Despite the government's push to encourage the development of the electronic medical record system, only a quarter of physicians keep medical records electronically, and only 11% of hospitals have fully implemented them, according to...

Pay-for-performance advocates acknowledge flaws: if not designed carefully, plans can warp physician behavior and fail to improve health care quality.(Practice Trends)
September 1, 2007... WASHINGTON -- If you're of the mind that the pay-for-performance plans instituted by federal as well as private payers are questionable at best and potentially dangerous at worst, don't worry: You're not alone. Many leaders of the...

Marketing on hold for Medicare Advantage plans.(Practice Trends)
September 1, 2007... Several Medicare Advantage fee-for-service plan sponsors have agreed to voluntarily suspend marketing of their plans until officials at the Centers for Medicare and Medicaid Services can verify that they are in compliance with certain...

Medicare private plans under pressure to improve.(Practice Trends)
September 1, 2007... WASHINGTON -- If competition drives prices down, why does the government pay private insurers more per patient than the Medicare program spends on the average beneficiary? That is the question on the minds of a growing number of people,...

Medicare may cover DNA stool screening test.(Practice Trends)
September 1, 2007... The Centers for Medicare and Medicaid Services is considering whether to add DNA stool testing as an alternative method of colorectal cancer screening, the agency announced in August. Exact Sciences holds the patent for the stool DNA...

Coverage expanded at ambulatory surgery centers.(Practice Trends)
September 1, 2007... Starting next year, federal health programs will cover any procedure performed at an ambulatory surgery center, with few but defined exclusions, according to final regulations released by the Centers for Medicare and Medicaid Services. The...

CMS proposes severity-adjusted inpatient device payments.(Practice Trends)
September 1, 2007... Under the just-proposed Medicare final inpatient payment rule for fiscal 2008, many procedures to implant medical devices would see substantial payment increases, a development that has physicians and surgeons cautiously applauding. A year...

Program improves advance planning at end of life.(Practice Trends)
September 1, 2007... HOLLYWOOD, FLA. -- Identifying nursing home residents with the greatest risk of dying, and offering them help with their advance planning, can improve the quality of care at the end of life, Dr. Cari R. Levy said at the annual symposium of the...

Doctor's (completely ignored) orders.(INDICATIONS)(Brief article)
September 1, 2007... "Yes, doctor, I've been taking all my meds, just like you said, and I still don't feel any better!" Ever heard that before? Next time, tell them to save their breath: A urine analysis by Ameritox, a toxicology laboratory based in Midland, Tex.,...