Family Practice News RSS feed: Current Issue. Family Practice News is an independent newspaper that provides the family physician with timely and relevant news and commentary about clinical developments in the field and about the impact of health care policy on the specialty and the physician's practice. To order this journal, and for more information, go to http://www.imng.com/ http://www.familypracticenews.com/?rss=yesElsevier Inc.en © 2010 Elsevier Inc. All rights reserved. Family Practice News0300-70734012July 2010 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.familypracticenews.com/article/PIIS0300707310707362/abstract?rss=yesA federal grant that has been sustaining a primary care safety net in and around New Orleans since hurricanes Katrina and Rita devastated the area in 2005 is set to expire in September, threatening the collapse of that system, according to health care providers in the region.New Orleans Primary Care Network Faces End of Funding, Oil SpillALICIA AULT10.1016/S0300-7073(10)70736-2Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XNews11http://www.familypracticenews.com/article/PIIS0300707310707374/abstract?rss=yesATLANTA — All adults with diabetes would receive hepatitis B vaccination, under a new proposal from an advisory group at the Centers for Disease Control and Prevention. The recommendation is based on new, unpublished CDC data revealing that adults with diabetes are more likely than those without the disease to be infected with the hepatitis B virus, along with other data suggesting that the problem may be associated with a lack of proper infection control at many health care facilities,ACIP Group: HBV Vaccination For All Adults With DiabetesSHARON WORCESTER10.1016/S0300-7073(10)70737-4Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XNews11http://www.familypracticenews.com/article/PIIS0300707310707386/abstract?rss=yes Major Finding: At 26 weeks, mean HbA1c values were 7.2% for exenatide, 7.7% for sitagliptin, and 7.4% for pioglitazone. From baseline to week 26, reduction in HbA1c with exenatide once weekly was significantly greater than with the other two drugs, 1.5 percentage points versus 0.9 for sitagliptin and 1.2 for pioglitazone.Once-Weekly Exenatide Cut HbA1c SignificantlyMIRIAM E. TUCKER10.1016/S0300-7073(10)70738-6Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XNews22http://www.familypracticenews.com/article/PIIS0300707310707398/abstract?rss=yesVital Signs: Top 10 U.S. Pharmaceutical Products by Sales in 200910.1016/S0300-7073(10)70739-8Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XNews22http://www.familypracticenews.com/article/PIIS0300707310707404/abstract?rss=yesThe fully human monoclonal antibody denosumab (Prolia) received Food and Drug Administration approval June 1 for the treatment of postmenopausal osteoporosis following the agency's fast-track review and request for resubmission of data.News From the FDAFrom staff reports10.1016/S0300-7073(10)70740-4Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XNews67http://www.familypracticenews.com/article/PIIS0300707310707416/abstract?rss=yesPresident Obama on June 25 signed into law a bill that replaces the 21% Medicare physician payment cut with a 2.2% pay raise for 6 months. The legislation (H.R. 3962) provides physicians with a 2.2% increase in their Medicare payments through Nov. 30. The change is retroactive to June 1, the date that the 21% cut officially went into effect. Officials at the Centers for Medicare and Medicaid Services held claims from June 1 to June 18 to give Congress time to reverse the cuts, but has been paying physicians at the lower rate since then.Medicare Pay Law Delivers 6-Month ReprieveMARY ELLEN SCHNEIDER10.1016/S0300-7073(10)70741-6Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XNews89http://www.familypracticenews.com/article/PIIS0300707310707428/abstract?rss=yesThe only large clinical trial to find that statins reduce mortality in patients taking them for primary prevention—a group that comprises 75% of statin users—was so seriously flawed that its conclusions were termed “clinically inconsistent” and invalid by one group of researchers and “extreme and exaggerated” by another, according to separate reports.Studies Dispute Statins Benefits for PreventionMARY ANN MOON10.1016/S0300-7073(10)70742-8Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XNews1011http://www.familypracticenews.com/article/PIIS030070731070743X/abstract?rss=yes MS. TAVENNER is acting administrator for the Centers for Medicare and Medicaid Services, which administers the Part D Medicare benefit and will be responsible for implementing many elements of the new health reform law. She previously served as secretary of health and human resources for Virginia.Closing Medicare's Doughnut HoleMARILYN TAVENNER10.1016/S0300-7073(10)70743-XFamily Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XImplementing Health Reform1212http://www.familypracticenews.com/article/PIIS0300707310707441/abstract?rss=yesI was glad to see the commentary by Dr. Lori Heim, president of the American Academy of Family Physicians, on nurse practitioners (Independent NPs Are Not the Answer,” Family Practice News, May 15, 2010, p. 8).LettersKeith Dinklage, David E. Hanson10.1016/S0300-7073(10)70744-1Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XOpinion1212http://www.familypracticenews.com/article/PIIS0300707310707453/abstract?rss=yesDENVER — Hiatal hernia is associated with sharply increased risk of atrial fibrillation, according to a large Mayo Clinic study. “The mechanism of the increased prevalence of atrial fibrillation in patients with hiatal hernia is not known but likely involves the direct mechanical effects of the hiatal hernia pressing on the left atrium or indirect effects through activation of the autonomic nervous system or inflammation,” Dr. Komandoor Srivathsan said at the meeting.Hiatal Hernia Upped Atrial Fibrillation RiskBRUCE JANCIN10.1016/S0300-7073(10)70745-3Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XCardiovascular Medicine1414http://www.familypracticenews.com/article/PIIS0300707310707465/abstract?rss=yesDENVER — Total annual pacemaker implantations in the United States will climb by 50% from the year 2010 level to 2027, while a 50% increase in implantable cardioverter defibrillator placements will occur by 2029, according to new mathematical modeling.Sharp Rise in Pacemaker Use Projected in Next 2 DecadesBRUCE JANCIN10.1016/S0300-7073(10)70746-5Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XCardiovascular Medicine1414http://www.familypracticenews.com/article/PIIS0300707310707477/abstract?rss=yesSAN ANTONIO — Six months of continuous positive airway pressure therapy markedly improved adverse left ventricular and atrial remodeling in patients with moderate to severe obstructive sleep apnea in a prospective study.CPAP Reversed Left Ventricular, Atrial RemodelingBRUCE JANCIN10.1016/S0300-7073(10)70747-7Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XCardiovascular Medicine1414http://www.familypracticenews.com/article/PIIS0300707310707489/abstract?rss=yes Major Finding: Allopurinol in patients with angina pectoris improved time to ST depression from 232 seconds at baseline to 249 seconds and 298 seconds in the placebo and treatment groups, respectively, for an absolute improvement of 43 seconds (19%).Allopurinol May Act as Anti-Ischemic in AnginaSHARON WORCESTER10.1016/S0300-7073(10)70748-9Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XCardiovascular Medicine1818http://www.familypracticenews.com/article/PIIS0300707310707490/abstract?rss=yesThe nonsteroidal anti-inflammatory drugs rofecoxib and diclofenac were linked to increased cardiovascular mortality and morbidity in a nationwide cohort of otherwise healthy Danish residents, while naproxen appeared to be associated with the least cardiovascular risk, researchers reported.Two NSAIDs Were Associated With Increase in Heart RisksDIANA MAHONEY10.1016/S0300-7073(10)70749-0Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XCardiovascular Medicine1818http://www.familypracticenews.com/article/PIIS0300707310707507/abstract?rss=yes Major Finding: Patients taking angiotensin receptor blockers had a significantly higher risk of new cancer occurrence (7.2%) than did patients not on ARBs (6.0%), with a risk ratio of 1.08.Angiotensin Receptor Blockers Tied to Ca RiskDIANA MAHONEY10.1016/S0300-7073(10)70750-7Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XCardiovascular Medicine2021http://www.familypracticenews.com/article/PIIS0300707310707519/abstract?rss=yesORLANDO — Intensive glycemic control did not reduce the risk for developing advanced measures of microvascular outcomes, although it did delay the onset of albuminuria and some measures of eye complications and neuropathy among patients with longstanding type 2 diabetes at high cardiovascular risk.Intensive Glycemic Control Did Not Reduce Microvascular End PointMIRIAM E. TUCKER10.1016/S0300-7073(10)70751-9Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMetabolic Disorders2626http://www.familypracticenews.com/article/PIIS0300707310707520/abstract?rss=yesORLANDO — A community-based lifestyle intervention program significantly reduced body weight and waist circumference and lowered fasting blood glucose levels at 1 year compared with usual care in a study of 301 adults with prediabetes.Community-Based Intervention Cut Blood Glucose LevelsMIRIAM E. TUCKER10.1016/S0300-7073(10)70752-0Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMetabolic Disorders2626http://www.familypracticenews.com/article/PIIS0300707310707532/abstract?rss=yes Major Finding: Nearly one-third of patients with diabetes who live in a hot climate (29%) did not initiate personal protective measures for self-management of their disease until temperatures reached 101°F, and 37% left their diabetes medications and supplies at home rather than risking them to heat exposure.Diabetic Patients Unaware of Heat's EffectDOUG BRUNK10.1016/S0300-7073(10)70753-2Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMetabolic Disorders2828http://www.familypracticenews.com/article/PIIS0300707310707544/abstract?rss=yes Major Finding: Subjects in the highest adiposity category had a two- to sixfold greater risk of incident diabetes than those in the lowest category.Weight, Fat Gain in Middle and Older Age Linked to DiabetesMARY ANN MOON10.1016/S0300-7073(10)70754-4Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMetabolic Disorders2828http://www.familypracticenews.com/article/PIIS0300707310707556/abstract?rss=yesA joint consensus statement from the American Diabetes Association and the American Cancer Society released June 16 reviews the current state of science regarding the complex relationship between diabetes and cancer.Joint Statement Addresses Diabetes-Cancer Link: Type 2 diabetes appears to increase risk of GI and breast cancer, but reduce risk of prostate cancer.MIRIAM E. TUCKER10.1016/S0300-7073(10)70755-6Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMetabolic Disorders2929http://www.familypracticenews.com/article/PIIS0300707310707568/abstract?rss=yesMedicare officials have temporarily increased payments for performing dual-energy x-ray absorptiometry, but osteoporosis experts say the boost isn't likely to make much of a difference in the number of physicians offering the service.DXA Access Concerns Remain Despite Payment IncreaseMARY ELLEN SCHNEIDER10.1016/S0300-7073(10)70756-8Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMetabolic Disorders2929http://www.familypracticenews.com/article/PIIS030070731070757X/abstract?rss=yesATLANTA — The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices voted at its June meeting to remove language from its meningococcal vaccine statement warning that a history of Guillain-Barré syndrome should be considered a “precaution” to administering meningococcal conjugate vaccines.GBS History, Meningococcal VaccinationSHARON WORCESTER10.1016/S0300-7073(10)70757-XFamily Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XInfectious Diseases3030http://www.familypracticenews.com/article/PIIS0300707310707581/abstract?rss=yesATLANTA — Children ages 6 months through 8 years who did not receive at least one dose of the 2009 influenza A(H1N1) monovalent vaccine during the 2009-2010 influenza season should receive two doses of a 2010-2011 seasonal influenza vaccine, which will include H1N1 coverage, according to a new recommendation from the Centers for Disease Control and Prevention.Seasonal Flu Vaccine Recs for Kids UpdatedSHARON WORCESTER10.1016/S0300-7073(10)70758-1Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XInfectious Diseases3031http://www.familypracticenews.com/article/PIIS0300707310707593/abstract?rss=yesORLANDO — Physicians will see more elderly people with HIV, because of both more new infections among the population and prolonged survival of people with HIV, according to a physician epidemiologist.Rising HIV in Older Adults Likely to ContinueDAMIAN McNAMARA10.1016/S0300-7073(10)70759-3Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XInfectious Diseases3333http://www.familypracticenews.com/article/PIIS030070731070760X/abstract?rss=yesWASHINGTON — Government incentives probably will be necessary to rejuvenate the drug development pipeline for antibiotics, Dr. Janet Woodcock, chief medical officer of the Food and Drug Administration, testified before a congressional committee.Incentives Called For to Fill Antibiotic PipelineDERRICK GINGERY10.1016/S0300-7073(10)70760-XFamily Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XInfectious Diseases3434http://www.familypracticenews.com/article/PIIS0300707310707611/abstract?rss=yesMONTREAL — Uptake of the human papillomavirus vaccination is too slow, say some experts, while others still question whether enough is known about the risk-benefit ratio to deem the vaccination truly necessary.Acceptance of HPV Vaccine Deemed Too LowKATE JOHNSON10.1016/S0300-7073(10)70761-1Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XInfectious Diseases3535http://www.familypracticenews.com/article/PIIS0300707310707623/abstract?rss=yes Major Finding: At least one novel influenza strain was discovered among swine tested during the height of the flu pandemic; neither antibodies from pandemic flu vaccine nor natural infection conferred protection against the novel strain in vitro.Pandemic Flu Reassortment Could Pose New ThreatDENISE NAPOLI10.1016/S0300-7073(10)70762-3Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XInfectious Diseases3535http://www.familypracticenews.com/article/PIIS0300707310707635/abstract?rss=yesSAN DIEGO — The scale that weighs risks and benefits tips more favorably for newly menopausal women who begin hormone therapy at age 50-59 years and who use it for 5 years, compared with women who start the therapy in their 60s, according to a systematic review of several studies and position statements.Timing Key in Balancing HT's Risks, BenefitsDOUG BRUNK10.1016/S0300-7073(10)70763-5Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XWomen's Health3636http://www.familypracticenews.com/article/PIIS0300707310707647/abstract?rss=yes Major Finding: Women who had menopause before the age of 46 were 2.1 times more likely to have a cardiovascular disease event later in life, compared with those who did not have early menopause.Menopause Before Age 46 Doubles CVD Risk Later in LifeDOUG BRUNK10.1016/S0300-7073(10)70764-7Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XWomen's Health3636http://www.familypracticenews.com/article/PIIS0300707310707659/abstract?rss=yesSAN ANTONIO — Women who snore frequently during pregnancy are at elevated risk for gestational diabetes mellitus, according to a case-control study. Although the risk is particularly high in obese snorers, snoring remained an independent risk factor for developing gestational diabetes mellitus (GDM) even after controlling for body mass index, reported Louise M. O'Brien, Ph.D.Snoring in Pregnancy Linked to Increased Gestational DiabetesBRUCE JANCIN10.1016/S0300-7073(10)70765-9Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XWomen's Health3737http://www.familypracticenews.com/article/PIIS0300707310707660/abstract?rss=yes DR. KOREN is a professor of pediatrics, pharmacology, pharmacy, medicine, and medical genetics at the University of Toronto. He heads the Research Leadership in Better Pharmacotherapy During Pregnancy and Lactation at the Hospital for Sick Children, Toronto, where he is director of the Motherisk Program. He also holds the Ivey Chair in Molecular Toxicology at the department of medicine, University of Western Ontario, London. He had no disclosures related to the topic of this column.Seafood SafetyGIDEON KOREN10.1016/S0300-7073(10)70766-0Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XDrugs, Pregnancy, and Lactation3737http://www.familypracticenews.com/article/PIIS0300707310707672/abstract?rss=yesNEW ORLEANS — Worrisome and clinically measurable metabolic changes can be seen in just 12 weeks among children and adolescents who received antipsychotic medications in a National Institutes of Health–sponsored study, prompting serious concern among clinicians who learned of the results at the meeting.Antipsychotic Drugs Spur Metabolic ChangesBETSY BATES10.1016/S0300-7073(10)70767-2Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMental Health3838http://www.familypracticenews.com/article/PIIS0300707310707684/abstract?rss=yesNEW ORLEANS — Proposed changes to the Diagnostic and Statistical Manual will likely put an end to separate diagnoses of substance “abuse” and “dependence,” distinctions that puzzled even addiction experts, members of the DSM-5 work group on substance-related disorders said at the meeting.DSM-5 May Change Categories on Substance UseBETSY BATES10.1016/S0300-7073(10)70768-4Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMental Health4343http://www.familypracticenews.com/article/PIIS0300707310707696/abstract?rss=yes Major Finding: Emergency department visits for nonmedical use of prescription analgesics more than doubled during 2004-2008.Emergency Physicians See More Nonmedical Opioid UseDIANA MAHONEY10.1016/S0300-7073(10)70769-6Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMental Health4343http://www.familypracticenews.com/article/PIIS0300707310707702/abstract?rss=yesA report from the American Academy of Pediatrics Task Force on Mental Health offers clinicians a comprehensive blueprint for improving delivery of mental health care services in pediatric settings.Resources Support Pediatric Mental HealthDOUG BRUNK10.1016/S0300-7073(10)70770-2Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMental Health4747http://www.familypracticenews.com/article/PIIS0300707310707714/abstract?rss=yesORLANDO — Primary care is a “ripe and rich environment” for youth suicide screening, and a new computer-based tool shows promise for identification of patients at risk, said Guy Diamond, Ph.D.A Web-Based Screening Tool Helps Gauge Suicide RiskDAMIAN McNAMARA10.1016/S0300-7073(10)70771-4Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMental Health4747http://www.familypracticenews.com/article/PIIS0300707310707726/abstract?rss=yesMADRID — Solar UV radiation may protect against melanoma of the vulva, a new international study suggests. This and other recent studies have demonstrated that UV radiation is a double-edged sword in melanoma, acting predictably as a well-established risk factor for cutaneous melanoma in susceptible individuals, while paradoxically decreasing the incidence of melanoma at non–sun-exposed sites, Dr. Isabel Longo reported.UV Exposure May Cut Vulvar Melanoma RiskBRUCE JANCIN10.1016/S0300-7073(10)70772-6Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XSkin Disorders4848http://www.familypracticenews.com/article/PIIS0300707310707738/abstract?rss=yes Major Finding: Percentage of participants doing skin self-exams at least monthly remained the same among those with a history of melanoma who were mutation carriers (73%) and doubled among unaffected mutation carriers (from 30% to 60%), but increased only slightly among noncarriers (from 38% to 44%).Genetic Testing Has Mixed Impact on Skin Self-ExamsSUSAN LONDON10.1016/S0300-7073(10)70773-8Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XSkin Disorders4848http://www.familypracticenews.com/article/PIIS030070731070774X/abstract?rss=yesCANCÚN, MEXICO — Osteoarthritis flares were reduced by 42% in patients who took 200 mg of celecoxib every day, compared with those who took the medication only when they experienced a disease flare, judging from randomized, placebo-controlled trial findings.Continuous Celecoxib Prevented OA Flares BestMICHELE G. SULLIVAN10.1016/S0300-7073(10)70774-XFamily Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMusculoskeletal Disorders5252http://www.familypracticenews.com/article/PIIS0300707310707751/abstract?rss=yes Major Finding: Osteophytosis was the dominant pathology in more than 3,700 hand joints examined by ultrasound in patients with hand OA.Hand OA Atlas Moves Scoring System ForwardCHRISTINE KILGORE10.1016/S0300-7073(10)70775-1Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMusculoskeletal Disorders5353http://www.familypracticenews.com/article/PIIS0300707310707763/abstract?rss=yes DR. PERROT is a professor of medicine and on the staff of the rheumatic pain clinic at Hôtel-Dieu Hospital, Paris. He has served as a speaker and consultant for Pierre Fabre Médicament.New Tool Streamlines Fibromyalgia ScreeningSERGE PERROT, Diana Mahoney10.1016/S0300-7073(10)70776-3Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XAsk the Expert5353http://www.familypracticenews.com/article/PIIS0300707310707775/abstract?rss=yesROME — The new ACR/EULAR criteria for diagnosing rheumatoid arthritis performed well, compared with two previously reported sets of criteria, in an early arthritis cohort of 736 people with early signs of synovitis or inflammatory tender joints, according to a report by Dr. Celina Alves.New RA Criteria Deemed Accurate, Easy to UseMITCHEL L. ZOLER10.1016/S0300-7073(10)70777-5Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMusculoskeletal Disorders5454http://www.familypracticenews.com/article/PIIS0300707310707787/abstract?rss=yesROME — Immunization with common vaccines is not associated with an increased risk for rheumatoid arthritis, nor does it trigger the autoimmune disease in individuals who have established risk factors, according to an analysis of data that was presented by Camilla Bengtsson.Common Vaccinations Do Not Raise RA RiskDIANA MAHONEY10.1016/S0300-7073(10)70778-7Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XMusculoskeletal Disorders5555http://www.familypracticenews.com/article/PIIS0300707310707799/abstract?rss=yes Major Finding: Treatment failure occurred in 10.9% of patients given high-dose IV steroids and 10.3% of those given low-dose oral steroids, a nonsignificant difference.Low-Dose Oral Steroids Work for Acute COPDMARY ANN MOON10.1016/S0300-7073(10)70779-9Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XPulmonary Medicine5656http://www.familypracticenews.com/article/PIIS0300707310707805/abstract?rss=yesBeta-blockers appeared to improve survival in chronic obstructive pulmonary disease and decreased the risk of exacerbations by nearly 30%, according to a recent report. Beta-blockers are known to improve survival in patients with a wide spectrum of cardiovascular diseases. But the benefits shown in an observational cohort study were surprising, the study investigators noted, because the drugs often are withheld in COPD patients because of fear they will promote bronchospasm and induce respiratory failure.Beta-Blockers May Boost COPD Survival RatesMARY ANN MOON10.1016/S0300-7073(10)70780-5Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XPulmonary Medicine5757http://www.familypracticenews.com/article/PIIS0300707310707817/abstract?rss=yesIn a cohort of more than 5,000 patients with a total of 755 colorectal polyps, 100% of malignancies were associated with polyps greater than or equal to 10 mm, Dr. Perry J. Pickhardt and his colleagues reported.Small Colorectal Polyps Show Low Malignancy RiskDENISE NAPOLI10.1016/S0300-7073(10)70781-7Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XDigestive Disorders5858http://www.familypracticenews.com/article/PIIS0300707310707829/abstract?rss=yesPatients who identified themselves as lactose intolerant recalled symptoms experienced at home as being much more severe than symptoms following a 50-gram lactose challenge, Dr. Francesc Casellas and colleagues reported.Patient Self-Report of Lactose Intolerance Found UnreliableDENISE NAPOLI10.1016/S0300-7073(10)70782-9Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XDigestive Disorders5858http://www.familypracticenews.com/article/PIIS0300707310707830/abstract?rss=yesIn guidelines, the American Society for Gastrointestinal Endoscopy is suggesting that blacks begin colonoscopy screening at age 45. It is a suggestion, not a recommendation, which would carry a greater weight, according to the ASGE's Standards of Practice Committee, which developed the guidelines (Gastrointest. Endosc. 2010;71:1108-11).Guidelines Suggest Colon Screening at Age 45 for BlacksALICIA AULT10.1016/S0300-7073(10)70783-0Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XDigestive Disorders5858http://www.familypracticenews.com/article/PIIS0300707310707842/abstract?rss=yes Major Finding: Of 76 patients who had unverified indications for a PPI, 11 were able to discontinue therapy without recurrence of symptoms during the 6 months of follow-up.PPIs Become ‘Addictive’ For Some GERD PatientsCAROLINE HELWICK10.1016/S0300-7073(10)70784-2Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XDigestive Disorders5959http://www.familypracticenews.com/article/PIIS0300707310707854/abstract?rss=yesNEW ORLEANS — More than 50 genetic risk factors for ulcerative colitis have now been identified by the International Inflammatory Bowel Disease Genetics Consortium, said John D. Rioux, Ph.D.Progress Made on Genetic Profile for Ulcerative ColitisCAROLINE HELWICK10.1016/S0300-7073(10)70785-4Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XDigestive Disorders5959http://www.familypracticenews.com/article/PIIS0300707310707866/abstract?rss=yes Major Finding: Patients with esophageal adenocarcinoma and esophagogastric junction adenocarcinoma were significantly less likely to have a history of H. pylori infection than population controls (odds ratios, 0.44 and 0.40, respectively).H. pylori May Protect Against Esophageal CancerDENISE NAPOLI10.1016/S0300-7073(10)70786-6Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XDigestive Disorders6464http://www.familypracticenews.com/article/PIIS0300707310707878/abstract?rss=yes Major Finding: Among patients taking proton pump inhibitors for at least 2 years, the risk of having a hip fracture was increased by 30%, but only when at least one other fracture risk factor (smoking, dementia, arthritis, visual impairment) was present. Among PPI users with none of these other risk factors, the odds ratio for fracture was 0.66.Hip Fracture Risk May Be Higher With Long-Term PPI UseDENISE NAPOLI10.1016/S0300-7073(10)70787-8Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XDigestive Disorders6464http://www.familypracticenews.com/article/PIIS030070731070788X/abstract?rss=yes Major Finding: In patients on the highest dose of phentermine plus controlled-release topiramate, systolic blood pressure reductions were significantly lower than with placebo: 3.4 mm Hg after 28 weeks in EQUATE, 3.8 mm Hg after 56 weeks in EQUIP, and 3.2 mm Hg after 56 weeks in CONQUER.Novel Weight-Loss Combo May Lower BPDAN HURLEY10.1016/S0300-7073(10)70788-XFamily Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XObesity6667http://www.familypracticenews.com/article/PIIS0300707310707891/abstract?rss=yes Major Finding: Fifty percent of American youths have no parks, community centers, and sidewalks in their neighborhoods. Only 17% of high school students are physically active.Chances for Exercise Are Few for SomeROBERT FINN10.1016/S0300-7073(10)70789-1Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XObesity6767http://www.familypracticenews.com/article/PIIS0300707310707908/abstract?rss=yes Major Finding: Inpatient hospital admission among high-risk patients randomized to a telephone-based diabetes care management program for 1 year decreased significantly from 1.029 per member per year to 0.774 per member per year.Phone Intervention Reduced Diabetes AdmissionsDOUG BRUNK10.1016/S0300-7073(10)70790-8Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XGeriatric Medicine6868http://www.familypracticenews.com/article/PIIS030070731070791X/abstract?rss=yes Major Finding: Among 52 elderly patients taking 12 or more drugs, 51 had drug combinations that could be dangerous.Dangerous Drug Combinations Common Among ElderlyMICHELE G. SULLIVAN10.1016/S0300-7073(10)70791-XFamily Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XGeriatric Medicine6868http://www.familypracticenews.com/article/PIIS0300707310707921/abstract?rss=yesSAN ANTONIO — The days when continuous positive airway pressure was the only arrow in the quiver for physicians targeting obstructive sleep apnea are long gone. The single most popular session at the meeting—the one whose overflow crowds brought out the fire marshals in full force—was devoted to alternatives to CPAP that have come of age: oral appliances; maxillofacial surgery; and weight loss through diet and exercise, bariatric surgery, or drugs.CPAP Alternatives Gaining Steam for Sleep Apnea: Suboptimal CPAP compliance is spurring greater use of oral appliances, maxillofacial surgery.BRUCE JANCIN10.1016/S0300-7073(10)70792-1Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XSleep Disorders7474http://www.familypracticenews.com/article/PIIS0300707310707933/abstract?rss=yesSAN ANTONIO — While obstructive sleep apnea is closely associated with obesity, not all the drugs being developed for the treatment of OSA are based upon weight loss as their mechanism of benefit.OSA Drugs No Longer Aim Only at Weight LossBRUCE JANCIN10.1016/S0300-7073(10)70793-3Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XSleep Disorders7575http://www.familypracticenews.com/article/PIIS0300707310707945/abstract?rss=yesSAN ANTONIO — Long-term use of gabapentin enacarbil for treatment of restless leg syndrome does not lead to the symptom augmentation that commonly occurs with dopaminergic agents, a study shows.Gabapentin Enacarbil Promising for Restless Legs SyndromeBRUCE JANCIN10.1016/S0300-7073(10)70794-5Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XSleep Disorders7575http://www.familypracticenews.com/article/PIIS0300707310707957/abstract?rss=yes Major Finding: One study found that men on active surveillance after a prostate cancer diagnosis are almost 19 times as likely to die from other causes as from prostate cancer over 10 years. Another study found that over 5 years, not a single man diagnosed with prostate cancer died of the disease while under active surveillance, and only 3% died of other causes.Studies Find Little Risk in ‘Watchful Waiting’ROBERT FINN10.1016/S0300-7073(10)70795-7Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XCancer7676http://www.familypracticenews.com/article/PIIS0300707310707969/abstract?rss=yes Major Finding: Gleason scores of 7 or higher were twice as common, 44% vs. 22%, in low-risk men who delayed radical prostatectomy compared with men who passed up active surveillance for immediate surgery, but many of the delayed surgeries were ordered after Gleason score reached 7 or higher on surveillance biopsies.Data Back Surveillance for Men at Low Prostate Cancer RiskRICHARD HYER10.1016/S0300-7073(10)70796-9Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XCancer7676http://www.familypracticenews.com/article/PIIS0300707310707970/abstract?rss=yesAutomated telephone reminders can increase colon cancer screening rates by 30%, according to a study from the Kaiser Permanente Center for Health Research. The study looked at nearly 6,000 patients who were overdue for screening. Half the patients received up to three reminder calls stressing the importance of screening. The phone calls also offered patients an in-home kit to detect blood in the stool. Within 6 months, more than 22% of people who received calls ordered and completed a stool card test, compared with only 16% of those who didn't receive the phone calls but may have been reminded of testing during a physician visit. Kaiser said it now uses the automated phone calls to remind all members who are overdue for colon cancer screening.Policy & Practice: Want more health reform news? Subscribe to our podcast – search ‘Policy & Practice’ in the iTunes storeJane Anderson10.1016/S0300-7073(10)70797-0Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XPractice Trends7878http://www.familypracticenews.com/article/PIIS0300707310707982/abstract?rss=yesPresident Obama announced the recess appointment of Dr. Donald Berwick to be the Administrator of the Centers for Medicare and Medicaid Services (CMS), bypassing what looked like a lengthy fight to have the nominee confirmed by the Senate.Recess Appointment Makes Berwick CMS ChiefAlicia Ault10.1016/S0300-7073(10)70798-2Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XPractice Trends7878http://www.familypracticenews.com/article/PIIS0300707310707994/abstract?rss=yesA new proposal from the Department of Health and Human Services aims to expand the rights of patients to choose who visits them at the hospital. The proposed rule, which was released last month, applies to all hospitals and critical access hospitals that participate in the Medicare and Medicaid programs. The proposal comes after President Obama issued a memorandum calling for new rules that would allow patients to pick who may and may not visit them. It also instructed HHS to ensure that hospitals are respecting patients' advance directives and giving patients' representatives the chance to be informed about and participate in care planning.Rule Expands Visiting Rights In HospitalsMARY ELLEN SCHNEIDER10.1016/S0300-7073(10)70799-4Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XPractice Trends7878http://www.familypracticenews.com/article/PIIS0300707310708008/abstract?rss=yes DR. SKOLNIK is associate director of the family medicine residency program at Abington (Pa.) Memorial Hospital. DR. NOTTE practices in Chalfont, Pa. They are partners in EHR Practice Consultants.Meaningful Use Criteria: What's MissingCHRISTOPER NOTTE, NEIL SKOLNIK10.1016/S0300-7073(10)70800-8Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XEHR Report8081http://www.familypracticenews.com/article/PIIS030070731070801X/abstract?rss=yesThe federal government published regulations in June that will allow for temporary certification of electronic health records—the first step in helping physicians and other providers get the software and hardware required to be eligible for bonus payments under federal health programs.EHR Rule Covers Certification, Meaningful UseALICIA AULT10.1016/S0300-7073(10)70801-XFamily Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XPractice Trends8282http://www.familypracticenews.com/article/PIIS0300707310708021/abstract?rss=yesCHICAGO — Frustration and concern about the lack of a permanent replacement for the Medicare Sustainable Growth Rate formula held center stage as the American Medical Association's legislative body met here.AMA to Seek Medicare Payment OptionSUSAN BIRK10.1016/S0300-7073(10)70802-1Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XPractice Trends8383http://www.familypracticenews.com/article/PIIS0300707310708033/abstract?rss=yesCHICAGO — Twenty percent of health insurance claims are processed inaccurately, according to the American Medical Association's third annual National Health Insurer Report Card, which rates the nation's largest commercial insurers on timeliness and accuracy of claims processing.AMA: Claims Process Now 80% AccurateSUSAN BIRK10.1016/S0300-7073(10)70803-3Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XPractice Trends8383http://www.familypracticenews.com/article/PIIS0300707310708045/abstract?rss=yes DR. TAN is professor of medicine and former adjunct professor of law at the University of Hawaii, Honolulu. This article is meant to be educational and does not constitute medical, ethical, or legal advice. It is adapted from the author's book, “Medical Malpractice: Understanding the Law, Managing the Risk” (2006). For additional information, readers may contact the author at siang@hawaii.edu.Liability of Supervising PhysiciansS.Y. TAN10.1016/S0300-7073(10)70804-5Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XLaw & Medicine8686http://www.familypracticenews.com/article/PIIS0300707310708057/abstract?rss=yesThe Agency for Healthcare Research and Quality has awarded $25 million in grants to states and health systems to test various approaches to medical liability reform. The grant awards follow through on a 2009 promise made by President Obama. In a speech to Congress last September, he pledged to fund demonstration projects that would look at malpractice reforms that also improve patient safety.AHRQ Gives Grants to Test Malpractice ReformsMARY ELLEN SCHNEIDER10.1016/S0300-7073(10)70805-7Family Practice News 40, 12 (2010)2010-07-01Family Practice News2010-07-014012S0300-7073(10)X7013-XPractice Trends8787