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 News0300-707340315 February 2010 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.familypracticenews.com/article/PIIS0300707310702590/abstract?rss=yesAlthough the barriers to children and adults receiving vaccines differ, experts agree that new strategies are desperately needed to address the lack of compliance with national immunization guidelines. Simply recommending that a group get immunized is clearly not getting the job done.Barriers Stymie Adult, Child ImmunizationJOYCE FRIEDEN10.1016/S0300-7073(10)70259-0Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9News17http://www.familypracticenews.com/article/PIIS0300707310702607/abstract?rss=yesSNOWMASS, COLO. — Serious questions exist about the safety and efficacy of the popular practice of high-dose vitamin D supplementation across a broad swath of the population. One of these concerns is that not all of the extra calcium absorption promoted by boosting vitamin D is going into bone to prevent fractures. Some of it may actually be taken up by atherosclerotic plaque, increasing the risk of cardiovascular events, Dr. Lenore M. Buckley cautioned at a symposium sponsored by the American College of Rheumatology.Skepticism Mounts on Need for Vitamin D SupplementationBRUCE JANCIN10.1016/S0300-7073(10)70260-7Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9News12http://www.familypracticenews.com/article/PIIS0300707310702619/abstract?rss=yesVital Signs: Medicaid Paid the Largest Portion of ADHD Costs in 200710.1016/S0300-7073(10)70261-9Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9News22http://www.familypracticenews.com/article/PIIS0300707310702620/abstract?rss=yesLarge group health plans must treat mental health and substance abuse services the same way they treat medical and surgical services under new government regulations that will take effect July 1.Mental Health Parity Goes Nationwide on July 1JANE ANDERSON10.1016/S0300-7073(10)70262-0Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9News44http://www.familypracticenews.com/article/PIIS0300707310702632/abstract?rss=yesThe Obama administration wants to combat waste, fraud, and abuse in the Medicare and Medicaid programs and plans to spend more than $500 million to do it. As part of the administration's budget proposal for fiscal year 2011, the Health and Human Services department is proposing to invest $561 million in discretionary funding to fight health care fraud, a $250 million increase over FY 2010. Specifically, the department plans to expand the Health Care Fraud Prevention and Enforcement Action Team (HEAT), which brings together high-level officials at HHS and the Department of Justice to spot trends and develop new fraud prevention tools.2011 Budget Proposal Would Expand Fraud PreventionMARY ELLEN SCHNEIDER10.1016/S0300-7073(10)70263-2Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9News44http://www.familypracticenews.com/article/PIIS0300707310702644/abstract?rss=yesA concentrated oral solution of morphine sulfate has been approved, rescuing a formulation that had been slated to be taken off the market last year until physician groups spoke up about its clinical utility and lack of equivalent products.News from the FDAFrom staff reports10.1016/S0300-7073(10)70264-4Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9News55http://www.familypracticenews.com/article/PIIS0300707310702656/abstract?rss=yes Dr. Pichichero, a specialist in pediatric infectious diseases, is director of the Rochester (N.Y.) General Research Institute. He serves as a consultant to GlaxoSmithKline and Merck & Co.Gardasil and Cervarix Are Not InterchangeableMICHAEL E. PICHICHERO10.1016/S0300-7073(10)70265-6Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Expert Commentary88http://www.familypracticenews.com/article/PIIS0300707310702668/abstract?rss=yesAlthough I don't disagree that there may be some undertreated chronic pain out there, prescription medication abuse, diversion, and misuse is such a huge problem in my practice and in the country as a whole that I feel we are on dangerous ground proclaiming that we are undertreating pain (“Report: Chronic Pain Is Public Health Problem,” Family Practice News, December 2009, p. 7).LettersRoger Hill, David A. Nardone10.1016/S0300-7073(10)70266-8Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Opinion88http://www.familypracticenews.com/article/PIIS030070731070267X/abstract?rss=yesIn a supplement supported by Daiichi-Sankyo (Case Study: Management Decisions in a Comorbid Patient With Type 2 Diabetes Having Primary Hyperlipidemia, January 2010, p. 13), the names of the American College of Endocrinology and the American Association of Clinical Endocrinologists were incorrect.Correction10.1016/S0300-7073(10)70267-XFamily Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Opinion88http://www.familypracticenews.com/article/PIIS0300707310702681/abstract?rss=yesSNOWMASS, COLO. — Optimal control of cardiovascular risk factors in diabetes patients in the community setting remains an elusive goal, according to the most recent data from the Framingham Heart Study.Framingham: CV Risks Still Plentiful in DiabetesBRUCE JANCIN10.1016/S0300-7073(10)70268-1Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Cardiovascular Medicine1010http://www.familypracticenews.com/article/PIIS0300707310702693/abstract?rss=yes Major Finding: Reducing salt by 3 g daily may reduce the annual new cases of coronary heart disease in the United States by 60,000 to 120,000, annual new cases of stroke by 32,000 to 60,000, and annual new cases of myocardial infarction by 54,000 to 99,000.Model Quantifies How Much to Cut Salt IntakeHEIDI SPLETE10.1016/S0300-7073(10)70269-3Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Cardiovascular Medicine1111http://www.familypracticenews.com/article/PIIS030070731070270X/abstract?rss=yesUp to a quarter of patients with diabetic retinopathy may also have unrecognized stenotic coronary artery disease, putting them at risk for heart attack or sudden cardiovascular death.Dual Clinic IDs Occult CAD in Diabetic Retinopathy PatientsMICHELE G. SULLIVAN10.1016/S0300-7073(10)70270-XFamily Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Cardiovascular Medicine1111http://www.familypracticenews.com/article/PIIS0300707310702711/abstract?rss=yes Major Finding: The prevalence of abnormal lipid levels is estimated to be 14% for normal weight, 22% for overweight, and 43% for obese youths aged 12-19 years.Abnormal Lipid Levels Put Many Youths at RiskJEFF EVANS10.1016/S0300-7073(10)70271-1Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Cardiovascular Medicine1111http://www.familypracticenews.com/article/PIIS0300707310702723/abstract?rss=yesSNOWMASS, COLO. — N-terminal pro–brain natriuretic peptide has a largely untapped potential for routine use in the office-based assessment of long-term risk in patients with chronic stable coronary artery disease.NT-proBNP May Have Predictive Value in CADBRUCE JANCIN10.1016/S0300-7073(10)70272-3Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Cardiovascular Medicine1212http://www.familypracticenews.com/article/PIIS0300707310702735/abstract?rss=yesSNOWMASS, COLO. — The large multicenter CABANA trial, which is now recruiting, may be the last and best chance to learn if maintaining sinus rhythm confers a survival advantage over rate control in patients with atrial fibrillation.Ablation for A Fib Trial RecruitingBRUCE JANCIN10.1016/S0300-7073(10)70273-5Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Cardiovascular Medicine1213http://www.familypracticenews.com/article/PIIS0300707310702747/abstract?rss=yes Major Finding: A majority (57%) of adults taking insulin for diabetes said they intentionally skipped an insulin injection occasionally and 20% did so regularly.Half of Adults With Diabetes Intentionally Skip Insulin InjectionsSHERRY BOSCHERT10.1016/S0300-7073(10)70274-7Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Metabolic Disorders1415http://www.familypracticenews.com/article/PIIS0300707310702759/abstract?rss=yes Major Finding: Hemoglobin A1c values below 7.5% were associated with increased all-cause mortality and cardiovascular events.Increased Mortality Seen With HbA1c Below 7.5%MIRIAM E. TUCKER10.1016/S0300-7073(10)70275-9Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Metabolic Disorders1616http://www.familypracticenews.com/article/PIIS0300707310702760/abstract?rss=yesThe Juvenile Diabetes Research Foundation has announced a partnership with Animas Corp. and DexCom Inc. to develop a first-generation automated system for managing type 1 diabetes.Partnership Forged to Design ‘Closed-Loop’ Insulin PumpMIRIAM E. TUCKER10.1016/S0300-7073(10)70276-0Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Metabolic Disorders1616http://www.familypracticenews.com/article/PIIS0300707310702772/abstract?rss=yes Major Finding: High-normal fasting plasma glucose levels in childhood may predict prediabetes and diabetes in young adulthood.Childhood Plasma Glucose May Predict Adult DiabetesMARY ANN MOON10.1016/S0300-7073(10)70277-2Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Metabolic Disorders1616http://www.familypracticenews.com/article/PIIS0300707310702784/abstract?rss=yesLeisure-time physical activity was linked to a decreased risk for type 2 diabetes in patients with vascular disease or poorly controlled risk factors, according to data from the ongoing Second Manifestations of Arterial Disease study in the Netherlands.Exercise Up, Diabetes Down in Vascular DiseaseJANE LOCASTRO10.1016/S0300-7073(10)70278-4Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Metabolic Disorders1717http://www.familypracticenews.com/article/PIIS0300707310702796/abstract?rss=yesThe U.K. medical journal the Lancet has taken the unusual step of withdrawing an article it published—a study of 12 children with behavioral disorders that developed following administration of vaccines or the onset of measles or otitis media.Lancet Withdraws Article on Vaccine's SafetyJOYCE FRIEDEN10.1016/S0300-7073(10)70279-6Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Infectious Diseases1819http://www.familypracticenews.com/article/PIIS0300707310702802/abstract?rss=yesSAN FRANCISCO — Antiretroviral medications may protect against heart attacks or increase cardiovascular risk, depending on the drug and the duration of use, recent studies suggest.Antiretrovirals May Increase Cardiovascular RiskSHERRY BOSCHERT10.1016/S0300-7073(10)70280-2Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Infectious Diseases2020http://www.familypracticenews.com/article/PIIS0300707310702814/abstract?rss=yesSAN FRANCISCO — People with HIV infection tend to have more risk factors for bone loss than do those without, and antiretroviral medications may be adding to that risk. The specific role of antiretroviral therapy in bone loss has been controversial: Some studies say there is no association, but others suggest that the drugs do contribute to bone loss.Antiretrovirals May Contribute to Bone Loss in HIV PatientsSHERRY BOSCHERT10.1016/S0300-7073(10)70281-4Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Infectious Diseases2020http://www.familypracticenews.com/article/PIIS0300707310702826/abstract?rss=yesSAN DIEGO — Nasopharyngeal flocked swabs are significantly more effective than nasopharyngeal aspirates for recovery of respiratory viruses, according to a nostril-to-nostril comparative study.Flocked Swabs Beat Aspiration for Virus RecoveryBRUCE JANCIN10.1016/S0300-7073(10)70282-6Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Infectious Diseases2525http://www.familypracticenews.com/article/PIIS0300707310702838/abstract?rss=yes Major Finding: Interval to treatment, First Nations ethnicity, and medical comorbidities independently predicted ICU admission for 2009 pandemic H1N1 influenza in Manitoba, Canada.Interval Between H1N1 Symptom Onset, Antiviral Treatment Affects ICU RiskMIRIAM E. TUCKER10.1016/S0300-7073(10)70283-8Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Infectious Diseases2525http://www.familypracticenews.com/article/PIIS030070731070284X/abstract?rss=yesThe National Vaccine Advisory Committee has endorsed a working group report concluding that no safety signals have been identified so far with the 2009 pandemic influenza A(H1N1) vaccine.Federal Panel Finds No Safety Signals With H1N1 VaccineMIRIAM E. TUCKER10.1016/S0300-7073(10)70284-XFamily Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Infectious Diseases2525http://www.familypracticenews.com/article/PIIS0300707310702851/abstract?rss=yesSAN DIEGO — Of the many cases of longitudinal melanonychia—a longitudinal brown-black discoloration of the nail plate—only a fraction are subungual melanomas. “With some of these you know they're going to require an extensive work-up or biopsy,” Dr. Arash Izadpanah said at a melanoma update sponsored by the Scripps Clinic. “Others are not so concerning, but it's not always intuitive whether these are benign or malignant.”ABCDEF Rule Guides Melanychia DiagnosisDOUG BRUNK10.1016/S0300-7073(10)70285-1Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Skin Disorders2627http://www.familypracticenews.com/article/PIIS0300707310702863/abstract?rss=yesFamilies USA is offering a free, downloadable consumer guide, “Your Medical Bills: A Consumer's Guide to Coping With Medical Debt.” The guide provides step-by-step advices for people who are overwhelmed by their medical bills. To download the guide, visit the Families USA Web site at www.familiesusa.org/assets/pdfs/medical-debt-guide.pdf.Guide to Coping With Medical Debt10.1016/S0300-7073(10)70286-3Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Skin Disorders2626http://www.familypracticenews.com/article/PIIS0300707310702875/abstract?rss=yesSAN DIEGO — Data on the estimated incidence of melanoma in the United States in 2010 from the National Cancer Institute's Surveillance, Epidemiology and End Results program will not be available until later this year, but Dr. Darrell S. Rigel does not expect the news to be good.Melanoma Incidence Expected to Rise This YearDOUG BRUNK10.1016/S0300-7073(10)70287-5Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Skin Disorders2829http://www.familypracticenews.com/article/PIIS0300707310702887/abstract?rss=yesMotivational interviewing can be an effective counseling technique for smoking cessation, particularly when it is delivered by a primary care physician, a review of intervention studies shows. However, the review results should be interpreted with caution, the authors wrote.Motivational Interviewing Might Help Smokers QuitDIANA MAHONEY10.1016/S0300-7073(10)70288-7Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Mental Health3031http://www.familypracticenews.com/article/PIIS0300707310702899/abstract?rss=yes Major Finding: African Americans were 60% less likely to receive pharmacotherapy and 40% less likely to receive psychotherapy than were non-Latino whites with depression. The results for receiving “any depression therapy” were 30% for Caribbean blacks vs. 54% for non-Latino whitesGaps Found in Depression Causes, TreatmentROBERT FINN10.1016/S0300-7073(10)70289-9Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Mental Health3232http://www.familypracticenews.com/article/PIIS0300707310702905/abstract?rss=yes Major Findings: The relative risk for depression after any cannabis use was 1.27, compared with nonusers, and 1.33 after use on 10 or more occasions.Depression Tends to Follow Cannabis Use, Not Vice VersaBETSY BATES10.1016/S0300-7073(10)70290-5Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Mental Health3232http://www.familypracticenews.com/article/PIIS0300707310702917/abstract?rss=yes Major Finding: The risk of pregnancy was 0.9% with ulipristal vs. 2.5% with levonorgestrel when women presented within 24 hours after unprotected intercourse.New Drug Effective for Emergency ContraceptionJENNIE SMITH10.1016/S0300-7073(10)70291-7Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Women's Health3333http://www.familypracticenews.com/article/PIIS0300707310702929/abstract?rss=yes Major Finding: The rates of teen pregnancy, birth, and abortion increased in 2006 after declining every year since 1990.Teen Pregnancy Rates Up by 3%ROBERT FINN10.1016/S0300-7073(10)70292-9Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Women's Health3434http://www.familypracticenews.com/article/PIIS0300707310702930/abstract?rss=yesWomen who are physically active at midlife, including those whose only exercise is walking, are more likely than sedentary women to have exceptionally good health in older age, according to an analysis of more than 2 decades of data from the Nurses' Health Study.Activity at Midlife Predicts Women's Health StatusMARY ANN MOON10.1016/S0300-7073(10)70293-0Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Women's Health3535http://www.familypracticenews.com/article/PIIS0300707310702942/abstract?rss=yes Major Finding: Six months of 70-minute aerobic exercise sessions three days per week significantly reduced the severity of menopausal symptoms while improving physical fitness.Aerobic Exercise May Cut Menopausal SymptomsSHERRY BOSCHERT10.1016/S0300-7073(10)70294-2Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Women's Health3535http://www.familypracticenews.com/article/PIIS0300707310702954/abstract?rss=yesWomen who used hormone therapy were more likely to need cataract surgery, a risk potentiated by drinking alcohol, a large Swedish prospective study found. In a 98-month study of 30,861 postmenopausal women, those who had ever used hormone therapy (HT) had a 14% higher risk for cataract extraction and current HT users had an 18% higher risk, compared with women who never used HT in a multivariate adjusted analysis, Dr. Birgitta Ejdervik Lindblad and her associates reported (Ophthalmology doi:10.1016/j.ophtha.2009.07.046).Hormone Therapy Associated With Need for Cataract SurgerySHERRY BOSCHERT10.1016/S0300-7073(10)70295-4Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Women's Health3535http://www.familypracticenews.com/article/PIIS0300707310702966/abstract?rss=yesGAITHERSBURG, MD. — Developers of targeted prostate cancer treatments should conduct randomized clinical trials with “watchful waiting” as a control, according to the Food and Drug Administration's Gastroenterology and Urology Devices Panel.Panel: Prostate Cancer Therapy Trials NeededJESSICA BYLANDER10.1016/S0300-7073(10)70296-6Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Men's Health3636http://www.familypracticenews.com/article/PIIS0300707310702978/abstract?rss=yes Dr. Skolnik is an associate director of the Family Medicine Residency Program at Abington (Pa.) Memorial Hospital. Dr. Neft is a second-year resident in the program. A handheld computer version of this guideline is available at www.redi-reference.com.Erectile DysfunctionNEIL S. SKOLNIK, EVAN E. NEFT10.1016/S0300-7073(10)70297-8Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Clinical Guidelines for Family Physicians3636http://www.familypracticenews.com/article/PIIS030070731070298X/abstract?rss=yesNew criteria for diagnosing rheumatoid arthritis should lead to earlier diagnoses, easier insurance coverage for treatment, and improved patient outcomes, agreed many rheumatologists. The new criteria are also likely to be adopted fairly quickly, experts added.RA Diagnostic Criteria Poised to Improve CareMITCHEL L. ZOLER10.1016/S0300-7073(10)70298-XFamily Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Musculoskeletal Disorders3838http://www.familypracticenews.com/article/PIIS0300707310702991/abstract?rss=yesBETHESDA, MD. — Colorectal cancer screening initiatives that use evidence-based interventions to target underscreened populations while encouraging use of the full range of screening options should be implemented to improve the use and quality of colorectal cancer screening, according to findings from a panel convened by the National Institutes of Health.Monitoring Needed for Colorectal Ca ScreeningJEFF EVANS10.1016/S0300-7073(10)70299-1Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Digestive Disorders4444http://www.familypracticenews.com/article/PIIS0300707310703005/abstract?rss=yesAn investigational immunoassay can accurately identify pancreatic cancer, potentially giving clinicians the ability to identify and treat the disease in its early stages, according to research presented at the American Society of Clinical Oncology's annual gastrointestinal cancer symposium.Immunoassay May Identify Early-Stage Pancreatic CancerKERRI WACHTER10.1016/S0300-7073(10)70300-5Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Digestive Disorders4444http://www.familypracticenews.com/article/PIIS0300707310703017/abstract?rss=yesSAN DIEGO — Patients whose chronic obstructive pulmonary disease was treated with tiotropium monotherapy had significantly fewer disease-related hospitalizations during a 12-month window than those on other long-acting bronchodilator regimens, a large national study shows.COPD Hospitalization Rate Low for TiotropiumBRUCE JANCIN10.1016/S0300-7073(10)70301-7Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Pulmonary Medicine4848http://www.familypracticenews.com/article/PIIS0300707310703029/abstract?rss=yesSANTA MONICA, CALIF. — Management of pulmonary hypertension in systemic sclerosis is inching its way toward a new age of prevention. The change is coming from the appreciation that the finding of exercise-induced pulmonary hypertension (PH) likely represents abnormal hemodynamic manifestation in patients with systemic sclerosis (SSc) who have normal resting mean pulmonary artery pressure. And that this finding may flag those patients who are most likely to benefit from early, aggressive treatment.Prevention Getting Closer for Pulmonary HypertensionSALLY KOCH KUBETIN10.1016/S0300-7073(10)70302-9Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Pulmonary Medicine4848http://www.familypracticenews.com/article/PIIS0300707310703030/abstract?rss=yes Major Finding: Obesity, whether measured by BMI, waist circumference, or waist-to-hips ratio, is an independent predictor of stroke risk regardless of sex or race.Obesity-Stroke Link Cuts Across Race, Sex LinesROBERT FINN10.1016/S0300-7073(10)70303-0Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Obesity5050http://www.familypracticenews.com/article/PIIS0300707310703042/abstract?rss=yesThe weight-loss drug sibutramine is now contraindicated in people with a history of cardiovascular disease, the Food and Drug Administration announced last month. The recommendation was based on a review of data indicating an increased risk of myocardial infarction and stroke is associated with the use of the drug in this population. On the same day, the European Medicines Agency (EMEA) announced that after its review of the same data, the EMEA's Committee for Medicinal Products for Human Use had recommended that the marketing of sibutramine be suspended in the European Union.CVD Contraindication Added to SibutramineELIZABETH MECHCATIE10.1016/S0300-7073(10)70304-2Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Obesity5151http://www.familypracticenews.com/article/PIIS0300707310703054/abstract?rss=yesIn chronic kidney disease, the risks of death, MI, and progression to kidney failure hinge on the presence and severity of proteinuria, regardless of the patient's estimated glomerular filtration rate, according to a large Canadian study.CKD Prognosis Hinges on Proteinuria Severity: Regardless of one's GFR, patients with heavy proteinuria were at high risk.MARY ANN MOON10.1016/S0300-7073(10)70305-4Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Urologic Disorders5252http://www.familypracticenews.com/article/PIIS0300707310703066/abstract?rss=yesSAN DIEGO — The more advanced the stage of chronic kidney disease, the greater the risk of developing congestive heart failure and subsequent risk of death, results from a large analysis of Medicare patients demonstrated.Kidney Disease Affects Risk Of Congestive Heart FailureDOUG BRUNK10.1016/S0300-7073(10)70306-6Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Urologic Disorders5252http://www.familypracticenews.com/article/PIIS0300707310703078/abstract?rss=yesORLANDO — American adults had a “surprisingly” high, 23% prevalence of chronic renal insufficiency in the late 1990s, according to data collected from nearly 2,000 randomly selected residents of Olmsted County, Minn.Chronic Renal Insufficiency Found in 23% of U.S. AdultsMITCHEL L. ZOLER10.1016/S0300-7073(10)70307-8Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Urologic Disorders5252http://www.familypracticenews.com/article/PIIS030070731070308X/abstract?rss=yes Major Finding: Fewer falls occurred after expedited surgery (76 out of 274 patients), compared with standard surgery (87 out of 271 patients), for an OR of 0.81; the result did not reach significance (CI 0.55-1.17).Expedited Cataract Surgery Doesn't Reduce FallsDENISE NAPOLI10.1016/S0300-7073(10)70308-XFamily Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Geriatric Medicine5757http://www.familypracticenews.com/article/PIIS0300707310703091/abstract?rss=yesFingolimod and cladribine, the first oral formulations for treating relapsing-remitting multiple sclerosis, proved effective in three phase III clinical trials. The two drugs have different mechanisms of action, but both target lymphocytes that are potentially autoaggressive against the CNS and both also are believed to promote neuroprotective and reparative processes. In separate multicenter, randomized, double-blind, placebo-controlled clinical trials, both oral medications reduced the rate of multiple sclerosis (MS) relapse, slowed the progression of disability, and decreased the number and severity of brain lesions on MRI.Oral Agents for Multiple Sclerosis Prove Effective: Discontinuation rates were low, but adverse event rates ranged from 8% to 14%.MARY ANN MOON10.1016/S0300-7073(10)70309-1Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Neurologic Disorders5858http://www.familypracticenews.com/article/PIIS0300707310703108/abstract?rss=yesA sustained-release formulation of the potassium channel blocker dalfampridine has been approved by the Food and Drug Administration as a treatment to improve walking in people with multiple sclerosis.FDA Approves First Drug to Improve Walking in MS PatientsElizabeth Mechcatie10.1016/S0300-7073(10)70310-8Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Neurologic Disorders5858http://www.familypracticenews.com/article/PIIS030070731070311X/abstract?rss=yes Major Finding: Children with autism spectrum disorders need careful GI evaluations, but there's no good evidence that they have unique gastrointestinal problems or benefit from restricted diets.Consensus: Evidence for Autism Diets LackingROBERT FINN10.1016/S0300-7073(10)70311-XFamily Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Neurologic Disorders5959http://www.familypracticenews.com/article/PIIS0300707310703121/abstract?rss=yesCHANDLER, ARIZ. — The idea of using suspended animation in trauma care was unthinkable just 5 years ago, but surgeons now stand at the cusp of the first clinical trial in humans.Hypothermia to Be Used in Resuscitation StudyPATRICE WENDLING10.1016/S0300-7073(10)70312-1Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Clinical Rounds6060http://www.familypracticenews.com/article/PIIS0300707310703133/abstract?rss=yes Dr. Lindenauer is director of the Center for Quality of Care Research at Baystate Medical Center, Springfield, Mass. He reported no conflicts of interest. Do hospitals that do better on discharge planning measures have lower rates of readmission than facilities that don't do as well? The question is critical, because readmissions have become emblematic of the problems inherent in the American health care system.Reexamining ReadmissionsPETER LINDENAUER10.1016/S0300-7073(10)70313-3Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Expert Commentary6161http://www.familypracticenews.com/article/PIIS0300707310703145/abstract?rss=yesOfficials at the Centers for Medicare and Medicaid Services recently released an initial set of pediatric quality measures that states can choose to use as part of their Medicaid and the Children's Health Insurance Programs.CMS: Use Pediatric Quality Measures for MedicaidMARY ELLEN SCHNEIDER10.1016/S0300-7073(10)70314-5Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Practice Trends6262http://www.familypracticenews.com/article/PIIS0300707310703157/abstract?rss=yesWhen Medicare managed care plans raise outpatient co-payments, they experience fewer outpatient visits but also more hospitalizations and longer inpatient stays, especially among chronically ill beneficiaries and those living in areas of poverty, a study showed.Hike in Visit Co-Payments Tied to More AdmissionsJANE ANDERSON10.1016/S0300-7073(10)70315-7Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Practice Trends6363http://www.familypracticenews.com/article/PIIS0300707310703169/abstract?rss=yesThe federal government has granted states and territories $119 million to reduce tobacco use, increase physical activity, and fight obesity, the Health and Human Services department announced.HHS Grants to States to Focus On Wellness, Anti-SmokingALICIA AULT10.1016/S0300-7073(10)70316-9Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Practice Trends6363http://www.familypracticenews.com/article/PIIS0300707310703170/abstract?rss=yesWant more health reform news? Subscribe to our podcast – search ‘Policy & Practice’ in the iTunes store Patients at “safety-net” clinics in New Orleans have fewer problems affording care and fewer instances of insufficient care than most U.S. adults, even though the clinic patients are disproportionately low-income and uninsured, the Commonwealth Fund reported. According to the group's researchers, this success indicates that the post-Katrina primary care program, which relies on a network of government-funded clinics, could serve as a national model for providing primary care to low-income groups. In a survey of the 27 New Orleans clinics, the nonprofit group found that clinic patients were much less concerned about affordability of care than were other U.S. adults and reported less medical debt and fewer unpaid medical bills. They also said they received more efficient care: Only 4% of clinic patients reported getting duplicate medical tests or being told results were delayed or missing, whereas studies of the general U.S. adult population have found that one-third of patients report such inefficiencies.Policy & PracticeJane Anderson10.1016/S0300-7073(10)70317-0Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Practice Trends6363http://www.familypracticenews.com/article/PIIS0300707310703182/abstract?rss=yesPhysicians in Montana may legally assist terminally ill patients in hastening death, according to a ruling by the Montana Supreme Court. The decision in the case of Baxter v. State of Montana concerned Robert Baxter, a retired truck driver from Billings, Mont., who was terminally ill with lymphocytic leukemia with diffuse lymphadenopathy. As a result of the disease and its treatment, Mr. Baxter suffered from symptoms including “infections, chronic fatigue and weakness, anemia, night sweats, nausea, massively swollen glands, significant ongoing digestive problems, and generalized pain and discomfort,” according to the decision.Montana Court Rules in Favor of Aid in DyingJOYCE FRIEDEN10.1016/S0300-7073(10)70318-2Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Practice Trends6465http://www.familypracticenews.com/article/PIIS0300707310703194/abstract?rss=yes DR. SCHETTLER is science director of the Science and Environmental Health Network and science adviser to Health Care Without Harm. He as no conflicts of interest. Physicians in private practice have a potentially large role to play in reducing medicine's impact on the environment. The opportunities to reduce your footprint are similar, whether you're running a large hospital or a small- to moderate-sized private practice.Greening Your PracticeTED SCHETTLER10.1016/S0300-7073(10)70319-4Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9The Office6666http://www.familypracticenews.com/article/PIIS0300707310703200/abstract?rss=yesU.S. hospitals have significantly improved the care they provide for patients with myocardial infarction, heart failure, and pneumonia, according to a report from the Joint Commission.Hospitals Score Well on MI, Heart Failure CareMARY ELLEN SCHNEIDER10.1016/S0300-7073(10)70320-0Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9Practice Trends6868http://www.familypracticenews.com/article/PIIS0300707310703212/abstract?rss=yesWhat started in 1986 as a bonfire and the spontaneous burning of a wooden man has evolved into a week-long camping event that attracts up to 50,000 people from around the globe each year. Dr. Marc S. Nelson has attended the Burning Man event for the past 10 years as one of three medical chiefs who serve the community of sculpture-building and sculpture-burning campers.Contributing to the BurnersDoug Brunk10.1016/S0300-7073(10)70321-2Family Practice News 40, 3 (2010)2010-02-15Family Practice News2010-02-15403S0300-7073(10)X7004-9The Rest of Your Life6969