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News, opinions and meeting coverage in primary care.

HTN May Halt Dementia in Very Elderly

COPENHAGEN -- Among individuals who developed hypertension at age 90 or later, their risk of also developing dementia was dramatically lower than other very elderly people whose blood pressure remained normal.

John West: The Doc at the Top of the World

Only one mountain pushes lungs to the absolute limit -- Mount Everest -- and only once has that limit been measured directly, by John B. West, MD, PhD, Dsc.

Friday Feedback: Zero-Tolerance Employment Smoking Bans?

Should hospitals, schools, and companies refuse to hire smokers for teachers and healthcare providers?

Now What? DEA Tosses Tramadol in Schedule IV

The Drug Enforcement Administration (DEA) scheduled tramadol as a Schedule IV substance -- whats the big fuss about tramadol that led to this decision by the DEA?

Staples or Sutures: Which Is Better After C-Section?

The decision to use sutures or staples to close incisions after a cesarean delivery has been debated in the obstetrics community, but results from a new study seem to give sutures the edge.

Arthritis Knee Pain Eased by Chinese Med

The traditional Chinese medicine practice of moxibustion was effective in reducing pain and improving function among patients with knee osteoarthritis, a randomized clinical trial found.

HIV Prophylaxis May Cut Herpes Risk

Drug therapy to prevent HIV infection also appeared to reduce the risk of catching another virus, herpes simplex 2, among heterosexual men and women, researchers reported.

FDA: Black Box Warning on Viscous Lidocaine for Teething

WASHINGTON -- Topical viscous lidocaine should not be used to treat infants' teething pain, the FDA said Thursday, emphasizing that teething pain generally needs no medicinal treatment.

FDA Panel Puts Brakes on Anti-PARP Drug

WASHINGTON -- Approval of a PARP inhibitor for patients with advanced ovarian cancer should await results of an ongoing clinical trial that has the potential to answer questions about the drug's safety and efficacy, according to an FDA advisory committee that voted against immediate approval.

Groups Want Gay Diagnoses Out of ICD-11

A WHO working group has recommended that diagnostic codes referencing homosexuality in ICD-10 be dropped from the forthcoming 11th edition, echoing policies of the leading U.S. psychiatry and psychology societies.

Estrogen Alone May Not Suppress Testosterone

CHICAGO -- Simply giving estrogen to male-to-female transgender patients won't completely suppress testosterone levels, researchers reported here.

FDA: No Clear Sign of Harm With Olmesartan in Diabetics

The evidence linking use of the angiotensin II receptor blocker (ARB) olmesartan in patients with diabetes and increased cardiovascular risk is not conclusive, according to a completed FDA safety review.

Obesity, T2D May Alter Gut Bacteria

CHICAGO -- The portfolio of gut bacteria in patients with obesity and type 2 diabetes may look different from that of healthy people, researchers reported here.

Learning How to Deal With Egos

Managing physicians need to take egos -- including their own -- into account when resolving conflicts among staff, says consultant Rosemarie Nelson.

PDE4 Inhibitor May Help PCOS Patients Slim Down

CHICAGO -- Adding the phosphodiesterase-4 inhibitor roflumilast to metformin may help obese women with polycystic ovarian syndrome shed pounds and improve other metabolic markers, researchers reported.

Heart Risk Higher in Sjogren's Patients

PARIS -- Patients with Sjogren's syndrome had more than double the heart attack risk seen in the general population, a researcher reported here.

Orencia Combo Tops in Early, Severe RA

PARIS -- In a study of patients with poor-prognosis early rheumatoid arthritis, more patients treated with abatacept (Orencia) plus methotrexate were in remission at 1 year than were those on methotrexate alone, a researcher reported here.

AMA Highlights: VA, Cheerleaders, and Guns

CHICAGO -- Wrapping up a full agenda, the AMA agrees cheerleading is a sport, doctors outside the VA need to pitch in to help care for veterans, and e-cigarettes need to be regulated.

AMA Clamps Down on MOC, But Punts on Gun Regs

CHICAGO -- The AMA鈥檚 House of Delegates drew the line on this year's hot button topic -- maintenance of certification (MOC), saying it should not be mandatory, nor should it be a condition of licensure.

Not Your Parent's School Nurse

Schools and health systems are forming partnerships to better integrate their services, and some school health professionals are gaining access to students' electronic health records.

AMA Mulls Gun Violence CME

CHICAGO -- As the AMA's House of Delegates was meeting in a downtown hotel here, 29 local residents were shot and four killed within a 10-mile radius.

Give Me That Old Time AMA

After an absence of a few years, I find myself back in Chicago for the AMA's annual meeting and discover that not much has changed.

ASCO: Myeloma Study Results Inconclusive

CHICAGO -- A trial comparing two immunomodulatory regimens for myeloma failed to demonstrate noninferiority for the newer drug.

Victoza Accused of Causing Pancreatitis

The watchdog group Public Citizen has conducted its own analysis of FDA adverse event reports and concluded that the type 2 diabetes drug liraglutide(Victoza) likely causes pancreatitis, the group said.

Lethal Injections, MOC, and E-Cigs on AMA Agenda

The American Medical Association is being asked to strengthen its ethical stance on physician participation in execution by extending its ban on doctors participating to include all health professionals.

ASCO: Combo Extends PFS in Relapsed Myeloma

CHICAGO -- Progression-free survival in relapsed/refractory myeloma increased significantly in patients treated with a three-drug regimen that included panobinostat versus a two-drug regimen, a randomized trial showed.

ASCO: Targeting PD-1 Works in Advanced Melanoma

CHICAGO -- Two studies indicate that using investigative immunotherapy drugs improves survival and response in patients with metastatic melanoma, researchers said here.

ASCO: Antibody Adds 6 Weeks to Squamous NSCLC Survival

CHICAGO -- The novel anti-EGFR monoclonal antibody necitumumab modestly improved survival in squamous non-small cell lung cancer (NSCLC) in a pivotal trial, but many called the effect too small to count.

Small eGFR Drops May Predict Kidney Outcomes

Declines in estimated glomerular filtration rate (eGFR) smaller than those that currently attract clinical attention may help predict the risk of end-stage renal disease, researchers reported.

ASCO: Targeted Combo Extends PFS in Ovarian Ca

CHICAGO -- Progression-free survival almost doubled in women with platinum-sensitive relapsed ovarian cancer treated with two targeted drugs instead of one, investigators reported here.

Dalfampridine: Not Just a Walking Aid

DALLAS -- Extended-release dalfampridine (Ampyra) is approved for boosting walking speed in multiple sclerosis patients, but its benefits extend to other aspects of physical function, according to a small study reported here.

CCSVI Practices Suboptimal but Patients Don't Mind

DALLAS -- Canadian multiple sclerosis patients who left the country to undergo the controversial procedure called chronic cerebrospinal venous insufficiency (CCSVI) often received poor pre- and postoperative care, but most were still relatively satisfied overall, a researcher reported here.

Real-Time Monitoring Cuts Cardiac Cath Radiation

LAS VEGAS -- A radiation detector that emits audible beeps might help interventional cardiologists and others in the cardiac catheterization laboratory reduce their exposure, researchers found.

Gastro Effects Dog Oral MS Drug Tecfidera

DALLAS -- Large proportions of patients starting on dimethyl fumarate (Tecfidera) for multiple sclerosis need additional medications to manage the drug's GI and other side effects, and a substantial minority ultimately find the drug intolerable.

MS Bladder Problems Show Up Early and Often

Nearly 80% of multiple sclerosis patients in a large registry reported overactive bladder symptoms, and one-third of a separate cohort of newly diagnosed patients also showed urinary dysfunction, researchers reported here.

Richard III: Shakespeare Blew It

Shakespeare got almost everything wrong about Richard III鈥檚 physical appearance.

'This Page Left Intentionally Blank'

Blank pages in correspondence from insurance companies are just an emblem of the endless waste and inefficiencies built into our healthcare system, says internist Fred Pelzman.

More Brain Bleeds With Stroke Drug in 'Real World鈥�

BOSTON -- Intracerebral hemorrhage was more common among patients receiving tissue plasminogen activator (tPA) in the real world compared with those in a clinical trial, a small, single-center study showed.

War Wounds: Hearing Loss Tracks Gulf War Vets

Battlefield wounds are often both life-threatening and life-changing, but when hearing is the casualty, the wound is too often undiagnosed or untreated, but a new initiative is underway to change tackle the silent wounds of war.

Vaccines and Biologics: Questions Remain

Vaccinations for patients with autoimmune diseases -- specifically patients being treated with biologics -- bring with them a variety of issues, including disease-specific, medication-related, and vaccine-associated factors, researchers suggested.

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