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News, opinions and meeting coverage in primary care.

Calif. Docs Among Top Billers for Complex Visits

Three California doctors are among the top five nationally in billing for the most complex office visits, according to data released by Medicare and analyzed by ProPublica and KQED.

AUA Offers Guidance for Kidney Stones

ORLANDO -- Treatment tailored to individual patient and stone characteristics provides the basis for an American Urological Association clinical guideline on medical management of kidney stones.

Enzyme Tx Durable for Peyronie's

ORLANDO -- Three-fourths of men with moderate to severe Peyronie's disease had meaningful improvement a year after treatment with an enzyme that dissolves scar tissue, investigators reported here.

Bone Drug No Help in Severe Gout

Bisphosphonate treatment failed to prevent the development of bone erosions in patients with longstanding tophaceous gout, a 2-year randomized study found.

Does Tylenol Protect Kidneys in Sepsis?

SAN DIEGO -- Acetaminophen (Tylenol) for severe sepsis patients improved renal function but gave mixed signals in terms of changes in the expected oxidative injury mechanism, researchers found in a pilot trial.

ICD-10 Follies: Falling From the Sky

The switch to the ICD-10 coding system may have been pushed back at least a year by Congress, but 麻豆传媒 still thinks it's worthwhile to spotlight some of those thousands of new codes that might just be getting a bit too granular.

'Bulletproof' Coffee May Hike Lipids

LAS VEGAS -- Spiking coffee with butter and coconut oil -- a concoction known as "bulletproof coffee" -- may be boosting hyperlipidemia in otherwise healthy patients, researchers said here.

FDA Slashes Starting Dose for Lunesta

SILVER SPRING, Md. -- Patients starting on the sleep drug eszopiclone (Lunesta) should take no more than 1 mg at bedtime -- one-third the current label-recommended dose -- because of the risk of next-day impairment, the FDA said Thursday.

'Thyroid' Issues May Really Be Hypothalamic

LAS VEGAS -- Obese patients who continue to have "thyroid symptoms" even when their levels are normalized may have a hypothalamic dysfunction, researchers reported here.

Shingle Risk High in Lupus, RA, COPD

Patients with autoimmune diseases and certain other chronic conditions are at increased risk for herpes zoster, a U.K. case-control study found.

Humira No Help for Arthritic Hands

Treatment of hand osteoarthritis with adalimumab (Humira) was unsuccessful, a randomized multicenter trial found.

Fewer False Positives With ECG for Young Athletes

SAN FRANCISCO -- When screening high school athletes for cardiac abnormalities, an electrocardiogram (ECG) interpreted using athlete-specific criteria had a lower false-positive rate than a history and physical examination, researchers found.

Leadless Pacing Shows Promise, But Hits Snags

SAN FRANCISCO -- Longer-term results from the first-in-man study of the Nanostim leadless pacemaker showed the device continued to work as expected, but a postmarketing study in Europe has been temporarily halted following reports of perforations and deaths.

Nasogastric Tube May Be Obsolete for GI Bleeds

CHICAGO -- Placement of a nasogastric tube for determining treatment of patients with upper gastrointestinal bleeding may be unnecessary since almost all these patients will eventually undergo an endoscopic procedure, researchers argued here.

Murder: Another Ambien Side Effect?

NEW YORK CITY -- Forensic psychiatrists are facing new challenges with murders committed by people under the influence of the sleep drug zolpidem (Ambien) -- not least to persuade the criminal justice system to take their conclusions seriously.

Depot Drug Keeps Schizophrenics Out of Jail

NEW YORK CITY -- Schizophrenia patients who had recently been released from jail were less likely to be rearrested or otherwise fail treatment when they took a depot antipsychotic drug in a randomized trial.

Aspirin: FDA Says 'No' Others Say 'Yes'

The FDA issued a message to consumers stating that the evidence does not support the "general" use of aspirin for the primary prevention of heart attacks and strokes.

MRI Helps ID Heart Risk in Scleroderma

LIVERPOOL -- Cardiac MRI could help provide diagnostic information about potential arrhythmogenic events among patients with scleroderma being considered for implantable cardioverter defibrillators, a researcher said here.

RA Patients Living a Decade Longer

LIVERPOOL -- Life expectancy among patients with rheumatoid arthritis has increased dramatically over the past 25 years, a researcher reported here.

FDA Panel Nixes OTC Singulair

Montelukast (Singulair) should not be allowed over-the-counter use for hay fever and other upper respiratory allergy symptoms, an FDA advisory panel recommended Friday.

Patients鈥� Eye Color a Clue to Pain Tolerance

TAMPA -- Caucasian women with light-colored eyes -- blue or green -- appear to tolerate pain better than Causcasian women with brown or hazel eyes, researchers reported here.

Humans Beat Stroke Scales for ICH Prognosis

PHILADELPHIA -- Physicians and nurses in stroke units more accurately predicted outcomes in patients with intracerebral hemorrhage (ICH) compared with common prognostic scales, a researcher reported here.

'Sensory Tricks' in Dystonia Examined

PHILADELPHIA -- The mystery of how "sensory tricks" adopted by patients to relieve symptoms of dystonia work is beginning to be unraveled, research presented here suggested.

APA Meeting Highlights Mental Health Biology

NEW YORK CITY -- The biological basis for normal and abnormal mental function is emerging as a dominant theme in psychiatry research, and the American Psychiatric Association annual meeting that starts here Saturday won't be an exception.

Top 5 Reasons Why Internists Are Sued

Not properly diagnosing a condition and nonmedical errors such as equipment failure accounted for more than half of the malpractice lawsuits against internists, a study found.

Prime Time: No Annual Exams? No Way, SGIM Members Say

SAN DIEGO -- A recommendation from the Society of General Internal Medicine (SGIM) to do away with annual checkups for asymptomatic adults evoked strong emotions in its membership.

CardioBuzz: Is Marijuana Bad for Your Heart?

Whether marijuana actually causes cardiovascular problems remains unclear, a situation that was not necessarily helped by a study based on 35 reports of cannabis-related complications in France, a country with about 1.2 million recreational users.

Hypoglycemia at Night Tied to Arrhythmias

Nocturnal hypoglycemia was a major risk factor for cardiac arrhythmias in type 2 diabetes patients who were already at an increased risk for cardiovascular events, according to British researchers.

How To Get Medicare To Cover A Spa Trip

Good news for doctors who think their patients need a trip to the spa: Medicare will reimburse, with only two catches.

Missed Doses Cripple Postop DVT Prevention

Missed doses of prophylactic anticoagulation account for much of the deep vein thrombosis that occurs in surgery and trauma patients, a study showed.

FDA Warns of Cancer Risk With Laparoscopic Device

WASHINGTON -- Hysterectomy and procedures to remove uterine fibroids should avoid use of laparoscopic power morcellation, according to a safety advisory from the Food and Drug Administration.

Simple, Short HCV Regimen Has High Cure Rate

LONDON -- A single pill once a day for 8 weeks is enough to cure more than 90% of hepatitis C virus patients with relatively uncomplicated disease, a researcher said.

Fatty Liver Tied to Diabetes, Atherosclerosis

LONDON -- Non-alcoholic fatty liver disease (NAFLD) is an independent predictor of both type 2 diabetes and carotid atherosclerosis, according to two studies presented here at the annual meeting of the European Association for the Study of the Liver.

Diet Rich in Beans, Lentils, Peas Lowers LDL

People who consumed a serving a day of dietary "pulses" -- beans, chickpeas, lentils, and peas -- significantly reduced their low-density lipoprotein cholesterol, a meta-analysis concluded.

White Boys More Likely to Be Color Blind

Color blindness is not colorblind, as it appears to afflict Caucasian boys at three times the rate of African-American boys, according to a new study.

Urine Test Can Uncover BP Med Adherence

A simple urine test might help clinicians figure out whether their patients aren't responding to antihypertensive therapy because of true resistance or because of nonadherence, a small study suggested.

Do Fat Teens Face an Early Death?

Life expectancy gains seen over the last half-century do not appear to extend to adults who were overweight or obese in adolescence, according to a large study spanning several decades.

FDA Panel Says Yes to Inhaled Insulin Device

HYATTSVILLE, Md. -- An FDA advisory panel has voted in favor of approving a new inhaled insulin device, Afrezza, as a short-acting treatment to improve glycemic control in both type 1 and type 2 diabetes.

How to Replace IV Nitroglycerin in the Shortage

What are the alternatives for IV nitroglycerin in the emergency setting as the shortage saps reserves? Several experts share their thoughts.

ACC: Gout Drug Tames the Heart

WASHINGTON -- Colchicine may be as effective at reducing multiple recurrences of pericarditis as it is in treating acute episodes and first recurrences.

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