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News, opinions and meeting coverage in primary care.

Painful Speed Bumps? Could Be Appendicitis

Diagnostic uncertainty surrounding appendicitis could turn into a small bump in the road, according to a study showing a high correlation between appendicitis and pain on driving over speed bumps on the way to the hospital.

Amgen Agrees to Pay $762 Million in Aranesp Case

The biotech drug giant Amgen pled guilty Monday to promoting its blockbuster anemia drug darbepoetin alfa (Aranesp) for off-label dosing regimens, agreeing to pay $762 million in fines.

FDA: Booze and Xyrem Are Dangerous Mix

WASHINGTON -- The FDA is warning healthcare professionals that patients taking the muscle weakness and narcolepsy drug sodium oxybate (Xyrem) should not consume alcohol or use central nervous system depressants.

Pfizer Will Pay $55 Million in Off-Label Case

Pfizer subsidiary Wyeth has agreed to pay $55 million plus interest to settle allegations it promoted off-label use of the acid reflux drug pantoprazole (Protonix), the company and government officials announced.

Infection High in Myeloma, with High Mortality

ATLANTA -- More than a fifth of patients with multiple myeloma died of infection within a year of diagnosis, Swedish investigators reported here.

Oral Azacitidine Safe, Effective in Low-Risk MDS

ATLANTA -- Oral azacitidine (Vidaza) given for up to 21 days per 4-week cycle for myelodysplastic syndrome appeared safe and effective in patients with lower-risk disease, a researcher said here.

No Need for Skin Preps to Be Sterile, FDA Told

WASHINGTON -- Requiring that antiseptic skin preparation products be sterile is unnecessary and wouldn't lead to a dramatic drop in infections, speakers told the FDA Wednesday.

New Combo Replaces CHOP for Lymphoma

ATLANTA - The combination chemotherapy known as CHOP, used for nonHodgkin's lymphoma, is rapidly being replaced by bendamustine (Treanda), frequently combined with rituximab (Rituxan), researchers reported.

Parents at Risk After Child's Suicide

Parents who lose a child to suicide are at high risk for mental health problems and subsequent marital breakup, researchers found.

Children OK with Long-Term Exjade

ATLANTA -- Children with thalassemia and treated with the anti-iron overload drug deferasirox (Exjade) appear to tolerate the treatment for at least as long as 3 years while serum iron levels fell, researchers said here.

Statins May Slow Inflammatory Breast Cancer

SAN ANTONIO -- Inflammatory breast cancer grew significantly more slowly in women who had a history of treatment with statin drugs, findings from a large retrospective review showed.

Cardio Notes: Stress Test Finds Heart Disease in Seniors

Researchers are taking a second look at the accuracy of treadmill exercise testing for women over 65. Also this week, the birth of a subspecialty for adults with congenital heart disease and leg artery stenting.

Extended Apixaban Stops VTE Recurrence

ATLANTA -- Apixaban taken for an additional year after standard venous thromboembolism (VTE) treatment reduced recurrent events in a placebo-controlled trial, researchers said.

Polycythemia Vera Better with Low Hematocrit

ATLANTA -- Maintaining patients with polycythemia vera at hematocrit levels below 45% reduced thrombotic complications without increasing rates of other serious adverse events.

FDA Panel Gives Thumbs Down to Opioid

SILVER SPRING, Md. -- An FDA advisory committee voted 11-2 on Friday against recommending approval of a single-entity hydrocodone product, raising questions about its abuse potential.

Melanoma Tx Ups Survival, but Very Pricey

LAS VEGAS -- The oral BRAF inhibitor vemurafenib (Zelboraf) increased survival in patients with metastatic melanoma, but the cost may not justify its use in a state Medicaid program, an analysis suggested.

High-Dose Zofran Pulled From Market

WASHINGTON -- The 32-mg dose of the anti-nausea drug ondansetron (Zofran) has been pulled from the market because of concerns about cardiac problems, the FDA announced Tuesday.

Injector Pen May Ease Emergency Seizure Tx

SAN DIEGO -- An investigational pen-type injector for delivering intramuscular diazepam appeared safe and effective for home treatment of acute seizures, researchers said here.

Climbers Face Lasting Effects if Brain Swells

CHICAGO -- Extreme mountaineers who develop serious brain swelling at altitude appear to have lasting evidence of small hemorrhages in their brains, researchers said here.

TB No Barrier to Anti-TNF Treatment

WASHINGTON -- Patients being treated with tumor necrosis factor inhibitors who develop tuberculosis may safely reinstitute their biologic before completing the lengthy TB treatment regimen, a retrospective study suggested.

Enbrel Best for RA If Taken Over Long Term

WASHINGTON -- Most rheumatoid arthritis patients who achieve a state of low disease activity taking etanercept (Enbrel) fare better if they remain on therapy, even if only at a lower dose, a researcher reported here.

Food Allergies Cost Society a Bundle

ANAHEIM, Calif. -- The economic cost of food allergy in an average American child tops $4,000, with less than 20% of that attributable to direct medical expenses, a researcher said here.

Eating Before Lipid Test OK

It may not be necessary to fast before a routine cholesterol check, a large community-based population study suggested.

Combo Drug for Nasal Allergy Tops Single Tx

ANAHEIM, Calif. -- A nasal spray combining a corticosteroid and an antihistamine was better than either drug alone for relieving allergic rhinitis in a comparison with "real-world鈥� commercial products, a researcher said here.

Early Stroke Risk After Hip Replacement

Patients undergoing a total hip replacement appear to have an elevated risk of stroke in the weeks following the operation, researchers found.

FDA Panel Wary on Making Bladder Control Drug OTC

WASHINGTON -- An FDA advisory panel on Friday voted against recommending making oxybutynin transdermal patch (Oxytrol) available over-the-counter for overactive bladder in women.

AHA: No Excess Bleeding Risk with Dabigatran

LOS ANGELES -- Patients starting dabigatran (Pradaxa) did not have a higher risk of bleeding compared with new users of warfarin, according to a postmarketing data review by the FDA.

Fainting in PE Signals High Risk

ATLANTA -- Patients with pulmonary embolism brought to emergency rooms because they had passed out tended to have the most ominous risk factors for poor outcomes, a researcher said here.

Colon Cancer Risk Rises After Endometrial Ca

LAS VEGAS -- A history of endometrial cancer at a younger age quadrupled the likelihood of a subsequent diagnosis of colorectal cancer, a retrospective analysis of administrative data showed.

Drug Relieves Opioid-Induced Constipation

LAS VEGAS -- An investigational opioid antagonist provided effective and durable relief from opioid-induced constipation in patients with chronic pain without interfering with analgesia, a randomized trial showed.

Novel Drug Stars in Phase III PAH Trial

ATLANTA -- Macitentan, a next-generation endothelin receptor antagonist for pulmonary arterial hypertension, met its efficacy endpoint and was said to be well tolerated in a large clinical trial.

Child Booster Seat Laws Work

锘縉EW ORLEANS -- States that implemented booster seat laws saw a drop in serious injuries from motor vehicle crashes among children ages 4 to 8 during a recent 11-year period, researchers found.锘�

BP Drug Linked to Severe Diarrheal Illness

LAS VEGAS -- A patient's insightful question led to the identification of almost two dozen cases of severe enteropathy associated with use of blood pressure medication, investigators reported here.

Subjective Effects Drive COPD Outcomes

ATLANTA -- For patients with COPD, their own assessment of breathing problems is more predictive of outcomes than spirometry or doctor-diagnosed exacerbations, a researcher said here.

Cardio Notes: Sex Improves with Stenting

Opening the arteries of those with stable coronary disease also opens the door to an improved sex life. Also this week, bariatric surgery helps remodel the heart.

Watchdog Group Wants Black Box on BP Meds

WASHINGTON -- The consumer watchdog group Public Citizen petitioned the FDA to add a black box warning to three classes of hypertension drugs, cautioning against their combined use.

Working with Weights May Help Stroke Rehab

Resistance training -- which is often overlooked in stroke rehab -- may help improve thinking and memory in stroke survivors, researchers found.

Study Counters WHI on Risk of Hormones in Menopause

Hormone therapy may actually help the heart in some respects for newly menopausal women, a randomized trial showed, although the impact on hard outcomes like stroke and breast cancer still remains to be seen.

Pot Smokers Who Quit Find It Harder to Function

The more severe a person's marijuana withdrawal symptoms when they quit using the drug, the bigger the effect on their functional ability and the more likely they were to start using again, results of an Australian study showed.

Weight Gain After Bypass Not Affected by Diet

SAN ANTONIO -- Lifestyle factors -- including dietary intake, physical activity levels, and treadmill time -- were not predictive of weight regain from 2 to 6 years after Roux-en-Y gastric bypass, researchers found.

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