It may be appropriate to forgo dual-energy x-ray absorptiometry scanning and instead use body mass index to rule out osteoporosis in some obese patients, according to the findings of a large study presented by Dr. Thomas Nelson at the annual European Congress of Rheumatology. Our reporter, Heidi Splete, was able to sit down with Dr. Nelson to talk about the study results.
Tag Archives: Internal Medicine News
At the meeting, investigators reported that yoga can help reduce arrhythmia episodes in patients with atrial fibrillation, and improve their anxiety and depression. The study authors caution, however, that yoga is not a treatment for atrial fibrillation.
Has the day of reckoning for the U.S. dialysis entitlement finally arrived?
An article in today’s New York Times by Gina Kolata says it has, and to me it seems like it’s about time. Kolata’s report notes that a committee of nephrologists assembled by the Renal Physicians Association recently drew up guidelines on which patients are appropriate dialysis candidates from a medical perspective and which are not, a test that until now has often not been applied to patients with end-stage renal disease. The new guidelines call for physicians and patients to discuss the patient’s condition and arrive at a mutually agreed on decision as to whether dialysis is the right course of action.
One of their criteria: Physicians treating a patient should ask themselves whether, even with dialysis, the patient likely has a year to live.
As the Times article summarizes, in 1972 Congress made free dialysis a right for just about any American with failing kidneys. The program now includes 400,000 patients with an annual bill of $40-$50 billion, and with those older than 75 the fastest growing segment of the dialysis patient load. The 1972 law never anticipated a program of this scope, and at a time when Congress is haggling over whether the entire U.S. budget should get cut by $30 billion or $60 billion, a $45 billion program that has ballooned into a clinically questionable, medically-blind monster stands out. Aren’t there more pressing and cost-beneficial ways to spend America’s health care dollars than providing dialysis to all comers?
I have heard many cost-benefit analyses in my years as a medical journalist, and I never fail to be struck that the perennial benchmark is the quality-adjusted life years–the QALYs–that dialysis delivers. Since American society accepts the dialysis entitlement, any other treatment that delivers as much medical bang as dialysis for a buck is judged acceptable. Now, finally, American nephrologists have questioned the premise that underlies this benchmark.
—Mitchel Zoler (on Twitter @mitchelzoler)
New tools for molecular and genetic testing of cancer tumors could individualize cancer care and revolutionize cancer research, but only if more people start using them, according to Dr. Joseph R. Nevins of Duke University.
Dr. Nevin talked with our reporter, Sherry Boschert, about how molecular and genetic tools have the potential to speed cancer research and greatly improve cancer treatment, at a translational cancer medicine meeting sponsored by the American Association for Cancer Research.
We have the tools that can be applied to these clinical studies that in many instances will give us the capability to identify those patients who will benefit from from a drug and so start moving toward trials that select subgroups of patients for the study based on those molecular characteristics and greatly improve the chance of success of the clinical study.
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Roughly 8.7% of Americans aged 12 years or older used illicit drugs in 2009. That’s up 0.7% from 2008, according to the latest National Survey on Drug Use and Health. The rise was largely driven by an increase in marijuana use.
Physicans “can make sure that they screen for alcohol use and other drug use,” said Dr. Clark. In particular, he recommended becoming familiar with available screening tools, such as those that can be found at NIDAMed.