CagA-Positive H. pylori Linked to Cerebral Ischemia

"Infection with Helicobacter pylori bearing cytotoxin-associated gene-A (CagA) appears to be associated with ischemic stroke and transient ischemia attacks, investigators in Germany report."

Patients More Worried About Clinician Relationship, Access to Care Than...

"Although medical errors that occur in clinic settings do not get the attention of a wrong-side surgery, studies show that they are the cause of more medical mistakes than those that take place in a hospital. Nevertheless, little is known about what kinds of errors actually occur in primary care settings and which mistakes or injuries are perceived to be most troublesome to patients.

Unlike physicians, who worry more about breakdowns in how medical information is transferred or whether treatment errors occur, patients are more concerned about breakdowns in the patient-clinician relationship and access to care, a new study finds."

There ya go. Start improving your manners!

GlycoMark Assay Reflects Glycemic Control

"The first U.S. trial of the GlycoMark assay, reported in the August issue of Diabetes Care, demonstrated that 1,5-anhydroglucitol (1,5-AG) levels are a good indicator of glycemic control. This assay has Food and Drug Administration (FDA) clearance for intermediate term monitoring. '1,5-Anhydroglucitol (1,5AG) is a major circulating polyol arising primarily from ingestion and excreted competitively with glucose,' write Janet B. McGill, MD, from the Washington University School of Medicine in St. Louis, Missouri, and colleagues. 'Japanese studies have demonstrated reduced concentrations of 1,5AG in serum in hyperglycemic patients in comparison with euglycemic subjects and a gradual normalization of 1,5AG values for patients responding to antihyperglycemic therapies.'"

Serum Uric Acid 'Strong Predictor' of Death in Middle-Aged Men

"In middle-aged men, elevated serum uric acid levels are a strong and independent predictor of death from cardiovascular disease (CVD) and all causes, according to results of a prospective cohort study published this week in the July 26th Archives of Internal Medicine. 'Despite abundant epidemiologic evidence, the role of elevated serum uric acid level as a cardiovascular risk factor is controversial,' Dr. Leo K. Niskanen from Kuopio University in Finland and colleagues write."

Diabetics Treated With Diet Only Have More Complications

"British general practitioners could do a lot better in their efforts to manage type 2 diabetic patients, say the authors of a study reported in the July 31st issue of The Lancet. Their cross-sectional study of 7870 patients with type 2 diabetes from 42 general practices showed that 31.3% were being managed with diet only. These patients had less rigorous monitoring than those taking drugs and more problems, such as poor glycaemic control and hypertension."

Carbohydrate/Protein Beverage Effects

"A carbohydrate beverage with additional protein calories produced significant improvements in time to fatigue and reductions in muscle damage in endurance athletes. Further research is necessary to determine whether these effects were the result of higher total caloric content of the CHO P beverage or due to specific protein-mediated mechanisms."

Not All ACE Inhibitors Have the Same Effect on Mortality

"Not all angiotensin-converting enzyme inhibitors (ACE-I) have the same effect on mortality, according to the results of a retrospective cohort study published in the July 20 issue of the Annals of Internal Medicine."

Treatment With Folate to Lower Homocysteine

"In general, a diet rich in fruits, vegetables, and low-fat dairy products as well as low in saturated and total fat can help to decrease serum homocysteine. For patients with known cardiovascular disease, it is generally recommended to treat with folic acid (1 mg/day), vitamin B6 (10 mg/day), and vitamin B12 (0.4 mg/day). Folic acid can be increased up to 5 mg/day to reach a goal of lowering homocysteine levels below 15 mmol/L. In patients refractory to 5 mg/day of folic acid, 750 mg twice daily of trimethylglycine have been used, but there are only limited data demonstrating efficacy.[1] It is known that trimethylglycine enhances the methylation metabolism of homocysteine."

Omalizumab: A Recombinant Humanized Anti-IgE Antibody for Allerg

"Omalizumab, a recombinant DNA-derived humanized monoclonal antibody, binds to the C?3 domain of immunoglobulin E (IgE) and forms complexes that inhibit the immune system's response to allergens by averting IgE-mediated inflammatory changes. Omalizumab exhibits a similar pharmacokinetic profile in adults, adolescents, and children. Omalizumab is indicated for adults and adolescents with moderate to severe persistent asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen and whose symptoms are inadequately controlled with inhaled corticosteroids."

Diet High in Fruit Fiber and Flavonoids May Prevent Chronic Cough

"A diet high in fruit fiber and soy products may reduce the incidence of respiratory symptoms such as productive cough, according to results of a prospective cohort study published in the August issue of the American Journal of Respiratory and Critical Care Medicine."

ACE Inhibitors Widely Underused for Heart Failure

"Almost one third of patients with left ventricular systolic dysfunction (LVSD) are not prescribed an angiotensin converting enzyme (ACE) inhibitor upon hospital discharge. As a result, investigators report in the August 10th issue of Circulation: Journal of the American Heart Association, these older patients are at higher risk of dying during the following year."

Cipro Helpful in Some Patients With Reactive Arthritis

"HLA-B27-positive patients who develop reactive arthritis (ReA) have improved long-term outcomes if treated with ciprofloxacin (Cipro) for three months at the onset of ReA, according to the results of a long-term follow-up study published in the September issue of the Annals of the Rheumatic Diseases."

Ankle Brachial Index Most Helpful to Diagnose PAD

"Lack of symptoms of patients with peripheral arterial disease (PAD) is more likely due to reduced function rather than lack of progression of disease, according to the results of a prospective cohort study published in the July 28 issue of JAMA. The investigators advocate checking the ankle brachial index (ABI) to make the diagnosis."

Acetaminophen Linked to Slight Decline in Renal Function

"Lifetime use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) did not cause a decline in renal function, but acetaminophen slightly increased risk, according to the results of an analysis from the Nurses' Health Study published in the July 26 issue of the Archives of Internal Medicine."

Have I gotten it all wrong? I thought NSAIDs (others) were known to cause Renal impairment

FDA Safety Labeling Changes: July 21, 2004

• Intravenous Fat Emulsions (Intralipid) May Cause Aluminum Toxicity in Patients With Impaired Kidney Function


• Metoclopramide Injection Associated With Neuroleptic Management Syndrome


• Abrupt Discontinuation of Tramadol HCl (Ultram) and Tramadol HCL/Acetaminophen