Lorinda Bullock

Patients who use blood glucose meters manufactured by Abbott Laboratories have been warned by the company to take caution and examine their display screens carefully if they have dropped the meters on a hard surface.

According to a statement from Abbott on Aug. 31, if any Precision Xtra, Optium, ReliOn Ultima, Rite Aid, or Kroger glucose monitors manufactured after Jan. 31, 2007, have been dropped on a hard surface, “part or all of the display screen may not work properly or may appear blank, which could result in an inability to view blood glucose test results.”

Abbott warns that the inability to view test results may cause serious risk for hypoglycemia or hyperglycemia. Glucose test strips used with the meters have not been affected by the recall, and no injuries have been reported to date.

Abbott has initiated a worldwide medical device correction for these particular meters, which are distributed through retail and mail-order pharmacies, in addition to notifying physicians, pharmacists, distributors, and registered users by letter.

Tama Donaldson, an Abbott spokeswoman, said approximately 330,000 users may be affected.

Ms. Donaldson emphasized that the Food and Drug Administration has not classified the meters for recall, but as a service to consumers the agency posted Abbott's statement on its “Recalls, Market Withdrawals and Safety Alerts” Web page (www.fda.gov/opacom/7alerts.html

Abbott is requesting that any users who have display screens that are not working properly immediately stop using the meters and call the Abbott Diabetes Care line (877-844-4404).

The company also recommends that users immediately perform a meter display check as directed in the user's guide if the meter drops on a hard surface.

Patients who use blood glucose meters manufactured by Abbott Laboratories have been warned by the company to take caution and examine their display screens carefully if they have dropped the meters on a hard surface.

According to a statement from Abbott on Aug. 31, if any Precision Xtra, Optium, ReliOn Ultima, Rite Aid, or Kroger glucose monitors manufactured after Jan. 31, 2007, have been dropped on a hard surface, “part or all of the display screen may not work properly or may appear blank, which could result in an inability to view blood glucose test results.”

Abbott warns that the inability to view test results may cause serious risk for hypoglycemia or hyperglycemia. Glucose test strips used with the meters have not been affected by the recall, and no injuries have been reported to date.

Abbott has initiated a worldwide medical device correction for these particular meters, which are distributed through retail and mail-order pharmacies, in addition to notifying physicians, pharmacists, distributors, and registered users by letter.

Tama Donaldson, an Abbott spokeswoman, said approximately 330,000 users may be affected.

Ms. Donaldson emphasized that the Food and Drug Administration has not classified the meters for recall, but as a service to consumers the agency posted Abbott's statement on its “Recalls, Market Withdrawals and Safety Alerts” Web page (www.fda.gov/opacom/7alerts.html

Abbott is requesting that any users who have display screens that are not working properly immediately stop using the meters and call the Abbott Diabetes Care line (877-844-4404).

The company also recommends that users immediately perform a meter display check as directed in the user's guide if the meter drops on a hard surface.

Patients who use blood glucose meters manufactured by Abbott Laboratories have been warned by the company to take caution and examine their display screens carefully if they have dropped the meters on a hard surface.

According to a statement from Abbott on Aug. 31, if any Precision Xtra, Optium, ReliOn Ultima, Rite Aid, or Kroger glucose monitors manufactured after Jan. 31, 2007, have been dropped on a hard surface, “part or all of the display screen may not work properly or may appear blank, which could result in an inability to view blood glucose test results.”

Abbott warns that the inability to view test results may cause serious risk for hypoglycemia or hyperglycemia. Glucose test strips used with the meters have not been affected by the recall, and no injuries have been reported to date.

Abbott has initiated a worldwide medical device correction for these particular meters, which are distributed through retail and mail-order pharmacies, in addition to notifying physicians, pharmacists, distributors, and registered users by letter.

Tama Donaldson, an Abbott spokeswoman, said approximately 330,000 users may be affected.

Ms. Donaldson emphasized that the Food and Drug Administration has not classified the meters for recall, but as a service to consumers the agency posted Abbott's statement on its “Recalls, Market Withdrawals and Safety Alerts” Web page (www.fda.gov/opacom/7alerts.html

Abbott is requesting that any users who have display screens that are not working properly immediately stop using the meters and call the Abbott Diabetes Care line (877-844-4404).

The company also recommends that users immediately perform a meter display check as directed in the user's guide if the meter drops on a hard surface.

A Food and Drug Administration advisory panel has recommended that raloxifene be approved to reduce the risk of invasive breast cancer in postmenopausal women who have osteoporosis or who are at high risk of breast cancer.

The Oncologic Drugs Advisory Committee on July 24 recommended approval of raloxifene, a selective estrogen receptor modulator. The drug was originally approved by the FDA in 1997 to prevent and treat osteoporosis in postmenopausal women.

More than 52 million prescriptions for raloxifene have been filled since its approval, according to a statement from Eli Lilly and Company, which markets the drug as Evista.

Using data gathered from 37,000 postmenopausal women over a 10-year period, Eli Lilly submitted a new drug application to the FDA in 2006 to extend the drug's use to reducing breast cancer risk in this same group of patients.

If approved, Evista would be the “first and only therapy available to address two leading health issues for postmenopausal women—osteoporosis and breast cancer,” Gwen Krivi, Ph.D., vice president of Lilly Research Laboratories, said in a written statement.

Although the committee voted to approve the indication for breast cancer risk reduction in postmenopausal women with osteoporosis (8 to 6) and in postmenopausal women at high risk for breast cancer (10 to 4), the agency is not obligated to approve these new indications.

The advisory committee reviewed four large studies also submitted in the application: The Study of Tamoxifen and Raloxifene (STAR) trial; Raloxifene Use for the Heart (RUTH) trial; Multiple Outcomes of Raloxifene Evaluation (MORE); and the Continuing Outcomes Relevant to Evista (CORE) trials.

Dr. Wulf Utian, executive director of the North American Menopause Society, said in an interview that the advisory committee's decision was a positive step that “increases the [number] of products available as potential reducers of breast cancer.”

Currently, tamoxifen is the only other drug that is indicated for the reduction of breast cancer incidence in women at high risk for the disease.

Dr. Utian said the recommendation to approve raloxifene for the two new indications comes at a good time, because tamoxifen sales and use have been “disappointing” because of various side effects and particularly because of the drug's association with an increased risk of uterine cancer.

Both doctors and patients may be more accepting of raloxifene, because it is already a well-known product for osteoporosis in postmenopausal patients, and its added benefit of reducing breast cancer would make it a viable alternative to tamoxifen for these women, he said.

When the RUTH study was published, it raised some concerns about risk of death from stroke and the incidence of blood clots associated with raloxifene use (N. Engl. J. Med. 2006;355:125–37).

Marcia Stefanick, Ph.D., from Stanford (Calif.) University, wrote in an accompanying editorial: “What level of breast cancer risk would justify the use of raloxifene for the prevention of breast cancer for a given person, if one takes into account the competing risks and patient preferences? Complicating the answer is our inability to predict these risks with high accuracy on an individual basis” (N. Engl. J. Med. 2006;355:190–2).

Dr. Utian said the prevalence of both stroke and venous thromboembolism increases with age, but most of the women who would start taking tamoxifen or raloxifene for prevention would do so at a younger age, when both the prevalence and absolute risk for these adverse events would be lower. Dr. Utian disclosed that he serves as a consultant to various pharmaceutical companies, including Eli Lilly and some of its competitors.

A Food and Drug Administration advisory panel has recommended that raloxifene be approved to reduce the risk of invasive breast cancer in postmenopausal women who have osteoporosis or who are at high risk of breast cancer.

The Oncologic Drugs Advisory Committee on July 24 recommended approval of raloxifene, a selective estrogen receptor modulator. The drug was originally approved by the FDA in 1997 to prevent and treat osteoporosis in postmenopausal women.

More than 52 million prescriptions for raloxifene have been filled since its approval, according to a statement from Eli Lilly and Company, which markets the drug as Evista.

Using data gathered from 37,000 postmenopausal women over a 10-year period, Eli Lilly submitted a new drug application to the FDA in 2006 to extend the drug's use to reducing breast cancer risk in this same group of patients.

If approved, Evista would be the “first and only therapy available to address two leading health issues for postmenopausal women—osteoporosis and breast cancer,” Gwen Krivi, Ph.D., vice president of Lilly Research Laboratories, said in a written statement.

Although the committee voted to approve the indication for breast cancer risk reduction in postmenopausal women with osteoporosis (8 to 6) and in postmenopausal women at high risk for breast cancer (10 to 4), the agency is not obligated to approve these new indications.

The advisory committee reviewed four large studies also submitted in the application: The Study of Tamoxifen and Raloxifene (STAR) trial; Raloxifene Use for the Heart (RUTH) trial; Multiple Outcomes of Raloxifene Evaluation (MORE); and the Continuing Outcomes Relevant to Evista (CORE) trials.

Dr. Wulf Utian, executive director of the North American Menopause Society, said in an interview that the advisory committee's decision was a positive step that “increases the [number] of products available as potential reducers of breast cancer.”

Currently, tamoxifen is the only other drug that is indicated for the reduction of breast cancer incidence in women at high risk for the disease.

Dr. Utian said the recommendation to approve raloxifene for the two new indications comes at a good time, because tamoxifen sales and use have been “disappointing” because of various side effects and particularly because of the drug's association with an increased risk of uterine cancer.

Both doctors and patients may be more accepting of raloxifene, because it is already a well-known product for osteoporosis in postmenopausal patients, and its added benefit of reducing breast cancer would make it a viable alternative to tamoxifen for these women, he said.

When the RUTH study was published, it raised some concerns about risk of death from stroke and the incidence of blood clots associated with raloxifene use (N. Engl. J. Med. 2006;355:125–37).

Marcia Stefanick, Ph.D., from Stanford (Calif.) University, wrote in an accompanying editorial: “What level of breast cancer risk would justify the use of raloxifene for the prevention of breast cancer for a given person, if one takes into account the competing risks and patient preferences? Complicating the answer is our inability to predict these risks with high accuracy on an individual basis” (N. Engl. J. Med. 2006;355:190–2).

Dr. Utian said the prevalence of both stroke and venous thromboembolism increases with age, but most of the women who would start taking tamoxifen or raloxifene for prevention would do so at a younger age, when both the prevalence and absolute risk for these adverse events would be lower. Dr. Utian disclosed that he serves as a consultant to various pharmaceutical companies, including Eli Lilly and some of its competitors.

A Food and Drug Administration advisory panel has recommended that raloxifene be approved to reduce the risk of invasive breast cancer in postmenopausal women who have osteoporosis or who are at high risk of breast cancer.

The Oncologic Drugs Advisory Committee on July 24 recommended approval of raloxifene, a selective estrogen receptor modulator. The drug was originally approved by the FDA in 1997 to prevent and treat osteoporosis in postmenopausal women.

More than 52 million prescriptions for raloxifene have been filled since its approval, according to a statement from Eli Lilly and Company, which markets the drug as Evista.

Using data gathered from 37,000 postmenopausal women over a 10-year period, Eli Lilly submitted a new drug application to the FDA in 2006 to extend the drug's use to reducing breast cancer risk in this same group of patients.

If approved, Evista would be the “first and only therapy available to address two leading health issues for postmenopausal women—osteoporosis and breast cancer,” Gwen Krivi, Ph.D., vice president of Lilly Research Laboratories, said in a written statement.

Although the committee voted to approve the indication for breast cancer risk reduction in postmenopausal women with osteoporosis (8 to 6) and in postmenopausal women at high risk for breast cancer (10 to 4), the agency is not obligated to approve these new indications.

The advisory committee reviewed four large studies also submitted in the application: The Study of Tamoxifen and Raloxifene (STAR) trial; Raloxifene Use for the Heart (RUTH) trial; Multiple Outcomes of Raloxifene Evaluation (MORE); and the Continuing Outcomes Relevant to Evista (CORE) trials.

Dr. Wulf Utian, executive director of the North American Menopause Society, said in an interview that the advisory committee's decision was a positive step that “increases the [number] of products available as potential reducers of breast cancer.”

Currently, tamoxifen is the only other drug that is indicated for the reduction of breast cancer incidence in women at high risk for the disease.

Dr. Utian said the recommendation to approve raloxifene for the two new indications comes at a good time, because tamoxifen sales and use have been “disappointing” because of various side effects and particularly because of the drug's association with an increased risk of uterine cancer.

Both doctors and patients may be more accepting of raloxifene, because it is already a well-known product for osteoporosis in postmenopausal patients, and its added benefit of reducing breast cancer would make it a viable alternative to tamoxifen for these women, he said.

When the RUTH study was published, it raised some concerns about risk of death from stroke and the incidence of blood clots associated with raloxifene use (N. Engl. J. Med. 2006;355:125–37).

Marcia Stefanick, Ph.D., from Stanford (Calif.) University, wrote in an accompanying editorial: “What level of breast cancer risk would justify the use of raloxifene for the prevention of breast cancer for a given person, if one takes into account the competing risks and patient preferences? Complicating the answer is our inability to predict these risks with high accuracy on an individual basis” (N. Engl. J. Med. 2006;355:190–2).

Dr. Utian said the prevalence of both stroke and venous thromboembolism increases with age, but most of the women who would start taking tamoxifen or raloxifene for prevention would do so at a younger age, when both the prevalence and absolute risk for these adverse events would be lower. Dr. Utian disclosed that he serves as a consultant to various pharmaceutical companies, including Eli Lilly and some of its competitors.

Many pediatricians and family physicians are not following recommended guidelines on the management of acute otitis media set by their professional organizations, results from a survey suggest.

Dr. Louis Vernacchio of the Slone Epidemiology Center at Boston University and his colleagues found while many pediatricians and family physicians believe the observation method–recommended by the American Academy of Pediatrics and American Academy of Family Physicians–is reasonable, they only used that method in 15% of the cases they diagnosed.

Even though acute otitis media (AOM) is considered “one of the most common illnesses for which children are brought to physicians,” and other studies have shown “the concept of initial observation without antibiotic treatment has been adopted as standard practice in some parts of the world,” AOM continues to be a management challenge for primary care providers, the researchers wrote.

According to the academies' 2004 clinical practice guideline, “Diagnosis and Management of Acute Otitis Media,” observation is an option for children 2 years and older with nonsevere symptoms or uncertain diagnosis and for those aged 6 months to 2 years old with both nonsevere symptoms and an uncertain diagnosis. The guideline was a joint response from the two organizations as a result of the established international acceptance of the observation method and because “the widespread emergence of antimicrobial resistance has increased the urgency to reduce antibiotic use,” Dr. Vernacchio and his associates said.

From a 2006 survey by mail or fax completed by 299 pediatricians or family physicians from the Slone Center Office Research (SCOR) Network, the researchers found that the proportion of physicians accepting the concept of the observation option actually decreased slightly from 88% in 2004 to 83% in 2006 (Pediatrics 2007 Aug. [Epub doi:10.1542/peds.2006-3601

The SCOR Network of physicians represents physicians who practice in private and community settings in 42 U.S. states. The participating physicians were surveyed twice–once after the publication of the guidelines in 2004 and then 18 months later (March-June 2006). Of the 299 physicians participating in the 2006 survey, 207 responded to the 2004 survey.

Pediatricians (compared with family physicians), suburban and urban non-inner city practices, and younger physicians were more accepting of the observation method.

Despite the small number of physicians using the observation method regularly, the researchers discovered that the physicians overall were more willing to follow the academies' antibiotic recommendations.

A little more than half (57%) of the physicians agreed with the guideline dosages and antibiotics used to treat nonsevere AOM, and 43% agreed that high doses of amoxicillin-clavulanate (80-90 mg/kg per day) were appropriate for severe cases (moderate to severe otalgia or fever of 39° C or higher) that failed amoxicillin. But once again, the researchers discovered the number of physicians agreeing with the guideline in comparison to 2004 has decreased as physicians found alternative treatments or dosages.

For example, only 17% of physicians administered the recommended intramuscular ceftriaxone for cases that failed the recommended high doses of amoxicillin-clavulanate, while increasing numbers of physicians are choosing to treat with oral antibiotic alternatives such as cefdinir (52%) or azithromycin (16%).

The survey also revealed a growing trend of physicians opting to treat with a standard dose of amoxicillin (40-45 mg/kg per day). In 2004, the number of physicians treating nonsevere AOM with a standard dose of amoxicillin was 22%; in 2006, that number jumped to 33%. The researchers surmise this trend could be attributed to recent data that “widespread use of the heptavalent pneumococcal conjugate vaccine has reduced the circulation of penicillin-resistant Streptococcus pneumoniae in some communities.”

In the survey, physicians identified “parental reluctance” (84%) and “the cost and difficulty of follow-up of children who do not improve” (31%), and demand for antibiotics (84%) as the three top barriers to the use of observation in their practice.

Many pediatricians and family physicians are not following recommended guidelines on the management of acute otitis media set by their professional organizations, results from a survey suggest.

Dr. Louis Vernacchio of the Slone Epidemiology Center at Boston University and his colleagues found while many pediatricians and family physicians believe the observation method–recommended by the American Academy of Pediatrics and American Academy of Family Physicians–is reasonable, they only used that method in 15% of the cases they diagnosed.

Even though acute otitis media (AOM) is considered “one of the most common illnesses for which children are brought to physicians,” and other studies have shown “the concept of initial observation without antibiotic treatment has been adopted as standard practice in some parts of the world,” AOM continues to be a management challenge for primary care providers, the researchers wrote.

According to the academies' 2004 clinical practice guideline, “Diagnosis and Management of Acute Otitis Media,” observation is an option for children 2 years and older with nonsevere symptoms or uncertain diagnosis and for those aged 6 months to 2 years old with both nonsevere symptoms and an uncertain diagnosis. The guideline was a joint response from the two organizations as a result of the established international acceptance of the observation method and because “the widespread emergence of antimicrobial resistance has increased the urgency to reduce antibiotic use,” Dr. Vernacchio and his associates said.

From a 2006 survey by mail or fax completed by 299 pediatricians or family physicians from the Slone Center Office Research (SCOR) Network, the researchers found that the proportion of physicians accepting the concept of the observation option actually decreased slightly from 88% in 2004 to 83% in 2006 (Pediatrics 2007 Aug. [Epub doi:10.1542/peds.2006-3601

The SCOR Network of physicians represents physicians who practice in private and community settings in 42 U.S. states. The participating physicians were surveyed twice–once after the publication of the guidelines in 2004 and then 18 months later (March-June 2006). Of the 299 physicians participating in the 2006 survey, 207 responded to the 2004 survey.

Pediatricians (compared with family physicians), suburban and urban non-inner city practices, and younger physicians were more accepting of the observation method.

Despite the small number of physicians using the observation method regularly, the researchers discovered that the physicians overall were more willing to follow the academies' antibiotic recommendations.

A little more than half (57%) of the physicians agreed with the guideline dosages and antibiotics used to treat nonsevere AOM, and 43% agreed that high doses of amoxicillin-clavulanate (80-90 mg/kg per day) were appropriate for severe cases (moderate to severe otalgia or fever of 39° C or higher) that failed amoxicillin. But once again, the researchers discovered the number of physicians agreeing with the guideline in comparison to 2004 has decreased as physicians found alternative treatments or dosages.

For example, only 17% of physicians administered the recommended intramuscular ceftriaxone for cases that failed the recommended high doses of amoxicillin-clavulanate, while increasing numbers of physicians are choosing to treat with oral antibiotic alternatives such as cefdinir (52%) or azithromycin (16%).

The survey also revealed a growing trend of physicians opting to treat with a standard dose of amoxicillin (40-45 mg/kg per day). In 2004, the number of physicians treating nonsevere AOM with a standard dose of amoxicillin was 22%; in 2006, that number jumped to 33%. The researchers surmise this trend could be attributed to recent data that “widespread use of the heptavalent pneumococcal conjugate vaccine has reduced the circulation of penicillin-resistant Streptococcus pneumoniae in some communities.”

In the survey, physicians identified “parental reluctance” (84%) and “the cost and difficulty of follow-up of children who do not improve” (31%), and demand for antibiotics (84%) as the three top barriers to the use of observation in their practice.

Many pediatricians and family physicians are not following recommended guidelines on the management of acute otitis media set by their professional organizations, results from a survey suggest.

Dr. Louis Vernacchio of the Slone Epidemiology Center at Boston University and his colleagues found while many pediatricians and family physicians believe the observation method–recommended by the American Academy of Pediatrics and American Academy of Family Physicians–is reasonable, they only used that method in 15% of the cases they diagnosed.

Even though acute otitis media (AOM) is considered “one of the most common illnesses for which children are brought to physicians,” and other studies have shown “the concept of initial observation without antibiotic treatment has been adopted as standard practice in some parts of the world,” AOM continues to be a management challenge for primary care providers, the researchers wrote.

According to the academies' 2004 clinical practice guideline, “Diagnosis and Management of Acute Otitis Media,” observation is an option for children 2 years and older with nonsevere symptoms or uncertain diagnosis and for those aged 6 months to 2 years old with both nonsevere symptoms and an uncertain diagnosis. The guideline was a joint response from the two organizations as a result of the established international acceptance of the observation method and because “the widespread emergence of antimicrobial resistance has increased the urgency to reduce antibiotic use,” Dr. Vernacchio and his associates said.

From a 2006 survey by mail or fax completed by 299 pediatricians or family physicians from the Slone Center Office Research (SCOR) Network, the researchers found that the proportion of physicians accepting the concept of the observation option actually decreased slightly from 88% in 2004 to 83% in 2006 (Pediatrics 2007 Aug. [Epub doi:10.1542/peds.2006-3601

The SCOR Network of physicians represents physicians who practice in private and community settings in 42 U.S. states. The participating physicians were surveyed twice–once after the publication of the guidelines in 2004 and then 18 months later (March-June 2006). Of the 299 physicians participating in the 2006 survey, 207 responded to the 2004 survey.

Pediatricians (compared with family physicians), suburban and urban non-inner city practices, and younger physicians were more accepting of the observation method.

Despite the small number of physicians using the observation method regularly, the researchers discovered that the physicians overall were more willing to follow the academies' antibiotic recommendations.

A little more than half (57%) of the physicians agreed with the guideline dosages and antibiotics used to treat nonsevere AOM, and 43% agreed that high doses of amoxicillin-clavulanate (80-90 mg/kg per day) were appropriate for severe cases (moderate to severe otalgia or fever of 39° C or higher) that failed amoxicillin. But once again, the researchers discovered the number of physicians agreeing with the guideline in comparison to 2004 has decreased as physicians found alternative treatments or dosages.

For example, only 17% of physicians administered the recommended intramuscular ceftriaxone for cases that failed the recommended high doses of amoxicillin-clavulanate, while increasing numbers of physicians are choosing to treat with oral antibiotic alternatives such as cefdinir (52%) or azithromycin (16%).

The survey also revealed a growing trend of physicians opting to treat with a standard dose of amoxicillin (40-45 mg/kg per day). In 2004, the number of physicians treating nonsevere AOM with a standard dose of amoxicillin was 22%; in 2006, that number jumped to 33%. The researchers surmise this trend could be attributed to recent data that “widespread use of the heptavalent pneumococcal conjugate vaccine has reduced the circulation of penicillin-resistant Streptococcus pneumoniae in some communities.”

In the survey, physicians identified “parental reluctance” (84%) and “the cost and difficulty of follow-up of children who do not improve” (31%), and demand for antibiotics (84%) as the three top barriers to the use of observation in their practice.

Many family physicians and pediatricians are not following recommended guidelines on the management of acute otitis media set by their professional organizations, results from a survey suggest.

Dr. Louis Vernacchio of the Slone Epidemiology Center at Boston University and his colleagues found while many family physicians and pediatricians believe the observation method–recommended by the American Academy of Family Physicians and the American Academy of Pediatrics–is reasonable, they only used that method in 15% of the cases they diagnosed.

Even though acute otitis media (AOM) is considered “one of the most common illnesses for which children are brought to physicians,” and other studies have shown “the concept of initial observation without antibiotic treatment has been adopted as standard practice in some parts of the world,” AOM continues to be a management challenge for primary care providers, the researchers wrote.

According to the academies' 2004 clinical practice guideline, “Diagnosis and Management of Acute Otitis Media,” observation is an option for children 2 years and older with nonsevere symptoms or uncertain diagnosis and for those aged 6 months to 2 years old with both nonsevere symptoms and an uncertain diagnosis. The guideline was a joint response from the two organizations as a result of the established international acceptance of the observation method and because “the widespread emergence of antimicrobial resistance has increased the urgency to reduce antibiotic use,” Dr. Vernacchio and his associates said.

From a 2006 survey by mail or fax completed by 299 pediatricians or family physicians from the Slone Center Office Research (SCOR) Network, the researchers found that the proportion of physicians accepting the concept of the observation option actually decreased slightly from 88% in 2004 to 83% in 2006 (Pediatrics 2007 Aug. [Epub doi:10.1542/peds.2006-3601]).

The SCOR Network of physicians represents physicians who practice in private and community settings in 42 U.S. states. The participating physicians were surveyed twice–once after the publication of the guidelines in 2004 and then 18 months later (March-June 2006). Of the 299 physicians participating in the 2006 survey, 207 responded to the 2004 survey.

Pediatricians (compared with family physicians), suburban and urban non-inner city practices, and younger physicians were more accepting of the observation method.

Despite the small number of physicians using the observation method regularly, the researchers discovered that the physicians overall were more willing to follow the academies' antibiotic recommendations.

A little more than half (57%) of the physicians agreed with the guideline dosages and antibiotics used to treat nonsevere AOM, and 43% agreed that high doses of amoxicillin-clavulanate (80-90 mg/kg per day) were appropriate for severe cases (moderate to severe otalgia or fever of 39° C or higher) that failed amoxicillin. But once again, the researchers discovered the number of physicians agreeing with the guideline in comparison to 2004 has decreased as physicians found alternative treatments or dosages.

For example, only 17% of physicians administered the recommended intramuscular ceftriaxone for cases that failed the recommended high doses of amoxicillin-clavulanate, while increasing numbers of physicians are choosing to treat with oral antibiotic alternatives such as cefdinir (52%) or azithromycin (16%).

The survey also revealed a growing trend of physicians opting to treat with a standard dose of amoxicillin (40-45 mg/kg per day). In 2004, the number of physicians treating nonsevere AOM with a standard dose of amoxicillin was 22%; in 2006, that number jumped to 33%. The researchers surmise this trend could be attributed to recent data that “widespread use of the heptavalent pneumococcal conjugate vaccine has reduced the circulation of penicillin-resistant Streptococcus pneumoniae in some communities.”

In the survey, physicians identified “parental reluctance” (84%) and “the cost and difficulty of follow-up of children who do not improve” (31%), and demand for antibiotics (84%) as the three top barriers to the use of observation in their practice.

Many family physicians and pediatricians are not following recommended guidelines on the management of acute otitis media set by their professional organizations, results from a survey suggest.

Dr. Louis Vernacchio of the Slone Epidemiology Center at Boston University and his colleagues found while many family physicians and pediatricians believe the observation method–recommended by the American Academy of Family Physicians and the American Academy of Pediatrics–is reasonable, they only used that method in 15% of the cases they diagnosed.

Even though acute otitis media (AOM) is considered “one of the most common illnesses for which children are brought to physicians,” and other studies have shown “the concept of initial observation without antibiotic treatment has been adopted as standard practice in some parts of the world,” AOM continues to be a management challenge for primary care providers, the researchers wrote.

According to the academies' 2004 clinical practice guideline, “Diagnosis and Management of Acute Otitis Media,” observation is an option for children 2 years and older with nonsevere symptoms or uncertain diagnosis and for those aged 6 months to 2 years old with both nonsevere symptoms and an uncertain diagnosis. The guideline was a joint response from the two organizations as a result of the established international acceptance of the observation method and because “the widespread emergence of antimicrobial resistance has increased the urgency to reduce antibiotic use,” Dr. Vernacchio and his associates said.

From a 2006 survey by mail or fax completed by 299 pediatricians or family physicians from the Slone Center Office Research (SCOR) Network, the researchers found that the proportion of physicians accepting the concept of the observation option actually decreased slightly from 88% in 2004 to 83% in 2006 (Pediatrics 2007 Aug. [Epub doi:10.1542/peds.2006-3601]).

The SCOR Network of physicians represents physicians who practice in private and community settings in 42 U.S. states. The participating physicians were surveyed twice–once after the publication of the guidelines in 2004 and then 18 months later (March-June 2006). Of the 299 physicians participating in the 2006 survey, 207 responded to the 2004 survey.

Pediatricians (compared with family physicians), suburban and urban non-inner city practices, and younger physicians were more accepting of the observation method.

Despite the small number of physicians using the observation method regularly, the researchers discovered that the physicians overall were more willing to follow the academies' antibiotic recommendations.

A little more than half (57%) of the physicians agreed with the guideline dosages and antibiotics used to treat nonsevere AOM, and 43% agreed that high doses of amoxicillin-clavulanate (80-90 mg/kg per day) were appropriate for severe cases (moderate to severe otalgia or fever of 39° C or higher) that failed amoxicillin. But once again, the researchers discovered the number of physicians agreeing with the guideline in comparison to 2004 has decreased as physicians found alternative treatments or dosages.

For example, only 17% of physicians administered the recommended intramuscular ceftriaxone for cases that failed the recommended high doses of amoxicillin-clavulanate, while increasing numbers of physicians are choosing to treat with oral antibiotic alternatives such as cefdinir (52%) or azithromycin (16%).

The survey also revealed a growing trend of physicians opting to treat with a standard dose of amoxicillin (40-45 mg/kg per day). In 2004, the number of physicians treating nonsevere AOM with a standard dose of amoxicillin was 22%; in 2006, that number jumped to 33%. The researchers surmise this trend could be attributed to recent data that “widespread use of the heptavalent pneumococcal conjugate vaccine has reduced the circulation of penicillin-resistant Streptococcus pneumoniae in some communities.”

In the survey, physicians identified “parental reluctance” (84%) and “the cost and difficulty of follow-up of children who do not improve” (31%), and demand for antibiotics (84%) as the three top barriers to the use of observation in their practice.

Many family physicians and pediatricians are not following recommended guidelines on the management of acute otitis media set by their professional organizations, results from a survey suggest.

Dr. Louis Vernacchio of the Slone Epidemiology Center at Boston University and his colleagues found while many family physicians and pediatricians believe the observation method–recommended by the American Academy of Family Physicians and the American Academy of Pediatrics–is reasonable, they only used that method in 15% of the cases they diagnosed.

Even though acute otitis media (AOM) is considered “one of the most common illnesses for which children are brought to physicians,” and other studies have shown “the concept of initial observation without antibiotic treatment has been adopted as standard practice in some parts of the world,” AOM continues to be a management challenge for primary care providers, the researchers wrote.

According to the academies' 2004 clinical practice guideline, “Diagnosis and Management of Acute Otitis Media,” observation is an option for children 2 years and older with nonsevere symptoms or uncertain diagnosis and for those aged 6 months to 2 years old with both nonsevere symptoms and an uncertain diagnosis. The guideline was a joint response from the two organizations as a result of the established international acceptance of the observation method and because “the widespread emergence of antimicrobial resistance has increased the urgency to reduce antibiotic use,” Dr. Vernacchio and his associates said.

From a 2006 survey by mail or fax completed by 299 pediatricians or family physicians from the Slone Center Office Research (SCOR) Network, the researchers found that the proportion of physicians accepting the concept of the observation option actually decreased slightly from 88% in 2004 to 83% in 2006 (Pediatrics 2007 Aug. [Epub doi:10.1542/peds.2006-3601]).

The SCOR Network of physicians represents physicians who practice in private and community settings in 42 U.S. states. The participating physicians were surveyed twice–once after the publication of the guidelines in 2004 and then 18 months later (March-June 2006). Of the 299 physicians participating in the 2006 survey, 207 responded to the 2004 survey.

Pediatricians (compared with family physicians), suburban and urban non-inner city practices, and younger physicians were more accepting of the observation method.

Despite the small number of physicians using the observation method regularly, the researchers discovered that the physicians overall were more willing to follow the academies' antibiotic recommendations.

A little more than half (57%) of the physicians agreed with the guideline dosages and antibiotics used to treat nonsevere AOM, and 43% agreed that high doses of amoxicillin-clavulanate (80-90 mg/kg per day) were appropriate for severe cases (moderate to severe otalgia or fever of 39° C or higher) that failed amoxicillin. But once again, the researchers discovered the number of physicians agreeing with the guideline in comparison to 2004 has decreased as physicians found alternative treatments or dosages.

For example, only 17% of physicians administered the recommended intramuscular ceftriaxone for cases that failed the recommended high doses of amoxicillin-clavulanate, while increasing numbers of physicians are choosing to treat with oral antibiotic alternatives such as cefdinir (52%) or azithromycin (16%).

The survey also revealed a growing trend of physicians opting to treat with a standard dose of amoxicillin (40-45 mg/kg per day). In 2004, the number of physicians treating nonsevere AOM with a standard dose of amoxicillin was 22%; in 2006, that number jumped to 33%. The researchers surmise this trend could be attributed to recent data that “widespread use of the heptavalent pneumococcal conjugate vaccine has reduced the circulation of penicillin-resistant Streptococcus pneumoniae in some communities.”

In the survey, physicians identified “parental reluctance” (84%) and “the cost and difficulty of follow-up of children who do not improve” (31%), and demand for antibiotics (84%) as the three top barriers to the use of observation in their practice.

Maternal weight gain that meets or exceeds recommendations made in current guidelines is associated with a fourfold increased risk of having a baby that is overweight in childhood, results of a large prospective study suggest.

Compared with women who had inadequate weight gain as defined by current Institute of Medicine (IOM) guidelines, those who had adequate or excessive gain were at increased risk of having an overweight child (odds ratios of 3.8 and 4.3, respectively).

The current societal trend of more overweight mothers and children is outpacing the IOM's guidelines for gestational weight gain, published in 1990. Since then, “excessive gains have become more common,” wrote study investigators Dr. Emily Oken and her colleagues at the department of ambulatory care and prevention, Harvard Medical School, Boston.

The researchers therefore recommended that the guidelines be updated to better reflect today's mothers and children.

The study—which was published in the American Journal of Obstetrics and Gynecology—is one of a few that have examined the links between weight gain during pregnancy and child weight outcomes after birth, according to the researchers. Most studies, they wrote, “have not considered gestational weight gain when predicting obesity perinatally.”

According to the IOM's standards, women with a normal prepregnancy body mass index (19.8–26.0 kg/m

The researchers recruited their participants through Project Viva, a prospective cohort study of pregnant women and their children. Of the 2,128 women who delivered a live singleton infant in that study, Dr. Oken and her colleagues examined 1,044 mother/child pairs.

Gestational weight gain was calculated as the difference between the last weight recorded before delivery and self-reported prepregnancy weight (Am. J. Obstet. Gynecol. 2007;196:322.e1–8).

The mean maternal prepregnancy BMI was 24.6 kg/m

According to the IOM's standards, 51% of these women gained excessive weight, 35% gained adequate weight, and 14% gained inadequate weight.

Although the researchers recorded a number of factors including age, income, education, and time between the last pregnancy weight and delivery, they did not include these factors in their final models because adjusting for them did not “appreciably change estimates.”

At the time of the analysis, the researchers reported that all the children completed the study visit at age 3 years.

The researchers found the mean child BMI z score was 0.45 units. Nine percent of children were overweight, defined as a BMI of equal to or greater than the 95th percentile. “Children of mothers in all Institute of Medicine weight gain groups, even those with inadequate gain, had mean BMI z scores above the median of the 2000 CDC growth curves, which were primarily based upon U.S. children in the 1970s,” they wrote. On bivariate analysis, investigators found “gestational weight gain was directly associated with child overweight (odds ratio 1.3).”

Dr. Oken and her colleagues reported that children of mothers who gained more weight also had somewhat higher systolic blood pressure. Even mothers with “adequate gain” still had a substantially higher risk of having children who were overweight. They also warned that “higher gestational weight gain may cause undesirable birth outcomes such as increased rates of macrosomia and cesarean sections and is associated with higher postpartum weight retention and later risk for obesity in the mother.”

Maternal weight gain that meets or exceeds recommendations made in current guidelines is associated with a fourfold increased risk of having a baby that is overweight in childhood, results of a large prospective study suggest.

Compared with women who had inadequate weight gain as defined by current Institute of Medicine (IOM) guidelines, those who had adequate or excessive gain were at increased risk of having an overweight child (odds ratios of 3.8 and 4.3, respectively).

The current societal trend of more overweight mothers and children is outpacing the IOM's guidelines for gestational weight gain, published in 1990. Since then, “excessive gains have become more common,” wrote study investigators Dr. Emily Oken and her colleagues at the department of ambulatory care and prevention, Harvard Medical School, Boston.

The researchers therefore recommended that the guidelines be updated to better reflect today's mothers and children.

The study—which was published in the American Journal of Obstetrics and Gynecology—is one of a few that have examined the links between weight gain during pregnancy and child weight outcomes after birth, according to the researchers. Most studies, they wrote, “have not considered gestational weight gain when predicting obesity perinatally.”

According to the IOM's standards, women with a normal prepregnancy body mass index (19.8–26.0 kg/m

The researchers recruited their participants through Project Viva, a prospective cohort study of pregnant women and their children. Of the 2,128 women who delivered a live singleton infant in that study, Dr. Oken and her colleagues examined 1,044 mother/child pairs.

Gestational weight gain was calculated as the difference between the last weight recorded before delivery and self-reported prepregnancy weight (Am. J. Obstet. Gynecol. 2007;196:322.e1–8).

The mean maternal prepregnancy BMI was 24.6 kg/m

According to the IOM's standards, 51% of these women gained excessive weight, 35% gained adequate weight, and 14% gained inadequate weight.

Although the researchers recorded a number of factors including age, income, education, and time between the last pregnancy weight and delivery, they did not include these factors in their final models because adjusting for them did not “appreciably change estimates.”

At the time of the analysis, the researchers reported that all the children completed the study visit at age 3 years.

The researchers found the mean child BMI z score was 0.45 units. Nine percent of children were overweight, defined as a BMI of equal to or greater than the 95th percentile. “Children of mothers in all Institute of Medicine weight gain groups, even those with inadequate gain, had mean BMI z scores above the median of the 2000 CDC growth curves, which were primarily based upon U.S. children in the 1970s,” they wrote. On bivariate analysis, investigators found “gestational weight gain was directly associated with child overweight (odds ratio 1.3).”

Dr. Oken and her colleagues reported that children of mothers who gained more weight also had somewhat higher systolic blood pressure. Even mothers with “adequate gain” still had a substantially higher risk of having children who were overweight. They also warned that “higher gestational weight gain may cause undesirable birth outcomes such as increased rates of macrosomia and cesarean sections and is associated with higher postpartum weight retention and later risk for obesity in the mother.”

Maternal weight gain that meets or exceeds recommendations made in current guidelines is associated with a fourfold increased risk of having a baby that is overweight in childhood, results of a large prospective study suggest.

Compared with women who had inadequate weight gain as defined by current Institute of Medicine (IOM) guidelines, those who had adequate or excessive gain were at increased risk of having an overweight child (odds ratios of 3.8 and 4.3, respectively).

The current societal trend of more overweight mothers and children is outpacing the IOM's guidelines for gestational weight gain, published in 1990. Since then, “excessive gains have become more common,” wrote study investigators Dr. Emily Oken and her colleagues at the department of ambulatory care and prevention, Harvard Medical School, Boston.

The researchers therefore recommended that the guidelines be updated to better reflect today's mothers and children.

The study—which was published in the American Journal of Obstetrics and Gynecology—is one of a few that have examined the links between weight gain during pregnancy and child weight outcomes after birth, according to the researchers. Most studies, they wrote, “have not considered gestational weight gain when predicting obesity perinatally.”

According to the IOM's standards, women with a normal prepregnancy body mass index (19.8–26.0 kg/m

The researchers recruited their participants through Project Viva, a prospective cohort study of pregnant women and their children. Of the 2,128 women who delivered a live singleton infant in that study, Dr. Oken and her colleagues examined 1,044 mother/child pairs.

Gestational weight gain was calculated as the difference between the last weight recorded before delivery and self-reported prepregnancy weight (Am. J. Obstet. Gynecol. 2007;196:322.e1–8).

The mean maternal prepregnancy BMI was 24.6 kg/m

According to the IOM's standards, 51% of these women gained excessive weight, 35% gained adequate weight, and 14% gained inadequate weight.

Although the researchers recorded a number of factors including age, income, education, and time between the last pregnancy weight and delivery, they did not include these factors in their final models because adjusting for them did not “appreciably change estimates.”

At the time of the analysis, the researchers reported that all the children completed the study visit at age 3 years.

The researchers found the mean child BMI z score was 0.45 units. Nine percent of children were overweight, defined as a BMI of equal to or greater than the 95th percentile. “Children of mothers in all Institute of Medicine weight gain groups, even those with inadequate gain, had mean BMI z scores above the median of the 2000 CDC growth curves, which were primarily based upon U.S. children in the 1970s,” they wrote. On bivariate analysis, investigators found “gestational weight gain was directly associated with child overweight (odds ratio 1.3).”

Dr. Oken and her colleagues reported that children of mothers who gained more weight also had somewhat higher systolic blood pressure. Even mothers with “adequate gain” still had a substantially higher risk of having children who were overweight. They also warned that “higher gestational weight gain may cause undesirable birth outcomes such as increased rates of macrosomia and cesarean sections and is associated with higher postpartum weight retention and later risk for obesity in the mother.”

The Juvenile Diabetes Research Foundation is currently enrolling patients to participate in the second phase of the Ranibizumab for Edema of the Macula in Diabetes (READ-2) study.

Supported by Genentech Inc. and the nonprofit U.S.-based JDRF, the study is designed to test the long-term safety and effectiveness of intraocular injections of ranibizumab in patients with diabetic macular edema. In this phase II study, researchers also would like to compare the results of ranibizumab injection with laser photocoagulation, the standard treatment of diabetic macular edema, according to a statement issued by the foundation.

The researchers want to enroll 126 participants in this multicenter clinical trial, age 18 and older with macular edema as a result of type 1 or type 2 diabetes. The study will consist of a 2-week screening period, a 6-month treatment period, and an 18-month follow-up and treatment period.

In a phase I study, Dr. Quan Dong Nguyen, Dr. Peter A. Campochiaro, and their colleagues found that ranibizumab was successful in improving visual acuity at 7 months. There were no adverse events related to ranibizumab, although some patients did experience redness on the surface of the eye at the injection site that lasted up to 72 hours. The cause of the redness was more likely caused by the injection and not by the drug itself, the investigators said.

Genentech manufactures ranibizumab, which is used to treat patients with wet age-related macular degeneration. The drug blocks a growth factor thought to be involved in the formation of abnormal blood vessels that cause the loss of vision in diabetic macular edema patients.

Ranibizumab was approved by the Food and Drug Administration in June 2006.

The phase I trial, which began in December 2006, took place at the Wilmer Eye Institute at Johns Hopkins University, Baltimore. Phase II will take place at the Phoenix-based Retinal Consultants of Arizona and other sites. The expected completion date of the phase II study is January 2009.

For additional study and participation information, visit www.clinicaltrials.gov/ct/show/NCT00407381?order=14

The Juvenile Diabetes Research Foundation is currently enrolling patients to participate in the second phase of the Ranibizumab for Edema of the Macula in Diabetes (READ-2) study.

Supported by Genentech Inc. and the nonprofit U.S.-based JDRF, the study is designed to test the long-term safety and effectiveness of intraocular injections of ranibizumab in patients with diabetic macular edema. In this phase II study, researchers also would like to compare the results of ranibizumab injection with laser photocoagulation, the standard treatment of diabetic macular edema, according to a statement issued by the foundation.

The researchers want to enroll 126 participants in this multicenter clinical trial, age 18 and older with macular edema as a result of type 1 or type 2 diabetes. The study will consist of a 2-week screening period, a 6-month treatment period, and an 18-month follow-up and treatment period.

In a phase I study, Dr. Quan Dong Nguyen, Dr. Peter A. Campochiaro, and their colleagues found that ranibizumab was successful in improving visual acuity at 7 months. There were no adverse events related to ranibizumab, although some patients did experience redness on the surface of the eye at the injection site that lasted up to 72 hours. The cause of the redness was more likely caused by the injection and not by the drug itself, the investigators said.

Genentech manufactures ranibizumab, which is used to treat patients with wet age-related macular degeneration. The drug blocks a growth factor thought to be involved in the formation of abnormal blood vessels that cause the loss of vision in diabetic macular edema patients.

Ranibizumab was approved by the Food and Drug Administration in June 2006.

The phase I trial, which began in December 2006, took place at the Wilmer Eye Institute at Johns Hopkins University, Baltimore. Phase II will take place at the Phoenix-based Retinal Consultants of Arizona and other sites. The expected completion date of the phase II study is January 2009.

For additional study and participation information, visit www.clinicaltrials.gov/ct/show/NCT00407381?order=14

The Juvenile Diabetes Research Foundation is currently enrolling patients to participate in the second phase of the Ranibizumab for Edema of the Macula in Diabetes (READ-2) study.

Supported by Genentech Inc. and the nonprofit U.S.-based JDRF, the study is designed to test the long-term safety and effectiveness of intraocular injections of ranibizumab in patients with diabetic macular edema. In this phase II study, researchers also would like to compare the results of ranibizumab injection with laser photocoagulation, the standard treatment of diabetic macular edema, according to a statement issued by the foundation.

The researchers want to enroll 126 participants in this multicenter clinical trial, age 18 and older with macular edema as a result of type 1 or type 2 diabetes. The study will consist of a 2-week screening period, a 6-month treatment period, and an 18-month follow-up and treatment period.

In a phase I study, Dr. Quan Dong Nguyen, Dr. Peter A. Campochiaro, and their colleagues found that ranibizumab was successful in improving visual acuity at 7 months. There were no adverse events related to ranibizumab, although some patients did experience redness on the surface of the eye at the injection site that lasted up to 72 hours. The cause of the redness was more likely caused by the injection and not by the drug itself, the investigators said.

Genentech manufactures ranibizumab, which is used to treat patients with wet age-related macular degeneration. The drug blocks a growth factor thought to be involved in the formation of abnormal blood vessels that cause the loss of vision in diabetic macular edema patients.

Ranibizumab was approved by the Food and Drug Administration in June 2006.

The phase I trial, which began in December 2006, took place at the Wilmer Eye Institute at Johns Hopkins University, Baltimore. Phase II will take place at the Phoenix-based Retinal Consultants of Arizona and other sites. The expected completion date of the phase II study is January 2009.

For additional study and participation information, visit www.clinicaltrials.gov/ct/show/NCT00407381?order=14

WASHINGTON — People who spend more time behind the wheel may be at increased risk for skin cancer, particularly on the left side of the face, according to a poster presentation at an annual meeting of the American Academy of Dermatology.

Dr. Scott W. Fosko, professor and chairman of dermatology at St. Louis University, and his colleagues observed 898 patients (559 men and 339 women) with skin cancers on either the right or left side of the body; the average patient age was 68 years. In 53% of the patients, skin cancer occurred on the left side, and nearly two-thirds (63%) of these were in men.

The most common cancer in observed patients was basal cell carcinoma (608 lesions). Other types included squamous cell carcinomas (178 lesions), invasive (23) and noninvasive (42) melanomas, and 64 additional miscellaneous cancers.

“What really jumped out in our data was a subtype of melanoma—melanoma in situ—in particular, lentigo maligna. … Significantly, this was seen on the left side of the face,” Dr. Fosko said during a press briefing at the meeting.

Questionnaires evaluating the driving habits of dermatology patients from the university clinic were also collected. Patients answered questions about age, gender, hours in a car per week, number of years driving, sunscreen use, and whether they drive with their windows open.

Men with left-sided cancers spent 3 hours more per week in a car than men with right-side cancers. In women, those with right-side cancers spent 1 hour more per week in a car than women with left-side cancers. Dr. Fosko cited data showing men as more likely to sit in the driver's seat than women, who spend more time in passenger seats.

He reported no conflicts of interest.

WASHINGTON — People who spend more time behind the wheel may be at increased risk for skin cancer, particularly on the left side of the face, according to a poster presentation at an annual meeting of the American Academy of Dermatology.

Dr. Scott W. Fosko, professor and chairman of dermatology at St. Louis University, and his colleagues observed 898 patients (559 men and 339 women) with skin cancers on either the right or left side of the body; the average patient age was 68 years. In 53% of the patients, skin cancer occurred on the left side, and nearly two-thirds (63%) of these were in men.

The most common cancer in observed patients was basal cell carcinoma (608 lesions). Other types included squamous cell carcinomas (178 lesions), invasive (23) and noninvasive (42) melanomas, and 64 additional miscellaneous cancers.

“What really jumped out in our data was a subtype of melanoma—melanoma in situ—in particular, lentigo maligna. … Significantly, this was seen on the left side of the face,” Dr. Fosko said during a press briefing at the meeting.

Questionnaires evaluating the driving habits of dermatology patients from the university clinic were also collected. Patients answered questions about age, gender, hours in a car per week, number of years driving, sunscreen use, and whether they drive with their windows open.

Men with left-sided cancers spent 3 hours more per week in a car than men with right-side cancers. In women, those with right-side cancers spent 1 hour more per week in a car than women with left-side cancers. Dr. Fosko cited data showing men as more likely to sit in the driver's seat than women, who spend more time in passenger seats.

He reported no conflicts of interest.

WASHINGTON — People who spend more time behind the wheel may be at increased risk for skin cancer, particularly on the left side of the face, according to a poster presentation at an annual meeting of the American Academy of Dermatology.

Dr. Scott W. Fosko, professor and chairman of dermatology at St. Louis University, and his colleagues observed 898 patients (559 men and 339 women) with skin cancers on either the right or left side of the body; the average patient age was 68 years. In 53% of the patients, skin cancer occurred on the left side, and nearly two-thirds (63%) of these were in men.

The most common cancer in observed patients was basal cell carcinoma (608 lesions). Other types included squamous cell carcinomas (178 lesions), invasive (23) and noninvasive (42) melanomas, and 64 additional miscellaneous cancers.

“What really jumped out in our data was a subtype of melanoma—melanoma in situ—in particular, lentigo maligna. … Significantly, this was seen on the left side of the face,” Dr. Fosko said during a press briefing at the meeting.

Questionnaires evaluating the driving habits of dermatology patients from the university clinic were also collected. Patients answered questions about age, gender, hours in a car per week, number of years driving, sunscreen use, and whether they drive with their windows open.

Men with left-sided cancers spent 3 hours more per week in a car than men with right-side cancers. In women, those with right-side cancers spent 1 hour more per week in a car than women with left-side cancers. Dr. Fosko cited data showing men as more likely to sit in the driver's seat than women, who spend more time in passenger seats.

He reported no conflicts of interest.