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IOM spells out antibiotics strategy in an anthrax attack

To prepare for a potential wide-scale anthrax attack, state and local health officials should determine how antibiotics should best be stored in their communities. One approach may be to dispense antibiotics to first responders, physicians and other health workers, said a Sept. 30 report by the Institute of Medicine. They would store antibiotics and distribute them to patients when appropriate. This strategy may be beneficial for those who cannot travel to distribution points to receive antibiotics because of a medical condition. Such prepositioning strategies may provide antibiotics more quickly and efficiently. Prepositioning refers to the storage of medical countermeasures, such as antibiotics, close to or in the possession of people who need rapid access. This could include local stockpiles, workplace caches and home storage. "Delivering antibiotics effectively following an anthrax attack is a tremendous public health challenge," said emergency physician Robert Bass, MD, c ...

Heart attacks can occur in women whose angiograms show open arteries

Physicians should not overlook myocardial infarction as a diagnosis for female patients with symptoms but who show no signs of obstructive coronary artery disease on an angiogram, a study says. The study, published online Sept. 26 in Circulation, found that a rupture or ulceration of cholesterol plaque in a coronary artery is common among these patients. The plaque disruption can lead to the blockage of an artery and cause a heart attack, the study authors said. By the time an angiogram is performed, however, the blood clot can break up, leaving the appearance of a normal or near-normal artery. These women "often are not treated for [myocardial infarction] and are often told that they did not have [a heart attack] based on the finding of open arteries in the angiogram," said lead study author Harmony R. Reynolds, MD. "Primary care physicians need to know that if a patient presents with myocardial infarction and has open arteries, that's still a myocardial infarction, and they ...

Physician shortage in Massachusetts continues to squeeze primary care

Massachusetts is facing severe or critical shortages of doctors in eight specialties, including a deficiency of primary care physicians for the sixth year, a survey shows. Internal medicine, psychiatry and urology are seeing critical shortages, according to the 2011 Massachusetts Medical Society's "Physician Workforce Study," released in September. Dermatology, family medicine, general surgery, neurosurgery and orthopedics are seeing severe shortages, according to the 10th annual MMS report, which evaluated 18 specialties. Researchers surveyed practicing physicians, residents and fellows across the state. Neurosurgery is the only specialty new to the shortage list this year. However, three specialties on the list in 2010 did not make it this year: emergency medicine, neurology and vascular surgery. MMS President Lynda M. Young, MD, said a long-term goal is to have more physicians enter primary care. Doctors and others are working toward that goal in various ways. For example, ...