February 2017 Briefing - Geriatrics

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Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for February 2017. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Strategies Suggested to Protect Practices From Hackers

TUESDAY, Feb. 28, 2017 (HealthDay News) -- Steps should be taken to protect medical practices, including small practices, from hackers, according to a report published in Medical Economics.

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Physician Burnout Eroding Sense of Calling

TUESDAY, Feb. 28, 2017 (HealthDay News) -- For physicians across specialties, burnout is associated with reduced odds of a sense of calling, according to a study published online Feb. 8 in the Mayo Clinic Proceedings.

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Antidepressant Efficacy Varies for Depressive Symptom Clusters

TUESDAY, Feb. 28, 2017 (HealthDay News) -- Antidepressant treatment efficacy varies for empirically-defined clusters of symptoms, according to a study published online Feb. 22 in JAMA Psychiatry.

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Higher Dietary Potassium to Sodium Ratio Can Lower CVD Risk

TUESDAY, Feb. 28, 2017 (HealthDay News) -- Higher dietary potassium seems to be associated with reduced blood pressure, regardless of sodium intake, with the postulated mechanism involving the distal tubule sodium chloride cotransporter (NCC), according to research published online Feb. 7 in the American Journal of Physiology - Endocrinology and Metabolism.

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Comorbid Neuropathies Common With MCI Diagnosis

TUESDAY, Feb. 28, 2017 (HealthDay News) -- A diagnosis of mild cognitive impairment (MCI) is frequently associated with comorbid neuropathologies, according to a study published online Feb. 22 in the Annals of Neurology.

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Doctors Need to Discuss Herbal Medication Use With CVD Patients

TUESDAY, Feb. 28, 2017 (HealthDay News) -- While there's little evidence that herbal medications are safe or effective to treat cardiovascular conditions, they remain popular among patients with cardiovascular disease, according to a review published in the March 7 issue of the Journal of the American College of Cardiology.

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Supreme Court Rules Patient Safety Data Subject to Litigation

MONDAY, Feb. 27, 2017 (HealthDay News) -- The Supreme Court of Florida has reversed a District Court of Appeal decision deeming information related to patient safety unprotected from litigation discovery, according to a report published from the American Medical Association.

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Many Patients Get Opioid Rx While Receiving Buprenorphine

MONDAY, Feb. 27, 2017 (HealthDay News) -- A substantial proportion of patients with opioid use disorder fill prescriptions for non-buprenorphine opioids during and following treatment with buprenorphine, according to a study published online Feb. 23 in Addiction.

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Periodontitis May Be Early Sign of Undiagnosed Diabetes

FRIDAY, Feb. 24, 2017 (HealthDay News) -- Periodontal disease may be a sign of undiagnosed type 2 diabetes, according to a study published in the January issue of BMJ Open Diabetes Research & Care.

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CDC: Fatal Drug Overdoses More Than Doubled Since 1999

FRIDAY, Feb. 24, 2017 (HealthDay News) -- Drug overdose deaths have nearly tripled in the United States since 1999, with the largest increases seen for whites and middle-aged Americans, according to a February data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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$20 Million Awarded for Quality Payment Program Training

FRIDAY, Feb. 24, 2017 (HealthDay News) -- About $20 million has been awarded to 11 organizations for the first of a five-year program to provide training and education about the Quality Payment Program for clinicians in individual or small group practices, with up to $80 million to be invested over the remaining four years, according to the U.S. Centers for Medicare & Medicaid Services (CMS).

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DPP-4i Treatment Doesn't Up MI, Stroke Risk in Seniors

FRIDAY, Feb. 24, 2017 (HealthDay News) -- For older U.S. Medicare beneficiaries, dipeptidyl peptidase-4 inhibitors (DPP-4i) treatment is not associated with increased cardiovascular (CV) risk relative to sulfonylureas (SU) and thiazolidinediones (TZD), according to a study published online Feb. 14 in Diabetes, Obesity and Metabolism.

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Fruit, Vegetable Consumption Linked to Lower Risk of COPD

FRIDAY, Feb. 24, 2017 (HealthDay News) -- Eating lots of fruits and vegetables may help current and former smokers avoid chronic obstructive pulmonary disease (COPD), according to a study published online Feb. 22 in Thorax.

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Central Adiposity More Harmful Than Obesity in Older Women

FRIDAY, Feb. 24, 2017 (HealthDay News) -- Among women 70 to 79, being overweight or obese doesn't appear to shorten life span -- unless the weight is centered around the waist; however, being underweight does appear to shorten life span, according to a study published online Feb. 23 in the Journal of the American Geriatrics Society.

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Similar Outcomes for Disc Surgery in Older, Younger Patients

FRIDAY, Feb. 24, 2017 (HealthDay News) -- Older patients, over the age of 65, seem to experience the same lower back pain relief as their younger peers from surgery for a herniated lumbar disc, according to a research letter published online Feb. 22 in JAMA Surgery.

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Cyberattacks Remain Serious Threat to Health Providers

THURSDAY, Feb. 23, 2017 (HealthDay News) -- Cyberattacks remain a serious threat to small providers as well as big institutions, according to a report published in Medical Economics.

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Stratification Tool IDs Who Will Benefit From Adding Ezetimibe

THURSDAY, Feb. 23, 2017 (HealthDay News) -- For patients stabilized after acute coronary syndrome (ACS), a nine-point risk stratification tool can identify patients who will derive benefit from the addition of ezetimibe to statin therapy, according to a study published in the Feb. 28 issue of the Journal of the American College of Cardiology.

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MRI Can Be Safe for Patients With Older Pacemakers, ICDs

THURSDAY, Feb. 23, 2017 (HealthDay News) -- Patients with cardiovascular implantable electronic devices not designed to be magnetic resonance imaging (MRI)-compatible can safely receive MRI, when a specific protocol is followed, according to a study published in the Feb. 23 issue of the New England Journal of Medicine.

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Off-Label Antidepressant Use Common, but Evidence Lacking

WEDNESDAY, Feb. 22, 2017 (HealthDay News) -- Up to one-third of antidepressants are prescribed for pain, insomnia, migraine, or other unapproved uses, but just 16 percent of those off-label prescriptions are supported by strong research, according to a study published online Feb. 21 in The BMJ.

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Health Information Theft a Pressing Concern for U.S. Patients

WEDNESDAY, Feb. 22, 2017 (HealthDay News) -- Forty-four percent of U.S. adults are worried about having their personal health care information stolen, according to findings from the Xerox eHealth Survey published Feb. 9 in HIT Consultant.

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Nursing Homes Rarely Use Isolation for Drug-Resistant Bugs

WEDNESDAY, Feb. 22, 2017 (HealthDay News) -- Isolation precautions are infrequently used for nursing home (NH) residents with multidrug-resistant organism (MDRO) infection, according to a study published online Feb. 17 in the Journal of the American Geriatrics Society.

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Weight Loss of 10% Beneficial in Overweight, Not Obese, With DM

WEDNESDAY, Feb. 22, 2017 (HealthDay News) -- For overweight, but not obese, individuals with type 2 diabetes (T2D), sustained weight loss (WL) of 10 percent body weight is associated with clinically meaningful cardiometabolic changes, according to research published online Feb. 19 in Diabetes Care.

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Cancer Survivors Likely to Change Rx Drug Use for Financial Reasons

WEDNESDAY, Feb. 22, 2017 (HealthDay News) -- Nonelderly cancer survivors are more likely to report changes in prescription drug use for financial reasons than individuals without a cancer history, according to a study published online Feb. 20 in Cancer.

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Collaborative Care Cuts Depressive Symptoms in Seniors

WEDNESDAY, Feb. 22, 2017 (HealthDay News) -- For older adults with subthreshold depression, collaborative care is associated with a reduction in depressive symptoms compared with usual care, according to a study published online Feb. 21 in the Journal of the American Medical Association.

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Exercise Most Important Lifestyle Change for Breast CA Survivors

TUESDAY, Feb. 21, 2017 (HealthDay News) -- For breast cancer survivors, exercise may help lower their mortality risk more than other healthy habits, according to a review published in the Feb. 21 issue of CMAJ, the journal of the Canadian Medical Association.

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Trials Highlight Benefits, Risks of Testosterone Treatment

TUESDAY, Feb. 21, 2017 (HealthDay News) -- Testosterone treatment can boost bone density and reduce anemia in older men with low levels of the hormone, but it might also increase the risk of future adverse cardiovascular events, a new set of trials suggests. The research was published Feb. 21 in either the Journal of the American Medical Association or JAMA Internal Medicine.

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CMS Rule Set to Stabilize Small Health Insurance Markets

TUESDAY, Feb. 21, 2017 (HealthDay News) -- The U.S. Centers for Medicare & Medicaid Services (CMS) has proposed a rule in relation to new reforms intended to stabilize individual and small group health insurance markets for 2018.

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Internet-Delivered Exercise, Pain-Coping Skills Alleviate Knee Pain

TUESDAY, Feb. 21, 2017 (HealthDay News) -- An internet-delivered physical therapist-prescribed home exercise and pain-coping skills training (PCST) intervention is beneficial for individuals with chronic knee pain, according to a study published online Feb. 21 in the Annals of Internal Medicine.

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Readmission Common After Hospitalization for Heart Failure

TUESDAY, Feb. 21, 2017 (HealthDay News) -- For patients with hospitalization for heart failure, readmission within 30 days is common, according to a study published in the March 1 issue of The American Journal of Cardiology.

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Depression, Anxiety Prevalent in Hospice Caregivers

MONDAY, Feb. 20, 2017 (HealthDay News) -- A considerable proportion of hospice caregivers are moderately to severely depressed or have moderate to severe symptoms of anxiety, according to a study published online recently in the Journal of Palliative Medicine.

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ICU Appears Overused for Some Patients With Heart, Lung Disease

MONDAY, Feb. 20, 2017 (HealthDay News) -- Admission to the intensive care unit (ICU) is not associated with a survival benefit for patients with uncertain ICU needs hospitalized with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure, or acute myocardial infarction (AMI), according to a study published online Feb. 17 in the Annals of the American Thoracic Society.

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Increased Active Vitamin D May Help Optimize Muscle Strength

MONDAY, Feb. 20, 2017 (HealthDay News) -- High blood levels of active vitamin D may increase muscle strength, according to a study published online Feb. 15 in PLOS ONE.

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Early PT Not Tied to Lower Health Care Use Later On

MONDAY, Feb. 20, 2017 (HealthDay News) -- Early use of physical therapy (PT) for new low back pain in older adults is not associated with less subsequent back pain-specific health care utilization, compared with patients not receiving early PT, according to a study published in the March issue of The Spine Journal.

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CDC: Influenza Vaccine 48 Percent Effective Overall

FRIDAY, Feb. 17, 2017 (HealthDay News) -- This year's influenza vaccine is a fairly good match for the circulating viruses, according to research published in the Feb. 17 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Doctors Often Write Rx for Antibiotics If Patients Expect It

FRIDAY, Feb. 17, 2017 (HealthDay News) -- Doctors are more likely to prescribe antibiotics if they think patients expect the medications, according to a study published online Feb. 16 in Health Psychology.

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Metformin Use Linked to Less Vitamin B12 Measurement

FRIDAY, Feb. 17, 2017 (HealthDay News) -- Long-term metformin use is associated with lower serum vitamin B12 concentration, although metformin users are less likely to receive vitamin B12 testing, according to a study published online Feb. 9 in the Journal of the American Geriatrics Society.

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Health Care Spending Expected to Grow 5.6% Annually to 2025

THURSDAY, Feb. 16, 2017 (HealthDay News) -- Health care spending is expected to grow at an average annual rate of 5.6 percent from 2016 to 2025, according to a report published online Feb. 15 in Health Affairs.

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Hormone Therapy Doesn't Appear to Protect Against Alzheimer's

THURSDAY, Feb. 16, 2017 (HealthDay News) -- Women who use hormone therapy (HT) after menopause may not have a lower risk of developing Alzheimer's disease (AD), although there is some evidence that long-term use -- over a decade -- might be tied to a lower risk, according to a study published online Feb. 15 in Neurology.

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Bacteria, Fungi Found in Some Medicinal Marijuana Samples

WEDNESDAY, Feb. 15, 2017 (HealthDay News) -- Medical marijuana may carry infectious bacteria and fungi that can pose a life-threatening risk to cancer patients who use it to ease the side effects of chemotherapy, according to a study published online recently in Clinical Microbiology and Infection.

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Lixisenatide Beneficial in Seniors With Uncontrolled Diabetes

WEDNESDAY, Feb. 15, 2017 (HealthDay News) -- Lixisenatide is more effective than placebo for older patients with uncontrolled diabetes on their current medication, with no unexpected safety findings, according to a study published online Feb. 10 in Diabetes Care.

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Similar Adverse Event Risk for Typical, Atypical Antipsychotics

WEDNESDAY, Feb. 15, 2017 (HealthDay News) -- The risks of adverse events are similar with short-term use of typical and atypical antipsychotic medications (APMs) after cardiac surgery in seniors, according to a study published online Feb. 10 in the Journal of the American Geriatrics Society.

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Health Care Utilization Common After ICD Shock Events

WEDNESDAY, Feb. 15, 2017 (HealthDay News) -- Health care utilization (HCU) is common after appropriate and inappropriate implantable cardioverter-defibrillator shock events, according to a study published online Feb. 14 in Circulation: Cardiovascular Quality and Outcomes.

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AHA: CVD Expected to Cost U.S. $1.1 Trillion Per Year by 2035

TUESDAY, Feb. 14, 2017 (HealthDay News) -- Cardiovascular disease (CVD) is increasing in the United States, with costs expected to double from $555 billion in 2016 to $1.1 trillion in 2035, a new American Heart Association report estimates.

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ACP Issues Guideline for Treating Acute, Subacute, Chronic LBP

TUESDAY, Feb. 14, 2017 (HealthDay News) -- First-line therapy for patients with low back pain should be simple non-pharmacological remedies -- from heat wraps to physical therapy, according to a new clinical practice guideline from the American College of Physicians (ACP) published online Feb. 14 in the Annals of Internal Medicine.

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Medicare Shared Savings Linked to Lower Post-Acute Spending

TUESDAY, Feb. 14, 2017 (HealthDay News) -- Participation in the Medicare Shared Savings Program (MSSP) is associated with an overall reduction in post-acute spending, and the performance of Oregon's Medicaid Accountable Care Organization (ACO) model is similar to that of Colorado, according to two studies published online Feb. 13 in JAMA Internal Medicine.

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NOACs Have Been Widely Adopted Into Practice

TUESDAY, Feb. 14, 2017 (HealthDay News) -- Non-vitamin K antagonist oral anticoagulants (NOACs) have been adopted into practice and are more frequently prescribed than vitamin K antagonists (VKAs) in the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation trial, according to research published in the Feb. 21 issue of the Journal of the American College of Cardiology.

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Interventions Up Discussion of Advanced Care Planning

TUESDAY, Feb. 14, 2017 (HealthDay News) -- Quality improvement interventions can increase discussions relating to advanced care planning and the mention of advance directives (ADs) in the electronic medical record (EMR), according to a study published online Feb. 9 in the Journal of the American Geriatrics Society.

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Use of Multiple CNS-Affecting Drugs Increasing Among Seniors

MONDAY, Feb. 13, 2017 (HealthDay News) -- There has been a sharp rise in the number of American seniors who take three or more medications that affect their central nervous system, according to a research letter published online Feb. 13 in JAMA Internal Medicine.

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Review Links Albuminuria to Cognitive Impairment, Dementia

MONDAY, Feb. 13, 2017 (HealthDay News) -- Albuminuria is associated with cognitive impairment, dementia, and cognitive decline, according to a review published online Feb. 2 in the Journal of the American Geriatrics Society.

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Yoga Linked to Low Back Pain Relief, Improvement in Function

FRIDAY, Feb. 10, 2017 (HealthDay News) -- For patients experiencing low back pain, yoga may be an effective pain reliever, according to a review published online Jan. 12 in The Cochrane Library.

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Shift in Bisphosphonate Tx After 2008 Recommendations

THURSDAY, Feb. 9, 2017 (HealthDay News) -- In response to revised osteoporosis recommendations in 2008, there was a shift in age-related trends in oral bisphosphonate (BP) therapy initiation, according to a study published online Feb. 2 in the Journal of the American Geriatrics Society.

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Acupressure Ups Sleep Quality in Nursing Home Residents

THURSDAY, Feb. 9, 2017 (HealthDay News) -- For nursing home (NH) residents, acupressure on specific acupoints is associated with improved sleep quality and well-being, according to a study published online Feb. 2 in the Journal of the American Geriatrics Society.

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Primary Care Exercise Counseling Cost-Effective for Older Men

WEDNESDAY, Feb. 8, 2017 (HealthDay News) -- For older male veterans, improvements in physical activity and rapid gait speed can be obtained at a relatively low cost relative to patient annual health care costs, according to a study published online Feb. 2 in the Journal of the American Geriatrics Society.

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CDC: Noise-Related Hearing Loss Often Unrecognized in U.S. Adults

TUESDAY, Feb. 7, 2017 (HealthDay News) -- The noise of modern life causes permanent hearing damage to many U.S. adults who don't even suspect they've experienced a loss, according to research published in the Feb. 7 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Urologic CA Predictors ID'd in Women With Microhematuria

TUESDAY, Feb. 7, 2017 (HealthDay News) -- Older age, history of smoking, and gross hematuria predict urologic cancer in women with microscopic hematuria, according to a study published in the February issue of the American Journal of Obstetrics & Gynecology.

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Nurse Practitioners Could Help Meet Need for Elderly Home Care

TUESDAY, Feb. 7, 2017 (HealthDay News) -- Nurse practitioners could meet the growing need for house calls to frail, elderly Americans, but restrictions in some states may get in the way, according to research published recently in the Journal of the American Geriatrics Society.

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Many Obese Patients Not Getting Optimal Hospice Care

TUESDAY, Feb. 7, 2017 (HealthDay News) -- Obese patients are less likely to spend their last days in hospice care and less likely to die at home, according to a study published online Feb. 7 in the Annals of Internal Medicine.

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Health Care Access Not Easy for Undocumented Immigrants

MONDAY, Feb. 6, 2017 (HealthDay News) -- New research, published online Feb. 6 in JAMA Internal Medicine, offers insights into the medical plights facing undocumented immigrants in the United States.

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Hospitalizations for Atrial Fibrillation on the Rise

MONDAY, Feb. 6, 2017 (HealthDay News) -- U.S. patients with atrial fibrillation (AF) are being hospitalized more often than before, according to a study published online Feb. 1 in Circulation.

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Mortality Down for U.S. Patients Treated by International Doctors

MONDAY, Feb. 6, 2017 (HealthDay News) -- Mortality rates are lower for older Americans treated by doctors trained in other countries than by those who went to a U.S. medical school, according to research published online Feb. 3 in The BMJ.

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Daily Energy Expenditure Linked to Health Care Utilization

MONDAY, Feb. 6, 2017 (HealthDay News) -- Lower intensity of peak daily energy expenditure estimated from ambulatory electrocardiographic (ECG) monitoring is associated with increased health care utilization, according to a study published in the Feb. 15 issue of The American Journal of Cardiology.

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Microvascular Complications Linked to Severity of Periodontitis

MONDAY, Feb. 6, 2017 (HealthDay News) -- Microvascular complications and poor glycemic control are associated with the severity of periodontitis, according to a study published online Jan. 27 in the Journal of Diabetes Investigation.

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Treatment of Hips Beneficial in Patients With Low Back Pain

MONDAY, Feb. 6, 2017 (HealthDay News) -- For individuals presenting with a primary complaint of mechanical low back pain (LBP), prescriptive treatment of the hips seems beneficial in addition to treatment of the lumbar spine, according to a study published online Jan. 27 in the Journal of Evaluation in Clinical Practice.

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10,000 Medicare Patients/Year Die in 7 Days After ER Discharge

FRIDAY, Feb. 3, 2017 (HealthDay News) -- Each year, about 10,000 generally healthy U.S. Medicare patients die within seven days of discharge from a hospital emergency department, according to research published online Feb. 1 in The BMJ.

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Lung Cancer Screening Rates Low Among Current, Former Smokers

FRIDAY, Feb. 3, 2017 (HealthDay News) -- Most current and former smokers in the United States don't get screened for lung cancer even though they're at increased risk for the disease, according to a research letter published online Feb. 2 in JAMA Oncology.

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One in Five Undergoing Telemetry for Noncardiac Indications

FRIDAY, Feb. 3, 2017 (HealthDay News) -- More than 20 percent of patients undergoing telemetry have noncardiac indications, according to a study published online Jan. 27 in the Journal of Evaluation in Clinical Practice.

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High TG, Low HDL-C Levels May Help Further Stratify CHD Risk

FRIDAY, Feb. 3, 2017 (HealthDay News) -- A high fasting triglyceride (TG) level combined with a low high-density lipoprotein cholesterol (HDL-C) level is associated with increased risks of incident coronary heart disease (CHD) and ischemic stroke, especially for patients with diabetes or a low-density lipoprotein cholesterol (LDL-C) level of ≥130 mg/dL, independent of other atherosclerotic cardiovascular disease risk factors, according to a study published online Jan. 25 in Diabetes Care.

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Zoster Ups Stroke Risk in Patients With Autoimmune Disease

FRIDAY, Feb. 3, 2017 (HealthDay News) -- For patients with autoimmune diseases, the risk of stroke is increased in the few months subsequent to incident herpes zoster (HZ), according to a study published online Jan. 28 in Arthritis & Rheumatology.

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NSAIDs Found to Be of Little Benefit to Patients With Back Pain

THURSDAY, Feb. 2, 2017 (HealthDay News) -- Nonsteroidal anti-inflammatory drugs (NSAIDs) don't help most patients with back pain, according to a review published online Feb. 2 in the Annals of the Rheumatic Diseases.

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Recommendations Updated for Diagnosis, Management of COPD

THURSDAY, Feb. 2, 2017 (HealthDay News) -- Recommendations have been updated for diagnosis, management, and prevention of chronic obstructive pulmonary disease (COPD), according to the Global Initiative for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease (GOLD) report published online Jan. 27 in the American Journal of Respiratory and Critical Care Medicine.

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Gout Linked to Increased Hip Fracture Risk in Women

THURSDAY, Feb. 2, 2017 (HealthDay News) -- For women, a history of gout is associated with increased risk of hip fracture, according to a study published online Jan. 28 in Arthritis & Rheumatology.

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Surgery Can Benefit T2DM Control for Patients With Lumbar Stenosis

THURSDAY, Feb. 2, 2017 (HealthDay News) -- Successful lumbar surgery is associated with improved glycemic control for patients with lumbar spinal stenosis (LSS) and type 2 diabetes mellitus (DM-2), according to a study published in the February issue of The Spine Journal.

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Paracardial Fat Linked to Risk of CAC in Postmenopausal Women

WEDNESDAY, Feb. 1, 2017 (HealthDay News) -- Paracardial adipose tissue may be a sign of developing cardiovascular disease in postmenopausal women, according to a study published online Jan. 30 in the Journal of the American Heart Association.

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Benefits for Intensive BP Lowering in Older HTN Patients

WEDNESDAY, Feb. 1, 2017 (HealthDay News) -- For older patients with hypertension, intensive blood pressure (BP) lowering strategies are associated with reduced risk of certain cardiovascular events, according to research published in the Feb. 7 issue of the Journal of the American College of Cardiology.

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