April 2016 Briefing - Geriatrics

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Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for April 2016. 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.

Hearing Aids Linked to Stronger Scores on Mini-Mental Exam

FRIDAY, April 29, 2016 (HealthDay News) -- New research suggests that hearing aids might help prevent or slow the development of dementia in elderly people with hearing loss. The study was published online April 25 in the American Journal of Geriatric Psychiatry.

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FDA Reconsidering Training for Doctors Prescribing Opioids

FRIDAY, April 29, 2016 (HealthDay News) -- Mandatory safety training for doctors who prescribe opioids is being reconsidered by the U.S. Food and Drug Administration.

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First Zika-Related Death in Puerto Rico Reported

FRIDAY, April 29, 2016 (HealthDay News) -- The first known Zika virus-linked death in Puerto Rico was announced Friday by officials of the U.S. territory.

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Wide Variation in Health Care Costs Across the U.S.

FRIDAY, April 29, 2016 (HealthDay News) -- Health care prices vary widely across the United States, even within the same state, according to a study published in the April issue of Health Affairs.

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Rosacea Linked to Increased Risk of Dementia

THURSDAY, April 28, 2016 (HealthDay News) -- Rosacea may be linked to a higher risk for dementia, particularly Alzheimer's disease (AD), according to research published online April 28 in the Annals of Neurology.

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Article Discusses Workplace Violence in Health Care

THURSDAY, April 28, 2016 (HealthDay News) -- There is a lack of data relating to the prevalence of workplace violence in health care and how to address it, according to a review article published in the April 28 issue of the New England Journal of Medicine.

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Review: Type 2 Diabetes Linked to Hearing Impairment

THURSDAY, April 28, 2016 (HealthDay News) -- Type 2 diabetes may raise the risk of hearing loss, according to a review published recently in Current Diabetes Reports.

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Mindfulness Therapy May Help Ease Recurrent Depression

WEDNESDAY, April 27, 2016 (HealthDay News) -- Mindfulness-based cognitive therapy may help reduce the risk of repeated episodes of depression, according to a study published online April 27 in JAMA Psychiatry.

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U.S. Health Report Card Finds Racial, Ethnic Disparities Persist

WEDNESDAY, April 27, 2016 (HealthDay News) -- An update on Americans' health finds that racial and ethnic disparities persist, with significant gaps in obesity, cesarean births, and dental care. But advances have been made in some important areas, including infant mortality rates, women smokers, and numbers of uninsured, according to the new report from the U.S. Department of Health and Human Services.

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Doctors Have a Only a Few Weeks Left to Review Financial Data

WEDNESDAY, April 27, 2016 (HealthDay News) -- Under the Physician Payments Sunshine Act, physicians have only a few weeks left to review and report disputes relating to their financial ties to drug and medical device manufacturers, according to the American Medical Association.

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Some Primary Care Physician Finances Are Improving

WEDNESDAY, April 27, 2016 (HealthDay News) -- The financial outlook for primary care practices is improving, but not all practices are experiencing the same improvements, according to an article published in Medical Economics.

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Certain Nutraceuticals May Augment Antidepressant Effects

WEDNESDAY, April 27, 2016 (HealthDay News) -- Certain nutritional supplements may improve the effectiveness of antidepressants, according to research published online April 26 in The American Journal of Psychiatry.

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Coronary Heart Disease Risk Up for Women Working Night Shifts

TUESDAY, April 26, 2016 (HealthDay News) -- Women who work rotating night shifts may face a slightly increased risk of coronary heart disease (CHD), according to a report published in the April 26 issue of the Journal of the American Medical Association.

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Influenza Vaccination Timing Appears to Affect Efficacy

TUESDAY, April 26, 2016 (HealthDay News) -- Influenza vaccination may be more effective when people receive it in the morning than in the afternoon, according to a study published online April 26 in Vaccine.

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Pharmacists Can Manage Some Chronic Conditions Effectively

TUESDAY, April 26, 2016 (HealthDay News) -- Pharmacists can do an effective job helping chronically ill patients manage their blood pressure, cholesterol, and blood glucose levels if they're allowed to direct patients' health care, according to an evidence review published online April 26 in the Annals of Internal Medicine.

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Saxagliptin, Sitagliptin Don't Up Hospitalized Heart Failure

TUESDAY, April 26, 2016 (HealthDay News) -- Use of saxagliptin or sitagliptin is not associated with increased risk of hospitalized heart failure (hHF) compared with other antihyperglycemic agents, according to a study published online April 26 in the Annals of Internal Medicine.

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Triple Therapy No Benefit for COPD Exacerbations

TUESDAY, April 26, 2016 (HealthDay News) -- The addition of tiotropium to long-acting β2-agonists (LABA) and/or inhaled corticosteroids (ICS) does not reduce chronic obstructive pulmonary disease (COPD) exacerbations compared to LABA/ICS alone, according to a study published online April 20 in the Journal of Clinical Pharmacology.

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Direct Primary Care Is Emerging Business Model

TUESDAY, April 26, 2016 (HealthDay News) -- Direct primary care, where doctors bypass insurance companies, is an emerging business model, according to an article published in The Boston Globe.

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A Doctor's View: EHRs Impair Physician-Patient Relationship

MONDAY, April 25, 2016 (HealthDay News) -- Electronic health records (EHRs) may be impairing the physician-patient relationship, according to an article published in Medical Economics.

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No Link for Smoking Cessation Meds, Mental Health Issues

MONDAY, April 25, 2016 (HealthDay News) -- Varenicline (Chantix) and bupropion (Wellbutrin) don't appear to raise the risk of mental health disorders such as depression, anxiety, and suicidal thoughts, according to a new study published online April 22 in The Lancet.

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Homocysteine Tied to Alzheimer's Via Aβ-Fibrinogen Interaction

MONDAY, April 25, 2016 (HealthDay News) -- Plasma homocysteine (HC) and its metabolite homocysteine thiolactone (HCTL) contribute to Alzheimer's disease (AD) pathology via the amyloid-β (Aβ)-fibrinogen interaction, according to a study published online April 19 in the Journal of Thrombosis and Haemostasis.

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Poor Persistence/Adherence With Long-Term Topical AK Treatment

MONDAY, April 25, 2016 (HealthDay News) -- A considerable proportion of patients with actinic keratosis (AK) receiving long-term topical treatment have poor persistence or adherence, according to a study published online April 18 in the British Journal of Dermatology.

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Physicians Can Get Involved in Developing Payment Models

FRIDAY, April 22, 2016 (HealthDay News) -- Doctors can be involved in developing new payment models for their practices, according to the American Medical Association.

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CDC: Suicide Rate Up 24 Percent in the United States Since 1999

FRIDAY, April 22, 2016 (HealthDay News) -- Suicide rates in the United States rose 24 percent between 1999 and 2014, with young girls and middle-aged men accounting for the largest increases, according to an April data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Aromatase Inhibitors Won't Raise Odds of Most Fatal CVD Events

FRIDAY, April 22, 2016 (HealthDay News) -- Treatment with aromatase inhibitors doesn't raise the risk of the most fatal cardiovascular disease events among breast cancer survivors, according to research published online April 21 in JAMA Oncology.

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How One Health System Is Shifting From Volume to Value

FRIDAY, April 22, 2016 (HealthDay News) -- ACCESS Health System, which operates 36 health centers, is transitioning to a patient-centered, physician-friendly health system that provides a continuum of care to underserved populations, according to the American Medical Association (AMA).

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Ideal BP in Elderly With Chronic Kidney Disease Unclear

FRIDAY, April 22, 2016 (HealthDay News) -- Age modifies the association between blood pressure (BP) and adverse cardiovascular and renal outcomes in elderly patients with chronic kidney disease (CKD), according to research published online April 21 in the Clinical Journal of the American Society of Nephrology.

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Stomach CA Risk Up With Alcohol, Processed Meat Consumption

THURSDAY, April 21, 2016 (HealthDay News) -- Alcohol, processed meats -- such as hot dogs, ham, and bacon -- and excess weight all may raise a person's risk of stomach cancer, according to a new review released by the American Institute for Cancer Research and the World Cancer Research Fund International.

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Comorbidity Tied to Prostate Cancer Upgrading, Up Staging

FRIDAY, April 22, 2016 (HealthDay News) -- Comorbidity burden is strongly and independently associated with pathological upgrading/up staging in men with clinically low-risk prostate cancer, according to a study published in the April issue of The Journal of Urology.

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Medical Expulsive Therapy Underused for Ureteral Stones

THURSDAY, April 21, 2016 (HealthDay News) -- For patients with ureteral stones, medical expulsive therapy remains underused, according to a study published in the April issue of The Journal of Urology.

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Improved Survival for Certain Cancers With Low-Dose Aspirin

THURSDAY, April 21, 2016 (HealthDay News) -- Patients with colorectal, breast, or prostate cancers may have better survival odds if they are on a low-dose aspirin regimen, according to a review published online April 20 in PLOS ONE.

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Decrease in Prostate CA Mortality Parallels Drop in Smoking

WEDNESDAY, April 20, 2016 (HealthDay News) -- Declines in prostate cancer mortality seem to parallel declines in cigarette smoking, based on data from four U.S. states. The report was published online April 14 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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LDL Reduction in Hypertriglyceridemia Varies Per Statin

WEDNESDAY, April 20, 2016 (HealthDay News) -- For patients with hypertriglyceridemia, low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) reductions depend of the choice and dose of statin, according to research published in the May 1 issue of The American Journal of Cardiology.

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Novel Case of Alzheimer's Reported in HIV+ Patient

TUESDAY, April 19, 2016 (HealthDay News) -- The first case of Alzheimer's disease (AD) diagnosed in a person with HIV suggests progressive dementia in older HIV+ individuals may be due to HIV-associated neurocognitive disorder (HAND), AD, or both. The case study was published online April 14 in Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring.

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Lower CVD Mortality for Metformin Versus Sulfonylureas

TUESDAY, April 19, 2016 (HealthDay News) -- Metformin is associated with reduced cardiovascular mortality compared with sulfonylureas, according to a large analysis published online April 19 in the Annals of Internal Medicine.

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Network Meta-Analysis Recommends Prostaglandins for Glaucoma

TUESDAY, April 19, 2016 (HealthDay News) -- Network meta-analysis, which compares multiple treatment options, suggests that prostaglandins are best for decreasing intraocular pressure at three months in primary open angle-glaucoma (POAG), according to research published online April 19 in the Annals of Internal Medicine.

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Mineralocorticoid Receptor Antagonists No Benefit Post MI

TUESDAY, April 19, 2016 (HealthDay News) -- For patients with post-myocardial infarction (MI) heart failure, mineralocorticoid receptor antagonists (MRAs) do not improve outcome, according to a study published in the April 26 issue of the Journal of the American College of Cardiology.

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Post-Op Gouty Arthritis Described in Patient Taking Thiazide

TUESDAY, April 19, 2016 (HealthDay News) -- A case of postoperative acute gouty arthritis following laparoscopic cholecystectomy with umbilical hernioplasty, secondary to hydrochlorothiazide use, has been documented in a case report published in the March issue in the Journal of Pharmacy Practice and Research.

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Suboptimal Guideline Adherence for Hematuria After Menopause

TUESDAY, April 19, 2016 (HealthDay News) -- The prevalence of urinary tract malignancy is low among postmenopausal women evaluated for asymptomatic microscopic hematuria, according to a study published in the April issue of The Journal of Urology.

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Article Offers Ways to Address Overlooked Details in Practice

MONDAY, April 18, 2016 (HealthDay News) -- Looking at a family medicine practice with fresh eyes can help address unsightly issues that patients notice, according to an article published in Family Practice Management.

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Physicians May Be Ordering Carotid Imaging Too Often

MONDAY, April 18, 2016 (HealthDay News) -- Many heart patients undergo carotid imaging for uncertain or inappropriate reasons, according to a study published online April 18 in JAMA Internal Medicine.

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Testosterone Undecanoate Cuts Anemia in Hypogonadal Men

MONDAY, April 18, 2016 (HealthDay News) -- Testosterone undecanoate reduces anemia in patients with subnormal testosterone levels, according to a study published in the April issue of The Journal of Urology.

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Antithrombotic Rx Could Be Optimized for Older A-Fib Patients

MONDAY, April 18, 2016 (HealthDay News) -- A considerable proportion of older patients with atrial fibrillation (AF) are not prescribed antithrombotics, according to a study published online April 7 in the Journal of Clinical Pharmacy and Therapeutics.

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No Racial Difference in Prognostic Value of Cardiorespiratory Fitness

FRIDAY, April 15, 2016 (HealthDay News) -- Cardiorespiratory fitness (CRF) predicts all-cause mortality, with no racial differences in its prognostic value, according to a study published in the May 1 issue of The American Journal of Cardiology.

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2016 Match Marks Record Highs for Registrants, Matching

FRIDAY, April 15, 2016 (HealthDay News) -- The 2016 Match was the largest ever recorded by the National Resident Matching Program, with a higher match rate that 2015, according to a report from the American Medical Association.

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Metformin May Reduce Cancer Mortality Risk

FRIDAY, April 15, 2016 (HealthDay News) -- Metformin may reduce the risk of dying from some cancers for postmenopausal women with type 2 diabetes, according to a study published in the April 15 issue of the International Journal of Cancer.

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Proton Pump Inhibitors Tied to Chronic Kidney Disease

FRIDAY, April 15, 2016 (HealthDay News) -- Patients who regularly use proton pump inhibitors (PPIs) may be at increased risk of developing chronic kidney disease, according to research published online April 14 in the Journal of the American Society of Nephrology.

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Abdominal Aortic Aneurysm Odds Up for Patients With Psoriasis

FRIDAY, April 15, 2016 (HealthDay News) -- Psoriasis patients may face a higher risk of an abdominal aortic aneurysm, according to a study published online April 14 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Improved Functional Outcomes With Adoption of GWTG-Stroke

FRIDAY, April 14, 2016 (HealthDay News) -- Adoption of the Get With The Guidelines (GWTG)-Stroke program is associated with improved functional outcomes at discharge and reduced post-discharge mortality for Medicare beneficiaries with acute stroke, according to a study published online April 14 in Stroke.

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Decrease in Medicare Spending for 2012 ACO Entrants

FRIDAY, April 15, 2016 (HealthDay News) -- Early reductions in Medicare spending were seen for the first full year of Medicare Shared Savings Program (MSSP) contracts for 2012 Accountable Care Organization (ACO) entrants, according to a study published online April 13 in the New England Journal of Medicine.

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Health Care Workers Skip Hand Washing One-Third of the Time

THURSDAY, April 14, 2016 (HealthDay News) -- Staff at many outpatient health care facilities in New Mexico failed to follow recommendations for hand hygiene more than one-third of the time, according to findings published in the April 1 issue of the American Journal of Infection Control.

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Older Age May Boost Radiation Benefits in Soft-Tissue Sarcoma

THURSDAY, April 14, 2016 (HealthDay News) -- Older patients with soft-tissue sarcomas may benefit more from radiation therapy after surgery than younger patients do, according to research published in the April issue of Anticancer Research.

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Fusion Not Always Necessary for Back Pain From Stenosis

THURSDAY, April 14, 2016 (HealthDay News) -- Spinal fusion surgery is too often used to treat lower back pain caused by stenosis when decompression would suffice, but is still beneficial for select patients, according to a pair of new clinical trials published in the April 14 issue of the New England Journal of Medicine.

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Surveillance Seems Safe for Some Intermediate Risk Prostate CA

THURSDAY, April 14, 2016 (HealthDay News) -- For men with prostate cancer, active surveillance seems safe for those at low risk and for select patients at intermediate risk, according to a study published in The Journal of Urology.

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Progress Made in Comprehensive Primary Care Initiative

THURSDAY, April 14, 2016 (HealthDay News) -- Two years into the Comprehensive Primary Care Initiative, practices have made progress toward transforming delivery of primary care but have not yet shown savings in expenditures, according to a study published online April 13 in the New England Journal of Medicine.

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Self-Management Group Rehab Benefits Persons With Dementia

THURSDAY, April 14, 2016 (HealthDay News) -- Self-management group rehabilitation is beneficial for persons with dementia (PwD) and their spouses, according to a study published online April 5 in the Journal of the American Geriatrics Society.

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Benefits of Polyunsaturated Over Saturated Fat Deemed Uncertain

WEDNESDAY, April 13, 2016 (HealthDay News) -- Controversial new research challenges the idea that heart health will improve if people cut saturated fat -- typically from animal sources -- from their diets in favor of vegetable oil. The findings were published online April 12 in The BMJ.

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Coalition Calls for Changes to Hospital Pain Assessments

WEDNESDAY, April 13, 2016 (HealthDay News) -- U.S. hospital procedures and questionnaires used to manage patient pain lead to overprescribing of addictive opioids and need to be changed, critics say.

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Potentially Inappropriate Meds Use Common With OAB Tx

WEDNESDAY, April 13, 2016 (HealthDay News) -- For older adults starting antimuscarinic treatment for overactive bladder (OAB), potentially inappropriate medication (PIM) use is highly prevalent and associated with greater total costs, according to a study published online April 5 in the Journal of the American Geriatrics Society.

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Low Fruit, Vegetable Intake Linked to Hip Fracture Risk

WEDNESDAY, April 13, 2016 (HealthDay News) -- For older adults, daily intake of no more than one serving of fruit and vegetables is associated with increased risk of hip fracture relative to moderate intake, according to a study published online April 8 in the Journal of Bone and Mineral Research.

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CV Risk Not Significantly Different for GLP-1 Receptor Agonists

TUESDAY, April 12, 2016 (HealthDay News) -- There are no significant differences in occurrence of cardiovascular disease (CVD) tied to treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RA) compared with dipeptidyl peptidase-4 inhibitors (DPP-4i), second generation sulfonylureas, or insulin, in combination with metformin, according to a study published online March 22 in Diabetes, Obesity and Metabolism.

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Androgen Deprivation Tx for Prostate CA Tied to Depression

TUESDAY, April 12, 2016 (HealthDay News) -- Older men who receive androgen deprivation therapy (ADT) for prostate cancer may be at increased risk of developing depression, according to a new, large study published online April 11 in the Journal of Clinical Oncology.

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Parental Hip Fracture Independently Ups Offspring Risk

TUESDAY, April 12, 2016 (HealthDay News) -- Parental hip fracture (HF) is independently associated with increased risk of offspring major osteoporotic fracture (MOF) and HF, according to research published online April 8 in the Journal of Bone and Mineral Research.

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Doctors Can Be Misled About FDA 'Breakthrough' Drug Designation

TUESDAY, April 12, 2016 (HealthDay News) -- Use of the word "breakthrough" in the U.S. Food and Drug Administration's expedited approval process could mislead doctors about the new drugs' actual benefits, according to a research letter published in the April 12 issue of the Journal of the American Medical Association.

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Hospice Care Doesn't Up Costs for Nursing Home Decedents

TUESDAY, April 12, 2016 (HealthDay News) -- For long-stay nursing home (NH) decedents, use of hospice does not increase Medicare costs in the six months before death, according to a study published online April 5 in the Journal of the American Geriatrics Society.

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New-Onset A-Fib Post Acute MI Ups Complications, Readmission

TUESDAY, April 12, 2016 (HealthDay News) -- New-onset atrial fibrillation (AF) after acute myocardial infarction (AMI) is strongly tied to in-hospital complications and higher short-term readmission rates, according to a study published in the April 15 issue of The American Journal of Cardiology.

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Telomere Length Tied to Higher Myocardial Infarction Risk

MONDAY, April 11, 2016 (HealthDay News) -- Telomere length (TL) is associated with an increased risk of myocardial infarction (MI), according to a study published in the April 19 issue of the Journal of the American College of Cardiology.

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Vitamin D Supplementation Doesn't Change Lean Mass, BMD

MONDAY, April 11, 2016 (HealthDay News) -- For postmenopausal women with vitamin D insufficiency completing a structured weight-loss program, vitamin D3 supplementation is not associated with changes in lean mass or bone mineral density (BMD), according to a study published online April 5 in the Journal of the American Geriatrics Society.

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VA Commission on Care: Eliminate VA Medical Centers

MONDAY, April 11, 2016 (HealthDay News) -- A radical proposal has been suggested for eliminating all Veterans Affairs (VA) medical centers and outpatient facilities in the next 20 years, floated by seven of 15 members of the VA Commission on Care, according to an article published in the Military Times.

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Colonic Diverticular Disease Linked to Dementia Risk

MONDAY, April 11, 2016 (HealthDay News) -- Colonic diverticular disease appears to be associated with increased risk of dementia in a population from Taiwan, according to a study published online March 31 in the Journal of Gastroenterology and Hepatology.

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Niacin-ER May Be Overlooked Cause of Thrombocytopenia

FRIDAY, April 8, 2016 (HealthDay News) -- Extended-release (ER) niacin is associated with progressive and reversible thrombocytopenia, according to a letter to the editor published online March 25 in the American Journal of Hematology.

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ACEI/ARBs Up AMI Outcomes Regardless of Renal Status

FRIDAY, April 8, 2016 (HealthDay News) -- For acute myocardial infarction (AMI) survivors, angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) treatment is associated with improved long-term survival, according to research published in the April 12 issue of the Journal of the American College of Cardiology.

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White Matter Hyperintensities Predate Alzheimer's Onset

FRIDAY, April 8, 2016 (HealthDay News) -- Autosomal dominant Alzheimer's disease is associated with increased white matter hyperintensities (WMH) on magnetic resonance imaging well before expected symptom onset, according to a study published online March 26 in the Annals of Neurology.

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Daily Fresh Fruit Intake May Improve Cardiovascular Health

THURSDAY, April 7, 2016 (HealthDay News) -- Eating fresh fruit regularly may help prevent heart attacks and strokes, according to a study published in the April 7 issue of the New England Journal of Medicine.

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Diuretic Dose Not Linked to Outcome in Heart Failure

WEDNESDAY, April 6, 2016 (HealthDay News) -- For patients with worsening heart failure, after adjustment for pre-specified covariates of disease severity, diuretic dose is not associated with mortality and heart failure rehospitalization, according to a study published online March 30 in JACC: Heart Failure.

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Local Heating Pad Eases IV Catheter Insertion

WEDNESDAY, April 6, 2016 (HealthDay News) -- Local heating pad application eases catheterization in chemotherapy patients, according to a study published online March 30 in the Journal of Clinical Nursing.

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USPSTF Recommends Against COPD Screening in Adults

TUESDAY, April 5, 2016 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends against screening for chronic obstructive pulmonary disease (COPD) in asymptomatic adults. These findings form the basis of a recommendation statement published online April 5 in the Journal of the American Medical Association.

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Hypoglycemia, Sleep Loss Prolong Cognitive Impairment

TUESDAY, April 5, 2016 (HealthDay News) -- Sleep deprivation does not exacerbate cognitive impairment induced by hypoglycemia, but the post-hypoglycemia recovery takes longer with persistence of both cognitive dysfunction and hypoglycemia symptoms, according to a study published online March 22 in Diabetes Care.

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Sensory Interventions Can Benefit Patients With Dementia

MONDAY, April 4, 2016 (HealthDay News) -- For patients with dementia, there are many available sensory interventions that seem to have significant effects, according to a review published online March 31 in the Journal of Clinical Nursing.

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Are Guidelines Needed to Assess Competence of Aging Physicians?

FRIDAY, April 1, 2016 (HealthDay News) -- The question of whether national guidelines need to be developed for assessing the competence of aging physicians was discussed during a recent meeting of key stakeholders, according to a news release from the American Medical Association (AMA).

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Inconsistent Link Found Between Oral Health, Cognitive Status

FRIDAY, April 1, 2016 (HealthDay News) -- There is an inconsistent correlation between oral health and cognitive status in older individuals, according to a review published online April 1 in the Journal of the American Geriatrics Society.

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