August 2017 Briefing - Neurology

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Here are what the editors at HealthDay consider to be the most important developments in Neurology for August 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.

No Link for Cardiovascular Meds Use, Cognitive Impairment

THURSDAY, Aug. 31, 2017 (HealthDay News) -- For older adults, there is no association between cardiovascular medication use and cognitive impairment, according to a study published online Aug. 24 in Cardiovascular Therapeutics.

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Minimal Evidence for Electronic Communication Guidelines

THURSDAY, Aug. 31, 2017 (HealthDay News) -- Minimal evidence is available for guidelines for electronic communication between patients and providers, according to research published online Aug. 28 in the Journal of the American Medical Informatics Association.

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More Evidence Links Epstein-Barr Virus to MS Risk

THURSDAY, Aug. 31, 2017 (HealthDay News) -- Infection with Epstein-Barr virus (EBV) or cytomegalovirus may up the risk for multiple sclerosis (MS), and the link isn't limited to whites, according to a study published online Aug. 30 in Neurology.

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Proactive Approach Encouraged for Online Patient Reviews

WEDNESDAY, Aug. 30, 2017 (HealthDay News) -- Most patients are using online reviews as a first step to finding a new doctor, with 65 percent forming an opinion from reading one to six reviews, according to a report published in Medical Economics.

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Intracranial Pressure Monitoring No Benefit in Pediatric TBI

WEDNESDAY, Aug. 30, 2017 (HealthDay News) -- For children with severe traumatic brain injury, intracranial pressure (ICP) monitoring is not associated with improved functional survival, according to a study published online Aug. 28 in JAMA Pediatrics.

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Review Links Sleep-Disordered Breathing, Cognitive Impairment

WEDNESDAY, Aug. 30, 2017 (HealthDay News) -- Sleep-disordered breathing (SDB) is associated with increased likelihood of cognitive impairment, according to a review published online Aug. 28 in JAMA Neurology.

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Gender-Specific High-Risk 'Window' Seen in Alzheimer's

TUESDAY, Aug. 29, 2017 (HealthDay News) -- Women with a genetic predisposition for Alzheimer's disease face a 10-year window -- between ages 65 and 75 -- when they have far greater chances of developing the disease than men with similar genetic risks, according to a study published online Aug. 28 in JAMA Neurology.

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FDA Cites 'Significant Deviations' at Florida Stem Cell Clinic

TUESDAY, Aug. 29, 2017 (HealthDay News) -- A Florida stem cell clinic has received a warning letter from the U.S. Food and Drug Administration about what the agency describes as serious problems that could pose health risks to patients.

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Being Awake for Aneurysm Brain Surgery May Offer Better Results

FRIDAY, Aug. 25, 2017 (HealthDay News) -- "Awake" brain surgery may improve treatment of brain aneurysms, according to a study published in the August issue of the Journal of Neurosurgery.

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Opioids Often Prescribed Unnecessarily for Migraine

FRIDAY, Aug. 25, 2017 (HealthDay News) -- Too many patients with migraines are prescribed opioids, while too few may be getting recommended medications, according to research published recently in Cephalalgia.

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Insufficient Sleep May Lead to Increased Risk-Taking Behavior

FRIDAY, Aug. 25, 2017 (HealthDay News) -- Chronic sleep restriction may lead to risk-seeking behavior, according to a study published online Aug. 21 in the Annals of Neurology.

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Meth Use Tied to Higher Risk of Stroke in Younger People

THURSDAY, Aug. 24, 2017 (HealthDay News) -- Younger adults who use methamphetamine appear to be at greater risk for stroke, particularly hemorrhagic stroke, according to research published online Aug. 23 in the Journal of Neurology Neurosurgery & Psychiatry.

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Less REM May Indicate Higher Dementia Risk in Seniors

THURSDAY, Aug. 24, 2017 (HealthDay News) -- Seniors who spend less time each night in rapid eye movement (REM) sleep may be more likely to develop dementia as they age, according to a study published online Aug. 23 in Neurology.

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Intensive BP Treatment Appears Safe, Well Tolerated

THURSDAY, Aug. 24, 2017 (HealthDay News) -- For patients at increased risk of cardiovascular disease, intensive blood pressure control may be just as safe as standard treatment, and is likely cost-effective, according to research published in the Aug. 24 issue of the New England Journal of Medicine.

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Patient Beliefs May Explain High Rate of Medicine Intake

THURSDAY, Aug. 24, 2017 (HealthDay News) -- Subjective norms and attitudes toward medicine consumption predict the intention and expectation to consume medicines, according to a study published online Aug. 19 in the Journal of Clinical Pharmacy and Therapeutics.

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Increased Risk of MI, Stroke for Patients With Hip Fracture

THURSDAY, Aug. 24, 2017 (HealthDay News) -- Patients with hip fracture have an increased risk of myocardial infarction (MI) and stroke, according to a study published online Aug. 21 in the Journal of Bone and Mineral Research.

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Pattern of Stressor-Evoked Brain Activity Can Predict BP Reactivity

WEDNESDAY, Aug. 23, 2017 (HealthDay News) -- A multivariate pattern of stressor-evoked brain activity can predict individual differences in blood pressure (BP) reactivity, according to a study published online Aug. 23 in the Journal of the American Heart Association.

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Sleep, Caffeine Use May Play Role in Post-Op Pain

WEDNESDAY, Aug. 23, 2017 (HealthDay News) -- Extended wakefulness prior to surgery significantly enhances postoperative pain behaviors and extends recovery time after surgery, but caffeine may help mitigate this effect, according to an experimental study published online Aug. 3 in SLEEP.

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Collaborative Communication Could Improve HTN Rx Adherence

WEDNESDAY, Aug. 23, 2017 (HealthDay News) -- Health care providers can help boost patient adherence to antihypertensive medications by communicating more collaboratively with patients, and including discussion of socioeconomic challenges, according to a study published online Aug. 22 in Circulation: Cardiovascular Quality and Outcomes.

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Tablet Use Encourages Patients to Explore Diabetes Risk

WEDNESDAY, Aug. 23, 2017 (HealthDay News) -- The multispecialty San Bernardino Medical Group has replaced magazines with digital devices in waiting rooms, which can help patients learn about their risk of diabetes and take preventive action, according to a report published by the American Medical Association (AMA).

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Cost-Effectiveness of PCSK9 Inhibitors Called Into Question

WEDNESDAY, Aug. 23, 2017 (HealthDay News) -- The costs of PCSK9 inhibitors would have to be 71 percent lower to be deemed cost-effective, according to a research letter published in the Aug. 22/29 issue of the Journal of the American Medical Association.

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Nurse-, System-Related Factors Analyzed in Wrong-Patient Events

WEDNESDAY, Aug. 23, 2017 (HealthDay News) -- Greater focus is needed on correct identification processes in order to prevent wrong-patient medication administration incidents, and system supports for nurses are critical, according to a study published online Aug. 17 in the Journal of Clinical Nursing.

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Zika Thrives in Pregnancy Due to Vulnerable Immune System

TUESDAY, Aug. 22, 2017 (HealthDay News) -- The Zika virus thrives in pregnant women by suppressing their already dampened immune systems and running roughshod over their body's natural defenses, which allows the virus to directly attack the fetus, according to a study published online Aug. 21 in Nature Microbiology.

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AAP Issues New Guidelines for ID, Treatment of HTN in Children

TUESDAY, Aug. 22, 2017 (HealthDay News) -- More U.S. children are likely to be diagnosed and treated for hypertension under new recommendations from the American Academy of Pediatrics. The updated clinical practice guideline was published online Aug. 21 in Pediatrics.

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Lower SBP Target for Blacks May Benefit Cognitive Function

TUESDAY, Aug. 22, 2017 (HealthDay News) -- For seniors and particularly blacks with hypertension, lowering systolic blood pressure to 120 mm Hg or lower may help prevent cognitive decline, according to a report published online Aug. 21 in JAMA Neurology.

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Higher BMI in Childhood Linked to Adult Stroke Risk

TUESDAY, Aug. 22, 2017 (HealthDay News) -- Above-average childhood body mass index (BMI) and increases in BMI during childhood are associated with increased risk of early adult ischemic stroke, according to a study published online Aug. 21 in JAMA Neurology.

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Hours Worked Impacted by Kids for Female, Not Male Doctors

MONDAY, Aug. 21, 2017 (HealthDay News) -- For women, but not men, in dual-physician couples, weekly hours worked are lower for those with versus those without children, according to a research letter published online Aug. 21 in JAMA Internal Medicine.

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Transcranial Magnetic Stimulation Aids PTSD in Eating Disorders

MONDAY, Aug. 21, 2017 (HealthDay News) -- Repetitive transcranial magnetic stimulation (rTMS) of the dorsomedial prefrontal cortex (DMPFC) seems to be beneficial for treatment of posttraumatic stress disorder (PTSD) in patients with eating disorders, according to research published online Aug. 16 in the International Journal of Eating Disorders.

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Radioiodine Therapy for Thyroid Cancer Doesn't Up Stroke Risk

FRIDAY, Aug. 18, 2017 (HealthDay News) -- Radioiodine (I-131) therapy for thyroid cancer is not associated with increased risk of stroke, according to a study published online Aug. 16 in Head & Neck.

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Visual Dysfunction Tied to Poor Cognitive Function in Seniors

FRIDAY, Aug. 18, 2017 (HealthDay News) -- Visual dysfunction at baseline is associated with poor cognitive function among older U.S. adults, according to a study published online Aug. 17 in JAMA Ophthalmology.

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Telehealth Feasible for Parkinson's Care

FRIDAY, Aug. 18, 2017 (HealthDay News) -- Virtual house calls by neurologists may be of great interest to and provide substantial convenience for patients with Parkinson's disease, according to a study published online Aug. 16 in Neurology.

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Increase in Survival Without Severe Disability for Preemies

THURSDAY, Aug. 17, 2017 (HealthDay News) -- During the past two decades, survival and survival without severe or moderate neuromotor or sensory disabilities have increased among preterm infants, according to a study published online Aug. 17 in The BMJ.

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Increasing Physical Activity, Function Can Decrease Fall Fears

THURSDAY, Aug. 17, 2017 (HealthDay News) -- Enhancing physical activity level and function can decrease the fear of falling among elderly patients, according to a study published online Aug. 9 in the Journal of Clinical Nursing.

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Evolocumab Doesn't Affect Cognition When Added to Statins

THURSDAY, Aug. 17, 2017 (HealthDay News) -- There is no significant difference in cognitive function for patients treated with evolocumab or placebo added to statin therapy, according to a study published in the Aug. 17 issue of the New England Journal of Medicine.

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Families Shoulder Majority of Costs Related to Dementia Care

THURSDAY, Aug. 17, 2017 (HealthDay News) -- Lifetime costs of care are substantially increased for individuals with dementia, according to a study published online Aug. 17 in the Journal of the American Geriatrics Society.

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Opioid Rx Frequently Issued for Nonspecific, Spinal Conditions

THURSDAY, Aug. 17, 2017 (HealthDay News) -- Within a cohort of patients insured through TRICARE, the most common diagnosis associated with initial opioid prescription is other ill-defined conditions, according to a research letter published online Aug. 16 in JAMA Surgery.

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Phenotype Varies for Presumed Pathogenic Variants in KCNB1

WEDNESDAY, Aug. 16, 2017 (HealthDay News) -- De novo KCNB1 missense and loss-of-function variants are associated with neurodevelopmental disorders, with or without seizures, according to a study published online Aug. 14 in JAMA Neurology.

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Studies Used for FDA Approval of Device Changes Often Low Quality

TUESDAY, Aug. 15, 2017 (HealthDay News) -- Many studies used to support U.S. Food and Drug Administration approval of high-risk medical device modifications are not controlled; and efficacy of drugs granted accelerated approval is often confirmed three years after approval, according to two studies published in the Aug. 15 issue of the Journal of the American Medical Association.

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High Platelet Reactivity Tied to Ischemic, Bleeding Outcomes

TUESDAY, Aug. 15, 2017 (HealthDay News) -- There is a strong relationship between high on-clopidogrel platelet reactivity and two-year ischemic and bleeding outcomes after drug-eluting stent implantation, according to a study published online Aug. 2 in JACC: Cardiovascular Interventions.

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Specialist Access No Better With Adoption of Access Standards

TUESDAY, Aug. 15, 2017 (HealthDay News) -- Adoption of specialty access standards does not improve access to specialists, according to a study published online Aug. 14 in JAMA Internal Medicine.

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Diverse Spectrum of Neurologic Syndromes Seen With Zika

TUESDAY, Aug. 15, 2017 (HealthDay News) -- Zika virus (ZIKV) infection is associated with increased incidence of neurological syndromes, according to a study published online Aug. 14 in JAMA Neurology.

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Intraindividual Variability in Reaction Time Tied to Mortality

TUESDAY, Aug. 15, 2017 (HealthDay News) -- Intraindividual variability of reaction time (IIVRT) is independently associated with mortality, according to a study published online Aug. 9 in PLOS ONE.

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Short-Term Risk of Arterial Embolism Up in Cancer Patients

MONDAY, Aug. 14, 2017 (HealthDay News) -- The risk of arterial thromboembolism is increased in the short term among patients with incident cancer, according to a study published in the Aug. 22 issue of the Journal of the American College of Cardiology.

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Review: Cannabis May Alleviate Neuropathic Pain

MONDAY, Aug. 14, 2017 (HealthDay News) -- Cannabis may alleviate neuropathic pain, but is not associated with benefit for adults with posttraumatic stress disorder (PTSD), according to two reviews published online Aug. 15 in the Annals of Internal Medicine.

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Rates of Active, Current Epilepsy in U.S. Adults Rising

MONDAY, Aug. 14, 2017 (HealthDay News) -- In 2015, an estimated 1.2 percent of the U.S. population reported active or current epilepsy, according to research published in the Aug. 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Cannabis Intoxication Admissions in Children Up in France

MONDAY, Aug. 14, 2017 (HealthDay News) -- From 2004 to 2014 there was an increase in annual admissions in France for children with unintentional cannabis intoxication, according to a study published online Aug. 14 in Pediatrics.

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Statin Use Among Nursing Home Residents Varies Significantly

MONDAY, Aug. 14, 2017 (HealthDay News) -- Statin prescribing is considerable among nursing home residents, with significant variation in prescribing seen across physicians, according to a study published online Aug. 9 in the Journal of the American Geriatrics Society.

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Taste, Calories Affect Metabolic Response to Sugared Beverages

FRIDAY, Aug. 11, 2017 (HealthDay News) -- There is a non-linear association between caloric load and reward, according to a study published online Aug. 10 in Current Biology.

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HTRA1 Mutations Tied to Cerebral Small Vessel Disease

FRIDAY, Aug. 11, 2017 (HealthDay News) -- Heterozygous HTRA1 mutations may play a role in familial cerebral small vessel disease (SVD), according to a study published online Aug. 6 in CNS Neuroscience & Therapeutics.

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Decrease Over Time in Incidence of Strokes in Men

WEDNESDAY, Aug. 9, 2017 (HealthDay News) -- The incidence of all strokes decreased over time in men, but not women, with the difference driven by a decrease in ischemic stroke, according to a study published online Aug. 9 in Neurology.

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Brexanolone Tolerated in Super-Refractory Status Epilepticus

WEDNESDAY, Aug. 9, 2017 (HealthDay News) -- For patients with super-refractory status epilepticus (SRSE), brexanolone as adjunctive therapy is tolerated and associated with a high rate of third-line agent (TLA) weaning, according to a study published online Aug. 5 in the Annals of Neurology.

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Midlife Vascular Risk Factors Tied to Increased Risk of Dementia

WEDNESDAY, Aug. 9, 2017 (HealthDay News) -- Risk factors for dementia include black race, older age, and lower educational attainment, as well as midlife vascular risk factors such as smoking, diabetes, and hypertension, according to a study published online Aug. 7 in JAMA Neurology.

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Sleep-Disordered Breathing Linked to Cognitive Dysfunction

WEDNESDAY, Aug. 9, 2017 (HealthDay News) -- Sleep-disordered breathing is associated with cognitive deficits, with the strongest associations seen in apolipoprotein ε-4 (APOE-ε4) allele carriers, according to a study published online July 21 in the Annals of the American Thoracic Society.

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Neuroanatomic Anomalies for Deletion, Duplication at 16p11.2

TUESDAY, Aug. 8, 2017 (HealthDay News) -- Carriers of a deletion or duplication at 16p11.2 have neuroanatomic abnormalities, which are associated with cognitive and behavioral impairment, according to a study published online Aug. 8 in Radiology.

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Impact of Video Games on Brain Varies With Game Type, Strategy

TUESDAY, Aug. 8, 2017 (HealthDay News) -- The effect of video games on the hippocampus varies with the navigation strategy employed, according to a study published online Aug. 8 in Molecular Psychiatry.

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Resistance Training May Help Protect Nervous System in MS

TUESDAY, Aug. 8, 2017 (HealthDay News) -- Progressive resistance training (PRT) may slow down the progression of multiple sclerosis, according to a small study published online July 28 in the Multiple Sclerosis Journal.

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Blood Pressure Variability Linked to Risk of Dementia in Elderly

TUESDAY, Aug. 8, 2017 (HealthDay News) -- Increased blood pressure variability is associated with a higher risk of all-cause dementia, vascular dementia (VaD), and Alzheimer's disease (AD) in the elderly, according to a study published in the Aug. 8 issue of Circulation.

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Interactions Occur With Cannabidiol, Antiepileptic Drugs

TUESDAY, Aug. 8, 2017 (HealthDay News) -- Several significant interactions can occur between cannabidiol and antiepileptic drugs, according to a study published online Aug. 6 in Epilepsia.

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Few Skull Radiation Patients Show Cognitive Impairment

TUESDAY, Aug. 8, 2017 (HealthDay News) -- The majority of patients undergoing skull base irradiation for cancer have no detectable cognitive impairment, but about one-third may have ambiguous results with a self-reporting tool, according to a study published online Aug. 1 in Head & Neck.

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Guidance Provided for Preventing Practice Billing Errors

MONDAY, Aug. 7, 2017 (HealthDay News) -- Strategies can help to prevent medical practice billing errors, according to a report published in Medical Economics.

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Neonatal Hypoglycemia Not Tied to Neurosensory Impairment

MONDAY, Aug. 7, 2017 (HealthDay News) -- Neonatal hypoglycemia is not associated with increased risk of neurosensory impairment at age 4.5 years, according to a study published online Aug. 7 in JAMA Pediatrics.

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Flatter Diurnal Cortisol Slopes Linked to Poorer Health Outcomes

MONDAY, Aug. 7, 2017 (HealthDay News) -- Flatter diurnal cortisol slopes correlate with poorer health in 10 of 12 subtypes of emotional and physical health outcomes examined, according to a review published in the September issue of Psychoneuroendocrinology.

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Exposure to Flame Retardants May Lower IQ in Children

MONDAY, Aug. 7, 2017 (HealthDay News) -- Developmental polybrominated diphenyl ethers (PBDEs) exposure may be tied to reduced intelligence, according to a review published online Aug. 3 in Environmental Health Perspectives.

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Seven Imaging Biomarkers Tied to Cognition in Male Fighters

FRIDAY, Aug. 4, 2017 (HealthDay News) -- In active male professional fighters, a set of biomarkers is associated with cognition, according to a study published online July 25 in Radiology.

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Model Predicts Bleeding in Those on Antiplatelets After TIA, Stroke

FRIDAY, Aug. 4, 2017 (HealthDay News) -- For patients with a transient ischemic attack (TIA) or ischemic stroke who use antiplatelet agents, a score with multiple predictors can be used to estimate the three-year major bleeding risk, according to research published online Aug. 2 in Neurology.

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Stopping Statins After Initial Stroke Raises Risk of Recurrence

THURSDAY, Aug. 3, 2017 (HealthDay News) -- Discontinuing statin therapy three to six months after an initial ischemic stroke is tied to higher risk of a recurrent stroke, according to a study published online Aug. 2 in the Journal of the American Heart Association.

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Review Suggests Benefits of Aerobic Exercise in Fibromyalgia

THURSDAY, Aug. 3, 2017 (HealthDay News) -- Aerobic exercise seems beneficial for patients with fibromyalgia, with improvements in health-related quality of life (HRQOL), according to a review published online June 21 in the Cochrane Library.

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Less Than Half of Stroke Discharges Prescribed a Statin

WEDNESDAY, Aug. 2, 2017 (HealthDay News) -- Less than half of ischemic stroke patients discharged from the hospital receive a prescription for statins, according to a study published online Aug. 2 in the Journal of the American Heart Association.

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Are Clinicians Overprescribing Gabapentinoids for Pain?

WEDNESDAY, Aug. 2, 2017 (HealthDay News) -- Clinicians may be overprescribing gabapentinoids, in part as a response to the opioid epidemic, according to a perspective piece published in the Aug. 3 issue of the New England Journal of Medicine.

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TXNIP Blocks Autophagic Flux, Causes α-Synuclein Accumulation

WEDNESDAY, Aug. 2, 2017 (HealthDay News) -- Thioredoxin-interacting protein (TXNIP) blocks autophagic flux and induces expression of α-synuclein accumulation via inhibition of ATP13A2, according to a study published online July 29 in CNS Neuroscience & Therapeutics.

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Review: Levetiracetam Best Monotherapy for Partial Seizures

WEDNESDAY, Aug. 2, 2017 (HealthDay News) -- Levetiracetam performs better than carbamazepine and lamotrigine for individuals with partial seizures, according to a review and meta-analysis published online June 29 in the Cochrane Library.

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Revenue Exceeds Expenditures for Many ABMS Member Boards

WEDNESDAY, Aug. 2, 2017 (HealthDay News) -- Overall revenue exceeds expenditures for many American Board of Medical Specialties (ABMS) member boards, according to a study published in the Aug. 1 issue of the Journal of the American Medical Association.

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Inappropriate Med Use High in Cognitively Impaired Seniors

WEDNESDAY, Aug. 2, 2017 (HealthDay News) -- Many nursing home residents with cognitive impairment or dementia have potentially inappropriate medication (PIM) use, with PIM use more likely among frail individuals, according to a study published online July 28 in the Journal of the American Geriatrics Society.

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U.S. Doctors Still Writing Too Many Opioid Prescriptions

TUESDAY, Aug. 1, 2017 (HealthDay News) -- More than one out of three average Americans used a prescription opioid in 2015, despite growing concerns these medicines are promoting widespread addiction and overdose deaths, according to a study published online Aug. 1 in the Annals of Internal Medicine.

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Little Risk of Oropharyngeal Mucosal Transmission of Zika

TUESDAY, Aug. 1, 2017 (HealthDay News) -- The Zika virus doesn't appear to be transmitted through saliva, according to a study published online Aug. 1 in Nature Communications.

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Higher Risk of Dementia Seen in Those Hailing From 'Stroke Belt'

TUESDAY, Aug. 1, 2017 (HealthDay News) -- Health issues for people born in high stroke mortality states (HSMSs) include a higher risk of developing dementia -- even if they move elsewhere, according to research published online July 31 in JAMA Neurology.

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Comprehensive Initiative Has Positive Impact on Opioid Rx

TUESDAY, Aug. 1, 2017 (HealthDay News) -- A comprehensive initiative, including creation of prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration, can have a positive impact on opioid prescribing, according to research published online July 14 in the Journal of Evaluation in Clinical Practice.

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