March 2016 Briefing - Geriatrics

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

Improper Prescribing Common at Hospital Discharge of Seniors

WEDNESDAY, March 30, 2016 (HealthDay News) -- More than one in three older adults are given at least one potentially inappropriate prescription (PIP) at the time of hospital discharge, according to a study published March 21 in the Journal of Evaluation in Clinical Practice.

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Antipsychotics Not Effective for Delirium in Hospitalized Patients

TUESDAY, March 29, 2016 (HealthDay News) -- Antipsychotic medications do not appear to be effective for preventing or treating delirium in adult medical or surgical inpatients, according to a review published online March 23 in the Journal of the American Geriatrics Society.

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AMA Addresses Elements of Team-Based Care Model

TUESDAY, March 29, 2016 (HealthDay News) -- The elements of a team-based care model are described in a report published by the American Medical Association (AMA).

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ACP Addresses Skyrocketing Costs of Prescription Medications

TUESDAY, March 29, 2016 (HealthDay News) -- The American College of Physicians (ACP) has developed recommendations in order to address the escalating cost of prescription drugs, according to a position paper published online March 29 in the Annals in Internal Medicine.

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Morning Home Blood Pressure Predicts Stroke, CAD Events

MONDAY, March 28, 2016 (HealthDay News) -- Morning home blood pressure (HBP) is a robust predictor of stroke and coronary artery disease (CAD) events, according to research published in the April 5 issue of the Journal of the American College of Cardiology.

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How Can We Fix the Wage Gap Among Female Physicians?

MONDAY, March 28, 2016 (HealthDay News) -- Women doctors can address the gender wage disparity by understanding the reasons why they earn less, according to a report published in Medical Economics.

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Adherence to Mediterranean Diet May Cut Hip Fracture Risk

MONDAY, March 28, 2016 (HealthDay News) -- Adherence to a Mediterranean diet is associated with reduced risk of hip fracture, according to a study published online March 28 in JAMA Internal Medicine.

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Delayed Diagnosis of Acromegaly Reported in Elderly Woman

MONDAY, March 28, 2016 (HealthDay News) -- In a letter to the editor published in the March issue of the Journal of the American Geriatrics Society, delayed diagnosis of acromegaly is described in an elderly woman who initially presented with cutis verticis gyrata (CVG).

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Exercise May Not Benefit Lungs of Seniors With Mobility Issues

FRIDAY, March 25, 2016 (HealthDay News) -- Structured physical activity does not improve respiratory outcomes in elderly adults with mobility limitations, but is linked with higher risk of respiratory hospitalization, according to a study published in the March issue of the Journal of the American Geriatrics Society.

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Medicare May Soon Cover Diabetes Prevention Program

FRIDAY, March 25, 2016 (HealthDay News) -- Medicare could soon pay for a program aimed at diabetes prevention, the U.S. Department of Health and Human Services announced this week.

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Low-Normal Sodium Deemed Major Risk for Mortality in Elderly

FRIDAY, March 25, 2016 (HealthDay News) - A slightly lower serum sodium concentration within the normal range is a major risk factor for mortality in elderly adults, according to a study published in the March issue of the Journal of the American Geriatrics Society.

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Patient Position, Timely Help Improve Inpatient Meal Intake

FRIDAY, March 25, 2016 (HealthDay News) -- Timely mealtime assistance and patient positioning during the meal are tied to meal intake among hospital patients, according to a study published online March 21 in the Journal of Advanced Nursing.

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FDA Wants Generic Opioids to Be Abuse-Deterrent

FRIDAY, March 25, 2016 (HealthDay News) -- Continuing their push to combat the nation's epidemic of opioid abuse, U.S. officials on Thursday urged generic drug makers to take steps to redesign drugs such as hydrocodone and oxycodone to make them harder to abuse.

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Diet High in Vitamin C May Help Delay Cataract Formation

THURSDAY, March 24, 2016 (HealthDay News) -- High intake of dietary vitamin C may help delay the onset of cataracts, according to research published online March 23 in Ophthalmology.

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Esophageal Rupture Described After Drinking PEG Solution

THURSDAY, March 24, 2016 (HealthDay News) -- Esophageal rupture can occur in association with colonoscopy preparation, according to a letter to the editor published in the March issue of the Journal of the American Geriatrics Society.

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SSRIs Do Not Appear to Increase Cardiovascular Risk

WEDNESDAY, March 23, 2016 (HealthDay News) -- Selective serotonin reuptake inhibitors (SSRIs) don't appear to raise cardiovascular risk among young and middle-age patients, according to research published online March 22 in The BMJ.

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Report of Bone Marrow/Liver Pathology Caused by Syphilis

WEDNESDAY, March 23, 2016 (HealthDay News) -- A case of acquired syphilis leading to involvement of the bone marrow and liver is described in a report published online March 22 in the Annals of Internal Medicine.

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FDA Orders Enhanced Warning Labels on Opioid Pain Medications

TUESDAY, March 22, 2016 (HealthDay News) -- The U.S. Food and Drug Administration has announced that immediate-release opioid pain medications will get new boxed warnings about the dangers of misuse.

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Mindful Meditation Technique May Help Ease Chronic Low Back Pain

TUESDAY, March 22, 2016 (HealthDay News) -- Mindfulness-based stress reduction (MBSR) may be more effective than standard medical care for managing low back pain, according to a study published in the March 22/29 issue of the Journal of the American Medical Association.

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Stress Management Could Help Optimize Cardiac Rehab

TUESDAY, March 22, 2016 (HealthDay News) -- The addition of stress management training can make cardiac rehabilitation programs more effective, according to a study published online March 21 in Circulation.

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Number of Seniors Mixing Medications, Supplements Rising

TUESDAY, March 22, 2016 (HealthDay News) -- More seniors than ever are taking supplements alongside their medications, a practice that puts them at risk for dangerous drug interactions, according to research published online March 21 in JAMA Internal Medicine.

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AANA: Men Should Avoid Erectile Dysfunction Meds Prior to Surgery

MONDAY, March 21, 2016 (HealthDay News) -- The American Association of Nurse Anesthetists (AANA) is recommending that men avoid erectile dysfunction medications before surgery.

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FDA: Most Powdered Medical Gloves Should Be Banned in U.S.

MONDAY, March 21, 2016 (HealthDay News) -- The U.S. Food and Drug Administration wants to ban most powdered medical gloves, saying they pose serious health risks to patients and health care providers alike.

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Physicians Respond to New CDC Opioid Guidelines

MONDAY, March 21, 2016 (HealthDay News) -- Physicians have responded to the new U.S. Centers for Disease Control and Prevention's clinical guidelines for prescribing opioids, according to a report published by the American Medical Association (AMA).

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Physical Activity May Lower Mortality Risk in COPD Patients

MONDAY, March 21, 2016 (HealthDay News) -- Physical activity could improve survival of patients with chronic obstructive pulmonary disease (COPD) after hospital discharge, according to research published online March 17 in ERJ Open Research.

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Acetaminophen May Not Be the Best Choice for Arthritis Pain

FRIDAY, March 18, 2016 (HealthDay News) -- Acetaminophen isn't an effective choice for osteoarthritis pain in the hip or knee, or for improving joint function, according to a report published online March 17 in The Lancet.

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Dialysis of Little Benefit to Elderly End-Stage Renal Disease Patients

FRIDAY, March 18, 2016 (HealthDay News) -- Dialysis does not significantly improve survival for elderly patients with end-stage renal disease (ESRD), according to research published online March 17 in the Clinical Journal of the American Society of Nephrology.

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Case Before Supreme Court May Expose Doctors to Large Fines

FRIDAY, March 18, 2016 (HealthDay News) -- A case before a state supreme court could potentially expose physicians to large fines based on a legal technicality relating to what they should have known, rather than what they knew, according to the American Medical Association (AMA).

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Rate of Transmission of Clostridium difficile Quantified

FRIDAY, March 18, 2016 (HealthDay News) -- Hospitalized patients with Clostridium difficile infection (CDI) transmit C. difficile at a much higher rate than that of asymptomatic carriers and community sources, according to a report published in the April issue of the U.S. Centers for Disease Control and Prevention's Emerging Infectious Diseases.

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Diabetes Management Program Doesn't Cut Disparities in Care

THURSDAY, March 17, 2016 (HealthDay News) -- A telephone-based disease management program delivered by a disease management vendor is ineffective in reducing racial/ethnic disparities in diabetes care, according to a study published online March 10 in Diabetes Care.

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Spending on Prescription Meds Up About 5 Percent in 2015

THURSDAY, March 17, 2016 (HealthDay News) -- Spending on prescription medications for insured Americans increased about 5 percent in 2015, with the increase half of that seen in 2014, the Associated Press reported.

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Free Training Being Offered for Substance Use Disorder Tx

WEDNESDAY, March 16, 2016 (HealthDay News) -- Free training is being offered to physicians in medication-assisted treatment (MAT), which combines use of medication with counseling and other support for patients with substance use disorders, according to a report published by the American Medical Association.

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Many A-Fib Patients Missing Out on Recommended Anticoagulation

WEDNESDAY, March 16, 2016 (HealthDay News) -- Fewer than half of atrial fibrillation patients at highest risk for stroke are prescribed recommended anticoagulation, according to research published online March 16 in JAMA Cardiology.

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FDA Safety Announcement Affected Bisphosphonate Use

WEDNESDAY, March 16, 2016 (HealthDay News) -- A U.S. Food and Drug Administration safety announcement relating to atrial fibrillation risk associated with bisphosphonates correlated with a reduction in bisphosphonate use, according to a study published online March 11 in the Journal of Bone and Mineral Research.

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Disruptive Patients Distract Docs, May Receive Compromised Care

WEDNESDAY, March 16, 2016 (HealthDay News) -- Disruptive patients may get worse care from physicians, according to a study published online March 7 in BMJ Quality & Safety. The findings aren't definitive because the researchers tested how physicians responded in fictional vignettes, instead of real-life encounters. Still, the results suggest that such patients distract physicians from doing their jobs.

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Incident A-Fib Linked to Shorter Disability-Free Survival

TUESDAY, March 15, 2016 (HealthDay News) -- For older adults, incident atrial fibrillation (AF) is associated with shorter disability-free survival, according to a study published online March 1 in the Journal of the American Geriatrics Society.

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CDC Issues New Prescription Guidelines for Opioids

TUESDAY, March 15, 2016 (HealthDay News) -- A new advisory, from the U.S. Centers for Disease Control and Prevention, stresses that doctors -- especially primary care physicians -- should try to avoid prescription of opioids whenever possible. Two research letters published online March 15 in the Journal of the American Medical Association highlight the scope of the opioid issue.

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Influenza Vaccine Safe for Patients in Hospital for Surgery

TUESDAY, March 15, 2016 (HealthDay News) -- Surgery patients don't have an increased risk for complications if they receive an influenza vaccine while in the hospital, according to a study published online March 15 in the Annals of Internal Medicine.

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Mayo Clinic Has Established Model to Help Battle Burnout

TUESDAY, March 15, 2016 (HealthDay News) -- In an effort to reduce burnout among physicians, the Mayo Clinic is initiating a model to raise camaraderie and increase collaboration, according to a report published by the American Medical Association (AMA).

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PA32540 Safe for Patients at Risk of Aspirin-Linked Upper GI Events

TUESDAY, March 15, 2016 (HealthDay News) -- For subjects at risk of aspirin-associated upper gastrointestinal (UGI) events, long-term PA32540 (enteric-coated aspirin 325 mg and immediate-release omeprazole 40 mg) appears to be safe, according to a study published in the April issue of Cardiovascular Therapeutics.

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Abruptly Quitting Appears to Work Best for Smoking Cessation

TUESDAY, March 15, 2016 (HealthDay News) -- Quitting cigarettes "cold turkey" beats a more gradual approach, according to research published online March 15 in the Annals of Internal Medicine.

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Guidance Offered for Negotiating Higher Rates From Payers

MONDAY, March 14, 2016 (HealthDay News) -- Negotiations to increase payment from insurance companies can be extremely difficult, although it is possible to get a payment increase, according to a report published in Medical Economics.

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Antihyperglycemic Medication Prescribing Trends Are Changing

MONDAY, March 14, 2016 (HealthDay News) -- Trends indicate a reduction in glyburide and thiazolidinedione prescriptions and increases in gliclazide and dipeptidyl peptidase-4 inhibitor prescriptions among older adults with diabetes and chronic kidney disease, according to a study published online March 4 in Diabetes, Obesity and Metabolism.

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Few Care Management Processes Used for Depression

MONDAY, March 14, 2016 (HealthDay News) -- U.S. primary care practices use less than one care management process for depression, on average, according to a study published in the March issue of Health Affairs.

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E-Consultations Can Improve Access to, Timeliness of Care

MONDAY, March 14, 2016 (HealthDay News) -- Electronic consultation (e-consultation), an asynchronous, non-face-to-face consultation between a primary care physician and a specialist, can improve access to care and reduce wait times, according to a study published in the March/April issue of the Annals of Family Medicine.

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Diabetes Patients More Susceptible to Staph Bacteremia

FRIDAY, March 11, 2016 (HealthDay News) -- Patients with diabetes may be significantly more likely to develop community-acquired Staphylococcus aureus bacteremia (CA-SAB) than those without diabetes, according to a study published online March 10 in the European Journal of Endocrinology.

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Evidence Links Agent Orange to Bladder Cancer, Hypothyroidism

FRIDAY, March 11, 2016 (HealthDay News) -- There is stronger evidence of a link between the herbicide Agent Orange and bladder cancer and hypothyroidism among U.S. military personnel exposed to the chemical during the Vietnam War, a new Institute of Medicine report shows.

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Elderly With Advanced CRC Often Get Costly, Unnecessary Tx

FRIDAY, March 11, 2016 (HealthDay News) -- Expensive medications are being given far more often to elderly patients with metastatic colorectal cancer, but they offer almost no benefit, according to a study published online Feb. 19 in Medical Care.

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Triple-Handed Approach Eases Palpation of Ticklish Patients

FRIDAY, March 11, 2016 (HealthDay News) -- A novel triple-handed approach allows for examination of lymph-node basins without eliciting a ticklish response, according to a letter to the editor published in the March 10 issue of the New England Journal of Medicine.

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Analgesics Plus Exercise Therapy Feasible for Knee OA

FRIDAY, March 11, 2016 (HealthDay News) -- A combined intervention of optimized analgesic prescription and exercise therapy is feasible and associated with significant reductions in pain and activity limitation in patients with knee osteoarthritis (OA) and severe knee pain, according to a study published in the March issue of Arthritis Care & Research.

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Five Strategies Employed to Help Promote Behavior Change

FRIDAY, March 11, 2016 (HealthDay News) -- Five key strategies are employed by clinicians to help promote patient behavior change, according to a study published in the March/April issue of the Annals of Family Medicine.

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Zika Now Tied to Meningoencephalitis

THURSDAY, March 10, 2016 (HealthDay News) -- The list of neurological disorders potentially associated with the Zika virus continues to grow, according to a letter to the editor and a perspective piece published online March 9 in the New England Journal of Medicine.

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Warfarin's Intracranial Bleed Risk Higher Than Previously Reported

THURSDAY, March 10, 2016 (HealthDay News) -- Warfarin treatment for patients with atrial fibrillation may raise the risk of traumatic intracranial bleeding by more than previously reported, according to a study published online March 9 in JAMA Cardiology.

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Predictive Model Developed for In-Hospital Mortality in TAVR

THURSDAY, March 10, 2016 (HealthDay News) -- A predictive model has been developed and validated for in-hospital mortality among patients undergoing transcatheter aortic valve replacement (TAVR); the findings were published online March 9 in JAMA Cardiology.

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Physicians' Contracts Can Affect Patients, Professionalism

WEDNESDAY, March 9, 2016 (HealthDay News) -- Problematic clauses in physicians' contracts can impact patient care and professionalism, according to an Ideas and Opinions piece published online March 8 in the Annals of Internal Medicine.

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Bevacizumab, Triamcinolone Up Outcome After Cataract Surgery

WEDNESDAY, March 9, 2016 (HealthDay News) -- For patients undergoing cataract surgery, both bevacizumab and triamcinolone administered at the time of surgery correlate with improvements in visual acuity (VA), but only triamcinolone is associated with sustained improvements in central macular thickness (CMT), according to a study published online Feb. 12 in Clinical & Experimental Ophthalmology.

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CPAP Improves Glycemic Control in Patients With T2DM, OSA

WEDNESDAY, March 9, 2016 (HealthDay News) -- For patients with obstructive sleep apnea (OSA) and suboptimally controlled type 2 diabetes, use of continuous positive airway pressure (CPAP) for six months is associated with improved glycemic control and insulin resistance, according to a study published online Feb. 24 in the American Journal of Respiratory and Critical Care Medicine.

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Vitamin D Not Beneficial for Osteoarthritis of the Knee

WEDNESDAY, March 9, 2016 (HealthDay News) -- Vitamin D supplements don't appear to relieve pain or slow the progression of knee osteoarthritis in patients with low levels of the vitamin, according to a study published in the March 8 issue of the Journal of the American Medical Association.

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Slow Gait After Acute MI Linked to Mortality, Readmission

TUESDAY, March 8, 2016 (HealthDay News) -- At one month after acute myocardial infarction (AMI), many older adults have slow gait, which is associated with increased risk of death or readmission at one year, according to a study published online March 1 in the Journal of the American Geriatrics Society.

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Bloodstream Infection Outbreak in Wisconsin Linked to 18 Deaths

FRIDAY, March 4, 2016 (HealthDay News) -- The source of a bacterial bloodstream infection linked with the deaths of 18 people in Wisconsin is being sought by federal, state, and local health officials.

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CDC: Hospitals Making Progress Against Antibiotic Resistance

FRIDAY, March 4, 2016 (HealthDay News) -- Although U.S. hospitals are making gains in the fight against some antibiotic-resistant bacteria, too many patients are still affected in health care facilities, according to a new report from the U.S. Centers for Disease Control and Prevention.

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More Chest Pain for Women Undergoing PCI With DES

FRIDAY, March 4, 2016 (HealthDay News) -- Women undergoing percutaneous coronary intervention (PCI) with new generation drug-eluting stents (DES) have a higher prevalence of clinically relevant chest pain, according to a study published online March 2 in JACC: Cardiovascular Interventions.

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Annual Visit Rate for Obesity Is 49 Visits Per 1,000 Persons

THURSDAY, March 3, 2016 (HealthDay News) -- In 2012 there were 11 million visits to health care providers for obesity, with variation in visit rates by age and sex, according to a March data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Recurrence Risk Estimator Valid for Acute Ischemic Stroke

THURSDAY, March 3, 2016 (HealthDay News) -- The Recurrence Risk Estimator (RRE) score is valid for identifying the risk of recurrence in patients with acute ischemic stroke, according to a study published online Feb. 29 in JAMA Neurology.

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SCOTUS: States Can't Force Health Care Data Release

WEDNESDAY, March 2, 2016 (HealthDay News) -- The Supreme Court has ruled against state efforts to collect health care data from insurance plans.

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Spouse Education Level May Impact Choice for Rural Practice

WEDNESDAY, March 2, 2016 (HealthDay News) -- Physicians who are married to a highly-educated spouse are less likely to work in rural underserved areas, according to a study published in the March 1 issue of the Journal of the American Medical Association.

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Metabolic Syndrome Tied to Risk of Mild Cognitive Impairment

WEDNESDAY, March 2, 2016 (HealthDay News) -- The incidence of mild cognitive impairment (MCI) and MCI progression to dementia is increased in association with metabolic syndrome (MetS), according to a study published online Feb. 29 in JAMA Neurology.

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USPSTF: Evidence Lacking for Visual Acuity Screening in Seniors

TUESDAY, March 1, 2016 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) has concluded that the evidence is currently inadequate to weigh the benefits and harms of primary care screening for impaired visual acuity in older adults. These findings form the basis of a final recommendation statement, published in the March 1 issue of the Journal of the American Medical Association.

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Dementia Incidence Higher Than CHD in Very Elderly

TUESDAY, March 1, 2016 (HealthDay News) -- For adults aged 80 years or older, the incidence of dementia is greater than that of coronary heart disease (CHD), according to a study published in the March 8 issue of the Journal of the American College of Cardiology.

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IVCF Use Up in Older Patients With Pulmonary Embolism

TUESDAY, March 1, 2016 (HealthDay News) -- The use of inferior vena caval filters (IVCFs) for pulmonary embolism (PE) increased from 1999 through 2010, according to research published in the March 8 issue of the Journal of the American College of Cardiology.

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AAN: Stroke Risk Up With Daylight Saving Transitions

TUESDAY, March 1, 2016 (HealthDay News) -- The transition to daylight saving time (DST) is associated with a transient increase in the risk of ischemic stroke, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held from April 15 to 21 in Vancouver, Canada.

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Prostate Cancer Tied to Higher Colorectal Cancer Risk

TUESDAY, March 1, 2016 (HealthDay News) -- The risk of colorectal cancer is increased after a diagnosis of prostate cancer, according to a study published online Feb. 25 in Cancer.

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High Levels of Exercise May Be Cardiotoxic

TUESDAY, March 1, 2016 (HealthDay News) -- Emerging evidence suggests that there may be some cardiotoxicity associated with exercise, according to a review published online Feb. 24 in the Canadian Journal of Cardiology.

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Supportive-Care Hospital Visits Linked to Better Outcomes

TUESDAY, March 1, 2016 (HealthDay News) -- Hospital supportive-care visits from a primary care physician result in lower risks of adverse patient outcomes, according to a study published online Feb. 23 in the Journal of Hospital Medicine.

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