May 2016 Briefing - Geriatrics

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

Glucocorticoid Use Ups Diabetes Risk in Rheumatoid Arthritis

TUESDAY, May 31, 2016 (HealthDay News) -- For patients with rheumatoid arthritis (RA), glucocorticoid treatment is associated with increased risk of diabetes mellitus (DM), according to a study published in the May issue of Arthritis & Rheumatology.

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AHRQ Communication Toolkit Can Help After Patient Harm Occurs

TUESDAY, May 31, 2016 (HealthDay News) -- A new communication toolkit created by the Agency for Healthcare Research and Quality (AHRQ) can help health care organizations and providers communicate with patients and families when harm occurs to patients.

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DAPT Score Improves Risk Prediction of Continued DAPT

TUESDAY, May 31, 2016 (HealthDay News) -- A decision tool (dual antiplatelet therapy [DAPT] score) improves risk prediction for continued DAPT beyond assessment of myocardial infarction (MI) history, according to a study published in the May 31 issue of the Journal of the American College of Cardiology.

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Prednisone Use Linked to Increased Risk of Mortality in RA

FRIDAY, May 27, 2016 (HealthDay News) -- For patients with rheumatoid arthritis (RA), prednisone use is associated with an increased risk of mortality, according to a study published in the May issue of Arthritis Care & Research.

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PPI Use Ups NSAID-Induced Small Bowel Injury

FRIDAY, May 27, 2016 (HealthDay News) -- Proton pump inhibitors (PPIs) increase the risk of nonsteroidal anti-inflammatory drug-induced small bowel injury, according to a study published in the June issue of Clinical Gastroenterology and Hepatology.

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Remaining Uninsured May Be Difficult to Reach Via ACA

FRIDAY, May 27, 2016 (HealthDay News) -- Uninsurance rates have decreased since the introduction of the Affordable Care Act (ACA), but reaching the remaining uninsured may prove challenging, according to a health policy brief published online May 23 in Health Affairs.

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Hip Fracture Incidence Up With Non-Dialysis-Requiring CKD

FRIDAY, May 27, 2016 (HealthDay News) -- The incidence of hip fracture and post-hip fracture mortality are increased for patients with non-dialysis-requiring chronic kidney disease (CKD), according to a study published online May 4 in the Journal of Bone and Mineral Research.

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Recognition of Patient Expertise Can Improve Adherence

FRIDAY, May 27, 2016 (HealthDay News) -- Recognizing the unique role of patients and their expertise within the physician-patient interaction can help to prevent non-adherence based on disagreement, according to an article published online May 18 in the Journal of Evaluation in Clinical Practice.

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Atrial Fibrillation Linked to Cancer Risk in Women

THURSDAY, May 26, 2016 (HealthDay News) -- Women with atrial fibrillation may be at an increased risk of developing cancer, particularly of the colon, according to research published online May 25 in JAMA Cardiology.

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Telomere Length Not Significantly Associated With Atherosclerosis

WEDNESDAY, May 25, 2016 (HealthDay News) -- Average leucocyte telomere length (LTL) and the abundance of short telomeres (percent LTL <3 kb) are not significant independent determinants of subclinical atherosclerosis, according to a study published in the May 31 issue of the Journal of the American College of Cardiology.

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Chemotherapy Toxicity Predictive Model Validated

WEDNESDAY, May 25, 2016 (HealthDay News) -- A predictive model for chemotherapy toxicity has been validated for older patients with solid tumors, according to a study published online May 16 in the Journal of Clinical Oncology.

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Wells Rule Beats 'Gestalt' in Ruling Out Pulmonary Embolism

WEDNESDAY, May 25, 2016 (HealthDay News) -- Both a physician's own probability estimate ("gestalt") and the Wells rule can be combined with D-dimer testing to safely rule out pulmonary embolism (PE) in primary care; however, the Wells rule is more efficient, according to a study published in the May/June issue of the Annals of Family Medicine.

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Health Coaches Can Help Increase Patient Engagement

TUESDAY, May 24, 2016 (HealthDay News) -- Introducing health coaches who can take on responsibilities to advance lifestyle changes, prevention, and patient health can help to increase patient satisfaction and engagement, according to the American Medical Association.

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Review: Hatha Yoga Beneficial for Reducing Anxiety

TUESDAY, May 24, 2016 (HealthDay News) -- Hatha yoga is effective for reducing anxiety, and efficacy increases with increasing number of practice hours, according to a meta-analysis published online May 20 in the Journal of Evidence-Based Medicine.

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Many Advanced Cancer Patients Lack Info About Their Disease

TUESDAY, May 24, 2016 (HealthDay News) -- Many patients with advanced cancer lack basic information about their prognosis or treatment, according to a study published online May 23 in the Journal of Clinical Oncology.

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Blood Pressure Variability Tied to Faster Cognitive Decline

TUESDAY, May 24, 2016 (HealthDay News) -- Variability in blood pressure (BP) readings may predict more rapid cognitive decline in older patients, according to research published online May 23 in Hypertension.

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Clinicians Should Ask, Counsel About Firearms

MONDAY, May 23, 2016 (HealthDay News) -- Clinicians ask and counsel their patients about firearms less often than recommended, according to an article published online May 17 in the Annals of Internal Medicine.

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Study Suggests a Low-Salt Diet Could Harm Certain Patients

MONDAY, May 23, 2016 (HealthDay News) -- Restricting dietary salt to below 3,000 mg a day appears to increase the risk for cardiovascular disease similar to that of hypertension patients who eat too much salt, according to research published online May 20 in The Lancet.

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Two New Drugs Added to Heart Failure Clinical Practice Guideline

MONDAY, May 23, 2016 (HealthDay News) -- An updated clinical guideline adds two new types of drugs to the list of treatment options for heart failure. The updated guideline was published online May 20 in the Journal of the American College of Cardiology, Circulation, and the Journal of Cardiac Failure.

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FDA Redesigns Nutrition Facts Label

MONDAY, May 23, 2016 (HealthDay News) -- The Nutrition Facts panel on packaged foods in the United States is about to undergo long-awaited changes, with a redesign emphasizing realistic portion sizes and added sugars.

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Opioid Prescriptions Drop for First Time in Two Decades

MONDAY, May 23, 2016 (HealthDay News) -- In a sign that the opioid epidemic might be waning, new data show that the number of opioid prescriptions has dropped for the first time in 20 years.

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Racism Can Disrupt Physician-Patient Power Dynamics

FRIDAY, May 20, 2016 (HealthDay News) -- A case of racism by a patient that disrupted the power dynamics between a physician and patient is described in a reflection piece published in the May/June issue of the Annals of Family Medicine.

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Major Stroke May Be Prevented by Taking Aspirin After TIA

FRIDAY, May 20, 2016 (HealthDay News) -- Taking aspirin immediately after a transient ischemic attack (TIA) significantly reduces the risk of a major stroke, according to research published online May 18 in The Lancet.

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Visual Impairment Expected to Rise Significantly by 2050

FRIDAY, May 20, 2016 (HealthDay News) -- As baby boomers age, the number of Americans with visual impairment and blindness is expected to double over the next three decades, according to a study published online May 19 in JAMA Ophthalmology.

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Strategies Can Help Streamline Revenue-Related Processes

THURSDAY, May 19, 2016 (HealthDay News) -- Strategies can be employed to maximize the amount of time available for patient care by streamlining revenue-related processes, according to the American Medical Association (AMA).

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Unrealistic Expectations for Many Men With Localized Prostate CA

THURSDAY, May 19, 2016 (HealthDay News) -- Men with localized prostate cancer (LPC) often have unrealistic survival expectations, according to a study published in the May/June issue of the Annals of Family Medicine.

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Physicians, Patient Families Often Disagree on Prognosis

WEDNESDAY, May 18, 2016 (HealthDay News) -- In more than half of recently studied cases, doctors and family members acting on behalf of critically ill patients disagreed about whether the patient would die or not, according to a study published in the May 17 issue of the Journal of the American Medical Association.

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Burnout, Lack of Job Satisfaction Driving Doctors to Cut Hours

WEDNESDAY, May 18, 2016 (HealthDay News) -- Full-time physicians reporting worsening burnout or decreased job satisfaction are more likely to reduce their work hours, according to a study published in the April issue of Mayo Clinic Proceedings.

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Age-Adjusted D-Dimer Testing Improves Ability to Rule Out PE

WEDNESDAY, May 18, 2016 (HealthDay News) -- Compared with fixed D-dimer testing, age-adjusted D-dimer testing is associated with an increase in the proportion of patients with suspected pulmonary embolism (PE) in whom imaging can be withheld, according to a review published online May 17 in the Annals of Internal Medicine.

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Sexual Harassment Experienced by One-Third of Female Doctors

WEDNESDAY, May 18, 2016 (HealthDay News) -- Thirty percent of female physicians face sexual harassment on the job, while close to three-quarters perceive gender bias at work and two-thirds say they have actually experienced it, according to survey findings published in the May 17 issue of the Journal of the American Medical Association.

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Rehab Beneficial in Spontaneous Coronary Artery Dissection

WEDNESDAY, May 18, 2016 (HealthDay News) -- Many patients with spontaneous coronary artery dissection (SCAD) participate in cardiac rehabilitation (CR), and most patients report benefit, according to a study published in the May 15 issue of The American Journal of Cardiology.

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Tai Chi Deemed Beneficial for Knee Osteoarthritis

TUESDAY, May 17, 2016 (HealthDay News) -- For knee osteoarthritis, similar benefits are seen for Tai Chi and standard physical therapy, according to a study published online May 17 in the Annals of Internal Medicine.

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Ambulatory BP Monitoring Can Help ID Masked Hypertension

TUESDAY, May 17, 2016 (HealthDay News) -- Ambulatory blood pressure monitoring could help identify undetected hypertension in at-risk populations, according to a study published online May 16 in Hypertension.

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About Half of Myocardial Infarctions Are Asymptomatic

TUESDAY, May 17, 2016 (HealthDay News) -- As many as half of all myocardial infarctions (MIs) may be silent, according to a study published online May 16 in Circulation.

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Recent Improvement in Heart Failure Process of Care Measures

TUESDAY, May 17, 2016 (HealthDay News) -- Adherence to heart failure process of care measures has improved significantly over the last 10 years for patients with acute decompensated heart failure with reduced ejection fraction (HFrEF) and end-stage renal disease (ESRD), according to a study published online May 11 in JACC: Heart Failure.

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Wine Beats Other Types of Alcohol in Reduction of T2DM Risk

TUESDAY, May 17, 2016 (HealthDay News) -- Wine is associated with a greater decrease in the risk of type 2 diabetes than beer or spirits, according to a review published online May 11 in the Journal of Diabetes Investigation.

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For New Antipsychotic Users, Dose, Duration Impact Mortality

TUESDAY, May 17, 2016 (HealthDay News) -- Dose and duration of therapy are associated with mortality for new antipsychotic users, according to a study published online May 10 in the Journal of the American Geriatrics Society.

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Physical Activity Associated With Lower Risk of Many Cancers

MONDAY, May 16, 2016 (HealthDay News) -- Exercise may significantly reduce risk for many types of cancer, according to a large review published online May 16 in JAMA Internal Medicine.

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Religious Service Attendance May Affect Mortality Among Women

MONDAY, May 16, 2016 (HealthDay News) -- Women who regularly attend religious services may live longer than women who never attend services, according to research published online May 16 in JAMA Internal Medicine.

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Hospitalists Need Strategies for Providing Adequate Pain Relief

MONDAY, May 16, 2016 (HealthDay News) -- Hospitalists report limited success and satisfaction for management of acute exacerbations of chronic pain with opioids, according to a study published online May 9 in the Journal of Hospital Medicine.

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Specific Language Important in Heart Failure Communication

MONDAY, May 16, 2016 (HealthDay News) -- Specific language is important for patient experience and shared decision-making in heart failure, according to research published in the June 1 issue of The American Journal of Cardiology.

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Complementary Medicine Use Up With Chronic Conditions

MONDAY, May 16, 2016 (HealthDay News) -- Adults with multiple chronic conditions frequently use complementary and alternative medicine (CAM), according to a study published online May 5 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Fall Risk Up With Initiation, Intensification of HTN Meds

FRIDAY, May 13, 2016 (HealthDay News) -- For older adults, initiation and intensification of antihypertensive medication is associated with a short-term increased risk of serious fall injuries, according to a study published online May 10 in Circulation: Cardiovascular Quality and Outcomes.

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CAM Use May Affect Breast Cancer Patients' Chemo Decisions

FRIDAY, May 13, 2016 (HealthDay News) -- Women with early-stage breast cancer who utilize complementary and alternative medicine (CAM) may delay recommended chemotherapy, according to research published online May 12 in JAMA Oncology.

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U.S. Stroke Hospitalizations Down Overall, but Rising for Some

THURSDAY, May 12, 2016 (HealthDay News) -- While Americans suffered fewer acute ischemic strokes overall from 2000 to 2010, stroke rates climbed substantially among younger adults and blacks, according to study findings published online May 11 in the Journal of the American Heart Association.

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Pre-Op Gait Speed Indicates Mortality Risk Post Heart Surgery

THURSDAY, May 12, 2016 (HealthDay News) -- Patients who aren't able to walk a short distance at a comfortable pace before cardiac surgery are at greater postoperative risk for death, according to research published online on May 11 in JAMA Cardiology.

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Midlife Occupational Physical Activity, Disability Linked

THURSDAY, May 12, 2016 (HealthDay News) -- High midlife occupational physical activity (PA) is associated with greater decline in functional capacity later in life, according to a study published online May 5 in the Journal of the American Geriatrics Society.

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Pop-Up Messages Up Physician Awareness of Osteoporosis

THURSDAY, May 12, 2016 (HealthDay News) -- The introduction of pop-up messages relating to a history of dual-energy X-Ray absorptiometry (DXA) in an order communication system can increase the rates of DXA prescription, as well as the rates of osteoporosis medication and exercise, according to a study published online May 6 in the Journal of Evaluation in Clinical Practice.

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Depressive Symptoms for Many Caregivers of Critically Ill

WEDNESDAY, May 11, 2016 (HealthDay News) -- Many caregivers of critically ill patients receiving mechanical ventilation in an intensive care unit (ICU) report high levels of depressive symptoms, according to a study published in the May 12 issue of the New England Journal of Medicine.

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Telemedicine Visits Up, but Not for Rural Medicare Beneficiaries

WEDNESDAY, May 11, 2016 (HealthDay News) -- Although Medicare telemedicine visits are increasing, in 2013 only 0.7 percent of rural Medicare beneficiaries received a telemedicine visit, according to a research letter published in the May 10 issue of the Journal of the American Medical Association.

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Yoga, Meditation Show Memory, Mood Benefit in Seniors

WEDNESDAY, May 11, 2016 (HealthDay News) -- A regular meditation practice might benefit older adults beginning to experience memory deficits, according to a study published online May 10 in the Journal of Alzheimer's Disease.

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Agreement High for Prognostic Cancer Screening Tools

TUESDAY, May 10, 2016 (HealthDay News) -- For cancer screening in Medicare beneficiaries, there is substantial agreement for different prognostic tools for short- and long-term survival, according to a study published online April 30 in the Journal of the American Geriatrics Society.

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Cutting Brand-Name Drug Use Could Save U.S. $73 Billion

TUESDAY, May 10, 2016 (HealthDay News) -- Americans could save tens of billions of dollars with more efficient drug use, replacing brand-name drugs with their generic equivalents whenever possible, according to a study published online May 9 in JAMA Internal Medicine.

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CDC Establishes New 'Clean Hands Count' Campaign

MONDAY, May 9, 2016 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has introduced a new campaign, "Clean Hands Count," to encourage health care professionals, patients, and patients' families to keep their hands clean in order to prevent health care-associated infections.

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Venlafaxine-Induced Rise in Intraocular Pressure Described

MONDAY, May 9, 2016 (HealthDay News) -- In a case report published online April 30 in Clinical & Experimental Ophthalmology, venlafaxine-induced increase in intraocular pressure (IOP) is described in a patient with open angle glaucoma.

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Preadmission SSRI Use Ups Stroke Mortality in Diabetes

MONDAY, May 9, 2016 (HealthDay News) -- For patients with diabetes, preadmission selective serotonin reuptake inhibitor (SSRI) use is associated with increased risk of stroke mortality, according to a study published online May 3 in the Journal of Internal Medicine.

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United States Still Has Shortages of Acute, Non-Acute Drugs

FRIDAY, May 6, 2016 (HealthDay News) -- Drug shortages remain a problem in the United States despite government legislation meant to increase availability, according to a study published in the May issue of Health Affairs.

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Lung Cancer Resection Linked to Longer Survival for Older Patients

THURSDAY, May 5, 2016 (HealthDay News) -- Older lung cancer patients are surviving longer when they have lung cancer surgery, according to a study published online May 5 in the Annals of Thoracic Surgery.

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Eyeglass Device May Benefit Those With Low Vision

THURSDAY, May 5, 2016 (HealthDay News) -- A device mounted onto eyeglasses enables people considered legally blind to "read" and perform other day-to-day activities, according to a study published online May 5 in JAMA Ophthalmology.

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CDC: Hepatitis C Leads Infectious Disease Mortality in U.S.

THURSDAY, May 5, 2016 (HealthDay News) -- The number of hepatitis C-linked deaths in the United States reached a record high in 2014, and the disease is now the leading cause of infectious disease mortality in the United States, according to a report published in the May 15 issue of Clinical Infectious Diseases.

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No Benefit Found for Perioperative Statin Therapy

THURSDAY, May 5, 2016 (HealthDay News) -- Taking statins right before cardiac surgery, once touted as a way to prevent common postoperative complications, has no benefit and may even cause harm, according to a study published in the May 5 issue of the New England Journal of Medicine.

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Guideline-Based Phone Program Ups Provision, Timeliness of CPR

THURSDAY, May 5, 2016 (HealthDay News) -- Cardiopulmonary resuscitation (CPR) instruction may be just a cellphone call away, according to a study published online May 4 in JAMA Cardiology.

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AHA: Stroke Patients Should Start Rehab Before Leaving Hospital

THURSDAY, May 5, 2016 (HealthDay News) -- New guidelines for rehabilitation after a stroke have been published online May 4 in Stroke.

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No Link for Tea, Coffee Intake With Barrett's Esophagus

THURSDAY, May 5, 2016 (HealthDay News) -- After adjustment for confounding variables there is no correlation between the risk of Barrett's esophagus (BE) and tea or coffee consumption, according to a study published in the May issue of Clinical Gastroenterology and Hepatology.

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Physician Leadership Training May Help Counteract Burnout

WEDNESDAY, May 4, 2016 (HealthDay News) -- Physician leaders with good leadership qualities are more likely to have employees who are satisfied and do not show signs of burnout, according to a study published in the April issue of the Mayo Clinic Proceedings and a report published by the American Medical Association.

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Herpes Simplex Virus Linked to Frailty, Mortality

WEDNESDAY, May 4, 2016 (HealthDay News) -- For older women, herpes simplex virus antibody levels are associated with incident frailty and mortality, according to a study published online April 30 in the Journal of the American Geriatrics Society.

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Price Transparency Tool Doesn't Cut Health Care Spending

WEDNESDAY, May 4, 2016 (HealthDay News) -- Employee use of a price transparency tool does not cut health care spending, according to a study published in the May 3 issue of the Journal of the American Medical Association.

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Still Too Many Antibiotic Prescriptions Being Written

TUESDAY, May 3, 2016 (HealthDay News) -- Nearly one-third of the antibiotics prescribed in the United States aren't appropriate for the conditions being treated, according to research published in the May 3 issue of the Journal of the American Medical Association.

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High Risk of Long-Term Complications Seen With ICDs

TUESDAY, May 3, 2016 (HealthDay News) -- Implantable cardioverter-defibrillators (ICDs) are associated with a high risk of long-term complications, according to research published online May 3 in the Annals of Internal Medicine.

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FDA: Brintellix Changing Name to Avoid Confusion With Brilinta

TUESDAY, May 3, 2016 (HealthDay News) -- Following a July 2015 Drug Safety Communication that warned about name confusion between Brintellix and Brilinta resulting in prescribing errors, the antidepressant Brintellix (vortioxetine) is changing its name to Trintellix, according to the U.S. Food and Drug Administration.

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Report: Why Health Care Costs Are Lower in Europe Than U.S.

TUESDAY, May 3, 2016 (HealthDay News) -- European residents have access to the same health care services as U.S. residents but pay much less, and this is related to several specific factors, according to a report published by INDIGOMED on April 25.

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2017 May Offer Fewer Choices for Affordable Care Act Enrollees

MONDAY, May 2, 2016 (HealthDay News) -- With the nation's largest health insurer exiting all but a few Affordable Care Act exchanges next year, some Americans may be left with fewer choices and some might see higher monthly premiums.

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Psychotherapy May Ease Chemo-Related Cognitive Dysfunction

MONDAY, May 2, 2016 (HealthDay News) -- Cognitive-behavioral therapy (CBT) might help cancer survivors manage the long-term cognitive dysfunction some experience after chemotherapy, according to research published online May 2 in Cancer.

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Delirium Predicts Function in Elderly After Aortic Valve Surgery

MONDAY, May 2, 2016 (HealthDay News) -- Delirium appears to predict reduced functioning in elderly individuals after surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI), according to a study published online April 23 in the Journal of the American Geriatrics Society.

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