November 2014 Briefing - Geriatrics

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Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for November 2014. 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.

Health Care Organizations See Value of Telemedicine

WEDNESDAY, Nov. 26, 2014 (HealthDay News) -- Health care organizations are developing and implementing telemedicine programs, although many have yet to receive reimbursement, according to a report published by Foley & Lardner.

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Jogging May Help Seniors Walk More Efficiently

WEDNESDAY, Nov. 26, 2014 (HealthDay News) -- Jogging helps seniors ward off age-related physical decline in walking efficiency, according to a study published online Nov. 20 in PLOS ONE.

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Clonal Hematopoiesis With Somatic Mutations Up With Age

WEDNESDAY, Nov. 26, 2014 (HealthDay News) -- Clonal hematopoiesis with somatic mutations is increasingly common with aging, according to two studies published online Nov. 26 in the New England Journal of Medicine.

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Most Seniors Eligible for Statin Rx Under New Guidelines

TUESDAY, Nov. 25, 2014 (HealthDay News) -- Most older Americans qualify for treatment with statins under new guidelines for the treatment of blood cholesterol released late last year by the American College of Cardiology and the American Heart Association. The findings appear in a research letter published online Nov. 17 in JAMA Internal Medicine.

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Higher Resting Heart Rate Tied to Higher Risk of Death in Men

TUESDAY, Nov. 25, 2014 (HealthDay News) -- A higher resting heart rate, independent of fitness, is tied to an increased risk of all-cause mortality in men, according to a study published in the Dec. 1 issue of The American Journal of Cardiology.

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Special Ambulance Delivers Vital Stroke Care More Quickly

MONDAY, Nov. 24, 2014 (HealthDay News) -- Stroke outcomes are better when patients are treated in an ambulance by a neurologist equipped with a computed tomography scanner and tissue plasminogen activator (tPA), according to a report published online Nov. 17 in JAMA Neurology.

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In Reperfusion Era, β-Blockers Have No Mortality Benefit in MI

MONDAY, Nov. 24, 2014 (HealthDay News) -- In the reperfusion era, β-blocker use has no mortality benefit in myocardial infarction, and patients discharged with high heart rate after myocardial infarction have increased mortality risk during the first year, according to research published in the October issue of The American Journal of Medicine.

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Digoxin for A-Fib Without Heart Failure Comes With Risks

MONDAY, Nov. 24, 2014 (HealthDay News) -- Digoxin is associated with increased risk of death and hospitalization among patients with atrial fibrillation but no evidence of heart failure, according to a study published online Nov. 20 in Circulation: Arrhythmia and Electrophysiology.

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Psychosocial Therapy Linked to Lower Suicide Risk

MONDAY, Nov. 24, 2014 (HealthDay News) -- Psychosocial therapy significantly reduces suicide attempts and deaths among people who have previously attempted suicide, according to a new study published online Nov. 24 in The Lancet Psychiatry.

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Newly Insured Under ACA May Have Trouble Finding Doctors

MONDAY, Nov. 24, 2014 (HealthDay News) -- Millions of Americans bought health insurance coverage through the Affordable Care Act in the past year and physicians may be reluctant to accept these patients.

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Strategies Needed to Encourage Appropriate Antibiotic Selection

MONDAY, Nov. 24, 2014 (HealthDay News) -- Although primary care providers are generally familiar with guideline recommendations for antibiotic drug selection, they do not always comply with these guidelines, according to research published in the December issue of the U.S. Centers for Disease Control and Prevention's Emerging Infectious Diseases.

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AMA: Gender Inequality Still Exists in Medicine

FRIDAY, Nov. 21, 2014 (HealthDay News) -- Gender inequality still exists in medicine, according to an article published by the American Medical Association (AMA).

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Exercise Might Not Help Glucose Control in Some T2DM

FRIDAY, Nov. 21, 2014 (HealthDay News) -- Certain genes might prevent regular exercise from improving glucose control in up to a fifth of people with type 2 diabetes, according to findings published online Nov. 20 in the Journal of Clinical Endocrinology & Metabolism.

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Effect of Interventions to Improve Meds Adherence Vary

FRIDAY, Nov. 21, 2014 (HealthDay News) -- The effects of trials to improve medication adherence are inconsistent, with few studies of the highest quality demonstrating improvement in both adherence and clinical outcome, according to a review published online Nov. 20 in The Cochrane Library.

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Could Occupation Help Preserve the Aging Brain?

THURSDAY, Nov. 20, 2014 (HealthDay News) -- Jobs requiring intellectually challenging tasks may help preserve thinking skills and memory as workers age, according to a study published online Nov. 19 in Neurology.

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U.S. Seniors' Health Poorest, Global Survey Shows

THURSDAY, Nov. 20, 2014 (HealthDay News) -- Seniors in America have more chronic health problems and take more medications than seniors in 10 other industrialized countries do, according to a new global survey. The United States also stood out among the 11 nations surveyed by The Commonwealth Fund for having more seniors struggling to get and afford the health care they need.

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Mortality Up for Long-Term Opioid Users With Chronic Pain

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- For adults with chronic noncancer pain, mortality is increased for long-term opioid users, with a smaller increase seen for short-term opioid users and for nonusers versus those without chronic pain, according to a study published in the November issue of PAIN.

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Patient-Doc Relationship Affects Alternative Med Use Disclosure

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- Patient-centered communication with a physician can improve the likelihood of cancer patients disclosing the use of complementary health approaches (CHAs), according to a study published online Nov. 11 in Cancer.

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Trainee-Led Time-Outs Can Improve Antimicrobial Use

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- Trainee-led time-outs to reevaluate antibiotic use can reduce costs in internal medicine units, according to a study published in a supplement to the Nov. 18 issue of the Annals of Internal Medicine, highlighting the Robert Wood Johnson Foundation Clinical Scholars Program.

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Low Levels of Vitamin D May Raise Early Death Risk

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- Having genetically low levels of vitamin D may raise the risk of early death, but the risk is not linked with early death due to cardiovascular-related causes, according to new research published online Nov. 18 in The BMJ.

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Psychological Intervention Beneficial for Dementia Carers

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- A psychological intervention demonstrates clinical effectiveness and cost-effectiveness for family carers for people with dementia, according to a study published online Nov. 19 in The Lancet Psychiatry.

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Nearly 3 in 10 Americans With Diabetes Don't Know It

TUESDAY, Nov. 18, 2014 (HealthDay News) -- Almost eight million Americans have diabetes but don't know it, and that's despite the fact that about two-thirds of those with undiagnosed diabetes have seen a doctor two or more times in the past year, according to a study published in the Nov. 18 issue of the Annals of Internal Medicine.

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NSAIDs Tied to Bleeding, Clotting in A-Fib Patients

TUESDAY, Nov. 18, 2014 (HealthDay News) -- Patients with atrial fibrillation who take common analgesics can significantly increase their risk for bleeding and thromboembolism, with risk higher among those on anticoagulation who also take a nonsteroidal anti-inflammatory drug (NSAID), according to a new study published in the Nov. 18 issue of the Annals of Internal Medicine.

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Low Medication Persistence for Older STEMI Patients

FRIDAY, Nov. 14, 2014 (HealthDay News) -- For older patients with non-ST-segment elevation myocardial infarction, evidence-based medication (EBM) persistence is similar after discharge from academic and nonacademic hospitals, according to a study published in the Nov. 15 issue of The American Journal of Cardiology.

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Triple Aim Should Be Expanded to Address Physician Burnout

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Expanding the Triple Aim approach -- which includes enhancing patient experience, improving population health, and reducing costs -- to the Quadruple Aim by adding the goal of improving health care provider work life is recommended, according to the authors of an article published in the November/December issue of the Annals of Family Medicine.

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Telemedicine Screening IDs Diabetic Retinopathy in 1 in 5

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images identifies diabetic retinopathy (DR) in about 20 percent of patients with diabetes, according to a study published online Nov. 13 in JAMA Ophthalmology.

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B Vitamins May Not Boost Cognitive Performance

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Taking vitamin B12 or folic acid supplements may not reduce seniors' risk of memory loss, according to a study published online Nov. 12 in Neurology.

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U.S. Prices Soaring for Some Generic Drugs

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Market forces are dramatically driving up the cost of some generic drugs, prompting U.S. investigations into the pricing of what should be cheap alternatives to brand-name medications.

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U.S. Medical Bills Pricey, Even With Private Insurance

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Many Americans may believe that private insurance can keep major medical bills at bay. But a new survey finds that one-fifth of people with private plans still spend at least 5 percent of their income on out-of-pocket health care costs.

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High-Intensity Statin Effect Independent of Lipoprotein, CRP

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- High-intensity statin therapy is associated with coronary atherosclerosis regression, regardless of baseline lipoprotein or C-reactive protein (CRP) levels, according to a study published in the Nov. 15 issue of The American Journal of Cardiology.

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Anemia Prevalent Among Older Patients With Diabetes

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- For older patients with diabetes, the prevalence of anemia is 59 percent, with determinants including older age and longer duration of diabetes, according to research published in the October issue of Clinical Diabetes.

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Biomarkers ID Disease Activity in Elderly With Low Back Pain

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Serum biomarkers can be used for assessment of active disease in older patients with low back pain, according to a study published online Nov. 3 in the Journal of the American Geriatrics Society.

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Axillary Hair, Deodorant Don't Affect Testosterone Absorption

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- After application of testosterone solution, serum testosterone concentration is unaffected by the presence or absence of axillary hair or by the use of deodorant/antiperspirant, according to a study published in the November issue of the Journal of Sexual Medicine.

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Pain, Depression Tied to Delirium Risk Post-Surgery

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Pain and depression before an operation may increase seniors' risk for delirium after surgery, according to a study published in the November issue of The Lancet Psychiatry.

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Cancer Patients in Hospice Face Less Aggressive Treatment

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Cancer patients who choose hospice care are less likely to receive aggressive end-of-life treatment or to die in hospitals and nursing homes, according to research published in the Nov. 12 issue of the Journal of the American Medical Association.

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Patient Preference for Anticoagulant Tx Outcome Varies

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Patients' preferences for outcomes of anticoagulation therapy vary and are affected by previous stroke or myocardial infarction experience, according to a study published online Nov. 11 in Circulation: Cardiovascular Quality and Outcomes.

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Computerized Dashboard Can ID Potentially Inappropriate Meds

TUESDAY, Nov. 11, 2014 (HealthDay News) -- A computerized potentially inappropriate medications (PIMs) dashboard can allow identification of older inpatients on high-risk medication regimens, according to research published online Nov. 3 in the Journal of the American Geriatrics Society.

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Worse Health-Related Quality of Life for Older Cancer Survivors

TUESDAY, Nov. 11, 2014 (HealthDay News) -- Health-related quality of life (HRQOL) is worse for older survivors of selected cancers, specifically survivors of multiple myeloma and pancreatic cancer, according to a study published online Nov. 4 in Cancer.

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PSA Rise With Testosterone Gel Tied to Specific Factors

TUESDAY, Nov. 11, 2014 (HealthDay News) -- Factors predicting greater prostate-specific antigen (PSA) increases with use of testosterone gel (T-gel) include age 60 years and older, baseline testosterone (T) ≤250 ng/dL, and percentage of free PSA <20 percent, according to a study published in the November issue of the Journal of Sexual Medicine.

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Medicare to Cover Lung Cancer CT Screening for Long-Time Smokers

TUESDAY, Nov. 11, 2014 (HealthDay News) -- Annual lung cancer screenings for long-term smokers may soon be covered by Medicare, the U.S. Centers for Medicare & Medicaid Services announced Monday.

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Cardiac Prognosis Bright for STEMI Survivors Post-PCI

TUESDAY, Nov. 11, 2014 (HealthDay News) -- Patients who survive the first month after an ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) have <1.5 percent annual risk of successive cardiac death; however, they still have an increased risk of death from noncardiac causes. These findings were published in the Nov. 18 issue of the Journal of the American College of Cardiology.

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NSAID Use Linked to Increased Risk of Incident A-Fib

MONDAY, Nov. 10, 2014 (HealthDay News) -- Nonsteroidal anti-inflammatory drug (NSAID) use is associated with an increased risk of atrial fibrillation (AF) incidence, particularly among new users, according to a meta-analysis published in the Nov. 15 issue of The American Journal of Cardiology.

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CDC: Skin Cancer Costs Soar Compared to Other Cancers

MONDAY, Nov. 10, 2014 (HealthDay News) -- The cost of skin cancer treatment in the United States more than doubled between 2002 and 2011, and rose five times faster than treatments for other cancers, according to study findings published online Nov. 9 in the American Journal of Preventive Medicine.

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Want to Be a Leader? Cultivate a Healthy Look

FRIDAY, Nov. 7, 2014 (HealthDay News) -- It's more important for potential business or political leaders to look healthy than intelligent, according to a study published online Nov. 5 in Frontiers in Human Neuroscience.

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CDC Spends $2.7 Million on Ebola Hospital Kits

FRIDAY, Nov. 7, 2014 (HealthDay News) -- About $2.7 million in personal protective gear has been ordered for health care workers at U.S. hospitals treating Ebola patients, the federal Centers for Disease Control and Prevention said Friday.

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Better Physician Communication at Shift Change Reduces Errors

FRIDAY, Nov. 7, 2014 (HealthDay News) -- Changing how doctors communicate during shift changes in hospitals reduces the risk of adverse events in patients by 30 percent, according to a study published in the Nov. 6 issue of the New England Journal of Medicine.

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Docs Spend ~16.6 Percent of Their Time on Administration

FRIDAY, Nov. 7, 2014 (HealthDay News) -- About 16.6 percent of doctors' working hours are spent on administrative work, according to a study published recently in the International Journal of Health Services.

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Genes May Determine Body Weight by Shaping Gut Bacteria

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Genes influence a person's body weight by determining the types of bacteria that live in the intestines, according to a study published in the Nov. 6 issue of Cell.

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Lung Cancer Screening Can Be Cost-Effective

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Lung cancer screening with computed tomography (CT) can be cost-effective while saving lives, as long as the procedure is performed by skilled professionals and the screening done on a very specific set of long-time smokers. These findings were published in the Nov. 6 issue of the New England Journal of Medicine.

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Predictors of Insomnia ID'd in Long-Term Care Facilities

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Predictors of insomnia in long-term care facilities in Europe and Israel include age, depression, hypnosedatives, and stressful life events, according to a study published online Oct. 30 in the Journal of the American Geriatrics Society.

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Bone Health After Fracture May Be Overlooked in Men

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Older men are much less likely than women to receive osteoporosis screening and treatment after suffering a wrist fracture, according to a study published in the Nov. 1 issue of The Journal of Bone & Joint Surgery.

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Walking Program Feasible, Safe for Older Adults in Hospital

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- A clinical demonstration program of supervised walking for older adults admitted to the hospital is feasible and safe, and its participants are more often discharged directly to home, according to a study published online Oct. 30 in the Journal of the American Geriatrics Society.

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Even Early Signs of Plaque in Arteries Signal Heart Risk

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Even the earlier signs of coronary artery disease significantly increase the risk of myocardial infarction (MI) and early death, according to a new study published in the Nov. 5 issue of the Journal of the American Medical Association.

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AMA: New Mapping Tool IDs Areas in Need of Physicians

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- A new interactive mapping tool can help physicians and their staff determine locations to establish or expand their practice, according to a report published by the American Medical Association (AMA).

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Psychosocial Interventions Tied to Telomere Length Maintenance

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- For distressed breast cancer survivors, psychosocial interventions such as mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET) result in a trend toward telomere length (TL) maintenance, according to a study published online Nov. 3 in Cancer.

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Ambulance Use With MI Tied to Higher Mortality

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Using an ambulance for hospital transport of patients with ST-segment elevation myocardial infarction (MI) is associated with higher mortality, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

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Urinary Retention Seen in ~5% of Posterior Lumbar Surgeries

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- The risk of developing postoperative urinary retention (POUR) after posterior lumbar spine surgery is approximately 5 percent, with certain patient factors associated with higher risk, according to a study published in the Oct. 15 issue of Spine.

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'Purpose in Life' a Boon to Seniors' Health

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Older adults with a strong sense of purpose in life may be particularly likely to get health screenings such as cholesterol tests and mammograms, and appear to spend less time in the hospital, according to research published online Nov. 3 in the Proceedings of the National Academy of Sciences.

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Nearly 75% of Patients With No CAD Have Persistent Symptoms

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Nearly three-quarters of people whose hearts are found to be healthy after being checked for coronary artery disease continue to have persistent symptoms such as chest pain, according to research published online Nov. 3 in Open Heart.

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Opening Visitation Access Boosts Patient, Family Experience

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Opening visitation access across all facilities can improve patient and family experience, according to research published in the July/August issue of the Journal of Nursing Administration.

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Many Americans May Get Hospice Care Too Late

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Of the more than 1.5 million patients who received hospice care in the United States in 2013, one-third died within one week, according to a new report from the National Hospice and Palliative Care Organization.

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Atrial Fibrillation May Double Risk for 'Silent Strokes'

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Atrial fibrillation (AF) may more than double the risk of silent cerebral infarction (SCI), a new review suggests. The report was published in the Nov. 4 issue of the Annals of Internal Medicine.

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Long-Term Shift Work May Drain the Brain

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Working non-standard hours -- "shift work" -- for many years is not only hard on the body, but may also dull the mind, new research suggests. According to the study, published online Nov. 3 in Occupational & Environmental Medicine, those who do shift work for more than 10 years seem to have the equivalent of an extra 6.5 years of age-related decline in memory and thinking skills.

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End-of-Life Care Discussions May Miss Patient Priorities

MONDAY, Nov. 3, 2014 (HealthDay News) -- Important points are often missed when doctors have end-of-life discussions with patients and their families, according to a study published online Nov. 3 in CMAJ, the journal of the Canadian Medical Association.

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Risk of Major Bleeds Up for Dabigatran Versus Warfarin

MONDAY, Nov. 3, 2014 (HealthDay News) -- Dabigatran (Pradaxa) is associated with higher risks of major bleeding and gastrointestinal bleeding compared with warfarin. However, patients taking dabigatran also have a reduced risk of intracranial bleeding compared with those taking warfarin, according to new research published online Nov. 3 in JAMA Internal Medicine.

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Ebola Elimination Possible With Early Patient Isolation

MONDAY, Nov. 3, 2014 (HealthDay News) -- Isolation of patients with Ebola in critical condition within days of symptom onset is likely to have a high chance of eliminating the disease, according to a study published online Oct. 28 in the Annals of Internal Medicine.

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Rate of PCI for Coronary Artery Disease Drops in the U.S.

MONDAY, Nov. 3, 2014 (HealthDay News) -- In the past several years, the rate of percutaneous coronary intervention (PCI) for coronary artery disease (CAD) has decreased in the United States, according to research published in the Oct. 1 issue of The American Journal of Cardiology.

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Median Neuropathy at the Wrist May Signal Diabetic Neuropathy

MONDAY, Nov. 3, 2014 (HealthDay News) -- Median neuropathy at the wrist (MN) may be an early indicator of diabetic neuropathy, according to a study published in the November issue of the Journal of Diabetes Investigation.

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AMA: Absence of Health Insurer Competition in Many Areas

MONDAY, Nov. 3, 2014 (HealthDay News) -- In most metropolitan areas, there is a significant absence of health insurer competition, according to a report published by the American Medical Association (AMA).

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Preterm, Low Birth-Weight Babies May Need New Hips As Adults

MONDAY, Nov. 3, 2014 (HealthDay News) -- Adults who were born preterm or at a low birth weight may have an increased risk of needing a hip replacement due to osteoarthritis, according to a study published online Nov. 3 in Arthritis Care & Research.

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