November 2017 Briefing - Cardiology

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

Severe Hypoglycemia a Potent Marker of Cardiovascular Risk

THURSDAY, Nov. 30, 2017 (HealthDay News) -- Among patients with diabetes, severe hypoglycemia is associated with high absolute risk of cardiovascular events and mortality, according to a study published online Nov. 10 in Diabetes Care.

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More Than Half Today's Children Expected to Be Obese at 35

THURSDAY, Nov. 30, 2017 (HealthDay News) -- More than half of today's children are expected to be obese at the age of 35 years, with about half of the prevalence occurring during childhood, according to a study published in the Nov. 30 issue of the New England Journal of Medicine.

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Many Seniors Have Not Discussed Avoiding Drug Interactions

WEDNESDAY, Nov. 29, 2017 (HealthDay News) -- Older adults report feeling confident that they know how to avoid drug interactions despite only 35 percent having spoken to someone about it in the past year, according to findings from the National Poll on Healthy Aging, published online Nov. 29.

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Wait Time Linked to Worse Outcomes in Hip Fracture Surgery

WEDNESDAY, Nov. 29, 2017 (HealthDay News) -- Increased wait time is associated with an increased risk of complications and 30-day mortality among adults undergoing hip fracture surgery, according to a study published in the Nov. 28 issue of the Journal of the American Medical Association.

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Measuring Plasma PCSK9 May ID Resistance to PCSK9 Inhibitors

TUESDAY, Nov. 28, 2017 (HealthDay News) -- Plasma levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) may help assess apparent resistance to PCSK9 inhibitors, according to a research letter published online Nov. 28 in the Annals of Internal Medicine.

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Clinician Denial of Patient Requests Impacts Satisfaction

TUESDAY, Nov. 28, 2017 (HealthDay News) -- Clinician denial of some types of tests requested by patients is associated with worse patient satisfaction with the clinician, according to a study published online Nov. 27 in JAMA Internal Medicine.

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Value-Based Payment Modifier Not Tied to Practice Performance

TUESDAY, Nov. 28, 2017 (HealthDay News) -- The Value-Based Payment Modifier (VM) is not associated with performance differences between practices serving higher-risk and lower-risk patients, according to a study published online Nov. 28 in the Annals of Internal Medicine.

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Simple ECG May Help Distinguish MDD From Bipolar Depression

TUESDAY, Nov. 28, 2017 (HealthDay News) -- Heart rate variability (HRV) and specific inflammatory biomarkers can differentiate major depressive disorder (MDD) from depression in bipolar disorder (BD), according to a study published online Oct. 5 in The World Journal of Biological Psychiatry.

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1998 to 2014 Saw Drop in CVD Hospitalization Rates in Diabetes

TUESDAY, Nov. 28, 2017 (HealthDay News) -- Cardiovascular disease (CVD) hospitalization rates have declined in recent years among individuals with and those without diabetes, according to a study published online Nov. 17 in Diabetes Care.

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Ablation Cuts Risk of Recurrent Stroke in Patients With A-Fib

TUESDAY, Nov. 28, 2017 (HealthDay News) -- For patients with atrial fibrillation (AF) and prior cerebrovascular accident (CVA), ablation is associated with reduced risk of recurrent stroke, according to a study published online Nov. 13 in the Journal of Cardiovascular Electrophysiology.

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Abdominal Obesity Linked to All-Cause Mortality in HFpEF

MONDAY, Nov. 27, 2017 (HealthDay News) -- For patients with heart failure with preserved ejection fraction (HFpEF), abdominal obesity is associated with increased risk of all-cause mortality, according to a study published in the Dec. 5 issue of the Journal of the American College of Cardiology.

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Essay Adds to Discourse on Impact of Suggestive Jokes

MONDAY, Nov. 27, 2017 (HealthDay News) -- Seemingly benign, recurring patterns of joking around a single theme (joke cycles) can contribute to humorizing and legitimizing sexual misconduct, according to an essay published online Nov. 12 in Communication and Critical/Cultural Studies.

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New Workflows Have Potential to Address Provider Burnout

MONDAY, Nov. 27, 2017 (HealthDay News) -- New solutions are needed to address burnout among health care team members, yet, in a catch-22 situation for health industry leaders, change fatigue contributes to burnout, according to a Vocera Communications report entitled In Pursuit of Resilience, Well-Being, and Joy in Healthcare.

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Percutaneous Transluminal Angioplasty Ineffective in MS

MONDAY, Nov. 27, 2017 (HealthDay News) -- Percutaneous transluminal angioplasty (PTA) seems to be safe but ineffective for patients with multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency (CCSVI), according to a study published online Nov. 18 in JAMA Neurology.

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Coffee Consumption Appears to Provide More Benefit Than Harm

MONDAY, Nov. 27, 2017 (HealthDay News) -- Coffee consumption seems safe and is associated with reduced risk for various health outcomes, according to a review published online Nov. 22 in The BMJ.

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Clinician Suspicion Minimally Accurate for Lyme Disease

MONDAY, Nov. 27, 2017 (HealthDay News) -- Clinician suspicion has minimal accuracy for the diagnosis of Lyme disease, according to a study published online Nov. 24 in Pediatrics.

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NTproBNP Levels Are Significantly Lower in Blacks

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Plasma N-terminal pro-B-type natriuretic peptide (NTproBNP) levels are significantly lower for black than white individuals, according to a study published online Nov. 22 in JAMA Cardiology.

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Female Physicians' Spouses More Likely to Work

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Spouses of female physicians are on average more educated and work more hours outside the home than spouses of male physicians, according to a research letter published online Nov. 21 in the Annals of Internal Medicine.

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High Costs Associated With Physician Burnout, Attrition

TUESDAY, Nov. 21, 2017 (HealthDay News) -- Physicians who are experiencing burnout are more than twice as likely to leave their organization within two years, and this is associated with significant economic costs, according to a report from the American Medical Association.

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NOACs Show Lower Risk of Adverse Renal Outcomes in A-Fib

TUESDAY, Nov. 21, 2017 (HealthDay News) -- For patients with atrial fibrillation (AF), non-vitamin K antagonist oral anticoagulants (NOACs) are associated with lower risks of adverse renal outcomes than warfarin, according to a study published in the Nov. 28 issue of the Journal of the American College of Cardiology.

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Few U.S. Adults Meet Fruit, Veg Intake Recommendations

TUESDAY, Nov. 21, 2017 (HealthDay News) -- Across all 50 states and the District of Columbia (D.C.), few adults consume the recommended amount of fruits and vegetables, according to research published in the Nov. 17 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Higher β-Blocker Dose Linked to Lower Mortality Risk

TUESDAY, Nov. 21, 2017 (HealthDay News) -- An increased β-blocker dose is associated with a greater prognostic advantage in patients with chronic heart failure (CHF) and diabetes than in those with CHF but no diabetes, according to a study published online Oct. 25 in Diabetes Care.

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Increased Repolarization Dispersion Seen in SCD Survivors

TUESDAY, Nov. 21, 2017 (HealthDay News) -- Survivors of sudden cardiac death (SCD) with structurally normal hearts have increased dispersion of repolarization after exertion, and this is detectable on non-invasive electrocardiographic imaging (ECGi), according to a study published online Nov. 1 in the Journal of Cardiovascular Electrophysiology.

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High Salt Intake Impacts Gut Microbiome

MONDAY, Nov. 20, 2017 (HealthDay News) -- High salt intake affects the gut microbiome; however, certain intestinal bacteria may help prevent high-salt diets contributing to hypertension, according to research published online Nov. 15 in Nature.

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Chronic Conditions Increasing Among Childbearing Women

MONDAY, Nov. 20, 2017 (HealthDay News) -- Between 2005 and 2014, the prevalence of chronic conditions increased across all segments of the childbearing population, according to a study published online Nov. 7 in Obstetrics & Gynecology.

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Intensive BP Control Lacks Benefit in Chronic Kidney Disease

FRIDAY, Nov. 17, 2017 (HealthDay News) -- Intensive blood pressure (BP) control may provide no benefit and may even be harmful for patients with moderate-to-advanced chronic kidney disease, according to a study published online Oct. 16 in the Journal of Internal Medicine.

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Simple Checklist Can Identify Useful Clinical Practice Guidelines

FRIDAY, Nov. 17, 2017 (HealthDay News) -- A simple, easy-to-use checklist, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST), can identify useful clinical practice guidelines, according to a study published in the September/October issue of the Annals of Family Medicine.

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Many Health Care Providers Work While Sick

FRIDAY, Nov. 17, 2017 (HealthDay News) -- More than 40 percent of health care personnel (HCP) with influenza-like illness (ILI) work while ill, according to a study published in the November issue of the American Journal of Infection Control.

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Docs' Preparedness Influences Exercise Recommendations

FRIDAY, Nov. 17, 2017 (HealthDay News) -- Primary care providers who feel prepared are more likely to recommend physical activity to patients with disabilities, according to a study published online Nov. 16 in Preventing Chronic Disease.

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Allopurinol Has Little Benefit in Cardiac Syndrome X

FRIDAY, Nov. 17, 2017 (HealthDay News) -- Allopurinol does not appear to improve exercise capacity or peripheral endothelial or coronary function in patients with cardiac syndrome X, according to a study published online Oct. 28 in Cardiovascular Therapeutics.

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Simpler Tool Promising for Atherosclerosis Prediction

THURSDAY, Nov. 16, 2017 (HealthDay News) -- The ideal cardiovascular health score (ICHS) and the Fuster-BEWAT (blood pressure, exercise, weight, alimentation, and tobacco) score (FBS) are similar in their ability to predict subclinical atherosclerosis, according to a study published online Nov. 13 in the Journal of the American College of Cardiology.

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Heart Murmur Disappearance on Standing Can Rule Out Pathology

THURSDAY, Nov. 16, 2017 (HealthDay News) -- For children aged 2 and older, disappearance of a heart murmur on standing is a reliable tool for excluding pathologic murmur, according to a study published in the November/December issue of the Annals of Family Medicine.

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Health Care Experts in Favor of Patient Contribution to Notes

WEDNESDAY, Nov. 15, 2017 (HealthDay News) -- Health care experts are supportive of OurNotes, an intervention in which patients and families co-produce medical notes with clinicians, according to a research letter published online Nov. 13 in the Annals of Internal Medicine.

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AHA: Noninvasive Testing Ups LOS in Patients With Chest Pain

WEDNESDAY, Nov. 15, 2017 (HealthDay News) -- Noninvasive cardiac testing leads to longer length of stay (LOS) for patients presenting to the emergency department with chest pain, according to a study published online Nov. 14 in JAMA Internal Medicine to coincide with the American Heart Association's Scientific Sessions, being held Nov. 11 to 15 in Anaheim, California.

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Perioperative Aspirin May Benefit Patients With Prior PCI

TUESDAY, Nov. 14, 2017 (HealthDay News) -- For patients with prior percutaneous coronary intervention (PCI), perioperative aspirin seems to be beneficial, according to a study published online Nov. 13 in the Annals of Internal Medicine.

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Eating More Nuts Associated With Lower Heart Disease Risk

TUESDAY, Nov. 14, 2017 (HealthDay News) -- Nut consumption is tied to a decreased risk of cardiovascular disease and coronary heart disease (CHD), according to a study published online Nov. 13 in the Journal of the American College of Cardiology.

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Outcomes for Atrial Fibrillation Similar With Dabigatran, Warfarin

TUESDAY, Nov. 14, 2017 (HealthDay News) -- In clinical practice, patients starting dabigatran therapy do not have significantly different rates of ischemic stroke or extracranial hemorrhage than those starting warfarin therapy, though they have lower rates of intracranial bleeding, according to a study published online Nov. 13 in the Annals of Internal Medicine.

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Thrombectomy May Be Best in Stroke Patients With Mismatch

MONDAY, Nov. 13, 2017 (HealthDay News) -- For patients with acute stroke who were last well six to 24 hours earlier and who had a mismatch between the severity of the clinical deficit and the infarct volume, thrombectomy plus standard care is associated with better outcomes than standard care alone, according to a study published online Nov. 11 in the New England Journal of Medicine to coincide with the annual meeting of the Society of Vascular and Interventional Neurology, held Nov. 8 to 11 in Boston.

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Cardiac Index Linked to Cerebral Blood Flow Regardless of CVD

MONDAY, Nov. 13, 2017 (HealthDay News) -- Among older adults, lower cardiac index is associated with lower resting cerebral blood flow (CBF) in the temporal lobes regardless of cardiovascular disease (CVD) but is not associated with cerebrovascular reactivity (CVR), according to a study published online Nov. 8 in Neurology.

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About 20 Percent of U.S. Adults Currently Use Tobacco Products

MONDAY, Nov. 13, 2017 (HealthDay News) -- About one in five U.S. adults currently uses any tobacco product, according to a study published online Nov. 9 in Morbidity and Mortality Weekly Report.

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Eclampsia Tied to Increased Relative Risk of Seizure Disorder

THURSDAY, Nov. 9, 2017 (HealthDay News) -- The relative risk of a seizure disorder after eclampsia is higher than that of women unaffected by eclampsia but remains extremely low, according to a study published online Nov. 7 in Obstetrics & Gynecology.

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Adding Exercise to Compression Therapy Promising for Leg Ulcers

THURSDAY, Nov. 9, 2017 (HealthDay News) -- Supervised exercise training in conjunction with compression may improve outcomes for patients with venous leg ulcers (VLUs), according to a study published online Oct. 27 in the British Journal of Dermatology.

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Doctors Have Extra Two Weeks to Preview Performance Data

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- Physicians have two extra weeks to preview their 2016 performance information as a result of a mistake related to the Centers for Medicare & Medicaid Services' Physician Compare online resource, according to a report published by the American Academy of Family Physicians.

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Increases in U.S. Health Spending Tied to Health Service Price

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- Factors including increases in health care service price and intensity are associated with increases in U.S. health care spending from 1996 to 2013, according to a study published online Nov. 7 in the Journal of the American Medical Association.

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Warfarin Use Linked to Reduced Incidence of Cancer

TUESDAY, Nov. 7, 2017 (HealthDay News) -- For adults older than 50 years, warfarin use is associated with reduced incidence of cancer, according to a study published online Nov. 6 in JAMA Internal Medicine.

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Intensity of Exercise Affects Impact on Mortality Risk

TUESDAY, Nov. 7, 2017 (HealthDay News) -- Total physical activity (PA) and moderate- to vigorous-intensity PA (MVPA) are inversely associated with mortality, though light-intensity PA and sedentary behavior are not associated with mortality, according to a research letter published online Nov. 6 in Circulation.

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Brain Measures Tied to Atrial Pressure in Valvular Heart Dz

TUESDAY, Nov. 7, 2017 (HealthDay News) -- For patients with chronic valvular heart disease, white matter hyperintensity (WMH) volume is associated with mean right atrial (RA) pressure, according to a study published online Nov. 6 in JAMA Neurology.

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Rates of IVC Filter Placement Decreased from 2010 to 2014

TUESDAY, Nov. 7, 2017 (HealthDay News) -- The rates of inferior vena cava (IVC) filter placement increased from 2005 until 2010 and then decreased through 2014, according to a research letter published online Nov. 6 in JAMA Internal Medicine.

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PCI Does Not Improve Exercise Time in Angina Patients

MONDAY, Nov. 6, 2017 (HealthDay News) -- Percutaneous coronary intervention (PCI) does not increase exercise time more than a placebo procedure in patients with medically treated angina and severe coronary stenosis, according to a study published online Nov. 2 in The Lancet.

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'09 to '15 Saw Increase in Transradial Access for STEMI PCI

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Use of transradial access (TRA) for ST-elevation myocardial infarction (STEMI) percutaneous coronary intervention (PCI) increased from 2009 to 2015, with considerable geographic, operator, and institutional variation, according to a study published online Nov. 1 in JACC: Cardiovascular Interventions.

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CYP2C19-Genotype Guided Antiplatelet Tx May Be Beneficial

FRIDAY, Nov. 3, 2017 (HealthDay News) -- Patients with a CYP2C19 loss-of-function allele have increased risk of major adverse cardiovascular events (MACE) with clopidogrel versus alternative antiplatelet therapy after percutaneous coronary intervention (PCI), according to a study published online Nov. 1 in JACC: Cardiovascular Interventions.

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Current Practice Not Cost-Effective for Air Medical Triage

FRIDAY, Nov. 3, 2017 (HealthDay News) -- Current practice is not cost-effective compared with the Air Medical Prehospital Triage (AMPT) score for trauma patients, and the field triage system undertriage rate for patients with severe injuries exceeds 20 percent, according to two studies published online Nov. 1 in JAMA Surgery.

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Pricing Interventions Increase Sales, Intake of Healthy Foods

FRIDAY, Nov. 3, 2017 (HealthDay News) -- Pricing interventions seem to improve access to healthy food and beverage options with increases in stocking and sales of these items, according to a review published online Nov. 2 in Preventing Chronic Disease.

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Favorable Prognosis for Syncope Patients Discharged From ER

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Most patients presenting to the emergency department (ED) with a primary diagnosis of syncope are discharged and have a favorable prognosis, and though total costs to care for discharged syncope patients are high, cost per patient is lower compared with hospitalized patients, according to a study published online Nov. 1 in JACC: Clinical Electrophysiology.

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Lead Shield Reduces Radiation Exposure During Catheterization

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Use of an accessory lead shield placed between the staff member and the patient during cardiac catheterization can reduce radiation exposure among technologists and nurses, according to a study published online Nov. 1 in JACC: Cardiovascular Interventions.

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ACE Inhibitor, Statin No Benefit for T1DM, High Albumin Excretion

THURSDAY, Nov. 2, 2017 (HealthDay News) -- For adolescents with type 1 diabetes and high levels of albumin excretion, neither angiotensin-converting-enzyme (ACE) inhibitors nor statins change the albumin-to-creatinine ratio over time, according to a study published online Nov. 1 in the New England Journal of Medicine.

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Race a Factor in Intracranial Atherosclerotic Disease

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Black men have increased prevalence and frequency of multiple intracranial atherosclerotic plaques, according to a study published online Nov. 1 in JAMA Cardiology.

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Driving Impairment Warnings Often Not Given With Rx Meds

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Not all prescription drug users report receiving warnings about driving impairment, according to a study published online Nov. 1 in the Journal of Studies on Alcohol and Drugs.

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CMS Launches Initiative to Examine Impact of Regulations

WEDNESDAY, Nov. 1, 2017 (HealthDay News) -- The Centers for Medicare & Medicaid Services (CMS) has launched an initiative to examine which provider regulations should be discarded or revamped amid concerns that the regulations are reducing the amount of time that physicians spend with patients, according to an article published in Modern Healthcare.

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Updated Guidelines Released for Ventricular Arrhythmias

WEDNESDAY, Nov. 1, 2017 (HealthDay News) -- The American College of Cardiology, the American Heart Association, and the Heart Rhythm Society have released updated guidelines for the management of adults who have ventricular arrhythmias (VAs) or who are at risk for sudden cardiac death (SCD). The guidelines were published online Oct. 30 in the Journal of the American College of Cardiology.

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Enjoyment of Spicy Food May Lower Salt Preference, Intake

WEDNESDAY, Oct. 31, 2017 (HealthDay News) -- Enjoyment of spicy food seems to reduce individual salt preference, salt intake, and blood pressure, according to research published online Oct. 31 in Hypertension.

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