October 2017 Briefing - Neurology

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

Football Career Length, Position Affect White Matter Structure

TUESDAY, Oct. 31, 2017 (HealthDay News) -- For former collegiate and professional football players, career duration and primary playing position appear to modify the effects of concussion history on white matter structure and neural recruitment, according to a study published online Oct. 31 in Radiology.

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Fentanyl or Analogs Tied to More Than Half of All Opioid Deaths

TUESDAY, Oct. 31, 2017 (HealthDay News) -- Fentanyl was involved in more than half of opioid overdose deaths reported in the second half of 2016, according to a study published online Oct. 27 in Morbidity and Mortality Weekly Report.

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Systemic Lupus Erythematosus Mortality Down Since 1968

TUESDAY, Oct. 31, 2017 (HealthDay News) -- Rates of systemic lupus erythematosus (SLE) mortality have decreased since 1968 but are still higher than non-SLE mortality, according to a study published online Oct. 30 in the Annals of Internal Medicine.

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Focused US Thalamotomy Effective in Tremor-Dominant PD

TUESDAY, Oct. 31, 2017 (HealthDay News) -- For patients with tremor-dominant Parkinson's disease (TDPD), unilateral focused ultrasound (FUS) thalamotomy is associated with improvements in tremor scores, according to a study published online Oct. 30 in JAMA Neurology.

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Depressive Symptoms Increase During Internship Year

TUESDAY, Oct. 31, 2017 (HealthDay News) -- Depressive symptoms increase during the internship year for training physicians, with a greater increase among women, according to a study published online Oct. 30 in JAMA Internal Medicine.

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Retinal Sensitivity Linked to Cognitive Status in T2DM

TUESDAY, Oct. 31, 2017 (HealthDay News) -- In patients with type 2 diabetes, retinal sensitivity is associated with cognitive status, according to a study published in the September issue of Diabetes.

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PFA-100-Measured Aspirin Resistance Linked to CV Events

TUESDAY, Oct. 31, 2017 (HealthDay News) -- Aspirin resistance, measured using the Platelet Function Analyzer (PFA)-100 system, is associated with cardiovascular events in aspirin-treated patients, according to a study published online Oct. 21 in the Journal of Clinical Pharmacy and Therapeutics.

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Maternal Use of Acetaminophen Linked to ADHD in Offspring

MONDAY, Oct. 30, 2017 (HealthDay News) -- Maternal use of acetaminophen in pregnancy is associated with attention-deficit/hyperactivity disorder (ADHD) in offspring, according to a study published online Oct. 30 in Pediatrics.

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Cataract Surgery Associated With Reduced Mortality in Women

THURSDAY, Oct. 26, 2017 (HealthDay News) -- For older women with cataract, cataract surgery is associated with lower all-cause and cause-specific mortality, according to a study published online Oct. 26 in JAMA Ophthalmology.

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Gifts From Pharma Companies Influence Prescribing Behavior

THURSDAY, Oct. 26, 2017 (HealthDay News) -- Receipt of gifts from pharmaceutical companies is associated with more prescriptions per patient and more costly prescriptions, according to a study published online Oct. 25 in PLOS One.

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Surgery Reduces Seizures in Drug-Resistant Epilepsy

THURSDAY, Oct. 26, 2017 (HealthDay News) -- For pediatric patients with drug-resistant epilepsy, surgery can improve freedom from seizures, and among adults with drug-resistant focal epilepsy undergoing surgery, hippocampal sclerosis is the most common histopathological diagnosis, according to two studies published online Oct. 25 in the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required) -- Dwivedi
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Most Patients Satisfied With Relationship With Physician

WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- Results of the Physicians Foundation 2017 Patient Survey show that most patients are satisfied with their overall relationship with their physician, according to an article published by the American Academy of Family Physicians.

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Detectable Levels of Roundup Ingredient Rising in Older Adults

WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- Detectable levels of glyphosate, the primary ingredient in the herbicide Roundup, have significantly increased in older adults over time, according to a research letter published online Oct. 24 in the Journal of the American Medical Association.

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Hypothermia May Help Newborns With Encephalopathy

WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- Hypothermia treatment initiated at six to 24 hours after birth for newborns with hypoxic-ischemic encephalopathy may reduce death or disability, but there is uncertainty about its effectiveness, according to a study published online Oct. 24 in the Journal of the American Medical Association.

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MRN Helps Quantify Peripheral Nerve Involvement in MS

WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- Patients with multiple sclerosis (MS) have peripheral nerve involvement that can be visualized and quantified by high-resolution magnetic resonance neurography (MRN), according to a study published online Oct. 10 in the Annals of Neurology.

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DEA Taking Back Unwanted Prescription Drugs on Oct. 28

TUESDAY, Oct. 24, 2017 (HealthDay News) -- The public is being given its 14th opportunity to safely dispose of pills and patches at collection points operated by the U.S. Drug Enforcement Agency (DEA) and its partners.

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Smoking Alters Genetic Relationship with Parkinson's

MONDAY, Oct. 23, 2017 (HealthDay News) -- Smoking may modify a previously reported genetic association with Parkinson's disease (PD), according to an analysis published online Oct. 5 in the Annals of Neurology.

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Design Thinking Enables Med Students to Solve Challenges

MONDAY, Oct. 23, 2017 (HealthDay News) -- A joint effort between students at Warren Alpert Medical School of Brown University and Rhode Island School of Design (RISD) is training future physicians in design thinking to help identify and repair health system issues that contribute to physician burnout, according to an article by the American Medical Association.

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Caution for PLEX in Progressive Multifocal Leukoencephalopathy

MONDAY, Oct. 23, 2017 (HealthDay News) -- For patients with progressive multifocal leukoencephalopathy (PML), plasma exchange (PLEX) and steroids should be used with caution, according to a study published online Oct. 10 in the Annals of Neurology.

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Limited Evidence of Benefit for Medical Cannabinoids in Children

MONDAY, Oct. 23, 2017 (HealthDay News) -- The strongest evidence for benefit of cannabinoids in children is for chemotherapy-induced nausea and vomiting, with more research needed to assess its role as a medical treatment, according to a review published online Oct. 23 in Pediatrics.

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Clinician Job Satisfaction Linked to Improved Burnout Scores

FRIDAY, Oct. 20, 2017 (HealthDay News) -- Clinicians' job satisfaction is associated with improved burnout scores and reduced intention to leave their practices, according to a study published in the October issue of Health Affairs.

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CDC Updates Zika Guidance for Infant Care

FRIDAY, Oct. 20, 2017 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention (CDC) has updated its interim guidance for U.S. health care providers caring for infants with possible congenital Zika virus infection, according to a report published online Oct. 19 in Morbidity and Mortality Weekly Report.

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Conditions Tied to Clinician Dissatisfaction Are Modifiable

THURSDAY, Oct. 19, 2017 (HealthDay News) -- Modifiable conditions, like chaos, incohesiveness, and lack of communication, contribute to unsatisfying workplaces for clinicians, according to a study published in the October issue of Health Affairs.

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More Penalties With Hospital-Wide Readmission Measure

THURSDAY, Oct. 19, 2017 (HealthDay News) -- Transition from a condition-specific to a hospital-wide readmission measure would result in a modest increase in the number of hospitals eligible for readmission penalties and would substantially increase penalties for safety-net hospitals, according to a study published online Oct. 18 in the New England Journal of Medicine.

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MACE Risk Similar for White Men, Women, Minorities After PCI

THURSDAY, Oct. 19, 2017 (HealthDay News) -- Women and minorities undergoing percutaneous coronary intervention (PCI) with everolimus-eluting stents have a risk of major adverse cardiac events (MACE) that is similar to that of white men, according to a study published online Oct. 18 in JAMA Cardiology.

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IV Prochlorperazine Beats IV Hydromorphone for Migraine

THURSDAY, Oct. 19, 2017 (HealthDay News) -- Intravenous (IV) hydromorphone is less effective than IV prochlorperazine plus diphenhydramine for acute migraine treatment in the emergency department, according to a study published online Oct. 18 in Neurology.

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MRI Findings Prognostic for Long-Term Recovery in Cardiac Arrest

THURSDAY, Oct. 19, 2017 (HealthDay News) -- Measures of cerebral functional network connectivity measured within four weeks of cardiac arrest (CA) are associated with a favorable outcome (FO) at one year, according to a study published online Oct. 18 in Radiology.

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Key Stakeholders Discuss How to Make EHRs More Usable

THURSDAY, Oct. 19, 2017 (HealthDay News) -- Key stakeholders and physicians discussed electronic health record (EHR) usability and optimization in the American Medical Association Running Your Practice Community.

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Sharing Passwords Is Widespread Among Medical Staff

WEDNESDAY, Oct. 18, 2017 (HealthDay News) -- Sharing of passwords to access electronic medical records is common among medical staff members, according to a study published in the July issue of Healthcare Informatics Research.

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PPI Use Linked to Increased Risk of Ischemic Stroke, MI

WEDNESDAY, Oct. 18, 2017 (HealthDay News) -- Proton pump inhibitor (PPI) use is associated with increased risk of first-time ischemic stroke and myocardial infarction (MI), according to a study published online Oct. 12 in the Journal of Internal Medicine.

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Men Now Comprise ~10 Percent of RN Workforce

WEDNESDAY, Oct. 18, 2017 (HealthDay News) -- The increasing participation of men in registered nursing can be attributed to multiple factors, including increasing educational attainment, rising labor demand in health care, and liberalizing gender role attitudes, according to a working paper published by the Washington Center for Equitable Growth.

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No Increased Risks for DOAC Use Versus Warfarin in VTE

WEDNESDAY, Oct. 18, 2017 (HealthDay News) -- For patients with venous thromboembolism, direct oral anticoagulant (DOAC) use is not associated with increased risk of major bleeding or mortality within the first 90 days compared with warfarin use, according to a study published online Oct. 17 in the BMJ.

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Overall Survival Up for Melanoma Brain Metastases

WEDNESDAY, Oct. 18, 2017 (HealthDay News) -- Overall survival (OS) for patients with melanoma brain metastases (MBM) has improved significantly since 2000, according to a study published online Oct. 12 in Cancer.

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Tau May Predict Neurological Outcome After Cardiac Arrest

WEDNESDAY, Oct. 18, 2017 (HealthDay News) -- Serum tau is a promising novel biomarker for prediction of neurological outcome in patients with cardiac arrest, according to a study published online Oct. 5 in the Annals of Neurology.

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Female Physicians May Be Especially at Risk of Burnout

TUESDAY, Oct. 17, 2017 (HealthDay News) -- Female physicians are more burned out than their male colleagues, but there are steps they can take to reduce the stress associated with burnout, according to a blog post published in Medical Economics.

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Screening Tools Identify Potentially Inappropriate Meds

TUESDAY, Oct. 17, 2017 (HealthDay News) -- Internal medicine patients are frequently prescribed potentially inappropriate medications (PIMs), but screening tools can detect clinically relevant PIMs, according to a study published online Oct. 8 in the Journal of Clinical Pharmacy and Therapeutics.

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Online Ratings Not Aligned With Objective Quality Measures

MONDAY, Oct. 16, 2017 (HealthDay News) -- Online consumer ratings of specialist physicians do not predict objective measures of quality of care or peer assessment of clinical performance, according to a study published online Sept. 8 in the Journal of the American Medical Informatics Association.

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Most Female Physicians Have Faced Sexist Patient Comments

MONDAY, Oct. 16, 2017 (HealthDay News) -- Most female physicians have been sexually harassed by patients at some point in their careers, according to a blog post published in Medical Economics.

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Many College Students Believe Stimulants Can Boost Grades

MONDAY, Oct. 16, 2017 (HealthDay News) -- More than one-quarter of college students report believing that nonmedical use of prescription stimulants (NPS) can improve academic performance, according to a study published in the January 2018 issue of Addictive Behaviors.

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Serious Suffering Affects Almost Half of Those Who Die Yearly

FRIDAY, Oct. 13, 2017 (HealthDay News) -- In 2015, more than 25.5 million people who died worldwide experienced serious health-related suffering (SHS), and the vast majority lacked access to palliative care and pain relief, according to a report published online Oct. 12 in The Lancet.

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Pre-Retirement Morbidity Higher in Later Birth Cohorts

FRIDAY, Oct. 13, 2017 (HealthDay News) -- Americans who must work longer to reach Social Security retirement age have worse measures of health in the years leading up to retirement, according to a study published in the October issue of Health Affairs.

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Quality Issues for Both Paper-, Electronic-Based Health Records

FRIDAY, Oct. 13, 2017 (HealthDay News) -- Both paper-based and electronic health records (EHRs) have shortcomings in terms of quality of content, process, and structure, with poor quality of nursing documentation seen for both methods, according to a study published online Oct. 5 in the Journal of Clinical Nursing.

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Court Considering Fate of Noneconomic Damages Cap

THURSDAY, Oct. 12, 2017 (HealthDay News) -- The Wisconsin Supreme Court is considering whether it will hear a case that will determine the fate of the state's $750,000 cap on noneconomic damages, according to an article published by the American Medical Association (AMA).

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New System Streamlines CME Credit Approval Process

THURSDAY, Oct. 12, 2017 (HealthDay News) -- The American Academy of Family Physicians (AAFP) and the American Board of Family Medicine (ABFM) have launched a new performance improvement activity credit reporting process called the AAFP Credit System, according to an article published by the AAFP.

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Neurotoxicity Characterized After Infusion of CD19 CAR-T Cells

THURSDAY, Oct. 12, 2017 (HealthDay News) -- Patients with severe neurotoxicity after infusion of CD19-targeted chimeric antigen receptor-modified T (CAR-T) cells have evidence of endothelial activation, according to a study published online Oct. 12 in Cancer Discovery.

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Low-Cost Services a Major Player in Unnecessary Health Spending

THURSDAY, Oct. 12, 2017 (HealthDay News) -- The costs associated with low-cost, low-value health services are nearly twice as high as those of high-cost, low-value services, according to a study published in the October issue of Health Affairs.

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2004 to 2014 Saw Increases in Risk Factors in Ischemic Stroke

THURSDAY, Oct. 12, 2017 (HealthDay News) -- From 2004 to 2014 there were increases in the prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse in acute ischemic stroke (AIS), according to a study published online Oct. 11 in Neurology.

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Medical License Questions Sway Doctors' Mental Health Help

WEDNESDAY, Oct. 11, 2017 (HealthDay News) -- Medical licensure application questions (MLAQs) regarding mental health contribute to physicians' reluctance to seek help for mental health, according to a study published in the October issue of Mayo Clinic Proceedings.

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Physician Salaries Appear to Be Flat or Declining

WEDNESDAY, Oct. 11, 2017 (HealthDay News) -- Anecdotally, physician career coaches report that physician salaries are flat at best, according to an article published in Medical Economics.

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Guide Offers Doctors Tips for Choosing a Health System

TUESDAY, Oct. 10, 2017 (HealthDay News) -- A guide has been developed to assist physicians considering joining a physician-led integrated health system, according to a report published by the American Medical Association (AMA).

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Dietary Fat, Relapse Linked in Pediatric Multiple Sclerosis

TUESDAY, Oct. 10, 2017 (HealthDay News) -- For children with multiple sclerosis, increased fat intake is associated with an increased risk of relapse, while vegetable intake may be protective, according to a study published online Oct. 9 in the Journal of Neurology, Neurosurgery & Psychiatry.

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Medicare Coverage Restrictions for Opioids Rose From '06 to '15

TUESDAY, Oct. 10, 2017 (HealthDay News) -- In an effort to restrict daily allowable prescribed dosing of prescription opioids, Medicare Part D formularies increasingly used quantity limits and prior authorization from 2006 to 2015, according to a research report published online Oct. 9 in the Annals of Internal Medicine.

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Pediatric Physicians Should Revisit Approaches to Marijuana

TUESDAY, Oct. 10, 2017 (HealthDay News) -- In light of the changing legal status of marijuana, physicians should provide counseling on its effects to adolescents, according to an opinion article published online Oct. 9 in JAMA Pediatrics.

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Medial Temporal Lobe Surgery Linked to Prevalence of Tinnitus

TUESDAY, Oct. 10, 2017 (HealthDay News) -- Patients with epilepsy undergoing medial temporal lobe (MTL) surgery have increased prevalence of tinnitus compared with controls and participants with self-reported epilepsy (SRE), according to a research letter published online Oct. 9 in JAMA Neurology.

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2HELPS2B Model Identifies Seizure Risk in Critically Ill

TUESDAY, Oct. 10, 2017 (HealthDay News) -- For critically ill patients, a model comprising six variables can identify the probability of seizure, according to a study published online Oct. 9 in JAMA Neurology.

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3MR Intervention Effective for Discontinuing Inappropriate Meds

TUESDAY, Oct. 10, 2017 (HealthDay News) -- The Multidisciplinary Multistep Medication Review (3MR) is effective for discontinuation of inappropriate medication among elderly nursing home residents without a decline in their well-being, according to a study published online Oct. 9 in the Annals of Internal Medicine.

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Novel Metrics Suggested for Assessing EHR Use

TUESDAY, Oct. 10, 2017 (HealthDay News) -- Novel metrics have been developed to assess electronic health record (EHR) use and are described in an opinion article published online Oct. 9 in the Annals of Internal Medicine.

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2016 Physician Quality Reporting System Reports Available

MONDAY, Oct. 9, 2017 (HealthDay News) -- The 2016 Physician Quality Reporting System (PQRS) and the 2016 annual Quality and Resource Use reports have been released for individuals and group practices, according to a report published by the American Academy of Family Physicians.

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Injured Patients Want More Info on Safety Improvement Efforts

MONDAY, Oct. 9, 2017 (HealthDay News) -- Communication-and-resolution program (CRP) experiences are positive overall for a small majority of patients and families, but they report that hospitals rarely share information about preventing recurrences, according to a study published online Oct. 9 in JAMA Internal Medicine.

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Antisocial Behavior May Be Highly Polygenic

MONDAY, Oct. 9, 2017 (HealthDay News) -- Antisocial behavior (ASB) may be highly polygenic, with sex-discordant associations identified for some loci, according to a study published online Oct. 4 in JAMA Psychiatry.

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Short-Lived Benefits for Abusive Supervisory Behavior

FRIDAY, Oct. 6, 2017 (HealthDay News) -- Engaging in abusive supervisory behavior may be associated with short-term beneficial effects, but over longer periods of time, abusive supervisory behavior is negatively related to supervisors' recovery level and engagement, according to a study published online Sept. 11 in the Academy of Management Journal.

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Stronger Nocebo Effect When Inert Rx Labeled As Expensive

FRIDAY, Oct. 6, 2017 (HealthDay News) -- Nocebo hyperalgesia is stronger when an inert treatment is labeled as being an expensive medication rather than a cheap one, according to a study published online Oct. 5 in Science.

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21 Percent of Americans Report Experiencing a Medical Error

THURSDAY, Oct. 5, 2017 (HealthDay News) -- More than one in five patients report having experienced a medical error, according to a survey released Sept. 28 by the Institute for Healthcare Improvement (IHI)/National Patient Safety Foundation Lucian Leape Institute and NORC at the University of Chicago.

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Stem Cell Gene Therapy Safe for Adrenoleukodystrophy

THURSDAY, Oct. 5, 2017 (HealthDay News) -- Early results suggest that stem cell gene therapy is a safe and effective treatment for boys with early-stage cerebral adrenoleukodystrophy, according to a study published online Oct. 4 in the New England Journal of Medicine to coincide with the 2017 Child Neurology Society Annual Meeting, being held Oct. 4 to 7 in Kansas City.

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Reasons Physicians Are Delaying Retirement Vary

THURSDAY, Oct. 5, 2017 (HealthDay News) -- Physicians are delaying retirement, often because they feel they are providing a useful service to patients or because of concerns about social interaction in retirement, according to an article published online Sept. 25 in Medical Economics.

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Maternal Multivitamin Use Tied to Lower Risk of Child ASD

THURSDAY, Oct. 5, 2017 (HealthDay News) -- Multivitamin supplementation during pregnancy is tied to a reduced risk of autism spectrum disorder (ASD) with intellectual disability, according to a study published online Oct. 4 in BMJ.

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Mid-Adulthood HTN Tied to Higher Dementia Risk in Women

THURSDAY, Oct. 5, 2017 (HealthDay News) -- Mid-adulthood hypertension is associated with increased risk of dementia among women but not men, according to a study published online Oct. 4 in Neurology.

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Pay Inequality, Work-Life Balance Top Concerns for Female Docs

WEDNESDAY, Oct. 4, 2017 (HealthDay News) -- Many female physicians report feeling disadvantaged when negotiating contracts and feel that they are assessed for promotion using different criteria than those used for men, according to a report published by the American Medical Association (AMA).

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Anticoagulants With Other Drugs Raise Bleeding Risk in AF

WEDNESDAY, Oct. 4, 2017 (HealthDay News) -- Nonvalvular atrial fibrillation (AF) patients who take non-vitamin K oral anticoagulants (NOACs) along with certain other medications are at increased risk for major bleeding, and antithrombotic medications are significantly associated with increased rates of hematuria-related complications in older adults, according to two studies published online Oct. 3 in the Journal of the American Medical Association.

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Scientists Support Genome Editing to Prevent Disease

WEDNESDAY, Oct. 4, 2017 (HealthDay News) -- Many basic scientists and clinical researchers support somatic genome editing in adults for prevention of serious disease but not for human enhancement; they also believe the public should be consulted before any clinical application of germline gene editing proceeds, according to survey results published online Oct. 3 in Circulation: Cardiovascular Genetics.

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Commercialization of Generics Impacts Adverse Event Rates

WEDNESDAY, Oct. 4, 2017 (HealthDay News) -- Immediate or delayed differences in adverse event rates were seen after generic commercialization of three antihypertensive drugs, according to a study published online Oct. 3 in Circulation: Cardiovascular Quality and Outcomes.

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Communication Program Doesn't Raise Hospital Liability Costs

TUESDAY, Oct. 3, 2017 (HealthDay News) -- A communication-and-resolution program, in which hospitals and liability insurers communicate with patients when adverse events occur, does not lead to higher liability costs, according to a study published online Oct. 2 in Health Affairs.

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Subjective Cognitive Decline Linked to Global Tau Burden

TUESDAY, Oct. 3, 2017 (HealthDay News) -- For clinically healthy older adults, subjective cognitive decline (SCD) is associated with increasing entorhinal cortical tau burden and β-amyloid (Aβ) burden, according to a study published online Oct. 2 in JAMA Neurology.

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Regular Leisure-Time Exercise May Cut Incidence of Depression

TUESDAY, Oct. 3, 2017 (HealthDay News) -- Regular leisure-time exercise of any intensity is associated with reduced incidence of future depression, according to a study published online Oct. 3 in The American Journal of Psychiatry.

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Patient With CAS of 50 Percent Should Not Undergo Screening

TUESDAY, Oct. 3, 2017 (HealthDay News) -- A vascular surgeon and primary care physician agree that an asymptomatic patient with cardiovascular risk and stenosis of 50 percent on screening carotid ultrasonography should not undergo carotid artery stenosis (CAS) screening, according to an article published online Oct. 2 in the Annals of Internal Medicine.

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Low-Dose Alteplase No Better for Acute Ischemic Stroke

MONDAY, Oct. 2, 2017 (HealthDay News) -- For key demographic subgroups of patients with acute ischemic stroke (AIS), low-dose alteplase does not differ from standard-dose alteplase in terms of treatment effects on death or disability, according to a study published online Oct. 2 in JAMA Neurology.

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Opioid Manufacturers to Provide Doctor Training

MONDAY, Oct. 2, 2017 (HealthDay News) -- In an effort to halt the ongoing opioid addiction crisis, U.S. regulators are requiring manufacturers to provide extensive training to doctors, according to a report published by the Associated Press.

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Skipping Breakfast Tied to Increased Odds of Atherosclerosis

MONDAY, Oct. 2, 2017 (HealthDay News) -- Habitual skipping of breakfast is associated with increased likelihood of atherosclerosis independent of traditional and dietary cardiovascular (CV) risk factors, according to a study published online Oct. 2 in the Journal of the American College of Cardiology.

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