April 2015 Briefing - Geriatrics

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Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for April 2015. 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.

Age-, Sex-Specific Thresholds Should Guide Statin Therapy

THURSDAY, April 30, 2015 (HealthDay News) -- Use of age- and sex-specific cardiovascular disease (CVD) risk thresholds could improve the sensitivity and specificity of statin treatment recommendations, according to a study published in the April 28 issue of the Journal of the American College of Cardiology.

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COPD May Increase Risk of Sudden Cardiac Death

WEDNESDAY, April 29, 2015 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) is already the third leading cause of death in the world, and the condition might also raise a patient's odds for sudden cardiac death, according to a new study published online April 28 in the European Heart Journal.

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FDA Approves First Generic Abilify

WEDNESDAY, April 29, 2015 (HealthDay News) -- The first generic versions of the atypical antipsychotic drug Abilify (aripiprazole) have been approved by the U.S. Food and Drug Administration to treat schizophrenia or bipolar disorder.

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Colon Cancer Risk Markers Appear Within Two Weeks of Diet Change

WEDNESDAY, April 29, 2015 (HealthDay News) -- Westernization of the diet induces changes in biomarkers of colon cancer risk within two weeks, according to research published online April 28 in Nature Communications.

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Physician Compensation Up for Most Specialties

TUESDAY, April 28, 2015 (HealthDay News) -- Physician compensation has gone up for almost all specialties, according to a 2015 report published by Medscape.

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CDC: Surveillance System Can Help Reduce Health Care Injuries

TUESDAY, April 28, 2015 (HealthDay News) -- A surveillance system for health care facilities can be used to identify and help reduce the number of preventable injuries among health care personnel, according to research published in the April 24 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Lasting Mortality Risk Increase With Hyperglycemic Crises

TUESDAY, April 28, 2015 (HealthDay News) -- During the first six years of follow-up, geriatric patients with diabetes have a higher mortality risk after hyperglycemic crisis episode (HCE), according to a study published in the May issue of Diabetes Care.

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Office Visits Common Before Suicide Attempt

MONDAY, April 27, 2015 (HealthDay News) -- Many people who attempt suicide have a health care visit in the weeks or months beforehand, which suggests health visits may provide opportunities for suicide prevention, researchers report in a new study published in the May issue of Medical Care.

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Hemoglobin Glycation Index IDs Harms, Benefits of T2DM Tx

MONDAY, April 27, 2015 (HealthDay News) -- The effect of intensive versus standard type 2 diabetes treatment varies according to the hemoglobin glycation index (HGI: observed hemoglobin A1c [HbA1c] − predicted HbA1c), according to a study published online April 17 in Diabetes Care.

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Over Half of Middle-Age, Older Americans Take Daily Aspirin

MONDAY, April 27, 2015 (HealthDay News) -- Slightly more than half of middle-aged adults and seniors in the United States take aspirin daily, with most taking it for primary prevention, according to survey findings published in the May issue of the American Journal of Preventive Medicine.

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Anxiety, Depression, PTSD Common After Acute Lung Injury

FRIDAY, April 24, 2015 (HealthDay News) -- Most acute lung injury (ALI) survivors have symptoms of general anxiety, depression, and posttraumatic stress disorder (PTSD) during 24 months of follow-up, according to a study published in the March issue of Critical Care Medicine.

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Focus on Calories Versus Quality of Food Misdirected

FRIDAY, April 24, 2015 (HealthDay News) -- All calories are not created equal and some foods are not as bad for weight management as many believe, according to new research published online April 8 in the American Journal of Clinical Nutrition.

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CRC Screening Among Older Adults Often Inappropriate

FRIDAY, April 24, 2015 (HealthDay News) -- Older adults with limited life expectancy (LE) frequently receive colorectal cancer (CRC) screening, according to a study published in the April issue of the Journal of the American Geriatrics Society.

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Challenging Jobs Could Protect in Frontotemporal Dementia

FRIDAY, April 24, 2015 (HealthDay News) -- Having a challenging job may help people live longer after developing frontotemporal dementia, according to a small study published online April 22 in Neurology.

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Self-Reported Health Predicts Survival in Breast Cancer

THURSDAY, April 23, 2015 (HealthDay News) -- For older women with breast cancer, low self-rated health (SRH) and limited walking ability predict worse all-cause survival at five and 10 years, according to a study published in the April issue of the Journal of the American Geriatrics Society.

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Abridged Standards of Care for Diabetes Developed for PCPs

THURSDAY, April 23, 2015 (HealthDay News) -- An abridged version of the 2015 Standards of Medical Care in Diabetes has been produced for primary care physicians. The condensed guidelines were published in the April issue of Clinical Diabetes.

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One in 10 AMI Patients Have Unrecognized Incident Diabetes

THURSDAY, April 23, 2015 (HealthDay News) -- One in 10 acute myocardial infarction (AMI) patients without a previous diagnosis of diabetes mellitus (DM) have underlying DM, according to research published online April 21 in Circulation: Cardiovascular Quality and Outcomes.

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EHR Data Mining Helps With Quality Improvement

WEDNESDAY, April 22, 2015 (HealthDay News) -- Electronic health records (EHRs) are a valuable source of data that can be mined to help practices with quality improvement performance, according to a study published in Medical Economics.

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EHR Decision Support Ups Radiologic Test Appropriateness

TUESDAY, April 21, 2015 (HealthDay News) -- Computerized clinical decision-support (CCDS) capabilities of electronic health records may improve appropriate use of diagnostic radiologic test ordering and reduce test use, according to a review published in the April 21 issue of the Annals of Internal Medicine.

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Drug-Eluting Beat Bare Stents in Older Patients Undergoing PCI

TUESDAY, April 21, 2015 (HealthDay News) -- For older patients undergoing percutaneous coronary intervention (PCI), drug-eluting stents (DES) offer clinical benefit over bare metal stents (BMS), according to a study published in the May 1 issue of The American Journal of Cardiology.

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CPAP Tied to Improved A-Fib Outcomes for Those With OSA

TUESDAY, April 21, 2015 (HealthDay News) -- Patients with both atrial fibrillation and obstructive sleep apnea are less likely to have a recurrence of atrial fibrillation if they use continuous positive airway pressure (CPAP) therapy, a new report says. The results were published in the March 1 issue of JACC: Clinical Electrophysiology.

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Statins Tenuously Cost-Effective for Primary Prevention in Seniors

TUESDAY, April 21, 2015 (HealthDay News) -- For U.S. adults aged 75 to 94 years, primary prevention with statins appears to be cost-effective, but even small increases in geriatric-specific adverse effects could offset the cardiovascular benefit, according to a study published in the April 21 issue of the Annals of Internal Medicine.

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Regular Walking Can Boost Quality of Life With Prostate CA

TUESDAY, April 21, 2015 (HealthDay News) -- Engaging in a regular walking regimen can improve well-being for men with prostate cancer, according to new research published online April 16 in the Journal of Cancer Survivorship: Research and Practice.

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Guidance Offered for Managing Conflict With Patients

MONDAY, April 20, 2015 (HealthDay News) -- Good communication is key to managing conflict with patients, according to an article published April 1 in Medical Economics.

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Age, Creatinine, Ejection Fraction Predict Post-MI Survival

MONDAY, April 20, 2015 (HealthDay News) -- A simple age, creatinine, and ejection fraction (ACEF) score can predict one-year mortality risk in myocardial infarction 30-day survivors who underwent percutaneous coronary intervention, according to a study published in the May 1 issue of The American Journal of Cardiology.

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A-Fib Recurrence Common Five Years After Ablation

FRIDAY, April 17, 2015 (HealthDay News) -- Most patients with atrial fibrillation (AF) and systolic heart failure who undergo ablation have AF recurrence at five years, according to a study published in the April issue of the Journal of Cardiovascular Electrophysiology.

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Clinician-Referred Exercise Program Beneficial in Prostate CA

FRIDAY, April 17, 2015 (HealthDay News) -- For men with prostate cancer, clinician referral to and participation in an exercise program has a positive impact on mental health, according to a study published online April 15 in Cancer.

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Suboptimal Prescribing Attitudes Could Signal Personal Distress

FRIDAY, April 17, 2015 (HealthDay News) -- Medical students in personal distress may be more likely to have suboptimal attitudes about self-prescribing and personal responsibility for reporting impaired colleagues, according to a study published in the April issue of Academic Medicine.

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Apple HealthKit App Facilitates Doctor-Patient Communication

THURSDAY, April 16, 2015 (HealthDay News) -- The latest version of Apple's operating system iOS 8 allows physicians to connect with patients in many ways using the HealthKit app that collects user health and fitness data, according to an article published in Medical Economics.

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Snoring, Sleep Apnea Linked to Dementia, but CPAP Helps

THURSDAY, April 16, 2015 (HealthDay News) -- People with sleep-disordered breathing (SDB) may be more likely to develop mild cognitive impairment (MCI) at younger ages than those without SDB, a new study suggests. The report was published online April 15 in Neurology.

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Ethical Implications for Looking Up Applicants on Facebook

THURSDAY, April 16, 2015 (HealthDay News) -- Looking up students on Facebook and other social networking sites (SNS) is associated with ethical concerns, according to a perspective piece published in the March issue of the Journal of Graduate Medical Education.

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Medicare Spending Down in Year One of Pioneer ACO

THURSDAY, April 16, 2015 (HealthDay News) -- Medicare spending is down in year one of the Pioneer accountable care organization (ACO) program, according to a study published online April 15 in the New England Journal of Medicine.

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Many Cataract Patients Undergo Unnecessary Pre-Op Testing

THURSDAY, April 16, 2015 (HealthDay News) -- Many patients still undergo routine preoperative testing before cataract surgery despite recommendations against it, according to a study published in the April 16 issue of the New England Journal of Medicine.

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Prolonged ADT Ups Diabetes, CVD Risk for Older Men

THURSDAY, April 16, 2015 (HealthDay News) -- For men diagnosed with prostate cancer aged older than 70 years, prolonged androgen deprivation therapy is associated with increased risk of diabetes and cardiovascular disease, especially among those with comorbidities, according to a study published in the April issue of The Journal of Urology.

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Acetaminophen Appears to Blunt Emotional Response

WEDNESDAY, April 15, 2015 (HealthDay News) -- Acetaminophen may do more than simply dull pain -- it may also dull positive and negative emotions, new research indicates. The study was published online April 10 in Psychological Science.

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Depression, Diabetes Both Tied to Increased Dementia Risk

WEDNESDAY, April 15, 2015 (HealthDay News) -- Depression and diabetes both appear to significantly raise the risk of dementia, according to new research. The findings were published online April 15 in JAMA Psychiatry.

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AMA Announces End of Sustainable Growth Rate Formula

WEDNESDAY, April 15, 2015 (HealthDay News) -- Recently adopted legislation has repealed the sustainable growth rate (SGR) formula, according to a report published by the American Medical Association (AMA).

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Meta-Analysis: Valgus Knee Bracing Helps Pain in Knee OA

WEDNESDAY, April 15, 2015 (HealthDay News) -- For patients with knee osteoarthritis (OA), valgus knee bracing is associated with improvements in pain, according to a meta-analysis published in the April issue of Arthritis Care & Research.

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Anticoagulation Both Over- and Under-Prescribed in A-Fib

WEDNESDAY, April 15, 2015 (HealthDay News) -- As many as one-quarter of people with atrial fibrillation who have a low risk of stroke are prescribed anticoagulation unnecessarily, a new study contends. The findings were published in a research letter online April 13 in JAMA Internal Medicine.

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Divorce Tied to Increased Risk of Acute Myocardial Infarction

WEDNESDAY, April 15, 2015 (HealthDay News) -- People who divorce face a higher risk of acute myocardial infarction (AMI) than those who remain married, but remarriage may not be the remedy, at least not for women, according to a new study published online April 14 in Circulation: Cardiovascular Quality and Outcomes.

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Survey Looks at Patient Attitudes Regarding Informed Consent

WEDNESDAY, April 15, 2015 (HealthDay News) -- Most U.S. adults would prefer to be asked for permission to participate in studies assessing usual medical practices, according to a study published online April 14 in the Annals of Internal Medicine.

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Pharmacist Support Boosts Anticoagulation Adherence

TUESDAY, April 14, 2015 (HealthDay News) -- The intervention of a local pharmacist could help improve adherence to newer anticoagulants, according to research published in the April 14 issue of the Journal of the American Medical Association.

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Security Breaches of Health Records Up Over Past Decade

TUESDAY, April 14, 2015 (HealthDay News) -- Breaches in data security exposed more than 29 million health records to potential criminal misuse between 2010 and 2013, according to a new study. Security breaches involving hacking have nearly doubled in recent years, rising to 8.7 percent in 2013 compared with 4.7 percent in 2010, according to the study, published as a research letter in the April 14 issue of the Journal of the American Medical Association.

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Placebo Response May Depend on Individual DNA

TUESDAY, April 14, 2015 (HealthDay News) -- The strength of the placebo effect may depend on particular DNA, according to a report published online April 13 in Trends in Molecular Medicine.

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Aspirin Use Not Found to Benefit Prostate Cancer Mortality

TUESDAY, April 14, 2015 (HealthDay News) -- Aspirin use does not appear to reduce the risk of mortality associated with prostate cancer, according to research published in the April issue of The Journal of Urology.

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Teledermatology Implications for Incidental Skin CA Detection

TUESDAY, April 14, 2015 (HealthDay News) -- An in-person skin examination is important for detection of incidentally-identified skin malignancies, according to a review published in the April issue of the Journal of the American Academy of Dermatology.

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Visit-to-Visit LDL-C Variability Predicts Cardiac Event Risk

TUESDAY, April 14, 2015 (HealthDay News) -- Visit-to-visit variability in low-density lipoprotein cholesterol (LDL-C) can independently predict cardiovascular events in individuals with coronary artery disease, according to a study published in the April 21 issue of the Journal of the American College of Cardiology.

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Gratitude Linked With Better Outcomes in Heart Patients

MONDAY, April 13, 2015 (HealthDay News) -- Higher levels of gratitude are associated with better mood, better sleep, less fatigue, and less inflammation in heart failure patients, according to a study published in the March issue of Spirituality in Clinical Practice.

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Single-Dose Injection Rx Ups Bone Density in Frail Elderly

MONDAY, April 13, 2015 (HealthDay News) -- Frail, older women may only need a single dose of the osteoporosis drug zoledronic acid (Reclast) to build bone strength, a new study suggests. But greater bone density did not translate into fewer fractures among these high-risk women, who were living in nursing homes and assisted-living facilities during the study. The research was published online April 13 in JAMA Internal Medicine.

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Mortality Up With Spontaneous Bleeding After PCI

MONDAY, April 13, 2015 (HealthDay News) -- For patients undergoing percutaneous coronary intervention (PCI), spontaneous bleeding is associated with increased risk of death, comparable to that associated with myocardial infarction (MI), according to a study published in the April 14 issue of the Journal of the American College of Cardiology.

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Only High Exercise Levels Tied to Better Erectile, Sexual Function

MONDAY, April 13, 2015 (HealthDay News) -- High weekly exercise levels are tied to better erectile/sexual function in men, whereas exercise at lower levels is not, according to a study published online March 20 in the Journal of Sexual Medicine.

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Exercise Cuts Pain Interference From Diabetic Neuropathy

MONDAY, April 13, 2015 (HealthDay News) -- Aerobic exercise may help reduce perceived pain interference resulting from diabetic peripheral neuropathy (DPN), according to a brief research report published online March 20 in Pain Medicine.

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Medical Debt Burden Higher in Texas, Florida

FRIDAY, April 10, 2015 (HealthDay News) -- Significantly more adults in Florida and Texas struggle to pay medical bills or pay off medical debt over time compared with residents of New York and California, according to a new Commonwealth Fund report released Friday.

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ACEi/ARB Use Lowers Incidence of Appropriate ICD Shock

FRIDAY, April 10, 2015 (HealthDay News) -- For patients with cardiomyopathy, use of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) is associated with significantly lower incidence of appropriate implantable cardiac defibrillator (ICD) shocks, according to a study published in the April 1 issue of The American Journal of Cardiology.

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Many Doctors Haven't Started Dealing With ICD-10 Revision

FRIDAY, April 10, 2015 (HealthDay News) -- Most physicians have barely begun to deal with issues relating to documentation associated with the transition to the International Classification of Diseases, 10th Revision (ICD-10), according to an article published in Medical Economics.

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Art Program Hones Med Students' Visual Observation Skills

FRIDAY, April 10, 2015 (HealthDay News) -- An innovative interdisciplinary program, Art Rounds, is effective for improving medical and nursing students' physical observation skills, according to a study published in the April issue of the Journal of Nursing Education.

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Almost One in 10 Readmitted After Carotid Revascularization

FRIDAY, April 10, 2015 (HealthDay News) -- Almost one in 10 Medicare patients undergoing carotid revascularization are readmitted within 30 days, according to a study published in the April 14 issue of the Journal of the American College of Cardiology.

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Overweight/Obesity Linked to Reduced Risk of Dementia

FRIDAY, April 10, 2015 (HealthDay News) -- A new study of nearly two million people suggests that those who are overweight or obese in middle age may be less likely to develop dementia than their normal-weight and underweight peers. The report was published online April 9 in The Lancet Diabetes & Endocrinology.

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Higher Risk of Suicide Seen in Stroke Survivors

THURSDAY, April 9, 2015 (HealthDay News) -- Stroke patients are at significantly increased risk of suicide, especially during the first two years after the stroke, according to a new study published online April 1 in Neurology.

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Pharmacists Raise Concerns for Patient Access to Generic Drugs

THURSDAY, April 9, 2015 (HealthDay News) -- Nearly all pharmacists have experienced upswings in the acquisition costs of generic drugs, with price spikes reported to be worse since 2013, according to a report published by the National Community Pharmacists Association (NCPA).

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Mindfulness Program Beneficial for Chronic Pain

THURSDAY, April 9, 2015 (HealthDay News) -- A mindfulness program appears to be beneficial for patients with chronic pain, according to a study published in the April issue of Pain Medicine.

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Older Blood May Be an Option for Cardiac Surgery Patients

THURSDAY, April 9, 2015 (HealthDay News) -- For patients undergoing cardiac surgery, using transfused red blood cells stored for 21 days or more is as good as using blood cells stored for 10 days or less, according to research findings reported in the April 9 issue of the New England Journal of Medicine.

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Medicare Beneficiaries With Melanoma May Face Tx Delay

WEDNESDAY, April 8, 2015 (HealthDay News) -- Approximately 20 percent of Medicare patients with melanoma face delays in getting surgical treatment, according to a new study published online April 8 in JAMA Dermatology.

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One Extra Stroke Risk Factor Ups Risk in Nonvalvular A-Fib

WEDNESDAY, April 8, 2015 (HealthDay News) -- The presence of one additional stroke risk factor is associated with a significant increase in event rates among nonanticoagulated low-risk patients with nonvalvular atrial fibrillation (CHA2DS2-VASc = 0 [male], 1 [female]), according to a study published in the April 14 issue of the Journal of the American College of Cardiology.

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Limited Time Available to Review Sunshine Act Data

WEDNESDAY, April 8, 2015 (HealthDay News) -- Physicians have only 45 days to review and dispute reports regarding their financial ties to drug and medical device manufacturers reported under the Physician Payments Sunshine Act, according to the American Medical Association (AMA).

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Model Predicts Cardiac Death After Life Support Withdrawal

WEDNESDAY, April 8, 2015 (HealthDay News) -- A new model accurately identifies potential organ donors following cardiac death in neurocritical patients removed from life support. The findings were published online March 21 in the American Journal of Transplantation.

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Additional Attention to Modifiable Risks in DM Could Benefit Greatly

WEDNESDAY, April 8, 2015 (HealthDay News) -- For adults with diabetes, inadequately controlled risk factors account for a considerable proportion of cardiovascular events and death, according to a study published online in Diabetes Care.

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Comparable Benefits for PT, Surgery in Lumbar Spinal Stenosis

TUESDAY, April 7, 2015 (HealthDay News) -- Physical therapy may be just as good as surgery for older adults with lower back pain due to lumbar spinal stenosis, according to new research published in the April 7 issue of the Annals of Internal Medicine.

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Veterans Listing Non-Nuclear Family Member As Next of Kin

TUESDAY, April 7, 2015 (HealthDay News) -- A considerable number of veterans list an individual as next of kin who is not a nuclear family member, according to a research letter published in the April 7 issue of the Journal of the American Medical Association.

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Med Students, Residents Rarely Perform Stethoscope Hygiene

TUESDAY, April 7, 2015 (HealthDay News) -- Stethoscope hygiene is rarely performed by trainee physicians, according to a research letter published online April 2 in the Journal of Hospital Medicine.

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Success Seen With Mini-Group Visits for Patients With Diabetes

TUESDAY, April 7, 2015 (HealthDay News) -- Mini-group visits yield good results among patients with diabetes, according to a report published by the American Academy of Family Physicians.

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More Vigorous Physical Activity May Offer More Benefits

MONDAY, April 6, 2015 (HealthDay News) -- Middle-aged or older people who get at least some high-intensity exercise may reduce their chances of dying early by up to 13 percent, according to a new study. The findings were published online April 6 in JAMA Internal Medicine.

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Lower Extremity Revascularization in Elderly Found Lacking

MONDAY, April 6, 2015 (HealthDay News) -- Lower extremity revascularization in frail nursing home residents rarely improves their ambulatory status, according to a study published online April 6 in JAMA Internal Medicine.

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Article Highlights Legal Issues Linked to Physician Extenders

FRIDAY, April 3, 2015 (HealthDay News) -- The use of physician extenders (PEs; mainly physician assistants and nurse practitioners) may bring added legal risks to a practice, according to an article published in Medical Economics.

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Sodium Content Too High in Over Half of Packaged Foods

FRIDAY, April 3, 2015 (HealthDay News) -- More than half of packaged grocery store foods included in a new study contained too much added salt, U.S. health officials reported Thursday. The report was published April 2 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Contemporary PCI Outcome Predictors Defined

FRIDAY, April 3, 2015 (HealthDay News) -- For patients undergoing percutaneous coronary intervention (PCI), predictors of outcome include previous anemia, previous chronic kidney injury, and previous moderate to severe left ventricular dysfunction, according to a study published in the April 1 issue of The American Journal of Cardiology.

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Case Study: Iced Tea Habit Likely Led to Man's Kidney Failure

THURSDAY, April 2, 2015 (HealthDay News) -- After conducting a kidney biopsy on a 56-year-old man with unexplained kidney failure, doctors discovered numerous oxalate crystals in his kidney tissue. Black tea is a significant source of oxalate, and the man acknowledged drinking 16 glasses of iced tea every day. The researchers reported the man's case in the April 2 issue of the New England Journal of Medicine.

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Patients May Be Modifying Meds Due to Trouble Swallowing

THURSDAY, April 2, 2015 (HealthDay News) -- Some patients experience difficulties swallowing and modify medication dosage forms, without necessarily consulting health professionals, according to research published in the March issue of the Journal of Pharmacy Practice and Research.

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Misuse of Prescribed Opioids in One-Quarter

WEDNESDAY, April 1, 2015 (HealthDay News) -- Almost a quarter of opioids that are prescribed for chronic pain are misused, and the rate of addiction among patients hovers near 10 percent, according to a new review published in the April issue of PAIN.

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Legal Issues of Removing Patient From Practice Explored

WEDNESDAY, April 1, 2015 (HealthDay News) -- The legal and ethical responsibilities of removing a patient from practice are discussed in an article published March 16 in Medical Economics.

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New Guidelines Issued for BP Mgmt in Coronary Artery Disease

WEDNESDAY, April 1, 2015 (HealthDay News) -- Three leading groups of heart experts have issued updated guidelines that set blood pressure goals for people with coronary artery disease. The updated guidelines, from the American Heart Association, the American College of Cardiology, and the American Society of Hypertension, were published online March 31 in Hypertension.

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Acetaminophen Appears Lacking in Low Back Pain

WEDNESDAY, April 1, 2015 (HealthDay News) -- Acetaminophen does not appear to help ease lower back pain and offers little relief for the most common form of arthritis, according to a new report. The findings were published March 31 in The BMJ.

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Amiodarone Linked to Lowest Risk of Hospitalization in A-Fib

WEDNESDAY, April 1, 2015 (HealthDay News) -- For younger patients with atrial fibrillation, amiodarone is associated with the lowest risk of atrial fibrillation hospitalization, while dronedarone has the greatest risk, according to a study published online March 31 in Circulation: Cardiovascular Quality and Outcomes.

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