July 2018 Briefing - Neurology

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Here are what the editors at HealthDay consider to be the most important developments in Neurology for July 2018. 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.

Learning to Change Important for Improving Practice

TUESDAY, July 31, 2018 (HealthDay News) -- Although physicians typically struggle with change, relying on habits created in their practice, learning to change is important in order to improve practices and better deal with the changes sweeping through medicine, according to an article published in Medical Economics.

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Front Desk Staff Can Set Up a Practice for Successful Billing

TUESDAY, July 31, 2018 (HealthDay News) -- Allowing front desk staff adequate time and an uninterrupted environment to focus on billing can prevent problems later on, according to an article published in Physicians Practice.

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High-Sensitivity Blood Test May Help Rule Out Intracranial Injury

TUESDAY, July 31, 2018 (HealthDay News) -- A combined test of ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) assay results has high sensitivity for detection of intracranial injury among patients with traumatic brain injury (TBI), according to a study published online July 24 in The Lancet Neurology.

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Few Published Programs Address Medical Trainee Mistreatment

TUESDAY, July 31, 2018 (HealthDay News) -- There are very few published descriptions of programs that address the mistreatment of medical trainees, according to a review published online July 27 in JAMA Network Open.

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Medical Boards May Contribute to Mental Health Stigma for Doctors

MONDAY, July 30, 2018 (HealthDay News) -- Existing policy has been amended to encourage licensing boards to require disclosure of physical or mental health conditions only when these would negatively impact a physicians' ability to practice medicine, according to an article published in the American Medical Association's AMA Wire.

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Four Strategies Help Doctors Make Personal, Professional Gains

MONDAY, July 30, 2018 (HealthDay News) -- In an article published in Physicians Practice, four strategies are presented to help physicians make personal and professional gains.

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Increased Levels of Human Herpesvirus ID'd in Alzheimer's

MONDAY, July 30, 2018 (HealthDay News) -- Subjects with Alzheimer's disease have increased levels of two strains of human herpesvirus, according to a study published online July 11 in Neuron.

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PFO Closure Plus Antiplatelet Tx Advised for Cryptogenic Stroke

FRIDAY, July 27, 2018 (HealthDay News) -- For patients younger than 60 years who have had a cryptogenic ischemic stroke thought to be secondary to patent foramen ovale (PFO), who are open to all treatment options, PFO closure plus antiplatelet therapy is recommended over antiplatelet therapy alone, according to a clinical practice guideline published online July 25 in The BMJ.

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Assessing, Improving Patient Satisfaction Cuts Malpractice Risk

THURSDAY, July 26, 2018 (HealthDay News) -- Assessing and improving patient satisfaction can help physicians avoid being sued for malpractice, according to an article published in Physicians Practice.

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Late-Life Blood Pressure Tied to Higher Number of Brain Infarcts

THURSDAY, July 26, 2018 (HealthDay News) -- Higher average late-life blood pressure (BP) is associated with an increased number of brain infarcts, according to a study published online July 11 in Neurology.

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Insurers May Be Underpaying Doctors

THURSDAY, July 26, 2018 (HealthDay News) -- Insurance companies sometimes underpay doctors the contracted amount for a service or procedure, according to an article published in Medical Economics.

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Many U.S. Adults View Marijuana Use Positively

WEDNESDAY, July 25, 2018 (HealthDay News) -- Most U.S. adults believe that marijuana has at least one benefit, according to a study published online July 24 in the Annals of Internal Medicine.

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Tools, Methods of RCTs Can Be Adapted to Real-World Settings

WEDNESDAY, July 25, 2018 (HealthDay News) -- Use of appropriate statistical methodology can allow for the synthesis of data collected as part of traditional clinical trials with real-world data, according to an Ideas and Opinions piece published online July 24 in the Annals of Internal Medicine.

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Modifiable Midlife Risk Factors Linked to Late-Onset Epilepsy

WEDNESDAY, July 25, 2018 (HealthDay News) -- Potentially modifiable risk factors in midlife are associated with the risk of developing late-onset epilepsy, according to a study published online July 23 in JAMA Neurology.

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Reduced Cognitive Function for Students During Heat Waves

TUESDAY, July 24, 2018 (HealthDay News) -- Cognitive function deficits resulting from indoor thermal conditions during heat waves affect university students, according to a study published online July 10 in PLOS Medicine.

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Physicians and Practices Should Prepare for Emergencies

TUESDAY, July 24, 2018 (HealthDay News) -- Practices and physicians should prepare for emergency situations, such as natural disasters, network communications failures, and active shooter situations, according to an article published in Medical Economics.

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VA MISSION Act May Up Costs, Lower Vet Health Care Quality

TUESDAY, July 24, 2018 (HealthDay News) -- The Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act may increase costs and reduce quality of health care for veterans, according to an Ideas and Opinions piece published online July 24 in the Annals of Internal Medicine.

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Walmart Generic Drug Discounts Often Offer More Patient Savings

MONDAY, July 23 2018 (HealthDay News) -- Walmart's Generic Drug Discount Program (GDDP), which sells many commonly used generic medications for $4 per 30-day supply, offers savings over Medicare for some generic cardiovascular medications, according to a research letter published online July 24 in the Annals of Internal Medicine.

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Medical Organizations Must Address Sexual Harassment

MONDAY, July 23, 2018 (HealthDay News) -- Medical institutions and organizations need to ensure there are proactive interventions to transform the workplace in order to address sexual harassment and discrimination, according to an article published in the American Medical Association's AMA Wire.

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FDA Warns Against Risks of Contaminated Synthetic Cannabis

MONDAY, July 23, 2018 (HealthDay News) -- Users of synthetic marijuana products and health care providers should be aware of the risk of bleeding associated with contamination of synthetic cannabinoid products with brodifacoum, according to the U.S. Food and Drug Administration.

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Details of Montreal Cognitive Assessment Widely Publicized

MONDAY, July 23, 2018 (HealthDay News) -- Many published news articles included details of the Montreal Cognitive Assessment (MoCA) in association with President Trump, some of which invited readers to self-administer the test, according to a research letter published online July 16 in JAMA Neurology.

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Embezzlement Not Uncommon in Medical Practices

MONDAY, July 23, 2018 (HealthDay News) -- Embezzlement occurs frequently in medical practices and steps should be taken to prevent it, according to an article published in Medical Economics.

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Increased Coverage in States With Medicaid Expansion

FRIDAY, July 20, 2018 (HealthDay News) -- Coverage rates and access to care are significantly higher in states with Medicaid expansion, compared with non-expansion states, according to a study published in the July issue of Health Affairs.

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Epinephrine Ups Survival in Out-of-Hospital Cardiac Arrest

FRIDAY, July 20, 2018 (HealthDay News) -- Epinephrine use results in improved 30-day survival versus placebo in patients with out-of-hospital cardiac arrest, according to a study published online July 18 in the New England Journal of Medicine.

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Same-Day Appointment System Implemented in Health Network

THURSDAY, July 19, 2018 (HealthDay News) -- A same-day appointment system can feasibly be introduced, according to the experiences of one health network presented in an article published in Managed Healthcare Executive.

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Ten Questions Screen Helps ID Disability in HIV+ Children

THURSDAY, July 19, 2018 (HealthDay News) -- The Ten Questions (TQ) screen is an effective way to screen HIV-positive children for neurodevelopmental problems in resource-poor areas, according to a study published online July 3 in PLOS ONE.

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WTC-Related PTSD May Up Risk for Stroke, MI in Clean-Up Crew

THURSDAY, July 19, 2018 (HealthDay News) -- World Trade Center-related post-traumatic stress disorder (PTSD) is a risk factor for myocardial infarction (MI) and stroke among workers involved in cleaning up the debris, according to a study published in the June issue of Circulation: Cardiovascular Quality and Outcomes.

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Patients Care About the Clothes Doctors Wear

THURSDAY, July 19, 2018 (HealthDay News) -- Patients do in fact care what doctors wear, according to a study recently published in BMJ Open.

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Seven Strategies Can Help Practices Manage Staff Time Off

WEDNESDAY, July 18, 2018 (HealthDay News) -- Several strategies can be implemented to help address management of staff time off, allowing mutual respect for the employee and employer requests, according to an article published in Medical Economics.

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Risk of CRC, Non-CRC Death Up With Positive Fecal Hb Test

WEDNESDAY, July 18, 2018 (HealthDay News) -- Individuals with a positive fecal hemoglobin (f-Hb) test result have an increased risk of dying from colorectal cancer (CRC) and non-CRC causes, according to a study published online July 16 in Gut.

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Five-Year Stroke Rates Lower After PCI Versus CABG

WEDNESDAY, July 18, 2018 (HealthDay News) -- Stroke rates are lower at 30 days and five years after percutaneous coronary intervention (PCI) than after coronary artery bypass grafting (CABG), according to a study published in the July 24 issue of the Journal of the American College of Cardiology.

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Risk of Cochlear Disorders Up With History of Migraine

WEDNESDAY, July 18, 2018 (HealthDay News) -- The risk of cochlear disorders, especially tinnitus, is increased among patients with a history of migraine, according to a study published online July 12 in JAMA Otolaryngology-Head & Neck Surgery.

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Alternative Payment Models Should Include Precision Medicine

TUESDAY, July 17, 2018 (HealthDay News) -- The American Medical Association has committed to working to integrate precision medicine into alternative payment models (APMs), according to an article published in the association's AMA Wire.

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FDA: Some Rx Drugs May Become Available Without Seeing a Doctor

TUESDAY, July 17, 2018 (HealthDay News) -- A new draft guideline from the U.S. Food and Drug Administration suggests Americans could get widely used prescription medicines for cholesterol, high blood pressure, asthma, and migraine headaches without having to see a doctor.

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Trials Supporting FDA Approval of Breakthrough Drugs Examined

TUESDAY, July 17, 2018 (HealthDay News) -- Pivotal trials supporting U.S. Food and Drug Administration approvals granted Breakthrough Therapy designation often lack randomization, double-blinding, and control groups, according to a research letter published in the July 17 issue of the Journal of the American Medical Association.

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Shared Decision-Making Approach to Zika Best for Travelers

TUESDAY, July 17, 2018 (HealthDay News) -- An approach to shared decision-making that stratifies risk might be most appropriate for preventing Zika infection, according to an Ideas and Opinion piece published online July 17 in the Annals of Internal Medicine.

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FDA Establishes New Task Force on Drug Shortages

TUESDAY, July 17, 2018 (HealthDay News) -- In a recent statement, U.S. Food and Drug Administration Commissioner Scott Gottlieb, M.D., announced the formation of a new drug shortages task force to thoroughly explore the reasons why drug shortages remain a persistent challenge.

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Adoption of EHR Linked to Reduction in Mortality Rates

MONDAY, July 16, 2018 (HealthDay News) -- Adoption of electronic health records (EHRs) is associated with a reduction in mortality rates in U.S. hospitals, according to a study published in the July issue of Health Affairs.

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Two-Thirds of Parents Report Their Child Has Had Headache

MONDAY, July 16, 2018 (HealthDay News) -- Two-thirds of parents report that their child has had a headache not related to a fall or head injury, according to the results of the C.S. Mott Children's Hospital National Poll on Children's Health at the University of Michigan.

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Declines in Vision Tied to Age-Related Cognitive Decline

MONDAY, July 16, 2018 (HealthDay News) -- Older adults' worsening vision may drive declines in cognitive function, according to a study published online July 10 in JAMA Ophthalmology.

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Compassion Training May Up Resilience to Others' Suffering

MONDAY, July 16, 2018 (HealthDay News) -- Compassion meditation can increase the visual preference for suffering while attenuating neural responses in regions of the brain associated with valence and empathic distress, according to a study published recently in Frontiers in Psychology.

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Physician Burnout Tied to Higher Risk of Medical Errors

MONDAY, July 16, 2018 (HealthDay News) -- Physician burnout, fatigue, and work-unit safety grades are independently associated with medical errors, according to a study published online July 9 in the Mayo Clinic Proceedings.

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eCare Plan Set to Improve Doctor/Pharmacist Relationship

MONDAY, July 16, 2018 (HealthDay News) -- The Pharmacist eCare Plan is designed to improve communication between pharmacists and physicians by allowing documentation to be available via electronic health records (EHRs), according to an article published online in Drug Topics.

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Virtual Assistants Not HIPAA Compliant

FRIDAY, July 13, 2018 (HealthDay News) -- Virtual assistant programs like Google Assistant, Siri, and Alexa are not yet in compliance with the Health Insurance Portability and Accountability Act (HIPAA), warns an article published in Medical Economics.

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Gender Bias in Medicine Has Far-Reaching Consequences

FRIDAY, July 13, 2018 (HealthDay News) -- Overlooking women in medicine can have far-reaching consequences, according to a perspective piece published in the June 14 issue of the New England Journal of Medicine.

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11.2% of U.S. Adults Aged ≥45 Report Subjective Mental Decline

FRIDAY, July 13, 2018 (HealthDay News) -- More than 11 percent of adults aged ≥45 years in the United States report subjective cognitive decline (SCD), according to research published in the July 13 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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2001 to 2015 Saw Decline in Self-Employment in Health Care

THURSDAY, July 12, 2018 (HealthDay News) -- From 2001 to 2015 there was a decrease in the percentage of health care professionals who are self-employed and a decrease in the earning gap between self-employed and employed health care professionals, according to a study published online July 12 in JAMA Network Open.

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AMA Aims to Boost Affordability of ACA Marketplace Plans

THURSDAY, July 12, 2018 (HealthDay News) -- The American Medical Association (AMA) House of Delegates has adopted policy to increase the number of people who obtain coverage through the Affordable Care Act (ACA) by making marketplace plans more affordable.

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Patient Experience Officers Can Play Key Role in Medical Offices

THURSDAY, July 12, 2018 (HealthDay News) -- A patient experience officer is an increasingly important new role in physician practices, according to an article recently published in Physicians Practice.

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Polio-Rhinovirus Promising for Malignant Glioma Patients

THURSDAY, July 12, 2018 (HealthDay News) -- Intratumoral infusion of recombinant nonpathogenic polio-rhinovirus chimera (PVSRIPO) can be delivered safely and is tied to higher survival rates than those of historical controls, according to a study published in the July 12 issue of the New England Journal of Medicine.

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Peer-Led Education Helps Physicians Save Time With EHRs

THURSDAY, July 12, 2018 (HealthDay News) -- A peer-based education program can improve the efficiency of electronic health record (EHR) use, according to an article published in the American Medical Association's AMA Wire.

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Apixaban Is Safest Direct Oral Anticoagulant Versus Warfarin

WEDNESDAY, July 11, 2018 (HealthDay News) -- Apixaban seems to be the safest direct oral anticoagulant (DOAC) compared with warfarin, according to a study published July 4 in The BMJ.

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Circadian System, Misalignment Have Distinct Impact on Insulin

WEDNESDAY, July 11, 2018 (HealthDay News) -- The endogenous circadian system, behavioral cycle, and circadian misalignment have distinct effects on insulin sensitivity and β-cell function, according to a study published online June 4 in Diabetes, Obesity and Metabolism.

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International Group Develops Best Practices for Drug Packaging

TUESDAY, July 10, 2018 (HealthDay News) -- Nine new drug labeling and packaging guidelines have been developed with an aim of reducing medication errors, according to a report published in Drug Topics.

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AMA Calls for Inclusive Family, Medical Leave Policies

TUESDAY, July 10, 2018 (HealthDay News) -- The American Medical Association (AMA) calls for inclusive family and medical leave policies to support lesbian, gay, bisexual, transgender, and queer (LGBTQ) workers who care for relatives, spouses, and partners.

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Error Rate 7.4 Percent in Speech Recognition-Assisted Notes

TUESDAY, July 10, 2018 (HealthDay News) -- The error rate in speech recognition (SR)-assisted documentation is 7.4 percent, according to a study published online July 6 in JAMA Network Open.

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Transfeminine Persons Have Increased VTE Incidence

TUESDAY, July 10, 2018 (HealthDay News) -- Transfeminine individuals have increased rates of venous thromboembolism (VTE) compared with cisgender men and cisgender women, with more pronounced differences for those initiating hormone therapy, according to research published online July 10 in the Annals of Internal Medicine.

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Sleep Apnea Linked to Changes in the Brain in Older Adults

MONDAY, July 9, 2018 (HealthDay News) -- Obstructive sleep apnea (OSA) is associated with changes to the structure of the brain that are seen in the early stages of dementia, according to a study published online July 5 in the European Respiratory Journal.

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Prenatal Folic Acid Fortification May Affect Cortical Development

MONDAY, July 9, 2018 (HealthDay News) -- Gestational exposure to folic acid fortification is associated with cortical development, according to a study published online July 3 in JAMA Psychiatry.

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IT Solutions for Easier EHRs Save Physicians Time, Burnout

FRIDAY, July 6, 2018 (HealthDay News) -- Yale Medicine is effectively targeting electronic health record (EHR) use and functionality as a way to improve physician job satisfaction and reduce burnout, according to an article published in the American Medical Association's AMA Wire.

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Organic Solvents + Genetics May Increase Risk of Multiple Sclerosis

FRIDAY, July 6, 2018 (HealthDay News) -- The combination of genetics and exposure to organic solvents in paints and varnishes increases the risk of multiple sclerosis (MS), according to a study published online July 3 in Neurology.

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Patisiran, Inotersen Aid Hereditary Transthyretin Amyloidosis

THURSDAY, July 5, 2018 (HealthDay News) -- For patients with hereditary transthyretin amyloidosis with polyneuropathy, an investigational RNA interference therapeutic agent (patisiran) and a 2'-O-methoxyethyl-modified antisense oligonucleotide (inotersen), which inhibits hepatic production of transthyretin, improve clinical manifestations of disease, according to two studies published in the July 5 issue of the New England Journal of Medicine.

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Hospitals Face $218B in Federal Payment Cuts From 2010 to 2028

THURSDAY, July 5, 2018 (HealthDay News) -- Cumulative reductions in federal payments to hospitals from 2010 to 2028 are estimated to reach $218.2 billion, according to a study commissioned by the Federation of American Hospitals and the American Hospital Association (AHA).

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Patient Complaints Mainly About Rudeness, Rushing, Reproach

THURSDAY, July 5, 2018 (HealthDay News) -- Understanding patients' complaints about practice can be instructive for physicians, according to an article published June 6 in Physicians Practice.

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WHO Calls for Renewed Effort to Combat Chronic Disease

THURSDAY, July 5, 2018 (HealthDay News) -- The World Health Organization (WHO) Independent High-Level Commission has proposed six recommendations to address the growing epidemic of non-communicable diseases (NCDs), according to a report published online June 1 in The Lancet.

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Marriage May Protect Against Cardiovascular Disease

THURSDAY, July 5, 2018 (HealthDay News) -- Marital status may influence cardiovascular disease (CVD) risk and prognosis after CVD, according to a review published online June 19 in Heart.

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Viruses ID'd As Most Common Cause of Meningitis in U.K. Adults

THURSDAY, July 5, 2018 (HealthDay News) -- Viruses are the most commonly identified cause of meningitis among U.K. adults, according to a study published online June 29 in The Lancet Infectious Diseases.

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Anticonvulsants Seem to Be Ineffective for Low Back Pain

THURSDAY, July 5, 2018 (HealthDay News) -- Anticonvulsant drugs are ineffective for chronic low back pain and can cause harm, despite a recent increase in prescribing, according to a review published online July 3 in CMAJ, the journal of the Canadian Medical Association.

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Patients Comfortable With Doctors Having Tattoos, Piercings

THURSDAY, July 5, 2018 (HealthDay News) -- Patients do not appear to mind if doctors have tattoos or piercings, according to a study published online July 2 in the Emergency Medicine Journal.

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U.K. Campaign Hasn't Aided Patient Presentations for TIA, Minor CVA

THURSDAY, July 5, 2018 (HealthDay News) -- The Face, Arm, Speech, Time (FAST) public education campaign in the United Kingdom has not improved the response to transient ischemic attack (TIA) and minor stroke, according to a study published online July 2 in JAMA Neurology.

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Dynamics of Brain Volume Loss Vary With MS Progression

TUESDAY, July 3, 2018 (HealthDay News) -- Brain volume loss (BVL) has nonlinear dynamics and limited reproducibility as a marker of therapeutic response in multiple sclerosis (MS), according to a study published online July 2 in JAMA Neurology.

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Intensive Management Program Benefits High-Risk Patients

MONDAY, July 2, 2018 (HealthDay News) -- For high-risk patients, use of an intensive management program is associated with greater receipt of outpatient care with no increase in total costs, according to a study published in the June 19 issue of the Annals of Internal Medicine.

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