June 2015 Briefing - Cardiology

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

Three Issues to Consider Before Selecting EHR

TUESDAY, June 30, 2015 (HealthDay News) -- Work flow, features and functionality, and technical infrastructure should all be considered in advance of selecting an electronic heath record (EHR) system, according to an article published in Medical Economics.

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Patients Want Online Access to Physicians, Health Records

TUESDAY, June 30, 2015 (HealthDay News) -- Internet-savvy Americans would like to add their doctors to their group of Facebook friends or e-mail contacts, according to a study published online June 24 in the Journal of General Internal Medicine.

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Trauma, PTSD May Raise Women's Odds of CVD

TUESDAY, June 30, 2015 (HealthDay News) -- Women who have experienced a traumatic event or develop posttraumatic stress disorder (PTSD) face an increased risk of cardiovascular disease (CVD), a new large study suggests. The report was published online June 29 in Circulation.

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AHA/ASA: Guidelines Support Endovascular Tx in Stroke

TUESDAY, June 30, 2015 (HealthDay News) -- Endovascular treatment should be used to treat certain stroke victims, according to new guidelines issued by the American Heart Association and American Stroke Association. The guidelines were published online June 29 in Stroke.

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AMA Discusses Pre-Retirement Evaluation for Aging Doctors

MONDAY, June 29, 2015 (HealthDay News) -- Issues relating to physician retirement and evaluation of aging physicians before retirement are discussed in a Council on Medical Education report published by the American Medical Association (AMA).

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Low-Calorie Diet May Improve Heart Rate Variability in Diabetes

MONDAY, June 29, 2015 (HealthDay News) -- A low-calorie diet may improve heart rate variability (HRV) in obese patients with type 2 diabetes, according to a study published online June 12 in Diabetes Care.

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As U.S. Smoking Rate Drops, Smokers More Likely to Quit

MONDAY, June 29, 2015 (HealthDay News) -- As the number of smokers in the United States drops, those who still light up are smoking less and more likely to try quitting, according to a study published online June 24 in Tobacco Control.

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U.S. Dietary Guidelines Will No Longer Focus on Fat

MONDAY, June 29, 2015 (HealthDay News) -- Nutrition experts are supporting a federal decision to drop recommended restrictions on total fat consumption in the forthcoming 2015 Dietary Guidelines for Americans.

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SCOTUS Upholds Subsidies for Affordable Care Act

FRIDAY, June 26, 2015 (HealthDay News) -- The U.S. Supreme Court upheld on Thursday the legality of tax subsidies for millions of Americans who signed up for health insurance under the Affordable Care Act.

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Methadone Linked to Initial QTc Prolongation in Chronic Pain

FRIDAY, June 26, 2015 (HealthDay News) -- For patients with chronic pain, methadone is associated with a small, but nonsignificant, initial increase in QTc, which does not persist, according to a study published in the June issue of Pain Medicine.

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Paclitaxel-Coated Balloon Found Superior in Femoropopliteal PAD

THURSDAY, June 25, 2015 (HealthDay News) -- For patients with symptomatic femoropopliteal peripheral artery disease, percutaneous transluminal angioplasty with a paclitaxel-coated balloon is associated with a superior rate of primary patency at 12 months versus angiography with a standard balloon, according to a study published online June 24 in the New England Journal of Medicine.

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Pharmacist-Managed Warfarin Therapy Beats Usual Care

THURSDAY, June 25, 2015 (HealthDay News) -- Pharmacist-managed warfarin therapy (PMWT) is superior to a usual medical care (UMC) model for management of warfarin therapy, according to a systematic review published online June 22 in the Journal of Clinical Pharmacology.

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Global Public Awareness of Venous Thromboembolism Is Low

THURSDAY, June 25, 2015 (HealthDay News) -- Global public awareness about thrombosis, venous thromboembolism in particular, is low, according to a study published online June 18 in the Journal of Thrombosis and Haemostasis.

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Proof-of-Concept Study to Assess Impact of Glycemic Variability

WEDNESDAY, June 24, 2015 (HealthDay News) -- A proof-of-concept study will be able to examine the contribution of glycemic variability to outcomes of type 2 diabetes, according to a report published online June 11 in Diabetes Care.

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Low Rate of ICD Implantation in Elderly, Despite Good Results

WEDNESDAY, June 24, 2015 (HealthDay News) -- Fewer than one in 10 older myocardial infarction (MI) survivors receive a potentially lifesaving implantable cardioverter-defibrillator (ICD), according to a new study published in the June 23/30 issue of the Journal of the American Medical Association.

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In Teens, Sedentary Behavior Independently Tied to Adiposity

WEDNESDAY, June 24, 2015 (HealthDay News) -- For adolescents, sedentary behavior is associated with markers of adiposity, independent of dietary intake, according to a systematic review published online June 22 in Obesity Reviews.

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Even Slightly Elevated BP May Pose Problems for Young Adults

WEDNESDAY, June 24, 2015 (HealthDay News) -- Young adults with even slightly elevated blood pressure may be at risk of cardiac dysfunction later in life, according to a new study published in the June 30 issue of the Journal of the American College of Cardiology.

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FDA Approves New Antiplatelet Drug for Patients Undergoing PCI

TUESDAY, June 23, 2015 (HealthDay News) -- Kengreal (cangrelor) has been approved by the U.S. Food and Drug Administration to prevent blood clots from forming during angioplasty.

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Variability Identified in Bridging Practices Among Pharmacists

TUESDAY, June 23, 2015 (HealthDay News) -- Optimal management of subtherapeutic international normalized ratios (INRs) is unclear, with differences in bridging practices among pharmacists seen for levels of experience, residency training, and prescribing privileges. These findings were published online June 18 in the Journal of Clinical Pharmacy and Therapeutics.

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Visit-to-Visit SBP Variability Not Linked to Major Cardiac Events

TUESDAY, June 23, 2015 (HealthDay News) -- Inadequate blood pressure (BP) control, but not visit-to-visit variability of systolic BP, is associated with major adverse cardiac events (MACE) among patients with hypertension and coronary artery disease (CAD), according to a study published in the July 15 issue of The American Journal of Cardiology.

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VA/DoD Release Guidelines for Dyslipidemia Management

TUESDAY, June 23, 2015 (HealthDay News) -- A joint clinical practice guideline for the management of dyslipidemia for cardiovascular disease risk reduction in adults has been summarized and published online June 22 in the Annals of Internal Medicine.

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Researchers Report U.S. Obesity Epidemic Getting Worse

MONDAY, June 22, 2015 (HealthDay News) -- About 35 percent of men and 37 percent of women are obese, while 40 percent of men and 30 percent of women are overweight, according to a research letter published online June 22 in JAMA Internal Medicine.

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About 8 Percent of SLE Patients Have Pulmonary HTN

MONDAY, June 22, 2015 (HealthDay News) -- About 8 percent of patients with systemic lupus erythematosus (SLE) have pulmonary hypertension (PH), and serum uric acid (UA) has reasonable accuracy for predicting PH, according to a study published in the June issue of the International Journal of Rheumatic Diseases.

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Medical Identity Theft Incidents Increasing

MONDAY, June 22, 2015 (HealthDay News) -- Medical identity theft is on the rise, costly to consumers, and challenging to resolve, according to the fifth annual report published by the Ponemon Institute.

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Minimal Yield Seen for Routine Noninvasive Testing for CAD

MONDAY, June 22, 2015 (HealthDay News) -- For patients presenting with acute chest pain and low clinical risk evaluated in a chest pain evaluation center (CPEC), the yield of routine noninvasive testing is low for coronary artery disease (CAD), according to a study published in the July 15 issue of The American Journal of Cardiology.

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Subclinical Hypothyroidism Ups DM Risk Only With Statin Use

MONDAY, June 22, 2015 (HealthDay News) -- Hypothyroidism is associated with increased risk of diabetes mellitus (DM); however, subclinical hypothyroidism appears to increase this risk only with statin use, according to research published online June 12 in Diabetes Care.

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Caution in Social Media Age: Self-Promotion Can Backfire

FRIDAY, June 19, 2015 (HealthDay News) -- In a series of experiments, researchers found that people who self-promote often offend others. The study was published in the June issue of Psychological Science.

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Medications Can Increase Risk of Heat-Related Illness

FRIDAY, June 19, 2015 (HealthDay News) -- Commonly used medications may increase the risk of dehydration and heat-related illness during hot weather, according to an article published online June 13 in the Journal of Clinical Pharmacy and Therapeutics.

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Hundreds Arrested Nationwide for Medicare/Medicaid Fraud

FRIDAY, June 19, 2015 (HealthDay News) -- Hundreds of people have been charged after health care fraud sweeps were made across the United States, the federal government said Thursday.

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FDA Cracks Down on Online Sale of Illegal Medical Products

FRIDAY, June 19, 2015 (HealthDay News) -- The U.S. Food and Drug Administration, along with international partners, moved this week against more than 1,050 websites that sell potentially dangerous counterfeit medicines and medical devices, the agency said Thursday.

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Virtual Credit Card Fees Amount to 3 to 5 Percent of Payments

THURSDAY, June 18, 2015 (HealthDay News) -- Payment with virtual credit cards (VCCs) is associated with considerable fees, although physicians are often unaware of these charges, according to the American Medical Association (AMA).

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Risk Score IDs One-Year Mortality in Elderly With NSTE-ACS

THURSDAY, June 18, 2015 (HealthDay News) -- A risk score involving five covariates can predict one-year mortality risk in patients ≥75 years presenting with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS), according to a study published in the July 15 issue of The American Journal of Cardiology.

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FDA: Improved Artificial Heart Valve Approved

THURSDAY, June 18, 2015 (HealthDay News) -- The newest version of the Sapien 3 Transcatheter Heart Valve has been approved by the U.S. Food and Drug Administration.

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Chromosomally Inherited HHV-6 Linked to Elevated Risk of Angina

WEDNESDAY, June 17, 2015 (HealthDay News) -- Individuals with inherited chromosomally integrated human herpesvirus 6 (iciHHV-6) may face three times the risk of angina as others, according to new research published online June 15 in the Proceedings of the National Academy of Sciences.

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Left Atrial Appendage Closure Beneficial in Nonvalvular A-Fib

WEDNESDAY, June 17, 2015 (HealthDay News) -- For patients with nonvalvular atrial fibrillation (NVAF), left atrial appendage closure (LAAC) is associated with reduced rates of hemorrhagic stroke, cardiovascular/unexplained death, and nonprocedural bleeding versus warfarin. The findings were published in the June 23 issue of the Journal of the American College of Cardiology.

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Direct Messaging Not Yet Widely Adopted by Physicians

TUESDAY, June 16, 2015 (HealthDay News) -- Direct secure messaging (Direct), which is a standardized protocol for exchanging clinical messages and attachments, has not been widely adopted by physicians, despite its potential for improving care coordination, according to an article published in Medical Economics.

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FDA: Food Manufacturers Have 3 Years to Remove Trans Fats

TUESDAY, June 16, 2015 (HealthDay News) -- In a move that it says is designed to protect the heart health of Americans, the U.S. Food and Drug Administration said Tuesday that food manufacturers have three years to remove artificial trans fats from the nation's food supply.

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Daily Milk or Dark Chocolate Linked to Cardiovascular Benefits

TUESDAY, June 16, 2015 (HealthDay News) -- Middle-aged or older individuals who eat as much as 3.5 ounces of chocolate a day may receive cardiovascular benefits, according to a report published online June 15 in Heart.

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HRQoL Outcomes Not Improving for Transapical TAVR

TUESDAY, June 16, 2015 (HealthDay News) -- Health-related quality of life (HRQoL) outcomes have not improved for patients undergoing transapical transcatheter aortic valve replacement (TA-TAVR), according to research published online June 9 in Circulation: Cardiovascular Quality and Outcomes.

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Review Examines Inappropriate Prescribing of IV Fluids

TUESDAY, June 16, 2015 (HealthDay News) -- Inappropriate prescribing of intravenous (IV) fluids most often involves incorrect volumes and types of IV fluids prescribed, according to a review published online June 11 in the Journal of Clinical Pharmacy and Therapeutics.

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Testosterone + Fenofibrate Yields Strongest Effect on Cardio Risks

TUESDAY, June 16, 2015 (HealthDay News) -- A combination of testosterone and fenofibrate may offer men with high cholesterol and late-onset hypogonadism the most cardiometabolic benefit, according to a study published online May 29 in Cardiovascular Therapeutics.

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Article Weighs Paying Off Student Loans Versus Investment

MONDAY, June 15, 2015 (HealthDay News) -- Newly-minted physicians should consider the issues relating to paying off their loans versus investing for retirement, according to an article published in Medical Economics.

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Low-Salt Diet Boosts Efficacy of Antihypertensives

MONDAY, June 15, 2015 (HealthDay News) -- A low-salt diet further improves the efficacy of antihypertensive drug regimens, according to a study published May 29 in the Journal of Clinical Pharmacology.

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Use of Novel Oral Anticoagulants Increasing in A-Fib

MONDAY, June 15, 2015 (HealthDay News) -- For patients with atrial fibrillation hospitalized with stroke or transient ischemic attack, use of novel oral anticoagulants (NOACs) has increased over time, according to a study published online June 9 in Circulation: Cardiovascular Quality and Outcomes.

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AdaptivCRT Algorithm Linked to Reduction in Readmissions

MONDAY, June 15, 2015 (HealthDay News) -- For patients with heart failure or all-cause index hospitalization, cardiac resynchronization therapy (CRT) devices equipped with the Medtronic AdaptivCRT (aCRT) algorithm correlate with a reduction in 30-day readmission, according to a study published online June 10 in JACC: Heart Failure.

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Younger Adults Receiving Excess Anticoagulant Dosing in PCI

FRIDAY, June 12, 2015 (HealthDay News) -- Many younger adults with acute myocardial infarction undergoing percutaneous coronary intervention (PCI) receive excess dosing of anticoagulants, with evidence of a trend toward an association between excess dosing and increased bleeding, according to a study published in the July 1 issue of The American Journal of Cardiology.

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Physical Activity Inversely Tied to Hypoglycemia With Coma in T1DM

FRIDAY, June 12, 2015 (HealthDay News) -- For patients with type 1 diabetes, regular physical activity (PA) is beneficial for glycemic control, diabetes-linked comorbidities, and cardiovascular risk factors, without apparent increase in adverse events, according to a study published online May 26 in Diabetes Care.

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Aerobic Fitness Measures Predict Post-AAA Complications

FRIDAY, June 12, 2015 (HealthDay News) -- Cardiopulmonary exercise testing variables can predict postoperative complications after abdominal aortic aneurysm repair, according to a study published in the June issue of Anaesthesia.

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CCTA Reclassifies CAD Risk for Most Patients With Chest Pain

FRIDAY, June 12, 2015 (HealthDay News) -- For most patients with chest pain and low to intermediate pretest probability (PTP) of obstructive coronary artery disease (CAD), coronary computed tomography angiography (CCTA) results in reclassification, according to a study published in the July 1 issue of The American Journal of Cardiology.

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Some Graduating Seniors Not Matching to Residency Positions

THURSDAY, June 11, 2015 (HealthDay News) -- More than 250 of this year's graduating seniors from U.S. medical schools did not match to a residency position, according to the American Medical Association.

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Length of Lookback Period Important in Incident AMI Trends

THURSDAY, June 11, 2015 (HealthDay News) -- The length of the lookback period (LP) affects trends in incident acute myocardial infarction (AMI), with a greater effect in women, according to a study published online June 9 in Circulation: Cardiovascular Quality and Outcomes.

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FDA Panel Recommends Approval of Second PCSK9 Inhibitor

THURSDAY, June 11, 2015 (HealthDay News) -- On Wednesday, U.S. health officials recommended the approval of a second new PCSK9 inhibitor, evolocumab (Repatha).

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Proton Pump Inhibitors Linked to Increased Risk of MI

WEDNESDAY, June 10, 2015 (HealthDay News) -- For U.S. adults with gastroesophageal reflux disease (GERD), the risk of myocardial infarction (MI) is slightly elevated among those using proton pump inhibitors, according to a review published online June 10 in PLOS ONE.

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Report Offers Guidance on Medical Ethics Education

WEDNESDAY, June 10, 2015 (HealthDay News) -- An analysis of the current state of medical ethics education in the United States has been published in the June issue of Academic Medicine. The article, the Romanell Report, also offers guidance to assist medial ethics educators in meeting expectations.

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Geographic Location Most Important for Residents

WEDNESDAY, June 10, 2015 (HealthDay News) -- For residents, the most important element in a future practice is geographic location, with lifestyle, adequate call hours and personal time, and a good financial package also cited as being important, according to the American Medical Association (AMA).

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Imaging Deemed More Effective Than Exercise Tolerance Testing

WEDNESDAY, June 10, 2015 (HealthDay News) -- For patients presenting with suspected coronary artery disease (CAD), cardiac imaging leads to fewer invasive coronary angiography (ICA) procedures and a higher yield of CAD, and is associated with lower costs than a traditional exercise tolerance test (ETT) strategy, according to a study published in the June 15 issue of The American Journal of Cardiology.

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Greater Decline in Renal Function With Warfarin in A-Fib

WEDNESDAY, June 10, 2015 (HealthDay News) -- For patients with atrial fibrillation, decline in renal function is significantly greater with warfarin versus dabigatran etexilate (DE), according to a study published in the June 16 issue of the Journal of the American College of Cardiology.

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Extra Time During MCAT Linked to Less Success in Med School

WEDNESDAY, June 10, 2015 (HealthDay News) -- Medical school applicants with Medical College Admission Test (MCAT) scores obtained with extra test administration time have lower rates of success in medical schools, according to a study published in the June 9 issue of the Journal of the American Medical Association.

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FDA Panel Recommends Approval for PCSK9 Inhibitor

WEDNESDAY, June 10, 2015 (HealthDay News) -- U.S. health experts voted on Tuesday to recommend approval of the first of two drugs in a new class of cholesterol medications that reduce low-density lipoprotein (LDL) cholesterol in patients who don't fare well on statins. The related research was published online April 28 in the Annals of Internal Medicine.

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Cardiac Dysfunction in Childhood Cancer Survivors Examined

TUESDAY, June 9, 2015 (HealthDay News) -- For long-term childhood cancer survivors, abnormal global longitudinal strain and diastolic function are more prevalent than reduced three dimensional (3D) left ventricular ejection fraction (LVEF), according to a study published in the June 16 issue of the Journal of the American College of Cardiology.

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Professional Guidelines Have Limited Impact on Pre-Op Testing

TUESDAY, June 9, 2015 (HealthDay News) -- The publication of 2002 professional guidelines on routine preoperative testing correlated with a reduction in routine electrocardiogram testing, but not in the incidence of radiography, hematocrit, urinalysis, or cardiac stress testing, according to research published online June 8 in JAMA Internal Medicine.

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Review Explores Effect of Sulfonylureas on Lipids in T2DM

TUESDAY, June 9, 2015 (HealthDay News) -- For patients with type 2 diabetes mellitus (T2DM), sulfonylureas seem to increase levels of free fatty acids (FFA) and triglycerides (TG) and lower low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), according to a meta-analysis published online June 4 in the Journal of Evidence-Based Medicine.

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Analysis Targets U.S. Hospitals With Highest Markups

TUESDAY, June 9, 2015 (HealthDay News) -- The 50 U.S. hospitals with the highest charge-to-cost ratio have markups approximately 10 times the Medicare-allowable costs, and most of these hospitals are for profit, according to a study published in the June issue of Health Affairs.

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AMA Offers Guidance for Physician-Hospital Relationships

MONDAY, June 8, 2015 (HealthDay News) -- New guidelines can enable successful physician hospital relationships and integrated leadership, according to a report published by the American Medical Association (AMA).

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25(OH)D Inversely Linked to Arterial Stiffness in Some Teens

MONDAY, June 8, 2015 (HealthDay News) -- In lean adolescents and in obese adolescents with type 2 diabetes (T2DM), but not obese adolescents with normoglycemia, 25-hydroxyvitamin D (25[OH]D) is inversely associated with some measures of arterial stiffness, according to a study published online May 26 in Diabetes Care.

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Scoring System Helps Predict Post-Hospital Mortality

MONDAY, June 8, 2015 (HealthDay News) -- A fairly simple scoring system appears to accurately estimate patients' risk of dying within a year of hospitalization, according to research results reported online June 8 in CMAJ, the journal of the Canadian Medical Association.

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Time-Updated Hemoglobin A1c Variables Linked to MI Risk

FRIDAY, June 5, 2015 (HealthDay News) -- Time-updated hemoglobin A1c (HbA1c) variables have a stronger association with myocardial infarction (MI) than baseline HbA1c, according to a study published online May 26 in Diabetes Care.

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Review: Short vs. Long Duration Dual Antiplatelet Tx After Stent

FRIDAY, June 5, 2015 (HealthDay News) -- Dual antiplatelet therapy (DAPT) continued beyond six months after drug-eluting stent implantation is associated with reduced stent thrombosis and myocardial infarction but also increased bleeding and all-cause mortality as compared to shorter-term DAPT therapy, according to a review published online May 25 in Cardiovascular Therapeutics.

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Statin + Ezetimibe May Benefit After Acute Coronary Syndrome

THURSDAY, June 4, 2015 (HealthDay News) -- In treatment following acute coronary syndrome, ezetimibe added to statin therapy appears beneficial, according to a study published online June 3 in the New England Journal of Medicine.

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Withholding ARBs After Surgery Linked to Higher Mortality

THURSDAY, June 4, 2015 (HealthDay News) -- For veterans regularly prescribed angiotensin receptor blockers (ARBs) admitted for noncardiac surgery, failure to resume ARB therapy by postoperative day two is associated with increased mortality risk, according to a study published online May 30 in Anesthesiology.

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Interstate Medical Licensure Compact Formed

THURSDAY, June 4, 2015 (HealthDay News) -- Nine states have enacted the Interstate Medical Licensure Compact law, with the seventh state's enactment triggering formation of a commission to administer a process for physicians seeking licensure in multiple states, according to a report published by the American Academy of Family Physicians.

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Intensive Glycemic Control May Ward Off Cardiovascular Events

THURSDAY, June 4, 2015 (HealthDay News) -- Intensive glycemic control appears to reduce cardiovascular events in patients with type 2 diabetes, according to a study published in the June 4 issue of the New England Journal of Medicine.

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Metabolic Syndrome Up With ADT in Prostate Cancer

THURSDAY, June 4, 2015 (HealthDay News) -- For patients with prostate cancer treated with androgen deprivation therapy there are increases in components of metabolic syndrome and in the prevalence of full metabolic syndrome, according to a study published in the June issue of The Journal of Urology.

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CMS: Hospital Charges for Common Procedures Up

WEDNESDAY, June 3, 2015 (HealthDay News) -- The prices hospitals charge patients for a number of common procedures rose more than 10 percent between 2011 and 2013, more than twice the rate of inflation, according to data released by the federal government Monday.

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Post-Op Myocardial Necrosis Common After Orthopedic Sx

WEDNESDAY, June 3, 2015 (HealthDay News) -- Myocardial necrosis is common after orthopedic surgery and is associated with increased risk of long-term mortality, according to a study published in the June 15 issue of The American Journal of Cardiology.

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Resident Education Intervention Ups Patient Satisfaction

WEDNESDAY, June 3, 2015 (HealthDay News) -- A patient satisfaction education, feedback, and incentive intervention provided to internal medicine residents can improve patient satisfaction, according to a study published online May 27 in the Journal of Hospital Medicine.

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6-Minute Walk Test Predicts Pulmonary HTN Outcomes

WEDNESDAY, June 3, 2015 (HealthDay News) -- For patients with pulmonary hypertension associated with heart failure and preserved ejection fraction (PH-HFpEF), the six-minute walk distance (6-MWD) test can independently predict outcome, according to a study published in the June issue of JACC: Heart Failure.

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24-Hour Diastolic BP Linked to Cognitive Performance in T2DM

WEDNESDAY, June 3, 2015 (HealthDay News) -- Among individuals with type 2 diabetes there is a quadratic association for 24-hour diastolic blood pressure (BP) with information processing speed and memory, according to a study published online May 27 in Diabetes Care.

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Women With HTN, Diabetes Less Likely to Use Alternative Rx

TUESDAY, June 2, 2015 (HealthDay News) -- Women with hypertension and diabetes are less likely to consult with a complementary and alternative medicine (CAM) practitioner and to self-prescribe CAM, according to a study published in the June 15 issue of The American Journal of Cardiology.

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U.S. Organ Donation System Needs 'Disruptive Innovation'

TUESDAY, June 2, 2015 (HealthDay News) -- Many state policies meant to increase organ donations and transplant rates have had almost no impact, according to new research published online June 1 in JAMA Internal Medicine.

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