September 2018 Briefing - Neurology

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

Physicians Often Don't Address Their Burnout

FRIDAY, Sept. 28, 2018 (HealthDay News) -- More than half of physicians experience burnout, and many do not seek treatment for burnout, according to a report published in the American Medical Association's AMA Wire.

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Implementing EMRs Affects Time Spent With Patients in Clinic

FRIDAY, Sept. 28, 2018 (HealthDay News) -- Following a six-month learning period to implement an electronic medical record (EMR) system, outpatient orthopedic clinics return to pre-implementation efficiency, but there may be other lasting effects on productivity, according to a study published in the Sept. 19 issue of The Journal of Bone & Joint Surgery.

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Prevalence of TBI 2.5 Percent Among U.S. Children

FRIDAY, Sept. 28, 2018 (HealthDay News) -- The prevalence of traumatic brain injury (TBI) is 2.5 percent among U.S. children, and TBI is associated with several health conditions, according to a study published online Sept. 24 in JAMA Pediatrics.

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Business Degree Increasingly Useful for Doctors

THURSDAY, Sept. 27, 2018 (HealthDay News) -- Having a Master of Business Administration degree (M.B.A.) can help doctors with important, practice-related decisions, according to a report published recently in Physician Practice.

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Heading a Soccer Ball Found to Be Riskier for Female Players

THURSDAY, Sept. 27, 2018 (HealthDay News) -- Female soccer players exhibit more widespread evidence of microstructural white matter alteration than males, despite having similar exposure to heading, according to a study recently published in Radiology.

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Practices Should Set Rules for Staff Social Media Use

THURSDAY, Sept. 27, 2018 (HealthDay News) -- Medical practices can take steps to avoid problems related to use of social media by staff members, according to an article published in Medical Economics.

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Burnout, Career Choice Regret Prevalent in U.S. Residents

WEDNESDAY, Sept. 26, 2018 (HealthDay News) -- Symptoms of burnout and career choice regret are prevalent among U.S. resident physicians, according to a study published in the Sept. 18 issue of the Journal of the American Medical Association.

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Childhood Poverty Can Affect Cognitive Skills in Old Age

WEDNESDAY, Sept. 26, 2018 (HealthDay News) -- Variation in childhood socioeconomic position (SEP) partially accounts for cognitive performance in older age, with adverse childhood SEP associated with lower level of baseline cognitive performance, according to a study published online Sept. 26 in Neurology.

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Lower Levels of Depression, Higher QOL for Older MS Patients

WEDNESDAY, Sept. 26, 2018 (HealthDay News) -- Older individuals with multiple sclerosis (MS) report less severe depressive symptoms and better physical quality of life (QOL), compared to younger patients, according to a brief report recently published in Rehabilitation Psychology.

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Head CT Decision Aid Ups Parent Knowledge in Child Head Trauma

WEDNESDAY, Sept. 26, 2018 (HealthDay News) -- Use of a decision aid can improve parent knowledge for children with minor head injury at intermediate risk of clinically important traumatic brain injury (ciTBI), according to a study published online Sept. 21 in JAMA Network Open.

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Novel Immunotherapy May Up Survival in Melanoma Brain Mets

TUESDAY, Sept. 25, 2018 (HealthDay News) -- Checkpoint blockade immunotherapy (CBI) is associated with significant increases in overall survival (OS) in a real-world population of patients undergoing treatment for melanoma brain metastases (MBM), according to research published in the September issue of Cancer Immunology Research.

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Positive Link Between Air Pollution, Diagnosis of Dementia

TUESDAY, Sept. 25, 2018 (HealthDay News) -- There is a positive association between residential levels of air pollution and being diagnosed with dementia, according to a study published in the September issue of BMJ Open.

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High-Risk Anticholinergics Prescribed to 6 Percent of Elderly

TUESDAY, Sept. 25, 2018 (HealthDay News) -- High-risk anticholinergic prescriptions are listed for 6.2 percent of visits of older adults, according to a study published in a recent issue of the Journal of the American Geriatrics Society.

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AAP Report Addresses Managing Fetal Alcohol Spectrum Disorder

TUESDAY, Sept. 25, 2018 (HealthDay News) -- In a clinical report published online Sept. 10 in Pediatrics, recommendations are presented to support pediatric providers in managing patients with a diagnosis of fetal alcohol spectrum disorder (FASD).

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In 2016, Proportion of Uninsured Americans Down to 10 Percent

TUESDAY, Sept. 25, 2018 (HealthDay News) -- From 2013 to 2016 there was a reduction in uninsurance among Americans from 17 to 10 percent, according to a report published in September by the Robert Wood Johnson Foundation (RWJF) and the Urban Institute.

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Physician-Group ACOs Generate Medicare Savings

TUESDAY, Sept. 25, 2018 (HealthDay News) -- Physician-group accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) generated significantly more savings for Medicare that grew from 2012 to 2015 compared with hospital-integrated ACOs, according to research published in the Sept. 20 issue of the New England Journal of Medicine.

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Multiple Pathways Explain Age-Linked Increase in Dementia Risk

MONDAY, Sept. 24, 2018 (HealthDay News) -- Multiple pathways account for the age-related increases in dementia risk, according to a study recently published in the Annals of Neurology.

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Brain Iron on MRI Linked to Disability in Multiple Sclerosis

MONDAY, Sept. 24, 2018 (HealthDay News) -- Brain iron at quantitative magnetic resonance imaging (MRI) is associated with disability in multiple sclerosis (MS), according to a study recently published in Radiology.

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Actigraphy May Overestimate Sleep in ICU Setting

MONDAY, Sept. 24, 2018 (HealthDay News) -- Using actigraphy as a measure of sleep, critically ill patients in the intensive care unit (ICU) show wide ranges of sleep quality and quantity, and actigraphy may estimate higher sleep durations than other measures, according to a review published in the September issue of the Annals of the American Thoracic Society.

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Some Clinicians, Patients Record Clinic Visits for Patient Use

FRIDAY, Sept. 21, 2018 (HealthDay News) -- A considerable proportion of clinicians and patients report having recorded a clinic visit for the patient's personal use, according to a study published in the September issue of the Journal of Medical Internet Research.

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Prevalence of Alzheimer's, Related Dementia Set to Double

FRIDAY, Sept. 21, 2018 (HealthDay News) -- The burden of Alzheimer's disease and related dementias (ADRD) is expected to increase to 3.3 percent in the United States by 2060, according to a study published online Sept. 19 in Alzheimer's & Dementia.

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Dozens of Medical Groups Join Forces to Improve Diagnoses

FRIDAY, Sept. 21, 2018 (HealthDay News) -- Every nine minutes, a patient in a U.S. hospital dies because a diagnosis was wrong or delayed -- resulting in 80,000 deaths a year. That sobering estimate comes from the Society to Improve Diagnosis in Medicine (SIDM).

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Age, Sex, APOE Genotype Identify Alzheimer's, Dementia Risk

FRIDAY, Sept. 21, 2018 (HealthDay News) -- Age, sex and apolipoprotein E (APOE) genotype can identify groups at high 10-year risk for Alzheimer's disease and all dementia, according to a study published Sept. 4 in CMAJ, the journal of the Canadian Medical Association.

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Cannabinoid Trials Needed for Peds Neurologic Disorders

THURSDAY, Sept. 20, 2018 (HealthDay News) -- There is an urgent need for clinical trials to investigate the use of cannabinoids in pediatric patients with neurological disorders, according to a commentary published in the Aug. 27 issue of CMAJ, the journal of the Canadian Medical Association.

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Research Links Doctor Burnout to Patient Safety Incidents

THURSDAY, Sept. 20, 2018 (HealthDay News) -- Physician burnout is associated with increased risk of patient safety incidents, poorer quality of care due to low professionalism, and reduced patient satisfaction, according to a review published online Sept. 4 in JAMA Internal Medicine.

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Educational Disabilities More Likely With Neonatal Abstinence

THURSDAY, Sept. 20, 2018 (HealthDay News) -- Children with a history of neonatal abstinence syndrome (NAS) are more likely to be referred for a disability evaluation and meet criteria for a disability, according to a study published in the September issue of Pediatrics.

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Hospitals Charge 479 Percent of Cost of Drugs on Average

THURSDAY, Sept. 20, 2018 (HealthDay News) -- On average, hospitals mark up drugs by 479 percent of their cost, according to a report from The Moran Company, commissioned by the Pharmaceutical Research and Manufacturers of America (PhRMA).

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Combo Physical, Mental Activity Prevents Cognitive Decline

THURSDAY, Sept. 20, 2018 (HealthDay News) -- Behavioral activation that increases mental, physical, and social activity may prevent cognitive and functional decline in older black patients, according to a study published online Sept. 10 in JAMA Neurology.

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Residents Should Take Advantage of Paid Time Off

THURSDAY, Sept. 20, 2018 (HealthDay News) -- Although there are many demands on residents, taking advantage of paid vacation time is one of the perks and should be maximized, according to an article published in the American Medical Association's AMA Wire.

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20% of Children, Adolescents Use Prescription Medications

WEDNESDAY, Sept. 19, 2018 (HealthDay News) -- Almost 20 percent of children and adolescents used prescription medications in 2013 to 2014, and 8.2 percent of concurrent users of prescription medications in 2009 to 2014 were at risk for a potentially major drug-drug interactions (DDIs), according to a study published in the September issue of Pediatrics.

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Patient Health Information Often Shared Electronically

WEDNESDAY, Sept. 19, 2018 (HealthDay News) -- The most common electronically sent and received types of patient health information (PHI) include laboratory results and medication lists, according to a report published Aug. 15 by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Global Prevalence of Insufficient Activity 27.5 Percent

WEDNESDAY, Sept. 19, 2018 (HealthDay News) -- In 2016 the age-standardized prevalence of insufficient physical activity was 27.5 percent, according to a study published in the October issue of The Lancet Global Health.

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Scribes Improve Physician Workflow, Patient Interaction

TUESDAY, Sept. 18, 2018 (HealthDay News) -- Use of medical scribes is associated with decreased physician documentation burden, improved work efficiency, and improved patient interactions, according to a study published online Sept. 17 in JAMA Internal Medicine.

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Compliance With Requirement to Report Results on EUCTR Is Poor

TUESDAY, Sept. 18, 2018 (HealthDay News) -- Half of trials on the European Union Clinical Trials Register (EUCTR) are non-compliant with the European Commission's requirement that all trials post results to the registry within 12 month of completion, according to a study published online Sept. 13 in The BMJ.

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Drug Prices Increase More Than Expected After Shortages

TUESDAY, Sept. 18, 2018 (HealthDay News) -- Prices for drugs under shortage increase more than twice as quickly as expected in the absence of a shortage, according to a research letter published online Sept. 18 in the Annals of Internal Medicine.

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Many RA Patients' Pain Related to Central Nervous System

MONDAY, Sept. 17, 2018 (HealthDay News) -- Centralized pain pathways may coexist with more established peripheral inflammation-driven pathways in some patients with rheumatoid arthritis (RA), according to a study published in the July issue of Arthritis & Rheumatology.

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Mercury in Traditional Tibetan Medicine Could Be Harmful

MONDAY, Sept. 17, 2018 (HealthDay News) -- The high mercury (Hg) concentration contained in traditional Tibetan medicine (TTM) could be harmful to humans and contribute to the environmental Hg burden in Tibet, according to a study published in the Aug. 7 issue of Environmental Science & Technology.

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Association Health Plans Can Help Small Businesses Offer Coverage

MONDAY, Sept. 17, 2018 (HealthDay News) -- Association health plans (AHPs) will provide small businesses with more choices, access, and coverage options, although critics warn that they may undermine the Affordable Care Act (ACA) marketplace, according to an article published in Managed Healthcare Executive.

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Model Estimates Mortality in Patients Waiting for Hearts

MONDAY, Sept. 17, 2018 (HealthDay News) -- For patients with advanced heart failure who are listed for transplantation, mortality risk is related to adverse events and end-organ dysfunction that vary over time, according to a study published in the Aug. 7 issue of the Journal of the American College of Cardiology.

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Situation Framing, Language Can Influence Decision-Making

FRIDAY, Sept. 14, 2018 (HealthDay News) -- How a situation is framed and the language used to describe risks can influence patients' decision-making, according to an article published in Physicians Practice.

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CDC: About One in Five U.S. Adults Have Chronic Pain

THURSDAY, Sept. 13, 2018 (HealthDay News) -- About 20.4 percent of U.S. adults have chronic pain and 8.0 percent have high-impact chronic pain, according to research published in the Sept. 14 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Pediatricians Have a Role in Encouraging Play Among Children

THURSDAY, Sept. 13, 2018 (HealthDay News) -- Pediatricians should encourage parents to ensure their children play, according to a clinical report published in the September issue of Pediatrics.

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Gains in Insurance Coverage Seen for Lesbian, Gay, Bisexual Adults

THURSDAY, Sept. 13, 2018 (HealthDay News) -- Lesbian, gay, and bisexual (LGB) adults report continued problems affording care despite coverage gains offered by the Affordable Care Act, according to a study published in the August issue of Health Affairs.

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Fingolimod Cuts Multiple Sclerosis Relapses in Pediatric Patients

WEDNESDAY, Sept. 12, 2018 (HealthDay News) -- Among pediatric patients with relapsing multiple sclerosis, fingolimod is associated with a lower rate of relapse but a higher rate of serious adverse events than interferon beta-1a, according to a study published in the Sept. 13 issue of the New England Journal of Medicine.

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Propofol May Decrease Delay in Neurocognitive Recovery

WEDNESDAY, Sept. 12, 2018 (HealthDay News) -- For older cancer patients undergoing major cancer surgery, propofol-based general anesthesia may reduce the incidence of delayed neurocognitive recovery versus sevoflurane-based general anesthesia, according to a study published in the September issue of the British Journal of Anesthesia.

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Six-Step Analysis Can Help Improve Practice Logistics

WEDNESDAY, Sept. 12, 2018 (HealthDay News) -- A six-step analysis can help redesign and improve the outpatient health care process, according to a study recently published in the Journal of Evaluation in Clinical Practice.

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Residents Working Long Hours Can Increase Alertness

WEDNESDAY, Sept. 12, 2018 (HealthDay News) -- Medical residents can take steps to maintain their energy and alertness during long shifts, according to an article published in the American Medical Association's AMA Wire.

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Early Talk, Interaction Predicts School-Age Language Outcomes

TUESDAY, Sept. 10, 2018 (HealthDay News) -- Talk and interaction during early childhood, especially during 18 to 24 months, is associated with language and cognitive outcomes, according to a study published online Sept. 10 in Pediatrics.

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Medicaid Work Requirements Don't Impact Many Enrollees

TUESDAY, Sept. 11, 2018 (HealthDay News) -- Medicaid work requirements will only impact a small proportion of persons and may only generate minimal savings, according to two research letters published online Sept. 10 in JAMA Internal Medicine.

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Data Age in Clinical Trials Is About Three Years at Publication

TUESDAY, Sept. 11, 2018 (HealthDay News) -- The median data age in clinical trials in journals with a high impact factor is about three years at publication, according to a study published in the Aug. 10 issue of JAMA Network Open.

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Many Opportunities for Doctors Using Twitter

MONDAY, Sept. 10, 2018 (HealthDay News) -- Doctors can use Twitter to build networks and learn more about research in real time, according to a blog post published by Penn Medicine News.

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Chronic Pain May Be Contributor to Suicide

MONDAY, Sept. 10, 2018 (HealthDay News) -- Chronic pain may be an important contributor to suicide, with 8.8 percent of suicide decedents having evidence of chronic pain, according to a study published online Sept. 11 in the Annals of Internal Medicine.

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Maternal Holding With Glucose or Breastfeeding Best Analgesic

MONDAY, Sept. 10, 2018 (HealthDay News) -- Maternal holding of newborns, combined with oral glucose and in breastfeeding, is associated with the greatest analgesic effect in infants, according to a study published in the September issue of Pediatrics.

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Docs, Consumers Agree on Benefits of Virtual Care

MONDAY, Sept. 10, 2018 (HealthDay News) -- Physicians and consumers agree on the benefits of virtual care, but physician adoption of virtual care technologies is low, according to a report on the Deloitte 2018 Survey of U.S. Physicians.

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Physician Burnout Rates Vary by Medical Specialty

MONDAY, Sept. 10, 2018 (HealthDay News) -- Nearly half of physicians report being burned out, but rates vary substantially by medical specialty, according to an article published in AMA Wire.

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Exposure to Toxic Metals May Up Cardiovascular Disease Risk

FRIDAY, Sept. 7, 2018 (HealthDay News) -- Exposure to arsenic, lead, cadmium, and copper is associated with elevated risk of clinical cardiovascular disease outcomes, according to a review and meta-analysis published online Aug. 29 in The BMJ.

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Increased Corticomotor Excitability ID'd in Restless Legs

FRIDAY, Sept. 7, 2018 (HealthDay News) -- For patients with restless leg syndrome (RLS), the primary motor cortex (M1) exhibits hyperexcitability, which is associated with disease severity, according to a study published recently in Sleep Medicine.

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X-Rays, Blood Tests Not Advised for Children's Concussions

FRIDAY, Sept. 7, 2018 (HealthDay News) -- Routine X-rays and blood tests should not be used to diagnose children's concussions, new U.S. government guidelines say. The guidelines were published online Sept. 4 in JAMA Pediatrics.

CDC Guideline
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CDC Press Release

Personalized Weighting Could Enhance Hospital Rating Tools

FRIDAY, Sept. 7, 2018 (HealthDay News) -- The weighting systems that underlie hospital performance rating tools should incorporate the needs, values, and preferences of patients, according to a perspective article published in the Aug. 30 issue of the New England Journal of Medicine.

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Better Training Needed to Boost LGBTQ Patient Health Care

THURSDAY, Sept. 6, 2018 (HealthDay News) -- High-quality health care needs to be provided to lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients, and improved training is necessary to deliver that care, according to a report published in the American Medical Association's AMA Wire.

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Hospital Groups Launch Own Generic Drug Company

THURSDAY, Sept. 6, 2018 (HealthDay News) -- Three U.S. health care foundations and seven hospital groups have formed a generic drug company to combat high prices and chronic shortages of medicines.

AP News Article

CDC Issues Recs on Diagnosis, Management of Pediatric mTBI

THURSDAY, Sept. 6, 2018 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has established an evidence-based guideline for diagnosis and management of pediatric mild traumatic brain injury (mTBI). The guideline was published online Sept. 4 in JAMA Pediatrics.

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Psychological Distress Linked to Increased Risk of MI, Stroke

THURSDAY, Sept. 6, 2018 (HealthDay News) -- Psychological distress is associated with myocardial infarction (MI) and stroke in men and women, according to a study published online Aug. 28 in Circulation: Cardiovascular Quality and Outcomes.

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Public Service Loan Forgiveness Program Has Uncertain Future

WEDNESDAY, Sept. 5, 2018 (HealthDay News) -- Uncertainty surrounds the future of the Public Service Loan Forgiveness (PSLF) program, according to an Ideas and Opinions article published online Aug. 28 in the Annals of Internal Medicine.

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Patient Distressed by Overturn of California End of Life Option Act

TUESDAY, Sept. 4, 2018 (HealthDay News) -- The decision to overturn the End of Life Option Act has added stress and anxiety to terminally ill patients, including those with amyotrophic lateral sclerosis (ALS), according to a patient testimonial published online Sept. 4 in the Annals of Internal Medicine.

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Enrollment in High-Deductible Health Plans Up From '07 to '17

TUESDAY, Sept. 4, 2018 (HealthDay News) -- Enrollment in high-deductible health plans (HDHPs) has increased among adults with employment-based insurance coverage, according to an August data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Breast Cancer Surgery Outcomes Poor for Nursing Home Residents

TUESDAY, Sept. 4, 2018 (HealthDay News) -- For female nursing home residents who undergo breast cancer surgery, rates of one-year mortality and functional decline are high, according to a study published online Aug. 29 in JAMA Surgery.

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