September 2013 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for September 2013. 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.

Lower National Health Spending Due to Slow Economy

MONDAY, Sept. 30 (HealthDay News) -- National health care expenditures remain sluggish but are expected to grow at a rate of approximately 6.2 percent per year after 2014, with federal, state, and local governments accounting for half, according to research published online Sept. 18 in Health Affairs.

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Medicare, Medicaid Will Still Run If Government Shuts Down

MONDAY, Sept. 30 (HealthDay News) -- According to U.S. officials, veterans and Medicare and Medicaid recipients will continue to receive health care benefits even if the federal government shuts down on Tuesday.

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Only One-Third of Voters Think Congress Should Delay ACA

MONDAY, Sept. 30 (HealthDay News) -- With a government shutdown impending, only one-third of voters think that Congress should delay, defund, or repeal the health care laws set to take effect imminently, according to a report from The Morning Consult.

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DOL Clarifies Employer Health Insurance Notification Duty

MONDAY, Sept. 30 (HealthDay News) -- The U.S. Department of Labor has provided clarification in the form of a frequently-asked-questions (FAQ) document, relating to employer obligations to provide employees with written notice about the Affordable Care Act's health insurance marketplaces by Oct. 1, 2013.

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Health Worker Roles Impacted When 'Undervalued' by Patients

FRIDAY, Sept. 27 (HealthDay News) -- Job satisfaction among nurse practitioners and other professionals can suffer when clientele lack a clear understanding of what they do, according to research published in the Aug. 1 issue of the Academy of Management Journal.

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Practical Tips Offered for Medical Employee Satisfaction

FRIDAY, Sept. 27 (HealthDay News) -- Managing staff is a learned skill, and one for which physicians are often ill-equipped. An article published Sept. 25 in Medical Economics lays out some practical tips and advice for motivating staff to excel.

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HEALTH REFORM: ACA Impact on Medicare Recipients Unclear

FRIDAY, Sept. 27 (HealthDay News) -- The Affordable Care Act (ACA) will help millions of uninsured Americans access affordable health care coverage, but it's unclear what effect the law will have on people covered by Medicare.

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Effect of Testosterone on CV Disease in Men Uncertain

FRIDAY, Sept. 27 (HealthDay News) -- Further research is required to determine the relationship between testosterone levels and cardiovascular disease in men and to explore the risk-benefit of testosterone therapy, according to a review published online Sept. 24 in the Journal of Clinical Endocrinology & Metabolism.

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Social Media May Make Quitting Smoking Easier

FRIDAY, Sept. 27 (HealthDay News) -- People who participate in health issue-specific social networking sites find it easier to quit smoking, according to research published online Sept. 16 in the Journal of Communication.

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Obesity Gene Testing Offers Psychological Benefit

FRIDAY, Sept. 27 (HealthDay News) -- Results from genetic testing for weight gain-related genes may offer psychological benefits beyond their limited clinical utility, according to a study published in the July issue of the Journal of Genetic Counseling.

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CDC: Flu Shot Coverage of Health Care Personnel Increasing

THURSDAY, Sept. 26 (HealthDay News) -- Influenza vaccination coverage has increased among health care personnel but varies by occupation type and occupational setting, according to a report published in the Sept. 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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HEALTH REFORM: Medicaid Expansion Will Up Coverage

THURSDAY, Sept. 26 (HealthDay News) -- Two aspects of the Affordable Care Act (ACA) have the potential to extend health insurance coverage to those who do not qualify for government-sponsored health care but cannot afford to purchase private plans.

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Cardiovascular Data Registry Provides Useful Information

THURSDAY, Sept. 26 (HealthDay News) -- Programs within the National Cardiovascular Data Registry (NCDR) provide valuable information about cardiovascular trends, according to a report published online Sept. 18 in the Journal of the American College of Cardiology.

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HEALTH REFORM: Exchanges Offer Options for the Uninsured

WEDNESDAY, Sept. 25 (HealthDay News) -- Millions of part-time, seasonal, self-employed workers and other individuals currently without health insurance may find a solution to their vulnerable status when the new health care exchanges go into effect on Oct. 1.

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More Options, Lower Premiums With Insurance Exchanges

WEDNESDAY, Sept. 25 (HealthDay News) -- Consumers are likely to find insurance options more plentiful and more affordable than expected in the new Health Insurance Marketplace that goes into effect Oct. 1, according to a report released Sept. 25 by the U.S. Department of Health and Human Services.

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ACP Provides Overview of Health Insurance Marketplaces

WEDNESDAY, Sept. 25 (HealthDay News) -- The opportunities and challenges presented by health care reform are discussed in an article published online Sept. 24 in the Annals of Internal Medicine.

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HEALTH REFORM: Health Care Reform a Mixed Bag for Workers

TUESDAY, Sept. 24 (HealthDay News) -- Much discussion of the Affordable Care Act revolves around the dramatic changes in store for America's uninsured, but the health care reform law will also have an impact on individuals with employer-based coverage.

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Arsenic Exposure Ups Risk for Cardiovascular Disease

TUESDAY, Sept. 24 (HealthDay News) -- Chronic exposure to low-to-moderate levels of inorganic arsenic is associated with increased risk of cardiovascular morbidity and mortality, according to research published online Sept. 24 in the Annals of Internal Medicine.

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Medicare Expenditure Per Patient Up for Acute MI

TUESDAY, Sept. 24 (HealthDay News) -- For patients with acute myocardial infarction (AMI), Medicare expenditures per patient increased significantly from 1998-1999 to 2008, according to research published online Sept. 23 in JAMA Internal Medicine.

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FDA Gives Final Guidance on Mobile Medical App Oversight

TUESDAY, Sept. 24 (HealthDay News) -- The U.S. Food and Drug Administration issued final guidance for mobile application (app) developers, and is focusing its oversight on medical apps that will be used as accessories to regulated medical devices, or that transform a mobile device into a regulated medical device.

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HEALTH REFORM: Young People Likely to Be Key to Success

MONDAY, Sept. 23 (HealthDay News) -- Young, healthy adults are considered key to the success of health insurance reform, but many are not even aware of state insurance exchanges.

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Infectious Endocarditis Risk ID'd in Congenital Heart Disease

MONDAY, Sept. 23 (HealthDay News) -- For children with congenital heart disease (CHD), the risk of infectious endocarditis (IE) is 6.1 per 1,000 children, and predictors include cyanotic CHD, endocardial cushion defects, and left-sided lesions, according to a study published in the Sept. 24 issue of Circulation.

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FDA Issues Final Rule for Device Identification System

MONDAY, Sept. 23 (HealthDay News) -- The U.S. Food and Drug Administration has released a final rule for the unique device identification system (UDI) that, when implemented, will improve patient safety by providing a consistent way to identify approved medical devices.

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HEALTH REFORM: Health Care Exchanges Going Into Effect

MONDAY, Sept. 23 (HealthDay News) -- As of Oct. 1, consumers looking for health insurance will be able to turn to state-based health care exchanges, a centerpiece of the Affordable Care Act intended to help the uninsured and small businesses find affordable coverage.

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Majority of U.S. Consumers Want Full Access to EMR

MONDAY, Sept. 23 (HealthDay News) -- Most U.S. consumers want to have full access to their electronic medical records (EMR), and 41 percent would be willing to switch doctors to gain access, according to a survey published by Accenture.

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Use of Digoxin Ups Risk of Death in Systolic Heart Failure

MONDAY, Sept. 23 (HealthDay News) -- Digoxin therapy was independently associated with increased mortality in patients with systolic heart failure, according to research published in the September issue of Circulation: Cardiovascular Quality and Outcomes.

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Statin Use Tied to Increased Risk of Cataracts

FRIDAY, Sept. 20 (HealthDay News) -- Statin users are at increased risk for cataracts, according to a study published online Sept. 19 in JAMA Ophthalmology.

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New Model Better Predicts Risk of Post-PCI Bleeding

FRIDAY, Sept. 20 (HealthDay News) -- A new definition of post-percutaneous coronary intervention (PCI) bleeding and a new predictive risk model can better identify patients at risk for bleeding complications, according to a study published in the September issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

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Little Correlation Between Care Quality, Patient Experience

FRIDAY, Sept. 20 (HealthDay News) -- There is little correlation between quality of care assessed by clinical measures versus by patient experience, according to research published in the September/October issue of the Annals of Family Medicine.

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New Medicaid Enrollees Under ACA May Be Healthier

THURSDAY, Sept. 19 (HealthDay News) -- Adults potentially eligible for Medicaid under the Patient Protection and Affordable Care Act (ACA) are expected to have equal or better health status than current beneficiaries, according to research published in the September/October issue of the Annals of Family Medicine.

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CDC: Evocative Campaign Motivates Smokers to Quit

THURSDAY, Sept. 19 (HealthDay News) -- The Tips from Former Smokers (Tips) television campaign, which features true stories of former smokers living with the unfortunate consequences of their past habit, appears to motivate smokers to seek information through quitlines and the Internet, according to a report published in the Sept. 20 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Increased QRS Duration on ECG Tied to Cardiovascular Mortality

THURSDAY, Sept. 19 (HealthDay News) -- Increased QRS duration on electrocardiogram (ECG) is an independent predictor of cardiovascular mortality, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Pros and Cons of Shortening Medical School Discussed

THURSDAY, Sept. 19 (HealthDay News) -- The pros and cons of shortening medical school to three years are discussed in two perspective pieces published in the Sept. 19 issue of the New England Journal of Medicine.

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Millions Are Harmed by Unsafe Medical Care Each Year

THURSDAY, Sept. 19 (HealthDay News) -- Adverse events caused by inferior medical care are a major source of morbidity and mortality globally, according to research published in the October issue of BMJ Quality & Safety.

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Gender Differences in Coronary Syndrome Presentation Studied

WEDNESDAY, Sept. 18 (HealthDay News) -- Chest pain is the most predominant symptom of acute coronary syndrome (ACS) in both middle-aged men and women, although women have a higher likelihood of presenting without chest pain, according to a study published online Sept. 16 in JAMA Internal Medicine.

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Enhanced Care Program Set Up at Six Mayo Clinic Hospitals

WEDNESDAY, Sept. 18 (HealthDay News) -- A new program has been developed and implemented at six Mayo Clinic Health System hospitals to improve care and shorten hospital stays using remote monitoring, according to a press release issued by the Mayo Clinic.

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Payment for Routine Office Visits Varies Substantially

WEDNESDAY, Sept. 18 (HealthDay News) -- There is substantial variation in private insurance payment to physicians for routine office visits, according to research published in the September issue of Health Affairs.

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EHR Systems Meeting Meaningful Use Criteria Beneficial

WEDNESDAY, Sept. 18 (HealthDay News) -- Most electronic health record (EHR) systems meet meaningful use criteria, and these systems are associated with time-saving and other benefits, according to a September data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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High LDL Cholesterol Remains Common Among U.S. Adults

TUESDAY, Sept. 17 (HealthDay News) -- High low-density lipoprotein (LDL) cholesterol remains common among U.S. adults, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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More Than 1.6 Million Americans Expected to Get Cancer in 2013

TUESDAY, Sept. 17 (HealthDay News) -- Although significant progress has been made in treating cancer, more than 1.6 million Americans are projected to receive a cancer diagnosis in 2013, according to the third American Association for Cancer Research's Cancer Progress Report 2013.

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Office Employees 'Too Tired' to Exercise

TUESDAY, Sept. 17 (HealthDay News) -- Barriers and enablers for good nutrition and physical activity influence employee health behaviors, according to research published online Sept. 12 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Americans Living Longer, Healthier Lives

MONDAY, Sept. 16 (HealthDay News) -- Health surveys show that quality-adjusted life expectancy has increased by about two years in U.S. adults over the past 20 years, according to research published online Sept. 12 in the American Journal of Public Health.

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Cinnamon Cuts Blood Glucose Levels in Diabetes Patients

MONDAY, Sept. 16 (HealthDay News) -- Consumption of cinnamon is associated with favorable reductions in plasma glucose and lipid levels, according to research published in the September/October issue of the Annals of Family Medicine.

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High Burden of Endocarditis in Older Adults

FRIDAY, Sept. 13 (HealthDay News) -- The 2007 American Heart Association guidelines recommending a restriction of antibiotic prophylaxis have not increased the rates of hospitalization or adjusted mortality for endocarditis among Medicare beneficiaries, although the burden of endocarditis is high, according to a study published online Aug. 28 in the Journal of the American College of Cardiology.

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Farmers' Market Coupons Up Produce Purchases for Poor

FRIDAY, Sept. 13 (HealthDay News) -- Health Bucks, a farmers' market incentive coupon program, increases access to produce in low-income communities, according to research published online Aug. 29 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Mindfulness Training Beneficial for Clinicians, Patients

THURSDAY, Sept. 12 (HealthDay News) -- Mindfulness training is associated with improvements in physician burnout; and, clinicians who rate themselves as more mindful engage in more patient-centered communication, according to two studies published in the September/October issue of the Annals of Family Medicine.

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Whole-Body MRI Helps Predict CVD Burden in Diabetes Patients

THURSDAY, Sept. 12 (HealthDay News) -- Whole-body magnetic resonance imaging (MRI) predicts cardiac and cerebrovascular disease burden in patients with diabetes mellitus (DM), according to a study published online Sept. 10 in Radiology.

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Insulin Status Impacts Weight-Loss-Associated Vascular Gains

THURSDAY, Sept. 12 (HealthDay News) -- The positive vascular effects of weight reduction in obese patients are partially determined by insulin status, according to a study published online Sept. 4 in the Journal of the American College of Cardiology.

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Inclusion of ABI May Better Identify Vascular Disease

WEDNESDAY, Sept. 11 (HealthDay News) -- Inclusion of the ankle/brachial index (ABI) may better identify vascular disease in patients with non-valvular atrial fibrillation (NVAF), according to a study published online Aug. 14 in the Journal of the American College of Cardiology.

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Women May Benefit More From Interval Training

WEDNESDAY, Sept. 11 (HealthDay News) -- For running, women may benefit more from high intensity interval training (HIIT), according to a study published in the September issue of the Journal of Strength and Conditioning Research.

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Poorer Outcomes After Non-Cardiac Surgery in DM

WEDNESDAY, Sept. 11 (HealthDay News) -- For patients undergoing non-cardiac surgery, diabetes is associated with adverse perioperative complications and mortality, according to a study published online Aug. 29 in Diabetes Care.

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Autonomic Dysfunction Predicts Cardiovascular Events in T2DM

WEDNESDAY, Sept. 11 (HealthDay News) -- Autonomic dysfunction predicts cardiovascular events for patients with type 2 diabetes; and, the presence of cardiovascular autonomic neuropathy (CAN) predicts severe hypoglycemia (SH) in type 2 diabetes, according to two studies published online Aug. 19 in Diabetes Care.

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Individual Physician-Level Incentives Improve BP Control

TUESDAY, Sept. 10 (HealthDay News) -- Individual physician-level financial incentives are associated with greater blood pressure control or appropriate response to uncontrolled blood pressure, but neither physician-level nor practice-level incentives result in greater use of guideline-recommended medications, according to a study published in the Sept. 11 issue of the Journal of the American Medical Association.

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Performance-for-Pay Incentives Improve Cardiovascular Care

TUESDAY, Sept. 10 (HealthDay News) -- Performance-for-pay (P4P) incentives correlate with improvements in cardiovascular health care quality in electronic health record (EHR)-enabled small primary care clinics; and, EHR use is associated with less health care utilization among patients with diabetes, according to two studies published in the Sept. 11 issue of the Journal of the American Medical Association.

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Prevalence of Hospitalization Due to Hypertensive Disease Up

TUESDAY, Sept. 10 (HealthDay News) -- From 1980 to 2007, the prevalence of hospitalization attributable to hypertensive disease increased for U.S. adults, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Cardiac Imaging Not Useful for Screening Healthy Athletes

TUESDAY, Sept. 10 (HealthDay News) -- The prognostic value of using cardiac imaging to screen healthy athletes is uncertain, according to research published in the Sept. 1 issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

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Treatment in Critical Care Often Perceived As Futile

TUESDAY, Sept. 10 (HealthDay News) -- Intensive care unit (ICU) treatment is frequently perceived as futile by critical care specialists, and entails considerable costs, according to a study published online Sept. 9 in JAMA Internal Medicine.

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Measures of Glucose and its Variability Are Inter-Related

TUESDAY, Sept. 10 (HealthDay News) -- Hemoglobin A1c (HbA1c) and glycated albumin (GA) are inter-related and correlate with retinopathy and nephropathy, while only HbA1c correlates with cardiovascular disease, according to a study published online Aug. 29 in Diabetes.

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About Half of Health Care Providers Are 'Digital Omnivores'

TUESDAY, Sept. 10 (HealthDay News) -- About half of health care providers are "digital omnivores," meaning they use a tablet, smartphone, and laptop/desktop computer routinely in a professional capacity, according to a report published by Epocrates.

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AHA Defines 'Severely Obese' As New Risk Category for Youth

MONDAY, Sept. 9 (HealthDay News) -- Severely obese is a newly defined class of risk which characterizes about 5 percent of U.S. children and teens, according to an American Heart Association (AHA) scientific statement published online Sept. 9 in Circulation.

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Cardiac Risk Assessed in Adult Survivors of Childhood Cancer

MONDAY, Sept. 9 (HealthDay News) -- Modifiable cardiovascular risk factors, particularly hypertension, add to the treatment-associated risk of major cardiac events in adult survivors of childhood cancer, according to research published online Sept. 3 in the Journal of Clinical Oncology.

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'Meaningful Use' Achievement Not Uniform Across Hospitals

MONDAY, Sept. 9 (HealthDay News) -- In regard to the adoption of electronic health records (EHRs), achievement of "meaningful use" criteria is not uniform across all hospitals, according to a study published in the August issue of Health Affairs.

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High Cholesterol Ups MI Risk More in Men Than Women

MONDAY, Sept. 9 (HealthDay News) -- Dyslipidemia seems to be more dangerous for men than women with regard to acute myocardial infarction (AMI) risk, according to a study published in the September issue of Epidemiology.

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Most Physicians Report Being Satisfied With Career Choice

MONDAY, Sept. 9 (HealthDay News) -- Most physicians report being satisfied with their career choice, although 40 percent would rethink their path given the chance to choose again, according to the 2013 Great American Physician Survey published in Physicians Practice.

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E-Cigarettes Modestly Effective for Helping Smokers Quit

MONDAY, Sept. 9 (HealthDay News) -- Electronic cigarettes (e-cigarettes) are modestly effective for helping smokers quit; and, a three-month television antismoking campaign is effective for increasing quit attempts, according to two studies published online Sept. 9 in The Lancet.

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New Stent Coating May Cut Risk of Clotting

FRIDAY, Sept. 6 (HealthDay News) -- A novel strategy using cyclopentenyl cytosine or other CTP synthase (CTPS) 1 inhibitors to coat stents can selectively block proliferation of smooth muscle cells (SMCs) without disturbing vascular repair and may potentially reduce the risk of blood clotting, according to research published online Sept. 5 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Moderate Exercise Doesn't Up Risk of Knee Osteoarthritis

THURSDAY, Sept. 5 (HealthDay News) -- Middle-aged adults who participate in moderate weekly physical activity do not increase their risk of knee osteoarthritis, according to a study published online Aug. 27 in Arthritis Care & Research.

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Low Cardiovascular Fitness Early in Life Linked to Later Epilepsy

WEDNESDAY, Sept. 4 (HealthDay News) -- Low cardiovascular fitness early in life is associated with an increased risk of epilepsy later in life, according to a study published online Sept. 4 in Neurology.

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Door-to-Balloon Times Have Improved in Primary PCI

WEDNESDAY, Sept. 4 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI), despite improvement in door-to-balloon times there has been no change in in-hospital mortality, according to a study published in the Sept. 5 issue of the New England Journal of Medicine.

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Sensor-Based Tracking System Helps With CRT Implantation

WEDNESDAY, Sept. 4 (HealthDay News) -- In patients requiring cardiac resynchronization therapy (CRT), implanting a CRT device via a sensor-based tracking system is safe and effective and requires much less fluoroscopy time, according to a study published online Sept. 3 in Circulation: Arrhythmia and Electrophysiology.

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Even Short Bouts of Higher-Intensity Activity Are Beneficial

WEDNESDAY, Sept. 4 (HealthDay News) -- Even short bouts of higher-intensity physical activity (PA) of less than 10 minutes are beneficial for prevention of weight gain, according to a study published online Sept. 1 in the American Journal of Health Promotion.

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Medication Adherence Up With Fixed Dose Combo Strategy

WEDNESDAY, Sept. 4 (HealthDay News) -- For patients with or at high risk of cardiovascular disease (CVD), a fixed-dose combination (FDC) strategy for antiplatelet, statin, and blood pressure lowering medications is associated with improved medication adherence and with reductions in systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C), according to a study published in the Sept. 4 issue of the Journal of the American Medical Association.

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Only Half of Hypertensive Adults Aware of Diagnosis

WEDNESDAY, Sept. 4 (HealthDay News) -- Among adults in 17 countries of varying incomes, only about half with hypertension are aware of the diagnosis, and among those treated, only about a third achieve blood pressure control, according to a study published in the Sept. 4 issue of the Journal of the American Medical Association.

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Docs' Confidence in Diagnosis Unrelated to Diagnostic Accuracy

TUESDAY, Sept. 3 (HealthDay News) -- Physicians' confidence in their diagnostic accuracy is not associated with actual diagnostic accuracy or with case difficulty, according to a study published online Aug. 26 in JAMA Internal Medicine.

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CDC: 200,000 Avoidable Deaths From Cardiovascular Disease

TUESDAY, Sept. 3 (HealthDay News) -- There were about 200,000 avoidable deaths from cardiovascular disease in 2010 in the United States, with deaths occurring disproportionately among those over 65 years old, males, non-Hispanic blacks, and those in the South, according to a report published in the Sept. 3 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Male-Female Physician Earnings Gap Has Persisted for 20 Years

TUESDAY, Sept. 3 (HealthDay News) -- For physicians, the male-female earnings gap has not changed significantly since 1987, according to a research letter published online Sept. 2 in JAMA Internal Medicine.

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USPSTF: Evidence Lacking for Ankle Brachial Index Screening

TUESDAY, Sept. 3 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) has found that there is currently insufficient evidence to weigh the benefits and harms of use of the ankle-brachial index (ABI) for screening for peripheral artery disease and for predicting cardiovascular disease risk, according to an evidence review and recommendation statement published in the Sept. 3 issue of the Annals of Internal Medicine.

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Employer-Based Health Insurance Premiums Rose Modestly in 2013

MONDAY, Sept. 2 (HealthDay News) -- Employer-sponsored health insurance premiums rose only modestly in 2013, according to research published in the August issue of Health Affairs.

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Workaholics Have Poorer Physical and Mental Health

MONDAY, Sept. 2 (HealthDay News) -- Workaholics, defined as those who work more than 50 hours per week, have reduced physical and mental well-being, according to researchers from Kansas State University.

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Physician's Briefing