March 2014 Briefing - Diabetes & Endocrinology

Here are what the editors at HealthDay consider to be the most important developments in Diabetes & Endocrinology for March 2014. 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.

Health Behavior Change Cuts CVD Risk After T2DM Diagnosis

MONDAY, March 31, 2014 (HealthDay News) -- For adults newly diagnosed with type 2 diabetes, adoption of healthy behavior changes is associated with reduced cardiovascular disease (CVD) risk, according to a study published online March 21 in Diabetes Care.

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Post-Discharge Deaths Drop in Young Acute MI Patients

MONDAY, March 31, 2014 (HealthDay News) -- In the most recent decade, compared with earlier decades, post-discharge death rates have dropped for young adults hospitalized for acute myocardial infarction (AMI), according to research published in the April 1 issue of The American Journal of Cardiology.

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Muscular Strength Linked to Teen Cardiometabolic Risk

MONDAY, March 31, 2014 (HealthDay News) -- Higher muscular strength correlates with lower cardiometabolic risk for adolescents, according to a study published online March 31 in Pediatrics.

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'White Coat Effect' Is Smaller for Nurses Than Doctors

FRIDAY, March 28, 2014 (HealthDay News) -- Doctors' readings of blood pressure are often higher than measurements made by nurses at the same visit, according to research published in the April issue of the British Journal of General Practice.

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Coronary CT Angiography IDs Cardiac Allograft Vasculopathy

FRIDAY, March 28, 2014 (HealthDay News) -- Noninvasive coronary computed tomography angiography (CCTA) is a reliable alternative to coronary angiography for detection of cardiac allograft vasculopathy (CAV), according to a meta-analysis published online March 26 in the Journal of the American College of Cardiology.

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Depression May Worsen Kidney Disease in Diabetes Patients

FRIDAY, March 28, 2014 (HealthDay News) -- Patients with diabetes who have comorbid major depression may be at greater risk of end-stage renal disease (ESRD), according to research published online March 27 in the Clinical Journal of the American Society of Nephrology.

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NCHS Estimates Health Insurance Coverage for 2013

THURSDAY, March 27, 2014 (HealthDay News) -- In the first nine months of 2013, 6.7 percent of children and 20.5 percent of adults were uninsured, according to a study published online March 27 by the National Center for Health Statistics (NCHS).

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Neck Circumference Not Tied to Subclinical Atherosclerosis

THURSDAY, March 27, 2014 (HealthDay News) -- Neck circumference (NC) is not associated with either coronary or carotid subclinical atherosclerosis, according to a study published online March 19 in Clinical Cardiology.

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White House Extends Affordable Care Act Enrollment Deadline

WEDNESDAY, March 26, 2014 (HealthDay News) -- Americans who've started applying for health insurance under the Affordable Care Act but can't complete the process by the March 31 enrollment deadline will be given an extension.

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1 in 25 Inpatients Has Health Care-Associated Infection Daily

WEDNESDAY, March 26, 2014 (HealthDay News) -- There were an estimated 648,000 patients with 721,800 health care-associated infections in U.S. acute care hospitals in 2011, according to research published in the March 27 issue of the New England Journal of Medicine.

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Glycated Hemoglobin Values Add Little to CVD Risk Prediction

WEDNESDAY, March 26, 2014 (HealthDay News) -- Addition of information on hemoglobin A1c (HbA1c) to conventional cardiovascular risk factors provides little benefit in terms of cardiovascular disease (CVD) risk prediction, according to a study published in the March 26 issue of the Journal of the American Medical Association.

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Physically Active Youth May Retain Bone Health

WEDNESDAY, March 26, 2014 (HealthDay News) -- Bone size and strength developed with physical activity in males during youth is maintained to some extent in old age, regardless of activity level, according to research published online March 24 in the Proceedings of the National Academy of Sciences.

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Americans Seem Unprepared for Health Insurance Exchanges

WEDNESDAY, March 26, 2014 (HealthDay News) -- Individuals in the United States seem not to be sufficiently informed about the health insurance exchanges established by the Affordable Care Act (ACA), according to a study published online March 24 in the Proceedings of the National Academy of Sciences.

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AMA Introduces Medical Education Initiative

WEDNESDAY, March 26, 2014 (HealthDay News) -- The American Medical Association's (AMA) Accelerating Change in Education initiative is being introduced in 11 medical schools in an effort to shift the focus of education toward real-world practice and competency assessment, according to an AMA report.

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Childhood Abuse May Up Risk of Adult Obesity

TUESDAY, March 25, 2014 (HealthDay News) -- Early-life adversity may contribute to metabolic abnormalities that lead to obesity later in life, according to research published online March 20 in the Journal of Clinical Endocrinology & Metabolism.

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Surgical Site Infection Rate Down With Lower Target Glucose

TUESDAY, March 25, 2014 (HealthDay News) -- For patients undergoing hepato-biliary-pancreatic surgery, having a lower blood glucose target (4.4 to 6.1 mmol/L) is associated with reduced incidence of surgical site infection (SSI), according to a study published online March 12 in Diabetes Care.

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Pharmacokinetics of Cetrorelix Altered in Obese Women

TUESDAY, March 25, 2014 (HealthDay News) -- The pharmacokinetics of the gonadotropin-releasing hormone (GnRH) antagonist, cetrorelix, are altered in obese women, according to a study published online March 20 in the Journal of Clinical Endocrinology & Metabolism.

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Patient Request Impacts Doc Prescribing Behavior

MONDAY, March 24, 2014 (HealthDay News) -- Patients requesting specific medications are more likely to be prescribed those medications, according to research published in the April issue of Medical Care.

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Review: Recently Diagnosed Diabetes Linked to Pancreatic CA

MONDAY, March 24, 2014 (HealthDay News) -- There is a strong association between pancreatic ductal adenocarcinoma (PDAC) and recently diagnosed diabetes mellitus (DM), according to a systematic review and meta-analysis published in the March issue of the Annals of Surgical Oncology.

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Practices Can Take Steps to Improve Care Transitions

FRIDAY, March 21, 2014 (HealthDay News) -- Implementation of a rigorous process can improve transitions of care, according to an article published March 10 in Medical Economics.

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ω-3 Fatty Acids, Xanthophylls Don't Cut CVD Risk

FRIDAY, March 21, 2014 (HealthDay News) -- Dietary supplementation with ω-3 polyunsaturated fatty acids or macular xanthophylls do not seem to reduce the risk of cardiovascular disease (CVD) in older adults with age-related macular degeneration, according to a study published online March 17 in JAMA Internal Medicine.

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Statin Costs Impact Value of Coronary Artery Calcium Test

FRIDAY, March 21, 2014 (HealthDay News) -- For patients at intermediate risk of coronary heart disease (CHD), coronary artery calcium (CAC) measurement and targeted statin treatment is cost-effective if statin assumptions are less favorable (costly or impact quality of life), according to research published online March 11 in Circulation: Cardiovascular Quality and Outcomes.

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Large Waist Size Ups Risk of Premature Mortality

FRIDAY, March 21, 2014 (HealthDay News) -- Among white adults, larger waist is associated with increased mortality at all levels of body mass index (BMI), according to research published in the March issue of the Mayo Clinic Proceedings.

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Fried Food Consumption Interacts With Gene-Adiposity Link

FRIDAY, March 21, 2014 (HealthDay News) -- Consumption of fried foods may influence the genetic association with adiposity, according to a study published March 19 in BMJ.

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Resolved Childhood Glomerular Disease Linked to HTN Risk

THURSDAY, March 20, 2014 (HealthDay News) -- Resolved childhood glomerular disease is associated with increased subsequent risk of hypertension, according to a research letter published in the March 19 issue of the Journal of the American Medical Association.

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Midlife Diabetes May Contribute to Later Cognitive Decline

THURSDAY, March 20, 2014 (HealthDay News) -- Midlife onset of diabetes and hypertension each may contribute to cognitive impairment later in life, according to research published online March 19 in Neurology.

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Exercise Ups Mitochondrial Biogenesis in Adipose Tissue

THURSDAY, March 20, 2014 (HealthDay News) -- Exercise training increases mitochondrial biogenesis, mitochondrial DNA (mtDNA) content, and glucose uptake in the subcutaneous adipose tissue of wild type, but not endothelial nitric oxide synthase (eNOS) knockout mice, according to research published online March 12 in Diabetes.

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Mortality Rates Higher in Cancer Patients With Diabetes

WEDNESDAY, March 19, 2014 (HealthDay News) -- The comorbid condition of diabetes may contribute to increased mortality in patients with cancer, according to research published online March 13 in Diabetologia.

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Continuity of Care Improves Outcomes in Chronic Disease

WEDNESDAY, March 19, 2014 (HealthDay News) -- For Medicare beneficiaries with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and type 2 diabetes mellitus (T2DM), continuity of care is associated with differences in costs, emergency department use, and complications, according to a study published online March 17 in JAMA Internal Medicine.

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For Girls, Obesity at Age 11 Impairs Academic Attainment

TUESDAY, March 18, 2014 (HealthDay News) -- For girls, obesity at age 11 years has a negative effect on academic attainment, according to a study published online March 11 in the International Journal of Obesity.

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Treatment, Control of HTN Lacking in U.S. Hispanics/Latinos

TUESDAY, March 18, 2014 (HealthDay News) -- For U.S. Hispanics/Latinos, treatment and control of hypertension is inadequate, especially among those without health insurance, according to a study published online March 12 in the American Journal of Hypertension.

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Personality Measures in Young Patients Predict Later Health

TUESDAY, March 18, 2014 (HealthDay News) -- Personality measurements can be useful tools in predicting which young adult patients will have poor health in middle age, according to a study published in the March issue of the Journal of Personality and Social Psychology.

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No Evidence Fatty Acid Guidelines Cut Coronary Risk

TUESDAY, March 18, 2014 (HealthDay News) -- Evidence does not support the current fatty acid consumption guidelines, according to a review published in the March 18 issue of the Annals of Internal Medicine.

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Rx Expenditures Expected to Rise in 2014

MONDAY, March 17, 2014 (HealthDay News) -- Drug costs are projected to rise 3 to 5 percent across all care settings in 2014, according to a study published in the March 15 issue of the American Journal of Health-System Pharmacy.

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Insurers Must Offer Same-Sex Couples Spousal Benefits

MONDAY, March 17, 2014 (HealthDay News) -- Health plans that offer benefits for heterosexual couples must do the same for same-sex married couples, the Obama administration says.

Other Health Highlights: March 17, 2014

Oxytocin Seems Beneficial for Patients With Anorexia

MONDAY, March 17, 2014 (HealthDay News) -- For females with anorexia nervosa, oxytocin attenuates attentional vigilance to eating and fat shape stimuli and affects attentional processes to social emotional stimuli, according to two studies published online in Psychoneuroendocrinology and PLOS ONE.

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Improving EHR Interoperability Is a National Priority: HHS

FRIDAY, March 14, 2014 (HealthDay News) -- Interoperability of electronic health record (EHR) systems is a national priority of the Office of the National Coordinator for Health Information Technology, according to an article published March 4 in Medical Economics.

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Chronic Hyperglycemia Tied to Worse Surgical Outcomes

FRIDAY, March 14, 2014 (HealthDay News) -- Chronic hyperglycemia (A1C >8 percent) is associated with poor surgical outcomes, as measured by an increased hospital length of stay (LOS), according to a study published in the March issue of Diabetes Care.

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CDC: Most Alcohol-Linked Deaths Occur Among Working-Age Adults

FRIDAY, March 14, 2014 (HealthDay News) -- Americans' excessive alcohol use contributes to thousands of deaths each year, and the majority who die are working-age adults, according to a report published in the March 14 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Gestational Diabetes Ups Risk of Early Atherosclerosis

FRIDAY, March 14, 2014 (HealthDay News) -- Among women who have not developed diabetes or metabolic syndrome, a history of gestational diabetes mellitus (GDM) may be a marker for early atherosclerosis, according to research published online March 12 in the Journal of the American Heart Association.

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Body Mass Index Linked to Methylation at HIF3A Locus

THURSDAY, March 13, 2014 (HealthDay News) -- For adults of European origin, increased body mass index (BMI) is associated with methylation at three sites in intron 1 of HIF3A, according to a study published online March 13 in The Lancet.

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Oldest Old at High Risk for Insulin-Related Hypoglycemia

THURSDAY, March 13, 2014 (HealthDay News) -- Among insulin-treated patients, those 80 years of age and older have the highest rate of emergency department visits and subsequent hospitalizations for insulin-related hypoglycemia and errors (IHEs), according to research published online March 10 in JAMA Internal Medicine.

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Health Education Not Routinely Provided to Patients

THURSDAY, March 13, 2014 (HealthDay News) -- For patients with chronic disease, health providers do not routinely provide health education, according to a study published March 6 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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AMA: CMS Wants Physician Input on Practice Transformation

WEDNESDAY, March 12, 2014 (HealthDay News) -- Physicians are being given the opportunity to describe what resources they need in order to transition to value-based models of care, according to a report published by the American Medical Association (AMA).

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Info, Motivation, Behavioral Skill Affect Med Adherence

WEDNESDAY, March 12, 2014 (HealthDay News) -- Patients' adherence-related information, motivation, and behavioral skills (IMB) are important targets for interventions promoting adherence to diabetes medications, according to a study published online March 5 in Diabetes Care.

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Medicare Drug Plan Changes Withdrawn by White House

TUESDAY, March 11, 2014 (HealthDay News) -- Proposed changes to the Medicare prescription drug program have been withdrawn by the Obama administration after strong opposition from patient groups.

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Discrepancies ID'd in Studies on ClinicalTrials.gov, Journals

TUESDAY, March 11, 2014 (HealthDay News) -- Nearly all clinical trials reported on ClinicalTrials.gov and published in high-impact journals report at least one discrepancy in cohort, intervention, or results, according to a research letter published in the March 12 issue of the Journal of the American Medical Association.

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White House: More Than Four Million Have Signed Up for ACA

TUESDAY, March 11, 2014 (HealthDay News) -- More than four million Americans have signed up for health coverage through state and federal insurance marketplaces established by the Affordable Care Act, the Obama administration announced Tuesday.

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For Obese Teens, Sleep Duration Predicts Cardiometabolic Risk

TUESDAY, March 11, 2014 (HealthDay News) -- For obese adolescents, sleep duration independently predicts cardiometabolic risk, according to a study published online March 6 in The Journal of Pediatrics.

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Keeping Salaries Secret Harms Worker Performance

MONDAY, March 10, 2014 (HealthDay News) -- Keeping salaries secret hurts worker performance and increases turnover of top talent, according to a study published online Jan. 13 in the Academy of Management Journal.

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Consultant Offers Tips for Evaluating Staff Pay

MONDAY, March 10, 2014 (HealthDay News) -- Setting salaries and dealing with raises for a practice's staff can be tricky, according to an article published Feb. 24 in Medical Economics.

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AMA Grants Curriculum Efforts to Address Health Disparities

FRIDAY, March 7, 2014 (HealthDay News) -- Medical schools are beginning to change their curriculum to address ways to eliminate health disparities, according to the American Medical Association (AMA).

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Gender Gap Exists in Domestic Duties of Working Physicians

FRIDAY, March 7, 2014 (HealthDay News) -- Gender differences exist in domestic activities among career-oriented academic physicians with children, according to a study published online March 3 in the Annals of Internal Medicine.

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In STEMI, Hyperglycemia Tied to Larger Myocardial Area-at-Risk

FRIDAY, March 7, 2014 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction (STEMI), hyperglycemia is associated with larger area-at-risk and infarct size, and the effect of exenatide treatment is independent of glucose levels, according to a study published online Feb. 28 in Diabetes.

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Relative Value Units Useful In Evaluating Practice Finances

THURSDAY, March 6, 2014 (HealthDay News) -- The Relative Value Unit (RVU) is a useful tool for managing practice finances, according to an article published Feb. 25 in Medical Economics.

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Drop in Compensation Gap for Primary Care Docs, Specialists

THURSDAY, March 6, 2014 (HealthDay News) -- From 2012 to 2013, there was a 5.7 percent increase in the median total cash compensation for primary care physicians, with a smaller gap seen for medical and surgical specialists, according to the results of a recent survey from SullivanCotter.

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Web-Based Mental Health Screening Feasible, Acceptable

THURSDAY, March 6, 2014 (HealthDay News) -- For patients in general hospital settings, a routine web-based mental health screening is feasible and acceptable, according to a study published in General Hospital Psychiatry.

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Alcohol, Especially Wine, May Reduce CV Risk in Diabetes

THURSDAY, March 6, 2014 (HealthDay News) -- Moderate alcohol intake, particularly wine consumption, is associated with reduced risks of cardiovascular events in patients with type 2 diabetes, according to research published online Feb. 27 in Diabetes Care.

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Value-Based Insurance Plans Can Up Rx Adherence

WEDNESDAY, March 5, 2014 (HealthDay News) -- Value-based insurance design (VBID) plans with certain features aside from solely lowering cost sharing can increase medication adherence, according to a study published in the March issue of Health Affairs.

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Cognitive Behavioral Tx Helpful for Diabetes + Depression

WEDNESDAY, March 5, 2014 (HealthDay News) -- For adults with type 2 diabetes and depression, cognitive behavioral therapy for adherence and depression (CBT-AD) is associated with enduring benefits for diabetes self-management and glycemic control, according to a study published in the March issue of Diabetes Care.

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Gap in Regulatory Coverage Affects 5 to 16 Percent of Trials

WEDNESDAY, March 5, 2014 (HealthDay News) -- Human subjects protections (HSP) policies do not provide regulatory coverage for all clinical trials, while up to about a quarter of trials are considered overlap trials, according to a research letter published in the March 5 issue of the Journal of the American Medical Association.

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WHO Program Improves U.S. Medical Facility Hand Hygiene

WEDNESDAY, March 5, 2014 (HealthDay News) -- For U.S. health care facilities, participation in the World Health Organization (WHO) global campaign to improve hand hygiene practices is associated with improved hand hygiene, according to a study published in the March issue of the American Journal of Infection Control.

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TV in the Bedroom Associated With Increased BMI for Teens

TUESDAY, March 4, 2014 (HealthDay News) -- For children and adolescents, having a television in the bedroom is associated with increased body mass index (BMI), while active video gaming can increase physical activity and weight loss, according to two studies published online March 3 in JAMA Pediatrics.

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Sex Hormone-Binding Globulin Tied to Gestational Diabetes Risk

TUESDAY, March 4, 2014 (HealthDay News) -- Low prepregnancy sex hormone-binding globulin (SHBG) concentrations correlate with increased risk of gestational diabetes mellitus (GDM), according to a study published online Feb. 21 in Diabetes Care.

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Docs Nominate Top U.S. Internal Medicine Residency Programs

TUESDAY, March 4, 2014 (HealthDay News) -- The top U.S. internal medicine residency programs have been ranked by physicians and include Massachusetts General Hospital in Boston, Johns Hopkins University in Baltimore, Brigham and Women's Hospital in Boston, and the University of California in San Francisco, according to an article published by U.S. News & World Report.

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Cesarean Section Delivery Linked to Increased Offspring BMI

TUESDAY, March 4, 2014 (HealthDay News) -- Compared with vaginal delivery (VD), cesarean section (CS) delivery is associated with increased offspring body mass index (BMI) and increased odds of overweight and obesity, according to research published online Feb. 26 in PLOS ONE.

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Polydeoxyribonucleotide Aids Healing of Diabetic Foot Ulcers

TUESDAY, March 4, 2014 (HealthDay News) -- The adenosine A2A receptor agonist polydeoxyribonucleotide (PDRN) facilitates healing of diabetic foot ulcers in patients with diabetes, according to a study published online Jan. 31 in the Journal of Clinical Endocrinology & Metabolism.

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Single-Patient Trials Determine Statin Tolerability

MONDAY, March 3, 2014 (HealthDay News) -- In patients with statin-related myalgia, single-patient randomized trials of statin and placebo can determine whether the myalgia is actually due to the statin, according to a small study published in the March 4 issue of the Annals of Internal Medicine.

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Women-Specific Research Is Still Inadequate

MONDAY, March 3, 2014 (HealthDay News) -- Women are still underrepresented in medical science and research, and sex differences are often ignored, according to a report published March 3 by the Brigham and Women's Hospital.

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CMS: No More Delays to ICD-10 Implementation Deadline

MONDAY, March 3, 2014 (HealthDay News) -- There will be no more delays to the Oct. 1, 2014, deadline for implementation of the International Classification of Diseases, 10th Revision (ICD-10), according to an article published Feb. 27 in Medical Economics.

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PFCs Linked to Metabolic Changes in Overweight Kids

MONDAY, March 3, 2014 (HealthDay News) -- Exposure to perfluorinated and polyfluorinated chemicals is associated with increased insulin and triglyceride concentrations in overweight children, according to research published online Feb. 25 in the Journal of Clinical Endocrinology & Metabolism.

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