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April 2012 Briefing - Geriatrics

Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for April 2012. 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.

Stress Reduction Ups Health Status in Type 2 Diabetes

FRIDAY, April 27 (HealthDay News) -- A mindfulness-based stress reduction (MBSR) intervention is effective at improving health status and lowering levels of depression among patients with type 2 diabetes, according to a study published in the May issue of Diabetes Care.

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Childhood Socioeconomic Status Affects Brain Volume

FRIDAY, April 27 (HealthDay News) -- Childhood socioeconomic status affects hippocampal volume in older adults, after adjusting for adult socioeconomic status, gender, education, and other factors, according to a study published in the May issue of the Annals of Neurology.

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Sunscreen Use May Lead to Vitamin D Deficiency

FRIDAY, April 27 (HealthDay News) -- Using the amount and sun protection factor (SPF) of sunscreen recommended by the World Health Organization (WHO) is associated with little or no vitamin D production, suggesting that regular sunscreen use may lead to vitamin D deficiency, according to research published online April 18 in the British Journal of Dermatology.

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Berries May Slow Cognitive Decline in Older Women

THURSDAY, April 26 (HealthDay News) -- Flavonoid-rich blueberries and strawberries may reduce cognitive decline in elderly women, according to a study published online April 25 in the Annals of Neurology.

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Sleep of Short Duration Common in U.S. Workers

THURSDAY, April 26 (HealthDay News) -- A substantial proportion of workers in the United States get less sleep than recommended by the National Sleep Foundation, according to a report published in the April 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Nutrition, Exercise Guidelines Updated for Cancer Survivors

THURSDAY, April 26 (HealthDay News) -- The American Cancer Society has updated the 2006 guidelines to provide new evidence and clinical practices related to nutrition and physical activity for cancer survivors during the continuum of cancer care, according to a report published online April 26 in CA: A Cancer Journal for Clinicians.

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Heart Surgery Safe for Compensated Cirrhosis Patients

THURSDAY, April 26 (HealthDay News) -- Patients with compensated cirrhosis, defined by a Child-Pugh (CP) score of <8, have no significant increase in postoperative mortality and morbidity following cardiac surgery with cardiopulmonary bypass, according to a study published in the May issue of Clinical Gastroenterology and Hepatology.

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Subtype Best Predictor of Basal Cell Carcinoma Invasion Depth

THURSDAY, April 26 (HealthDay News) -- Basal cell carcinoma (BCC) subtype identified on biopsy and excision specimens is the best predictor of depth of invasion, according to a study published online April 16 in the Journal of the American Academy of Dermatology.

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Age, Life Expectancy Influence Termination of PSA Screening

THURSDAY, April 26 (HealthDay News) -- Most primary care providers consider both a man's age and life expectancy in deciding whether to discontinue prostate-specific antigen (PSA) screenings, but multiple factors are involved in this decision, according to a study published online April 19 in Cancer.

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Early Menopause Ups Risk of Osteoporosis, Fractures, Death

THURSDAY, April 26 (HealthDay News) -- The occurrence of menopause before age 47 correlates with increased osteoporosis at age 77, increased incidence of fragility fractures, and increased mortality, according to a study published online April 25 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Erosive, but Not Nonerosive, GERD Ups Esophageal CA Risk

WEDNESDAY, April 25 (HealthDay News) -- Patients with gastroesophageal reflux disease with a history of esophagitis are at increased risk for esophageal adenocarcinoma, although the absolute risk is low, according to a study published in the May issue of Clinical Gastroenterology and Hepatology.

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Warfarin Keeps Stroke Risk Low in Patients With A-Fib

WEDNESDAY, April 25 (HealthDay News) -- Use of warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (AF) is associated with a low risk of stroke or systemic embolism, according to a meta-analysis published in the April 23 issue of the Archives of Internal Medicine.

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Amyloid-β-Linked Cognitive Decline Linked to Phospho-Tau

WEDNESDAY, April 25 (HealthDay News) -- In cognitively normal older individuals, amyloid-β (Aβ)-associated longitudinal cognitive decline only occurs in the presence of elevated phospho-tau 181 (p-tau181p) in the cerebrospinal fluid (CSF), according to a study published online April 23 in the Archives of Neurology.

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Resistance Training Aids Memory in Senior Women

WEDNESDAY, April 25 (HealthDay News) -- For senior women with mild cognitive impairment, twice-weekly resistance training (RT) for six months is associated with improved cognition and brain plasticity compared with balance and tone (BAT) exercises, according to a research letter published in the April 23 issue of the Archives of Internal Medicine.

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Mortality High for Cardiac Device Infective Endocarditis

TUESDAY, April 24 (HealthDay News) -- Patients with infective endocarditis involving implanted cardiac devices experience high in-hospital and one-year mortality rates, particularly if there is valve involvement, according to a study published in the April 25 issue of the Journal of the American Medical Association.

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USPSTF Guidelines Haven't Changed PSA Screening Practice

TUESDAY, April 24 (HealthDay News) -- Despite the 2008 changes in U.S. Preventive Services Task Force (USPSTF) recommendations against prostate-specific antigen (PSA)-based screening for prostate cancer in men 75 years or older, screening rates remained unchanged for men of all ages between 2005 and 2010, according to a research letter published in the April 25 issue of the Journal of the American Medical Association.

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Subclinical Hyperthyroidism Tied to Coronary Heart Disease

TUESDAY, April 24 (HealthDay News) -- Subclinical hyperthyroidism is associated with increased risk of coronary heart disease (CHD) morbidity and mortality; and treatment with levothyroxine for subclinical hypothyroidism is associated with fewer ischemic heart disease (IHD) events in patients aged 40 to 70 years, according to two studies published online April 23 in the Archives of Internal Medicine.

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Hip Replacement Outcomes Similar With/Without Cement

TUESDAY, April 24 (HealthDay News) -- Hemiarthroplasty with the cemented Exeter implant provides pain relief comparable to hemiarthroplasty with the uncemented Alloclassic implant in elderly patients with a displaced femoral neck fracture, according to a study published in the April 4 issue of The Journal of Bone & Joint Surgery.

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Meds, Clinic Noncompliance Linked to Mortality in Diabetes

TUESDAY, April 24 (HealthDay News) -- Insulin-treated patients with type 2 diabetes who are noncompliant with their medication or clinic appointments face increased all-cause mortality, according to a study published online April 17 in Diabetes Care.

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Angiotensin Receptor Blockers Reduce No-Reflow Post-PCI

MONDAY, April 23 (HealthDay News) -- For patients with acute myocardial infarction (AMI), pretreatment with angiotensin receptor blockers (ARBs) is linked with reduced incidence of the no-reflow phenomenon after percutaneous coronary intervention (PCI), according to a study published online April 10 in Cardiovascular Therapeutics.

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Shingles Vaccine Generally Well Tolerated in Older Adults

MONDAY, April 23 (HealthDay News) -- The zoster vaccine is safe and well tolerated in older adults, despite an increased risk of allergic reaction in the days following vaccination, according to a study published in the Journal of Internal Medicine.

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Letting Go of Regret Linked to Healthy Aging

FRIDAY, April 20 (HealthDay News) -- Emotionally healthy aging is associated with an ability to let go of regrets and not dwell on missed opportunities, according to a study published online April 19 in Science.

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Race, Location Affect Probability of Survival to Age 70

FRIDAY, April 20 (HealthDay News) -- The probability of a person surviving from birth to age 70 varies according to geographic location and gender, with a set of 22 socioeconomic and environmental factors accounting for almost all the variation, according to a study published online April 17 in PLoS One.

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QRS Width on ECG Linked to Sudden Cardiac Arrest in CAD

FRIDAY, April 20 (HealthDay News) -- For patients with coronary artery disease (CAD), QRS width on electrocardiogram and echocardiographic evidence of heart failure are associated with out-of-hospital sudden cardiac arrest (SCA), regardless of whether they have a history of previous myocardial infarction (MI), according to a study published in the May 1 issue of The American Journal of Cardiology.

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Pulmonary HTN Predicts Heart Failure After Acute MI

THURSDAY, April 19 (HealthDay News) -- Pulmonary hypertension (PH) is a strong independent predictor of heart failure in patients with acute myocardial infarction (AMI), according to a study published in the May 1 issue of The American Journal of Cardiology.

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Eating Low-Fat Dairy Linked to Reduced Stroke Risk

THURSDAY, April 19 (HealthDay News) -- Eating low-fat dairy products is associated with a reduced risk of total stroke and cerebral infarctions, according to a study published online April 19 in Stroke.

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Long-Term Air Pollution Linked to Multiple Diseases

THURSDAY, April 19 (HealthDay News) -- Long-term exposure to fine particulate matter in the air increases hospital admissions for respiratory diseases, cardiovascular diseases, stroke, and diabetes in the elderly considerably more than short-term exposure does, according to a study published online April 17 in PLoS One.

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Review Shows Gum Disease Does Not Cause Heart Disease

THURSDAY, April 19 (HealthDay News) -- Periodontal disease (PD) and atherosclerotic vascular disease (ASVD) share common risk factors, but there is no evidence for a causal relationship between the two, nor evidence that treating PD prevents or alters the outcomes of ASVD, according to a scientific statement from the American Heart Association (AHA) published online April 18 in Circulation.

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Higher Daily Physical Activity Reduces Alzheimer's Risk

WEDNESDAY, April 18 (HealthDay News) -- Higher total daily physical activity is associated with a reduced risk of developing Alzheimer's disease (AD) and with a lower rate of cognitive decline, according to research published online April 18 in Neurology.

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Basal Cell Carcinoma on Ear Significantly More Aggressive

WEDNESDAY, April 18 (HealthDay News) -- Basal cell carcinoma (BCC) on the ear is significantly more likely to be aggressive, and occurs more frequently in men, according to a study published in the May issue of the Journal of the American Academy of Dermatology.

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Medicare Coverage Gap Leads to Drug Discontinuation

WEDNESDAY, April 18 (HealthDay News) -- Part D Medicare beneficiaries who do not have financial assistance during the coverage gap are at increased risk for cardiovascular drug discontinuation, according to research published online April 17 in Circulation: Cardiovascular Quality and Outcomes.

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Numerous Genetic Variants Linked to Bone Mineral Density

WEDNESDAY, April 18 (HealthDay News) -- Pooling the results of numerous studies, 56 genetic variants associated with bone mineral density have been identified, of which 14 are associated with fracture risk, according to a study published online April 15 in Nature Genetics.

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New Fibrate Use Ups Serum Creatinine Levels in Elderly

TUESDAY, April 17 (HealthDay News) -- For elderly adults, new fibric acid derivative (fibrate) use is associated with an increase in serum creatinine levels, in hospitalizations for these levels, and in nephrologist consultations, according to a study published in the April 17 issue of the Annals of Internal Medicine.

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ICD-9 Codes Underestimate Statin-Linked Rhabdomyolysis

TUESDAY, April 17 (HealthDay News) -- Use of diagnostic codes, such as International Classification of Diseases -- Ninth Revision (ICD-9) codes, may result in misclassification of rare, adverse drug reactions (ADRs), including the risk of rhabdomyolysis from high-dose simvastatin, according to a research letter published in the April 18 issue of the Journal of the American Medical Association, a theme issue on comparative effectiveness research.

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Nutrition, Mobility Predict Early Death in Elderly Cancer Patients

TUESDAY, April 17 (HealthDay News) -- Low nutritional assessment scores, poor mobility, and advanced disease predict early death after chemotherapy initiation among elderly patients with cancer, according to a study published online April 16 in the Journal of Clinical Oncology.

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Pain Correlates Most Strongly With Disability in Hispanics With RA

FRIDAY, April 13 (HealthDay News) -- For Hispanic patients with rheumatoid arthritis (RA), self-reported pain correlates most strongly with disability, according to a study published online April 5 in Arthritis Care & Research.

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Mentholated Cigarettes Linked to Increased Stroke Risk

THURSDAY, April 12 (HealthDay News) -- Mentholated cigarettes are associated with a significantly increased risk of stroke, particularly among women and non-African-American smokers, according to a letter published in the April 9 issue of the Archives of Internal Medicine.

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Role of Omega-3 in Secondary Prevention of CVD Questioned

THURSDAY, April 12 (HealthDay News) -- For patients with a history of cardiovascular disease (CVD), evidence is lacking for a secondary preventive effect of omega-3 fatty acid supplements, according to a meta-analysis published online April 9 in the Archives of Internal Medicine.

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Antidepressants Don't Worsen Parkinson's Symptoms

WEDNESDAY, April 11 (HealthDay News) -- The antidepressants paroxetine and venlafaxine extended release (XR) reduce depression without worsening motor function in patients with Parkinson's disease, according to a study published online April 11 in Neurology.

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Perception of Breast Cancer Care Differs From Actual Care Quality

WEDNESDAY, April 11 (HealthDay News) -- The perception of care for women living in inner cities with newly diagnosed, early-stage breast cancer is dependent, in large part, on factors other than the actual quality of care provided, including the quality of the process of getting care, trust in the physician, and perceptions of racism, according to research published online April 9 in the Journal of Clinical Oncology.

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BMD Loss Occurs Early in Androgen Deprivation Therapy

WEDNESDAY, April 11 (HealthDay News) -- The highest average change in bone mineral density (BMD) occurs during early treatment of nonmetastatic, hormone-sensitive prostate cancer in men receiving intermittent androgen deprivation therapy (ADT), according to research published online April 9 in the Journal of Clinical Oncology.

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Stroke Risk Much Higher If Sibling Has Had a Stroke

WEDNESDAY, April 11 (HealthDay News) -- Having a sibling who has had a stroke significantly increases the familial stroke risk by at least 60 percent, according to a study published online April 10 in Circulation: Cardiovascular Genetics.

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Mobile Stroke Units Halve Time to Treatment

WEDNESDAY, April 11 (HealthDay News) -- Diagnosis and treatment of stroke in patients at the scene of the emergency rather than at the hospital about halves the time to treatment, according to a study published online April 11 in The Lancet Neurology.

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ECG Abnormalities Add to Accuracy of CHD Risk Prediction

TUESDAY, April 10 (HealthDay News) -- Major and minor electrocardiographic (ECG) abnormalities are associated with an increased risk of coronary heart disease (CHD) events, particularly in elderly individuals, according to a study published in the April 11 issue of the Journal of the American Medical Association.

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Insurers Should Screen Older Smokers for Lung Cancer

TUESDAY, April 10 (HealthDay News) -- Lung cancer screening with low-dose spiral computed tomography could be of substantial value in high-risk smoker populations over the age of 50, and commercial insurers should consider providing coverage for the screening, according to a study published in the April issue of Health Affairs.

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Frequent, Older Dental X-Rays Linked to Brain Cancer

TUESDAY, April 10 (HealthDay News) -- Frequent bitewing or panorex dental X-rays taken on previous generations of machines are linked to an increased risk of intracranial meningioma, according to a study published online April 10 in Cancer.

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Urinary Incontinence Drugs Have Comparable Efficacy

MONDAY, April 9 (HealthDay News) -- Available pharmacotherapies for treating women with urinary incontinence (UI) produce comparable small benefits, according to research published online April 9 in the Annals of Internal Medicine.

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Infection May Be Trigger for Venous Thromboembolism

MONDAY, April 9 (HealthDay News) -- Older adults recovering from an infection are at increased risk of being hospitalized for a venous thromboembolism (VTE), according to a study published online April 3 in Circulation.

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Statins Moderate Effect of Metformin on Prostate Cancer

MONDAY, April 9 (HealthDay News) -- For men with type 2 diabetes treated with metformin, prostate cancer (PCa) incidence varies depending on statin use, with a significantly reduced risk for patients taking a combination of metformin and statins, according to a study published online March 28 in Diabetes Care.

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Lumbar Spinal Stenosis Lowers Health-Related QoL

FRIDAY, April 6 (HealthDay News) -- Patients diagnosed with lumbar spinal stenosis (LSS) have a substantial burden of illness and reduced health-related quality of life (HRQL) compared to the general population, and their HRQL is compounded by associated comorbidities, according to a study published in the March issue of The Spinal Journal.

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Immunotherapy Tied to Lower Alzheimer's CSF Biomarkers

FRIDAY, April 6 (HealthDay News) -- For patients with mild-to-moderate Alzheimer's disease, immunotherapy treatment with the anti-β-amyloid (Aβ) monoclonal antibody bapineuzumab results in lower concentrations of two cerebrospinal fluid (CSF) biomarkers: total (T)-tau and phosphorylated (P)-tau, according to a study published online April 2 in the Archives of Neurology.

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Physical Activity Predicts Functionality in Older Adults

FRIDAY, April 6 (HealthDay News) -- Physically active older adults experience significantly fewer functional limitations than more sedentary older adults, according to a study published online April 5 in the Journal of the American Geriatrics Society.

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Asbestos Exposure Linked to Cardiovascular Death

THURSDAY, April 5 (HealthDay News) -- Occupational exposure to asbestos is associated with a higher risk of dying of cardiovascular disease, according to a study published online April 2 in Occupational & Environmental Medicine.

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Flavonoid Intake May Protect Men Against Parkinson's

THURSDAY, April 5 (HealthDay News) -- Total flavonoid intake is significantly associated with a lower risk of Parkinson's disease (PD) in men, particularly the intake of anthocyanins and berries, according to a study published online April 4 in Neurology.

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Medical Malpractice Claims Incur Substantial Defense Costs

WEDNESDAY, April 4 (HealthDay News) -- Defense costs for medical malpractice claims vary among specialties and are higher for claims that result in indemnity payments, according to a letter published in the April 5 issue of the New England Journal of Medicine.

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End-of-Life Decline of Cognitive Functions Are Correlated

WEDNESDAY, April 4 (HealthDay News) -- In the last years of life, cognitive abilities decline rapidly, with a strong correlation between different functions; and cognitive activity is associated with cognitive function and predictive of cognitive decline, according to two studies published online April 4 in Neurology.

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Cancer Diagnosis Linked to Higher Immediate Suicide Risk

WEDNESDAY, April 4 (HealthDay News) -- A recent cancer diagnosis is associated with a higher risk of suicide and death from cardiovascular causes, with the risk being highest in the weeks after diagnosis, according to a study published in the April 5 issue of the New England Journal of Medicine.

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Metal-on-Metal Bearing Not Linked to Cancer Incidence

WEDNESDAY, April 4 (HealthDay News) -- Hip replacements with metal-on-metal bearing surfaces do not seem to be associated with cancer incidence, according to study published online April 3 in BMJ.

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Antibiotic-Resistant S. aureus Found in Many Ambulances

WEDNESDAY, April 4 (HealthDay News) -- Antibiotic-resistant strains of Staphylococcus aureus (S. aureus) are found in the majority of advanced life support (ALS) ambulances in the Chicago area, according to a study published in the April issue of the American Journal of Infection Control.

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Fluoroquinolone Use Linked to Retinal Detachment

TUESDAY, April 3 (HealthDay News) -- The use of the oral fluoroquinolone antibiotics is associated with an increased risk of retinal detachment, although the absolute risk is small, according to a study published in the April 4 issue of the Journal of the American Medical Association.

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Neupro Approved for Advanced Parkinson's and Restless Leg Syndrome

TUESDAY, April 3 (HealthDay News) -- The Neupro (rotigotine) transdermal system has been approved by the U.S. Food and Drug Administration to treat advanced Parkinson's disease and moderate-to-severe restless leg syndrome, the Belgian drug maker UCB said Tuesday in a news release.

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Obesity Epidemic in U.S. Worse Than Previously Thought

TUESDAY, April 3 (HealthDay News) -- The body mass index (BMI) substantially underdiagnoses obesity when compared to the dual-energy X-ray absorptiometry (DXA) scan, a direct simultaneous measure of body fat, muscle mass, and bone density, according to a study published online April 2 in PLoS One.

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Study Estimates Overdiagnosis From Mammography Screening

TUESDAY, April 3 (HealthDay News) -- Implementation of a mammography screening program leads to a substantial amount of overdiagnosis, according to a study published in the April 3 issue of the Annals of Internal Medicine.

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Serious Eye Disease Linked to Bisphosphonate Use

MONDAY, April 2 (HealthDay News) -- First-time users of oral bisphosphonates have an increased risk of both uveitis and scleritis compared with nonusers, according to a study published online April 2 in CMAJ, the journal of the Canadian Medical Association.

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In Taiwan, Diabetes Linked to Increased Parkinson's Risk

MONDAY, April 2 (HealthDay News) -- Individuals with diabetes in Taiwan have a significantly increased risk of Parkinson's disease (PD), which is robust across most age and gender stratifications, according to a study published online March 19 in Diabetes Care.

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More Complications After Thyroid Surgery in Elderly

MONDAY, April 2 (HealthDay News) -- Advanced age is a risk factor for complications after thyroidectomy, according to a study published online March 14 in the Journal of Clinical Endocrinology & Metabolism.

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