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April 2020 Briefing - Geriatrics

Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for April 2020. 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.

Symptomatic Health Care Staff in U.K. Screened for COVID-19

THURSDAY, April 30, 2020 (HealthDay News) -- Screening symptomatic health care workers for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is feasible during the pandemic, according to a research letter published online April 22 in The Lancet.

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Pandemic Disrupting Health Care for 55 Percent of Older Adults

THURSDAY, April 30, 2020 (HealthDay News) -- At least half of older adults report experiencing a disruption to their medical care at one month into social distancing in response to the COVID-19 pandemic, according to a survey released April 27 by NORC at University of Chicago.

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Food Insecurity Rates High Amid COVID-19 Pandemic

THURSDAY, April 30, 2020 (HealthDay News) -- Food insecurity in the United States is high as a result of the COVID-19 pandemic, according to a survey released April 23 by the University of Arkansas Community and Family Institute.

Press Release

Psoriasis Tied to Higher Alzheimer Disease Risk

THURSDAY, April 30, 2020 (HealthDay News) -- The incidence of Alzheimer disease (AD) is significantly higher in patients with psoriasis versus individuals without psoriasis, according to a Korean study published online April 15 in Scientific Reports.

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Men Have More Serious Disease, Higher Death Rate From COVID-19

THURSDAY, April 30, 2020 (HealthDay News) -- For patients with COVID-19, male gender is associated with worse outcomes, independent of age, according to a study published online April 29 in Frontiers in Public Health.

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Many Health Care Workers Face Risk for Poor Outcomes With COVID-19

WEDNESDAY, April 29, 2020 (HealthDay News) -- More than one-quarter of health care workers with patient contact are at risk for poor outcomes from COVID-19, according to a study published online April 28 in the Annals of Internal Medicine.

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David Shulkin, M.D., on COVID-19 Financial Consequences for Health Care System

MONDAY, April 27, 2020 (HealthDay News) -- Health care organizations are facing hard financial decisions amid the COVID-19 pandemic, but an end is in sight as some are beginning to slowly open back up around the country, according to David Shulkin, M.D. Shulkin, who served as ninth secretary for Veterans Affairs and is former president and CEO of Beth Israel Medical Center in New York, spoke with HealthDay during a live stream on the HealthDay YouTube channel and live blog.

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KIMT3 Article

Rheumatoid Arthritis Patients Remain Unaware of CV Risk

WEDNESDAY, April 29, 2020 (HealthDay News) -- Patients with rheumatoid arthritis (RA) have low awareness about associated cardiovascular (CV) risk, according to a study published online April 20 in ACR Open Rheumatology.

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Reviews Assess Tools to Identify, Diagnose, Treat Alzheimer Dementia

WEDNESDAY, April 29, 2020 (HealthDay News) -- Limited tools are available for identifying, diagnosing, and treating cognitive dysfunction from Alzheimer disease, according to three studies published online April 28 in the Annals of Internal Medicine.

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Abstract/Full Text -- Fink Study 1 (subscription or payment may be required)
Abstract/Full Text -- Fink Study 2 (subscription or payment may be required)
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Multicancer Blood Test, PET-CT Combo Feasible for Cancer Screen

WEDNESDAY, April 29, 2020 (HealthDay News) -- Multicancer blood testing combined with positron emission tomography-computed tomography (PET-CT) imaging can detect cancers, according to a study published online April 28 in Science to coincide with the virtual annual meeting of the American Association for Cancer Research.

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Nearly Half of U.S. Population Breathes Unhealthy Air

TUESDAY, April 28, 2020 (HealthDay News) -- Climate change continues to make air pollution worse, with 45.8 percent of the U.S. population living in counties with unhealthy ozone or particle pollution, according to the American Lung Association (ALA) 21st annual State of the Air report.

State of the Air Report

Low Vitamin D May Reduce Survival for Some With Multiple Myeloma

TUESDAY, April 28, 2020 (HealthDay News) -- Vitamin D deficiency is associated with reduced overall survival for patients with multiple myeloma (MM), with a differential effect across race, according to a study published online April 21 in Blood Advances.

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Neurologic Features Tied to ARDS in Severe COVID-19 Described

MONDAY, April 27, 2020 (HealthDay News) -- Acute respiratory distress syndrome (ARDS) due to COVID-19 is associated with neurologic features, including encephalopathy, agitation, and confusion, according to a letter to the editor published online April 15 in the New England Journal of Medicine.

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Hearing Loss Linked to Postural Instability in Older Adults

MONDAY, April 27, 2020 (HealthDay News) -- The odds of postural instability are increased in older adults with moderate or worse hearing loss, even when hearing loss is present on only one side, according to a study published online April 23 in JAMA Otolaryngology-Head & Neck Surgery.

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Infection Rate Up Prior to Detection of Malignant Cancer

FRIDAY, April 24, 2020 (HealthDay News) -- The rate of infection with influenza, gastroenteritis, hepatitis, and pneumonia is increased before detection of malignant cancer, according to a study published online April 17 in Cancer Immunology Research.

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COVID-19 Outcomes Worse With Diabetes, Hyperglycemia

FRIDAY, April 24, 2020 (HealthDay News) -- Diabetes and/or uncontrolled hyperglycemia occur frequently among hospitalized patients with COVID-19 and are associated with worse outcomes, according to a study accepted for publication in the Journal of Diabetes Science and Technology.

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ACEIs/ARBs Not Linked to Severity or Mortality of COVID-19

THURSDAY, April 23, 2020 (HealthDay News) -- For patients with hypertension hospitalized with COVID-19 infections, angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) are not associated with the severity or mortality of COVID-19, according to a brief report published online April 23 in JAMA Cardiology.

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Visual Impairment May Up Risk for Dementia in Older Women

THURSDAY, April 23, 2020 (HealthDay News) -- In older women, objectively measured visual impairment is associated with a twofold to more than fivefold increased risk for dementia, according to a study published online April 16 in JAMA Ophthalmology.

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Hydroxychloroquine Seems Not to Cut Ventilator Use in COVID-19

WEDNESDAY, April 22, 2020 (HealthDay News) -- There is no evidence that use of hydroxychloroquine alone (HC) or with azithromycin (HC+AZ) reduces the risks for mechanical ventilation or death from any cause in patients hospitalized with COVID-19, according to a study that has not yet been peer reviewed and was posted online April 21 at medRxiv.org.

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Processed Meat, Unhealthy Snack Food Networks Tied to Dementia

WEDNESDAY, April 22, 2020 (HealthDay News) -- Focused eating habits with high processed meats and unhealthy snacking may be associated with increased dementia risk, according to a study published online April 22 in Neurology.

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Clinical, Genetic, Biomarker Model IDs Risk for Pancreatic Cancer

WEDNESDAY, April 22, 2020 (HealthDay News) -- A model that includes data on clinical and genetic factors and circulating biomarkers may improve risk discrimination for pancreatic cancer, according to a study published online April 22 in Cancer Epidemiology, Biomarkers & Prevention.

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Living Alone Ups Admission Risk for Respiratory Disease in Seniors

WEDNESDAY, April 22, 2020 (HealthDay News) -- For older adults, the risk for hospital admission due to respiratory disease (RD) is increased in association with living alone and social disengagement, according to a study published online April 21 in Thorax.

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Scoring System Helps Guide Surgical Care During COVID-19

WEDNESDAY, April 22, 2020 (HealthDay News) -- A scoring system for medically necessary time-sensitive (MeNTS) procedures can facilitate decision making and triage in the setting of COVID-19, according to a study published online April 9 in the Journal of the American College of Surgeons.

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Alone, Low Vitamin D Does Not Cause Osteoporotic Fractures

WEDNESDAY, April 22, 2020 (HealthDay News) -- While low blood levels of vitamin D are associated with osteoporotic fractures, the link is not causative, according to the results of an analysis published online April 7 in Clinical Chemistry.

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Coinfection With SARS-CoV-2, Other Respiratory Pathogens ID'd

TUESDAY, April 21, 2020 (HealthDay News) -- About 20 percent of specimens positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are positive for other respiratory pathogens, according to a research letter published online April 15 in the Journal of the American Medical Association.

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Cardiac Cath Lab STEMI Activations Drop During Pandemic

TUESDAY, April 21, 2020 (HealthDay News) -- During the COVID-19 pandemic, there has been a 38 percent reduction in U.S. cardiac catheterization laboratory ST-segment elevation myocardial infarction (STEMI) activations, according to a research letter published online April 10 in the Journal of the American College of Cariology.

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Most Older Adults With New Dementia Die Within Five Years

TUESDAY, April 21, 2020 (HealthDay News) -- Most community-dwelling older adults with newly identified dementia die or are admitted to a long-term care home within five years, according to a study published online April 20 in CMAJ, the journal of the Canadian Medical Association.

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Diabetes Increases Risk for Poorer Prognosis in COVID-19

MONDAY, April 20, 2020 (HealthDay News) -- Diabetes may contribute to more severe symptoms, rapid progression, and poorer prognosis in patients infected with COVID-19, according to a study published online March 31 in Diabetes Metabolism Research and Reviews.

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Benefit of Social Distancing Outweighs Economic Impact

MONDAY, April 20, 2020 (HealthDay News) -- The economic benefits of lives saved through social distancing substantially outweigh the value of the projected losses to the U.S. economy, according to a study to be published in a forthcoming issue of the Journal of Benefit-Cost Analysis.

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IDSA Issues Rapid Guidelines for Treatment of COVID-19

FRIDAY, April 17, 2020 (HealthDay News) -- In rapid guidelines issued by the Infectious Diseases Society of America (IDSA), recommendations are presented for the treatment and management of coronavirus disease 2019 (COVID-19).

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Chest X-Ray Findings Normal for Many Confirmed COVID-19 Cases

FRIDAY, April 17, 2020 (HealthDay News) -- Most patients presenting to urgent care centers with confirmed coronavirus disease 2019 (COVID-19) have normal or mildly abnormal findings on chest X-rays (CXRs), according to a study published online April 14 in the Journal of Urgent Care Medicine.

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Risk for Severe COVID-19 May Be Up in People With COPD, Smokers

FRIDAY, April 17, 2020 (HealthDay News) -- Active cigarette smokers and individuals with chronic obstructive pulmonary disease (COPD) have up-regulation of angiotensin converting enzyme II (ACE-2) expression in the lower airways, which could explain the increased risk for severe COVID-19 in these subpopulations, according to a study published online April 8 in the European Respiratory Journal.

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Prevalence of Autoimmunity May Be on the Rise

THURSDAY, April 16, 2020 (HealthDay News) -- The prevalence of antinuclear antibodies (ANA) in the United States has increased considerably between 1988 and 2012, according to a study published online April 7 in Arthritis & Rheumatology.

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Regardless of Genetics, Obesity Ups Risk for Type 2 Diabetes

THURSDAY, April 16, 2020 (HealthDay News) -- Having normal body weight is crucial in the prevention of type 2 diabetes, regardless of genetic predisposition, according to a study published online April 15 in Diabetologia.

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BP Levels Influence Racial Differences in Cognitive Decline

THURSDAY, April 16, 2020 (HealthDay News) -- Black individuals' higher cumulative blood pressure (BP) levels may influence racial differences in cognitive decline, according to a study published online April 13 in JAMA Neurology.

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SARS-CoV-2 Contamination of Air, Surfaces Examined in ICU, Wards

WEDNESDAY, April 15, 2020 (HealthDay News) -- Considerable severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) contamination of air and object surfaces is reported in intensive care units (ICUs) and general coronavirus disease 2019 (COVID-19) wards (GW), according to a study published online April 10 in Emerging Infectious Diseases, a publication of the U.S. Centers for Disease Control and Prevention.

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Risk for Cognitive Decline Reduced With Adherence to aMED Diet

WEDNESDAY, April 15, 2020 (HealthDay News) -- Closer adherence to the alternative Mediterranean diet (aMED) is associated with a reduced risk for cognitive decline, but not with slower decline in cognitive function, according to a study published online April 13 in Alzheimer's & Dementia.

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Medical Masks May Be Sufficient During COVID-19 Routine Care

TUESDAY, April 14, 2020 (HealthDay News) -- Use of medical masks, such as surgical or procedural masks, does not increase the risk for viral infection or respiratory illness, and their use may serve as a protective measure in instances of N95 respirator shortages, according to the results of a meta-analysis published online April 4 in Influenza and Other Respiratory Viruses.

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KL-VSHET+ Genotype Linked to Reduced Alzheimer Disease Risk

TUESDAY, April 14, 2020 (HealthDay News) -- Klotho-VS heterozygosity (KL-VSHET+ status) is associated with a reduced risk for Alzheimer disease (AD) and β-amyloid (Aβ) burden in cognitively normal individuals aged older than 60 years who carry apolipoprotein e4 (APOE4), according to research published online April 13 in JAMA Neurology.

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Kidney Transplants From, to Extreme Elderly Feasible in ESRD

TUESDAY, April 14, 2020 (HealthDay News) -- Kidney transplantation among elderly people with end-stage renal disease (ESRD) can be successful, allowing them to live dialysis-free, according to a study recently published in Nephrology Dialysis Transplantation.

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High Rates of Appropriate E-Consults Seen Across Specialties

MONDAY, April 13, 2020 (HealthDay News) -- The rates of appropriate electronic consultations (e-consults) are high across specialties, according to a study published online April 14 in the Annals of Internal Medicine.

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Air Pollution May Hasten Cognitive Decline in Older Adults

THURSDAY, April 8, 2020 (HealthDay News) -- Exposure to air pollution may have adverse effects on cognitive aging and brain health in older adults, according to a study published online April 8 in Neurology.

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'Dead' Probiotic Treatment May Help Reduce Irritable Bowel Symptoms

THURSDAY, April 9, 2020 (HealthDay News) -- Probiotic treatment with dead bacteria is better than placebo at alleviating symptoms of irritable bowel syndrome (IBS), according to a study published online April 8 in The Lancet Gastroenterology & Hepatology.

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Claims-Based Frailty Index Can Improve Cost Prediction

WEDNESDAY, April 8, 2020 (HealthDay News) -- A claims-based frailty index can improve current Medicare cost prediction for patients with different levels of frailty, according to a study published online April 7 in the Annals of Internal Medicine.

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Heavy Drinking Tied to Larger Waist Lines, Higher Stroke Risk

WEDNESDAY, April 8, 2020 (HealthDay News) -- Heavy drinkers who continue drinking into old age have significantly larger waistlines and increased stroke risk, according to a study published online March 31 in Addiction.

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Majority of Physicians Report Serious Concerns About COVID-19

MONDAY, April 6, 2020 (HealthDay News) -- According to a national survey conducted by Harvard Medical School, the RAND Corporation, and Doximity, practicing physicians currently report substantial concerns about supplies, the government response, and availability of testing amid the COVID-19 pandemic.

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Social Distancing Minimizes COVID-19 Spread in Assisted Living

MONDAY, April 6, 2020 (HealthDay News) -- Early implementation of social distancing and preventive measures after identification of coronavirus disease 2019 (COVID-19) can minimize virus spread in senior independent and assisted living communities, according to research published in the April 3 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Initial Invasive Strategy No Better in Stable Coronary Disease

MONDAY, April 6, 2020 (HealthDay News) -- For patients with stable coronary disease and moderate-to-severe ischemia, an initial invasive strategy does not improve outcomes, but it may improve angina-related health status, according to two studies published online March 30 in the New England Journal of Medicine.

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Bacteremia Risk Higher in Older Patients Hospitalized With IBD

MONDAY, April 6, 2020 (HealthDay News) -- Older age is associated with an increased risk for bacteremia in hospitalized patients with inflammatory bowel disease (IBD), according to a study published in the March issue of the United European Gastroenterology Journal.

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Presymptomatic Transmission of SARS-CoV-2 ID'd in Singapore

FRIDAY, April 3, 2020 (HealthDay News) -- Presymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed in epidemiological clusters in Singapore, with transmission occurring one to three days before symptom onset, according to research published in the April 1 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Gastrointestinal Symptoms Common in COVID-19 Patients

FRIDAY, April 3, 2020 (HealthDay News) -- Gastrointestinal symptoms are common in patients with coronavirus disease 2019 (COVID-19), with increased prevalence seen in the later stages of the epidemic in China, according to a review published online March 29 in Alimentary Pharmacology & Therapeutics.

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Many Legal Marijuana Products Too Strong for Treating Pain

FRIDAY, April 3, 2020 (HealthDay News) -- Legally dispensed marijuana products have stronger concentrations of tetrahydrocannabinol (THC) and cannabidiol (CBD) than needed for chronic pain relief, according to a study published online March 26 in PLOS ONE.

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COPD Independent Risk Factor for Lung Cancer

FRIDAY, April 3, 2020 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) is an independent risk factor for lung cancer incidence, regardless of smoking status, according to a study published online April 2 in Thorax.

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Unemployed Workers Less Likely to Be Uninsured Post-ACA

THURSDAY, April 2, 2020 (HealthDay News) -- Following implementation of the Affordable Care Act (ACA), unemployed workers were less likely to be uninsured, and uninsurance rates decreased more in states with Medicaid expansion, according to a report from the Urban Institute and the Robert Wood Johnson Foundation.

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COVID-19 Outbreak Described in Long-Term Care Facility

THURSDAY, April 2, 2020 (HealthDay News) -- Outbreaks of coronavirus disease 2019 (COVID-19) can have a considerable impact on long-term care facilities, according to a report published online March 27 in the New England Journal of Medicine.

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Rural Doctors Can Be Trained to Treat Advanced Heart Failure

THURSDAY, April 2, 2020 (HealthDay News) -- Patients with left ventricular assist devices (LVADs) who live remotely can be successfully managed with specialized training and cooperation between local physicians and specialty medical centers, according to a study published in the April issue of JACC: Heart Failure.

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CT Scores Higher With Longer Time to COVID-19 Diagnosis

THURSDAY, April 2, 2020 (HealthDay News) -- Patients with coronavirus disease 2019 (COVID-19) with longer time from symptom onset to diagnosis have higher computed tomography (CT) scores and longer time to disease resolution, according to a study published online March 30 in the American Journal of Roentgenology.

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Burden of Clostridioides difficile Infection Down in the U.S.

THURSDAY, April 2, 2020 (HealthDay News) -- From 2011 to 2017, there was a decrease in the estimated national burden of Clostridium difficile infection, according to a study published in the April 2 issue of the New England Journal of Medicine.

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Polypharmacy Ups Postchemo Hospitalization Risk in Seniors

WEDNESDAY, April 1, 2020 (HealthDay News) -- Older patients taking five or more medications in the six months before intravenous (IV) chemotherapy are at higher risk for postchemotherapy inpatient hospitalizations, according to a study published online March 18 in the Journal of Geriatric Oncology.

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Low Vitamin D May Reduce Mobility After Hip Fracture Surgery

WEDNESDAY, April 1, 2020 (HealthDay News) -- Vitamin D deficiencies are associated with a lower likelihood of older patients regaining independent walking ability following hip fracture surgery, according to a study recently published in the American Journal of Clinical Nutrition.

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Patients With Mild COVID-19 May Present With Digestive Symptoms

WEDNESDAY, April 1, 2020 (HealthDay News) -- Patients with mild coronavirus disease 2019 (COVID-19) can present with digestive symptoms, sometimes without concurrent fever, according to a study published online March 30 in the American Journal of Gastroenterology.

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