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August 2014 Briefing - Geriatrics

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

Photodynamic Therapy Beats Cryotherapy for Actinic Keratoses

FRIDAY, Aug. 29, 2014 (HealthDay News) -- For actinic keratoses (AKs), photodynamic therapy (PDT) is associated with improved response compared with cryotherapy, according to a meta-analysis published online Aug. 27 in JAMA Dermatology.

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Report Highlights Progress, Challenges in Health IT

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Progress has been made toward widespread adoption of electronic health records (EHRs), although there are still barriers to adoption of advanced use of EHRs, according to a report published by the Robert Wood Johnson Foundation.

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Factors ID'd for Late Hospice Admission for Cancer Patients

FRIDAY, Aug. 29, 2014 (HealthDay News) -- For patients with cancer, factors associated with late admission to hospice have been identified, according to a study published online Aug. 25 in the Journal of Clinical Oncology.

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Poor Prostate Cancer Knowledge Ups Decisional Conflict

FRIDAY, Aug. 29, 2014 (HealthDay News) -- For economically disadvantaged men with newly diagnosed prostate cancer, poor knowledge about prostate cancer is associated with increased decisional conflict and lower perceived effectiveness of decision-making, according to a study published in the Sept. 1 issue of Cancer.

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AMGA: Physician Turnover Still High in 2013

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For the second year running, physician turnover remains at the highest rate since 2005, according to a report published by the American Medical Group Association (AMGA).

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Doctors Frequently Experience Ethical Dilemmas

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For physicians trying to balance various financial and time pressures, ethical dilemmas are common, according to an article published Aug. 7 in Medical Economics.

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Age Doesn't Impact Deep Brain Stimulation Complications

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For patients with Parkinson's disease undergoing deep brain stimulation (DBS), increasing age does not impact complication rates, according to a study published online Aug. 25 in JAMA Neurology.

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CPAP Treats Excessive Daytime Sleepiness in Seniors

THURSDAY, Aug. 28, 2014 (HealthDay News) -- Continuous positive airway pressure (CPAP) is an effective treatment for daytime sleepiness in seniors with sleep apnea, according to a new study published online Aug. 27 in The Lancet Respiratory Medicine.

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CSF Biomarkers ID Alzheimer's, Independent of APOE Genotype

THURSDAY, Aug. 28, 2014 (HealthDay News) -- Cerebrospinal fluid (CSF) biomarkers for Alzheimer's disease (AD), particularly β-amyloid 42 (Aβ42), are strongly associated with AD diagnosis, independent of APOE genotype, according to a study published online Aug. 27 in JAMA Psychiatry.

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Team Approach Improves Practice Efficiency

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- The increasing administrative requirements of a medical practice are requiring a team-based approach to care, and physicians must learn to manage the team, according to an article published Aug. 7 in Medical Economics.

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Confusional Arousal Common, Linked to Other Disorders

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Confusional arousals (CAs) are common in the general population and they may be associated with other factors, such as medication consumption, sleep disorders, and mental disorders, according to research published in the Aug. 26 issue of Neurology.

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Vitamin D Deficiency Worsens Outcomes With B-Cell Lymphoma

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Vitamin D deficiency (VDD) contributes to worse outcomes in elderly patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, according to a study published online Aug. 18 in the Journal of Clinical Oncology.

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Review: Surgery Doesn't Benefit Age-Related Meniscal Tears

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Evidence suggests that arthroscopic surgery does not benefit middle-aged patients with degenerative meniscal tears, according to research published online Aug. 25 in CMAJ, the journal of the Canadian Medical Association.

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Cognitive Impairment May Increase Subsequent Stroke Risk

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Cognitive impairment is associated with an increased risk of subsequent stroke, according to a meta-analysis published online Aug. 25 in CMAJ, the journal of the Canadian Medical Association.

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Restrictive, Non-Solicitation Covenants Are Valid

MONDAY, Aug. 25, 2014 (HealthDay News) -- Restrictive and non-solicitation covenants are valid and can be enforced, according to an article published Aug. 5 in Medical Economics.

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U.S. to Tighten Access to Certain Narcotic Painkillers

FRIDAY, Aug. 22, 2014 (HealthDay News) -- The U.S. Drug Enforcement Administration (DEA) is going ahead with tough new controls on painkillers containing hydrocodone, which has been tied to a surge in dangerous addictions across the United States.

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Organizations Can Help Docs Retain Their Independence

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Ways for physicians to remain in independent practice are highlighted in an article published Aug. 7 in Medical Economics.

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Decline in Visual Acuity Ups Mortality Risk in Aging Adults

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Among aging adults, decreasing visual acuity is associated with increased mortality risk through associated decreases in instrumental activities of daily living (IADL), according to a study published online Aug. 21 in JAMA Ophthalmology.

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Wellness Visits, Physicals Need Different Documentation

THURSDAY, Aug. 21, 2014 (HealthDay News) -- Documentation rules for annual wellness visits (AWVs) for Medicare differ from those for preventive visits, which are not covered by Medicare, according to an article published Aug. 5 in Medical Economics.

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Age Affects Link Between Obesity, Dementia Risk

THURSDAY, Aug. 21, 2014 (HealthDay News) -- The association between obesity and subsequent dementia varies with the age at which obesity is first recorded, according to a study published online Aug. 20 in the Postgraduate Medical Journal.

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Asthma Outcomes Worse in Older Women

THURSDAY, Aug. 21, 2014 (HealthDay News) -- Older women face increased challenges in managing their asthma, according to a review published in the August issue of the Annals of Allergy, Asthma & Immunology.

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Organized Processes Help Practices Hire Well

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- A defined process is necessary to help physicians hire the right staff for their practice, according to an article published July 24 in Medical Economics.

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Docs Must Consider Liability When Ordering Screening Tests

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Physicians and health care providers must be aware of their potential liability when ordering screening tests, according to an article published July 24 in Medical Economics.

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Boxed Warnings Are Common in Novel Therapeutics

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Boxed warnings are common on recent drug approvals, and many occur years after approval, according to a research letter published online Aug. 15 in JAMA Internal Medicine.

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Atypical Antipsychotics Up Renal Injury Risk in Seniors

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Use of atypical antipsychotic drugs is associated with increased risk of acute kidney injury (AKI) in older adults, according to research published in the Aug. 19 issue of the Annals of Internal Medicine.

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Hospitalizations for Acute CVD, Stroke Down From 1999 to 2011

TUESDAY, Aug. 19, 2014 (HealthDay News) -- From 1999 through 2011 there were considerable declines in hospitalizations for acute cardiovascular disease and stroke, outpacing those of other conditions, according to a study published online Aug. 18 in Circulation.

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Cancer Screening Common in Those With Low Life Expectancy

MONDAY, Aug. 18, 2014 (HealthDay News) -- Cancer screening is common among those with limited life expectancy, and more frequent colorectal cancer screening than recommended does not provide benefit, according to two studies published online Aug. 18 in JAMA Internal Medicine.

Abstract - Royce
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Bidirectional Association for Cognitive Function, Stroke

MONDAY, Aug. 18, 2014 (HealthDay News) -- Lower cognitive function is associated with increased risk of stroke in older adults, and cognitive decline increases after stroke versus before stroke, according to a study published online Aug. 7 in Stroke.

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Malnutrition Prevalent Among Seniors Presenting to ER

FRIDAY, Aug. 15, 2014 (HealthDay News) -- More than half of older patients presenting to the emergency department are malnourished or at risk of malnutrition, according to a study published online Aug. 12 in the Annals of Emergency Medicine.

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Prevnar-13 Should Be Routine for Seniors

THURSDAY, Aug. 14, 2014 (HealthDay News) -- A second vaccine to protect seniors against pneumonia has been recommended by the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.

Health Highlights: Aug. 14, 2014
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Poor Sleep Quality Tied to Suicide Risk

THURSDAY, Aug. 14, 2014 (HealthDay News) -- Poor self-reported sleep quality is tied to an increased risk of suicide death within 10 years among older adults, according to a study published online Aug. 13 in JAMA Psychiatry.

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Extra Time Spent Counseling, Coordinating Care Billable

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Extra time spent counseling patients and coordinating care can be billed using evaluation and management (E/M) and prolonged service codes, according to an article published July 24 in Medical Economics.

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High-Dose Trivalent Flu Shot Better Protects Seniors

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- A high-dose, trivalent, inactivated influenza vaccine (IIV3-HD) is associated with improved protection for seniors against laboratory-confirmed influenza infection compared with standard-dose trivalent, inactivated influenza vaccine (IIV3-SD), according to a study published in the Aug. 14 issue of the New England Journal of Medicine.

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40-Year-Old Man With Absence of ApoE Has Normal Cognition

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- The identification of a patient with a rare form of severe dysbetalipoproteinemia will allow the study of the consequences of total absence of apolipoprotein E (apoE), according to research published online Aug. 11 in JAMA Neurology.

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Meta-Analysis Strategy Impacts Estimation of Tx Outcome

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Estimation of treatment outcome varies with the meta-analysis strategy, according to a study published in the Aug. 13 issue of the Journal of the American Medical Association.

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EHR Adoption Increasing, But Stage 2 Criteria Often Not Met

MONDAY, Aug. 11, 2014 (HealthDay News) -- Most U.S. hospitals and office-based physicians have adopted electronic health records (EHR), according to two studies published in the August issue of Health Affairs.

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Neighborhood's Socioeconomic Status Tied to Readmissions

MONDAY, Aug. 11, 2014 (HealthDay News) -- Neighborhood socioeconomic status (SES) is linked to six-month, all-cause readmission among patients with heart failure, even after adjustment for patient-level factors, according to a study published online July 29 in Circulation: Cardiovascular Quality and Outcomes.

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Emergency Department Closures Up Inpatient Mortality Nearby

MONDAY, Aug. 11, 2014 (HealthDay News) -- Emergency department closures are associated with increased mortality for admissions that occur nearby, according to research published in the August issue of Health Affairs.

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Issues to Consider With Integration of Telemedicine

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Integrating telemedicine raises various considerations, including operational and legal issues, according to an article published July 24 in Medical Economics.

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Zoster Vaccine Still Effective With Subsequent Chemo

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Zoster vaccine is effective even for individuals who subsequently undergo chemotherapy, according to a study published online Aug. 4 in Clinical Infectious Diseases.

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Polypill Can Potentially Offer Global Cardiovascular Benefit

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Use of a polypill can potentially improve global cardiovascular health, according to research published in the Aug. 12 issue of the Journal of the American College of Cardiology.

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VA Health Care Reform Bill Signed Into Law

THURSDAY, Aug. 7, 2014 (HealthDay News) -- A bill signed into law Thursday by President Barack Obama is meant to provide veterans with easier access to government-paid health care.

Health Highlights: Aug. 7, 2014

Low Vitamin D May Up Risk of Dementia, Alzheimer's Disease

THURSDAY, Aug. 7, 2014 (HealthDay News) -- Low concentrations of serum 25-hydroxyvitamin D (25[OH]D) may increase the risk of developing all-cause dementia and Alzheimer's disease, according to research published online Aug. 6 in Neurology.

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Prophylactic Aspirin Use May Help Prevent Cancer

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Prophylactic aspirin use seems to be beneficial for men and women between ages 50 and 65 in the general population, with increased benefits seen for long-term use, according to a review published online Aug. 5 in the Annals of Oncology.

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Mortality Up With CKD in PCI Contrast-Induced Nephropathy

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Contrast-induced nephropathy (CIN) is associated with long-term mortality in patients with, but not those without, chronic kidney disease (CKD), according to a study published in the Aug. 1 issue of The American Journal of Cardiology.

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Review: Earlier Alteplase Benefits Acute Ischemic Stroke More

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Alteplase delivered within 4.5 hours of acute ischemic stroke onset is associated with increased odds of a good stroke outcome irrespective of age or stroke severity and despite an increased risk of fatal intracranial hemorrhage, with earlier treatment associated with bigger proportional benefits, according to a review published online Aug. 6 in The Lancet.

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Hypertension in Middle Age May Speed Cognitive Decline

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Hypertension during midlife is associated with greater cognitive decline during a 20-year period, according to research published online Aug. 4 in JAMA Neurology.

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Favorable Resource Use With Long-Detection Interval for ICD

TUESDAY, Aug. 5, 2014 (HealthDay News) -- A long-detection interval for implantable cardioverter-defibrillators (ICDs) is associated with favorable results in terms of hospitalization and costs, according to a research letter published in the Aug. 6 issue of the Journal of the American Medical Association.

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Women Over 75 May Still Benefit From Mammograms

TUESDAY, Aug. 5, 2014 (HealthDay News) -- Women 75 and older may still benefit from routine mammograms, according to new research. The study was published online Aug. 5 in Radiology.

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Statin Use After CRC Diagnosis Reduces Mortality Risk

TUESDAY, Aug. 5, 2014 (HealthDay News) -- For patients with newly diagnosed colorectal cancer, statin use is associated with reduced cancer-specific mortality risk, according to a study published online Aug. 4 in the Journal of Clinical Oncology.

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Five Servings of Fruit and Veggies a Day Cut Mortality

TUESDAY, Aug. 5, 2014 (HealthDay News) -- Consuming five or more servings of fruit and vegetables daily is associated with reduced risk of all-cause mortality, particularly cardiovascular mortality, according to research published online July 29 in BMJ.

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Many Physicians Have Secondary Income

MONDAY, Aug. 4, 2014 (HealthDay News) -- Many physicians report earning income from sources other than their primary practice/employer, according to an article published July 24 in Medical Economics.

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Best Outcomes Seen at Systolic BP of 130 to 139 mm Hg

MONDAY, Aug. 4, 2014 (HealthDay News) -- For patients with treated hypertension, worse outcomes are seen for those with systolic and diastolic blood pressures lower and higher than 130 to 139 mm Hg and 60 to 79 mm Hg, respectively, according to a study published in the Aug. 12 issue of the Journal of the American College of Cardiology.

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New Onset, Post-Op Atrial Fibrillation Ups Mortality

MONDAY, Aug. 4, 2014 (HealthDay News) -- New onset postoperative atrial fibrillation (POAF) is associated with worse patient outcomes, including increased risk-adjusted mortality, according to a study published in the August issue of The Annals of Thoracic Surgery.

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Hx of Alcohol Use Disorder Ups Odds of Memory Impairment

MONDAY, Aug. 4, 2014 (HealthDay News) -- For middle-aged U.S. adults, a history of alcohol use disorder is associated with increased odds of severe memory impairment, according to a study published online June 9 in the American Journal of Geriatric Psychiatry.

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Guidelines Issued for Cardiac Management of Noncardiac Sx

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Recommendations have been developed for perioperative cardiovascular management of patients undergoing noncardiac surgery. These revised guidelines were published online Aug. 1 in the Journal of the American College of Cardiology.

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CMS Recognizes Telehealth in New Physician Fee Schedule

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Earlier this month, the Centers for Medicare & Medicaid Services issued proposed rules for updates to the Physician Fee Schedule and will accept comments until Sept. 2, according to an article published July 7 in Medical Economics.

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Florida Officials Issue Warning on Vibrio Bacteria

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Florida health officials are cautioning visitors to the state's beaches about the threat of Vibrio vulnificus bacteria in warm seawater this summer.

Health Highlights: July 31, 2014

Each Chronic Condition Further Reduces Life Expectancy

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Each additional chronic condition among older people diminishes life expectancy, according to a study published in the August issue of Medical Care.

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Off-Hour Arrival at Hospital Impacts Heart Attack Outcomes

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Time of presentation to the hospital may influence treatment and mortality for patients with myocardial infarction, according to research published online July 29 in Circulation: Cardiovascular Quality and Outcomes.

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Older Adults With Dementia More Likely to Receive Pacemaker

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Older adults with dementia are more likely to receive a pacemaker than those without cognitive impairment, according to a research letter published online July 28 in JAMA Internal Medicine.

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