June 2014 Briefing - Geriatrics

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

New Plan Would Permit Doctors to Treat Patients in Other States

MONDAY, June 30, 2014 (HealthDay News) -- A proposal to make it much easier for doctors licensed in one state to treat patients in other states in person, online, or by videoconference has been prepared by the Federation of State Medical Boards, which includes the agencies that license and discipline doctors.

Health Highlights: June 30, 2014

Nursing Home Care May Be Out of Reach for Many Aging 'Boomers'

MONDAY, June 30, 2014 (HealthDay News) -- A growing number of older Americans are developing chronic diseases but can't cover the costs of long-term care in a nursing facility, the U.S. National Institute on Aging (NIA)-funded report says.

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UnitedHealth Cutting More Docs From Medicare Advantage

FRIDAY, June 27, 2014 (HealthDay News) -- UnitedHealth Group's Medicare Advantage network has begun notifying physicians of a new wave of cuts to its network, according to an article published June 17 in Medical Economics.

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Court: Patients Responsible for Outcomes of Risky Behavior

FRIDAY, June 27, 2014 (HealthDay News) -- The Colorado Supreme Court has ruled that patients can be at least partially responsible for their health outcomes resulting from their own unhealthy behavior, according to the American Medical Association (AMA), which supported the physicians in the case.

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Cancer Screening Discussions Lack Shared Decision-Making

FRIDAY, June 27, 2014 (HealthDay News) -- The majority of patients report that shared decision-making (SDM) is lacking when it comes to cancer screening decisions, according to a study published online June 8 in the American Journal of Preventive Medicine.

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Television Viewing Time Linked to All-Cause Mortality

FRIDAY, June 27, 2014 (HealthDay News) -- Television viewing, but not computer or driving time, is associated with all-cause mortality, according to a study published online June 25 in the Journal of the American Heart Association.

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PCP Follow-Up Cuts Readmission After High-Risk Surgery

THURSDAY, June 26, 2014 (HealthDay News) -- For surgical patients at high risk of readmission, especially those with surgical complications, early primary care provider (PCP) follow-up reduces the rate of readmission, according to a study published online June 25 in JAMA Surgery.

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CDC: One in 10 Deaths Due to Excessive Drinking

THURSDAY, June 26, 2014 (HealthDay News) -- Nearly one in 10 deaths among working-age adults in the United States are attributable to excessive drinking, according to a study published online June 26 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Tips Offered for Improving Practice Productivity

THURSDAY, June 26, 2014 (HealthDay News) -- Four steps can be utilized to improve practice productivity, according to an article published June 24 in Medical Economics.

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Wikipedia Drug Entries Often Not Up-to-Date

THURSDAY, June 26, 2014 (HealthDay News) -- Patients frequently turn to digital media for drug information; however, many Wikipedia entries about medications aren't up-to-date and accurate, according to a perspective piece published in the June 26 issue of the New England Journal of Medicine.

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Higher Plasma Vitamin D May Cut Hypertension Risk

THURSDAY, June 26, 2014 (HealthDay News) -- People who have genetic variants tied to low production of 25-hydroxyvitamin D (25[OH]D) have an increased risk of hypertension, according to a study published online June 26 in The Lancet Diabetes & Endocrinology.

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30-Day ECG Monitoring Ups A-Fib Detection After Stroke

THURSDAY, June 26, 2014 (HealthDay News) -- For patients with ischemic stroke or transient ischemic attack, electrocardiogram (ECG) monitoring with a 30-day event-triggered recorder improves detection of atrial fibrillation, according to a study published June 26 in the New England Journal of Medicine.

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CDC: Over Half of Seniors Plagued by Incontinence

WEDNESDAY, June 25, 2014 (HealthDay News) -- More than 50 percent of older Americans struggle with incontinence, a new government report released Wednesday shows. The National Center for Health Statistics report was published in the June edition of the CDC's Vital and Health Statistics.

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States Opening Registries to Ease Backlog of Veterans' Care Cases

WEDNESDAY, June 25, 2014 (HealthDay News) -- Physicians in several states are acting to ease the access-to-care crisis recently exposed in the U.S. Department of Veterans Affairs (VA) health care system, according to the American Medical Association (AMA).

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Active Surveillance Underused for Low-Risk Prostate Cancer

WEDNESDAY, June 25, 2014 (HealthDay News) -- Although most prostate cancer specialists believe active surveillance to be effective and underused, fewer endorse active surveillance than other therapies for low-risk prostate cancer, according to a study published in the July issue of Medical Care.

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Shortage Seen for Adult Endocrinologists

TUESDAY, June 24, 2014 (HealthDay News) -- There is a shortage of adult endocrinologists that will continue to grow with increasing patient demand, according to a study published online June 18 in The Journal of Clinical Endocrinology & Metabolism.

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Medicaid Backlog May Have Financial Ramifications

TUESDAY, June 24, 2014 (HealthDay News) -- There is a considerable backlog in Medicaid enrollment applications, which may have financial ramifications on physicians and practices, according to an article published online June 10 in Medical Economics.

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Quitting Smokeless Tobacco Cuts Mortality Risk After Heart Attack

TUESDAY, June 24, 2014 (HealthDay News) -- Discontinuation of use of a moist smokeless tobacco product, snus (Swedish form of snuff), after myocardial infarction (MI) is associated with a reduced risk of mortality, according to a study published online June 23 in Circulation.

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USPSTF Recommends One-Time AAA Screening for Male Smokers

TUESDAY, June 24, 2014 (HealthDay News) -- The United States Preventive Services Task Force (USPSTF) has concluded that a one-time abdominal aortic aneurysm (AAA) screening should be offered to asymptomatic men, aged 65 to 75 years, who have ever smoked, while screening for non-smoking men should be selective. These findings are presented in a final recommendation statement published online June 24 in the Annals of Internal Medicine.

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CMS Launches Initiative to Assist Newly Insured

MONDAY, June 23, 2014 (HealthDay News) -- A national initiative has been launched to help answer questions that people may have about their new health coverage and to offer health providers the tools needed to promote patient engagement, according to a press release from the Centers for Medicare and Medicaid Services (CMS).

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Complex Electronic Record Safety Issues Surface Long After Launch

MONDAY, June 23, 2014 (HealthDay News) -- Electronic health record-related safety concerns involving both unsafe technology and unsafe use of technology persist long after "go-live," according to a study published online June 20 in the Journal of the American Medical Informatics Association.

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FDA: Bee Pollen Weight Loss Products Pose Health Risks

MONDAY, June 23, 2014 (HealthDay News) -- The undeclared ingredients sibutramine and/or phenolphthalein have been found in the following bee pollen weight loss products: Zi Xiu Tang, Ultimate Formula, Fat Zero, Bella Vi Amp'd Up, Insane Amp'd Up, Slim Trim U, Infinity, Perfect Body Solution, Asset Extreme, Asset Extreme Plus, Asset Bold, and Asset Bee Pollen, according to the U.S. Food and Drug Administration.

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Patient Variables Predict Expectations in Spine Surgery

FRIDAY, June 20, 2014 (HealthDay News) -- Clinical and demographic variables can predict patients' expectations regarding anticipated improvement from cervical spine surgery, according to a study published June 15 in Spine.

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Frequent Prior Hospitalization May Predict Stroke Readmission

FRIDAY, June 20, 2014 (HealthDay News) -- Frequent prior hospitalization and National Institutes of Health Stroke Scale (NIHSS) rating at admission may predict 30-day readmission after ischemic or hemorrhagic stroke, according to a study published online June 11 in the American Journal of Medical Quality.

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Shared Medical Appointments Can Improve Quality of Life Measures

FRIDAY, June 20, 2014 (HealthDay News) -- Shared medical appointments (SMAs) with a group of patients with the same disorder can improve aspects of quality of life (QOL) in patients with a chronic neuromuscular conditions, according to a study published online June 18 Neurology.

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Guidance Offered for Protection When Firing Employees

FRIDAY, June 20, 2014 (HealthDay News) -- Steps can be taken to protect employers in the case of termination of an employee, according to an article published online June 10 in Medical Economics.

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Meta-Analysis Confirms Serum 25(OH)D, Mortality Link

FRIDAY, June 20, 2014 (HealthDay News) -- Serum 25-hydroxyvitamin (25[OH]D) levels are associated with all-cause and cardiovascular mortality, according to a meta-analysis published online June 17 in BMJ.

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NCHS: Insurance Coverage Expands, Gaps Remain

THURSDAY, June 19, 2014 (HealthDay News) -- Two new U.S. government reports provide a statistical snapshot of health and health insurance coverage in 2013, before new coverage options took effect under the Affordable Care Act.

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Anesthesiologists Issue Choosing Wisely Recommendations

THURSDAY, June 19, 2014 (HealthDay News) -- A list of the top five unnecessary medical services in anesthesiology has been developed as part of the Choosing Wisely campaign, according to a study published online June 16 in JAMA Internal Medicine.

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Lower Blood Pressure Might Not Be Better Once HTN Managed

WEDNESDAY, June 18, 2014 (HealthDay News) -- Among patients with hypertension (HTN), elevated systolic blood pressure (SBP) is associated with the highest risk for cardiovascular events, although once SBP is below 140, lowering it below 120 does not further reduce the risk of cardiovascular events, according to a study published June 16 in JAMA Internal Medicine.

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Preop β-Blockers Don't Improve CABG Outcomes

WEDNESDAY, June 18, 2014 (HealthDay News) -- Preoperative β-blockers do not improve perioperative outcomes in patients undergoing nonemergent coronary artery bypass grafting (CABG) surgery, according to a study published June 16 in JAMA Internal Medicine.

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Beta-Blocker Therapy Cuts All-Cause Mortality in STEMI

WEDNESDAY, June 18, 2014 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), beta-blocker therapy at discharge correlates with reduced all-cause mortality, according to a study published in the June issue of JACC: Cardiovascular Interventions.

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FDA to Issue Salt Reduction Guidelines for Food Industry

TUESDAY, June 17, 2014 (HealthDay News) -- Voluntary guidelines to reduce the amount of salt in grocery and restaurant foods are being prepared for release by the U.S. Food and Drug Administration.

Health Highlights: June 17, 2014

Prolonged Sitting Ups Risk of Developing Certain Cancers

TUESDAY, June 17, 2014 (HealthDay News) -- Prolonged television (TV) viewing and other sedentary behaviors are associated with increased risks of some cancers, according to research published online June 16 in the Journal of the National Cancer Institute.

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Tips Offered for Finding Buyer for Medical Practice

TUESDAY, June 17, 2014 (HealthDay News) -- Suggestions are provided for finding a buyer for a medical practice in an article published online June 10 in Medical Economics.

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U.S. Health Care System Ranked Last Again: Report

MONDAY, June 16, 2014 (HealthDay News) -- The United States' health system once again comes in last when compared to 10 other rich nations, according to the latest Commonwealth Fund report on the issue.

Health Highlights: June 16, 2014
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Clinicians Often Fail to Empathize After Adverse Event

MONDAY, June 16, 2014 (HealthDay News) -- The health care industry is recognizing the benefits of prompt and transparent physician communication with patients and families about bad outcomes, according to an article published June 10 in Medical Economics.

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Physician Leadership, Ownership Dominates ACOs

MONDAY, June 16, 2014 (HealthDay News) -- Physicians are playing strong leadership and ownership roles in accountable care organizations (ACOs), according to research published in the June issue of Health Affairs.

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Processed Red Meat May Increase Risk of Heart Failure in Men

MONDAY, June 16, 2014 (HealthDay News) -- Men who eat moderate amounts of processed red meat may have an increased risk of heart failure, according to research published online June 12 in Circulation: Heart Failure.

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Walking Protects Against Functional Limitation of OA

MONDAY, June 16, 2014 (HealthDay News) -- More walking can protect against the functional limitation associated with knee osteoarthritis, according to a study published online June 12 in Arthritis Care & Research.

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HHS Inspector General Finds Big Problem With Medicare Coding

FRIDAY, June 13, 2014 (HealthDay News) -- Nearly 42 percent of Medicare claims for evaluation and management (E/M) services are incorrectly coded, according to an article published June 2 in Medical Economics.

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Frailty Index Predicts Adverse Outcomes in Geriatric Trauma

FRIDAY, June 13, 2014 (HealthDay News) -- Frailty index is an independent predictor of in-hospital complications and adverse discharge disposition among geriatric trauma patients, according to a study published online June 11 in JAMA Surgery.

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Life Expectancy Affects Treatment for Acute MI

FRIDAY, June 13, 2014 (HealthDay News) -- Evidence-based treatment for acute myocardial infarction is strongly influenced by the clinician's assessment of life expectancy of a patient, according to a study published online June 3 in Circulation: Cardiovascular Quality & Outcomes.

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Inverse Link for Cognitive Impairment, Heart Health

FRIDAY, June 13, 2014 (HealthDay News) -- Intermediate and high cardiovascular health (CVH), measured with Life's Simple 7 scores, correlate with lower incidence of cognitive impairment, according to a study published online June 11 in the Journal of the American Heart Association.

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Older Men on Statins Found Less Physically Active

FRIDAY, June 13, 2014 (HealthDay News) -- Among older, community-dwelling men, use of statins is associated with modestly lower levels of physical activity, according to research published online June 9 in JAMA Internal Medicine.

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Researchers Hesitant to Use Social Media to Show Findings

FRIDAY, June 13, 2014 (HealthDay News) -- Researchers remain uncertain about the use of social media to communicate their findings to policy makers, according to research published online June 6 in Health Affairs.

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Data From EHRs Should Be Used to Improve Patient Care

THURSDAY, June 12, 2014 (HealthDay News) -- The data from electronic health records (EHRs) should be utilized to improve the quality of patient care, according to an article published online June 10 in Medical Economics.

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CPAP Cuts BP in Sleep Apnea; Other Heart Benefits Unclear

THURSDAY, June 12, 2014 (HealthDay News) -- Continuous positive airway pressure treatment (CPAP) for sleep apnea can effectively lower blood pressure but other heart health interventions are still important, according to new research published in the June 12 issue of the New England Journal of Medicine.

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Higher Protein Intake Linked to Reduced Stroke Risk

THURSDAY, June 12, 2014 (HealthDay News) -- Moderate dietary protein intake is associated with a reduced risk of stroke, according to a meta-analysis published online June 11 in Neurology.

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FDA Approves New Nail Fungus Treatment

WEDNESDAY, June 11, 2014 (HealthDay News) -- A new topical nail fungus treatment, Jublia, has been approved by the U.S. Food and Drug Administration.

Health Highlights: June 11, 2014

Medicare Will Cover Primary Care-Ordered HCV Testing

WEDNESDAY, June 11, 2014 (HealthDay News) -- Medicare will cover primary care provider-ordered hepatitis C virus testing for adults, according to a statement released by the Centers for Medicare and Medicaid Services (CMS) and discussed in an article published online June 3 in Medical Economics.

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Follow-Up Care Guidelines Issued for Prostate Cancer Survivors

WEDNESDAY, June 11, 2014 (HealthDay News) -- New guidelines have been developed for clinical follow-up care for prostate cancer survivors. The guidelines were published online June 10 in CA: A Cancer Journal for Clinicians.

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Sleep Quality Tied to Subsequent Low Back Pain Intensity

TUESDAY, June 10, 2014 (HealthDay News) -- In patients with acute low back pain, sleep quality is strongly related to subsequent pain intensity, according to a study published in the May issue of Arthritis & Rheumatology.

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Study Identifies 41 Powerhouse Fruits and Vegetables

TUESDAY, June 10, 2014 (HealthDay News) -- Forty-one powerhouse fruits and vegetables (PFV) have been classified and validated, according to a study published online June 5 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Millions Will Not Have to Pay ACA Tax Penalties: Report

TUESDAY, June 10, 2014 (HealthDay News) -- Although an estimated 30 million people will still be uninsured in 2016, only four million are expected to pay penalties, according to the latest report from the nonpartisan Congressional Budget Office (CBO).

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Incentives May Lead to Greater Support for Practice Goals

MONDAY, June 9, 2014 (HealthDay News) -- Incentives may aid employees in meeting practice goals, according to an article published May 23 in Medical Economics.

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Veterans Affected by Scandal May Seek Private Care

FRIDAY, June 6, 2014 (HealthDay News) -- The recent scandal at the U.S. Department of Veterans Affairs (VA) may lead to more veteran visits to private physicians and community health centers, according to an article published June 2 in Medical Economics.

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Physician Political Contributions Are Increasing, Shifting

FRIDAY, June 6, 2014 (HealthDay News) -- The political alignment of physicians in the United States has shifted from predominantly Republican to predominantly Democrat, based in part on the larger number of women physicians and smaller percentage of physicians practicing solo or in small practices, according to research published online June 2 in JAMA Internal Medicine.

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High Recurrence Risk With Severe Cutaneous Adverse Reactions

FRIDAY, June 6, 2014 (HealthDay News) -- The risk of recurrent episodes of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) is substantially higher than the risk of a first episode in the general population, according to a research letter published in the June 4 issue of the Journal of the American Medical Association.

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Switching Ophthalmologic Drugs Could Save Medicare $

FRIDAY, June 6, 2014 (HealthDay News) -- By switching preferred therapy for macular degeneration, Medicare can realize substantial cost savings, according to a report published in the June issue of Health Affairs.

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Air Pollution Has Short-Term Impact on Specific Cardiac Events

FRIDAY, June 6, 2014 (HealthDay News) -- Ambient air pollution has short-term effects on specific cardiovascular disease (CVD) events, according to a study published online June 4 in Heart.

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Bilingualism May Aid Later-Life Cognition

THURSDAY, June 5, 2014 (HealthDay News) -- Bilingualism may have a positive effect on later-life cognition, according to a study published online June 2 in the Annals of Neurology.

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Lower Mortality Tied to Azithromycin for Pneumonia

THURSDAY, June 5, 2014 (HealthDay News) -- Older patients hospitalized with pneumonia and treated with azithromycin have lower risk of 90-day mortality, compared to those treated with other antibiotics, according to a study published in the June 4 issue of the Journal of the American Medical Association.

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Many 'Inconsistencies' in ACA Sign-Ups: Report

THURSDAY, June 5, 2014 (HealthDay News) -- A new government document finds that more than a quarter of the eight million people who signed up for coverage under the Obama Administration's new health care law have "inconsistencies" in the data they supplied.

Health Highlights: June 5, 2014

Midlife HTN Affects Late-Life BP, Brain Pathology Link

THURSDAY, June 5, 2014 (HealthDay News) -- For older men and women without dementia, the impact of late-life blood pressure on brain pathology varies with their history of midlife hypertension, according to a study published online June 4 in Neurology.

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Naloxegol Found Effective for Opioid-Induced Constipation

THURSDAY, June 5, 2014 (HealthDay News) -- Treatment with the oral, peripherally acting µ-opioid receptor antagonist naloxegol is safe and effective for opioid-induced constipation, according to a study published online June 4 in the New England Journal of Medicine.

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Risk of Unnatural Death Is Higher in Diabetes Patients

THURSDAY, June 5, 2014 (HealthDay News) -- Unnatural deaths occur more frequently among individuals with diabetes, according to research published online May 21 in Diabetes Care.

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Financial Incentive Can Up Fruit, Vegetable Purchases

THURSDAY, June 5, 2014 (HealthDay News) -- An intervention to increase fruit and vegetable purchases at farmers' markets for recipients of food assistance (Shop N Save [SNS]) correlates with a significant increase in use of food assistance at the farmers' market, according to a study published online May 22 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Claim Denials Expected to Increase

WEDNESDAY, June 4, 2014 (HealthDay News) -- Even with good office procedures, most practices are plagued by claim denials, a hassle that is expected to increase in the coming years, according to an article published May 8 in Medical Economics.

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Medicare Panel Says No to CT-Based Lung Cancer Screen

WEDNESDAY, June 4, 2014 (HealthDay News) -- The Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) recently recommended against screening of high-risk, older adults for lung cancer using low-dose computed tomography (CT), according to a news release from the American Academy of Family Physicians (AAFP).

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Most Physicians Would Forgo Aggressive Treatment

WEDNESDAY, June 4, 2014 (HealthDay News) -- Although physicians regularly recommend high-intensity, aggressive, life-prolonging care for their terminally ill patients, the vast majority would choose to forgo such care for themselves at the end of life, according to a study published online May 28 in PLOS ONE.

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CDC: Food Handlers Cause Most Food-Poisoning Cases

WEDNESDAY, June 4, 2014 (HealthDay News) -- Norovirus illness is more often caused by infected restaurant workers than outbreaks on cruise ships, U.S. health officials said Tuesday.

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Number of Cancer Survivors Projected to Grow in the U.S.

WEDNESDAY, June 4, 2014 (HealthDay News) -- Factors such as the aging and growth of the population accompanied by improvements in early detection and treatment are expected to contribute to the growth of the number of cancer survivors in the United States, according to research published online June 1 in CA: A Cancer Journal for Clinicians.

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High Blood Pressure Has Varied Effect on Cardio End Points

WEDNESDAY, June 4, 2014 (HealthDay News) -- The impact of high blood pressure on cardiovascular end points varies, with different effects for high systolic and diastolic blood pressure, according to a study published in the May 31 issue of The Lancet.

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Rx Adherence Up for Hispanics Post-Medicare Part D Launch

TUESDAY, June 3, 2014 (HealthDay News) -- Hispanics became much more likely to take their heart medicines after Medicare's prescription drug benefit plan was launched in 2006, but there was only a small increase seen among black patients, according to a new study slated for presentation Monday at an American Heart Association (AHA) meeting in Baltimore.

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Quality Up in Patient-Centered Medical Home Care

TUESDAY, June 3, 2014 (HealthDay News) -- The patient-centered medical home (PCMH) model of care is associated with quality improvements compared to care provided by physicians using paper medical records or electronic health records (EHRs), according to a study published in the June 3 issue of the Annals of Internal Medicine.

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Holistic Exercise Program Seems Feasible in Dementia

TUESDAY, June 3, 2014 (HealthDay News) -- A holistic exercise program seems feasible and acceptable for people with dementia, according to a feasibility study published online April 25 in the Journal of Bodywork and Movement Therapies.

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EHRs Can Be Used to Boost Practice Revenue

TUESDAY, June 3, 2014 (HealthDay News) -- Practices can achieve return on investment (ROI) for implementation of electronic health record (EHR) systems if they participate in alternative delivery models, according to an article published May 8 in Medical Economics.

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Colonoscopy Is Indicated in Unscreened Elderly Patients

MONDAY, June 2, 2014 (HealthDay News) -- Colorectal cancer (CRC) screening should be considered as a cost-effective strategy in unscreened patients older than 75 years, according to research published in the June 3 issue of the Annals of Internal Medicine.

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FDA Approves Generic Version of Celebrex

MONDAY, June 2, 2014 (HealthDay News) -- The U.S. Food and Drug Administration on Friday gave its approval to the first generic version of the pain reliever Celebrex (celecoxib).

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One-Fifth of Medicare Patients Sustain Adverse Medical Events

MONDAY, June 2, 2014 (HealthDay News) -- Adverse medical events (AMEs) are associated with excess mortality and increased costs among Medicare beneficiaries, according to research published online May 28 in Injury Prevention.

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Physician's Briefing