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March 2014 Briefing - Geriatrics

Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for March 2014. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Azithromycin, Levofloxacin Up Cardiac Risk in Study of Veterans

MONDAY, March 31, 2014 (HealthDay News) -- Use of azithromycin or levofloxacin is associated with increased risks of death and cardiac arrhythmia compared with amoxicillin use, according to a study published in the March/April issue of the Annals of Family Medicine.

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CDC: Invasive Cancer Diagnoses Down Slightly in 2010

FRIDAY, March 28, 2014 (HealthDay News) -- Cancer incidence declined from 2009 to 2010, according to a report published in the March 28 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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'White Coat Effect' Is Smaller for Nurses Than Doctors

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

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NIH Launches Online Resource for End-of-Life Issues

THURSDAY, March 27, 2014 (HealthDay News) -- People grappling with terminal illness now have a new online source of advice and help, sponsored by the U.S. National Institute on Aging, part of the National Institutes of Health.

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NCHS Estimates Health Insurance Coverage for 2013

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

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White House Extends Affordable Care Act Enrollment Deadline

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

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1 in 25 Inpatients Has Health Care-Associated Infection Daily

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

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Americans Seem Unprepared for Health Insurance Exchanges

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

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AMA Introduces Medical Education Initiative

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

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USPSTF: Evidence Lacking for Cognitive Impairment Screening

MONDAY, March 24, 2014 (HealthDay News) -- The United States Preventive Services Task Force (USPSTF) has found that evidence is currently insufficient to weigh the benefits and harms of universal screening for cognitive impairment in older adults. These findings are presented in a final recommendation statement published online March 25 in the Annals of Internal Medicine.

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Patient Request Impacts Doc Prescribing Behavior

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

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Husbands' Health, Attitude Play Larger Role in Marital Conflict

FRIDAY, March 21, 2014 (HealthDay News) -- In older married couples, the husband's health and attitude seem to affect perceptions of marital conflict, according to a study published in the February issue of the Journal of Marriage and Family.

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Practices Can Take Steps to Improve Care Transitions

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

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Older Drivers More Susceptible to the Effects of Alcohol

FRIDAY, March 21, 2014 (HealthDay News) -- Older adults' driving performance may be more susceptible to the effects of alcohol, according to a study published in the February issue of Psychopharmacology.

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Rates of Colorectal Cancer Continue to Drop in Older Adults

FRIDAY, March 21, 2014 (HealthDay News) -- Incidence rates for colorectal cancer declined by approximately 3 percent per year from 2001 to 2010 in the United States, with the largest drops occurring in adults aged 65 and older, according to research published in the March/April issue of CA: A Cancer Journal for Clinicians.

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Stress-Linked Protein May Play Major Role in Alzheimer's

FRIDAY, March 21, 2014 (HealthDay News) -- Dysfunction in the brain's stress response system may be an important factor in the memory and thinking problems experienced by people with Alzheimer's disease and other dementias, according to a report published online March 19 in Nature.

Health Highlights: March 20, 2014
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Age-Adjusted D-Dimer Levels Aid Pulmonary Embolism Dx

FRIDAY, March 21, 2014 (HealthDay News) -- Age-adjusted levels of D-dimer safely exclude pulmonary embolism (PE) in older patients, according to a study published in the March 19 issue of the Journal of the American Medical Association.

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Alzheimer's Strikes Women Harder Than Men: Report

THURSDAY, March 20, 2014 (HealthDay News) -- A 65-year-old American woman has a one in six chance of developing Alzheimer's disease later in life, while a man the same age has about a one in 11 chance, according to a report published in the March issue of Alzheimer's & Dementia, the journal of the Alzheimer's Association.

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2014 Alzheimer's Disease Facts and Figures

Review: Tamiflu Saved Lives During Swine Flu Pandemic

WEDNESDAY, March 19, 2014 (HealthDay News) -- The antiviral drug Tamiflu (oseltamivir) reduced the risk of death by 25 percent among adults hospitalized during the 2009 H1N1 swine flu pandemic, according to a review published online March 19 in The Lancet Respiratory Medicine. In addition, antiviral treatment within 48 hours of developing flu symptoms halved the risk of death compared with starting treatment later or receiving no treatment.

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Simvastatin Might Help Slow Multiple Sclerosis Progression

WEDNESDAY, March 19, 2014 (HealthDay News) -- High-dose simvastatin appears to slow brain shrinkage in patients with multiple sclerosis, according to a small, early study from England, published online March 19 in The Lancet.

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COPD Tied to Development of Cognitive Impairment

WEDNESDAY, March 19, 2014 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) is associated with an increased risk for mild cognitive impairment (MCI), particularly nonamnestic MCI (NA-MCI), according to a study published online March 17 in JAMA Neurology.

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Continuity of Care Improves Outcomes in Chronic Disease

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

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

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

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No Evidence Fatty Acid Guidelines Cut Coronary Risk

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

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Geriatric Care Principles Can Be Applied to Care Transitions

MONDAY, March 17, 2014 (HealthDay News) -- Approaches from geriatric care can be developed to provide a framework for care transition activities, according to a study published online Feb. 21 in the Journal of General Internal Medicine.

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Rx Expenditures Expected to Rise in 2014

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

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Insurers Must Offer Same-Sex Couples Spousal Benefits

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

Other Health Highlights: March 17, 2014

Most Influenza Infections Seem to Be Asymptomatic

MONDAY, March 17, 2014 (HealthDay News) -- For individuals infected with influenza, most cases are asymptomatic, and a minority of those with confirmed disease have medically attended illness, according to a study published online March 17 in The Lancet Respiratory Medicine.

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Animal Protein May Slow Functional Decline in Older Men

MONDAY, March 17, 2014 (HealthDay News) -- Among older men, higher intake of protein, particularly animal protein, is associated with lower risk of decline in higher-level functional capacity, according to research published in the March issue of the Journal of the American Geriatrics Society.

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Improving EHR Interoperability Is a National Priority: HHS

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

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Chronic Hyperglycemia Tied to Worse Surgical Outcomes

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

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Benefits of Faster Thrombolysis Time Quantified

FRIDAY, March 14, 2014 (HealthDay News) -- Faster thrombolysis treatment is associated with improved stroke outcome, with each minute of onset-to-treatment time saved correlating with an additional 1.8 days of healthy life, according to a study published online March 13 in Stroke.

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Oldest Old at High Risk for Insulin-Related Hypoglycemia

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

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Prehypertension Linked With Increased Risk of Stroke

THURSDAY, March 13, 2014 (HealthDay News) -- Prehypertension is associated with increased risk of stroke, according to research published online March 12 in Neurology.

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Multiple 60-Minute Massage Sessions Effective for Neck Pain

THURSDAY, March 13, 2014 (HealthDay News) -- Multiple 60-minute massage sessions are effective for neck dysfunction and pain among patients with chronic neck pain, according to a study published in the March/April issue of the Annals of Family Medicine.

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Glucosamine Fails to Prevent Knee Cartilage Deterioration

THURSDAY, March 13, 2014 (HealthDay News) -- Oral glucosamine supplementation is not associated with a decrease in knee cartilage deterioration among individuals with chronic knee pain, according to a study published online March 10 in Arthritis & Rheumatology.

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Health Education Not Routinely Provided to Patients

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

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AMA: CMS Wants Physician Input on Practice Transformation

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

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Prehospital Stroke Alerts Speed Door-to-CT Times

WEDNESDAY, March 12, 2014 (HealthDay News) -- Emergency medical services (EMS) prenotification regarding the arrival of patients who have had a stroke allows patients to bypass the emergency department and undergo computed tomography (CT) in a timely manner, according to a study published in the March issue of Neurosurgery.

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About One-Quarter of Patients With MCI Progress to Dementia

WEDNESDAY, March 12, 2014 (HealthDay News) -- About 22 percent of patients with mild cognitive impairment (MCI) progress to dementia within three years, and depression symptoms modify the prognosis, according to a study published in the March/April issue of the Annals of Family Medicine.

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Info, Motivation, Behavioral Skill Affect Med Adherence

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

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More Lumbar Sx Complications at Teaching Hospitals

WEDNESDAY, March 12, 2014 (HealthDay News) -- Patients undergoing lumbar spine surgery at teaching hospitals incur longer hospitalizations and have more postoperative complications compared to those treated at nonteaching hospitals, according to a study published in the March 1 issue of Spine.

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Medicare Drug Plan Changes Withdrawn by White House

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

Other Health Highlights: March 11, 2014

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

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

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

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

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Patients Prefer Specific Info From Docs for Prostate Cancer

TUESDAY, March 11, 2014 (HealthDay News) -- Although patients with prostate cancer endorse multiple sources of information, they report greatest satisfaction with information from the treating physician about patient outcomes, according to research to be published in the May issue of The Journal of Urology.

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High-Fiber Diet Cuts Risk of Colorectal Adenoma

TUESDAY, March 11, 2014 (HealthDay News) -- There is a significant inverse relationship between total dietary fiber intake and risk of colorectal adenoma (CRA), according to research published in the March issue of Gastroenterology.

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Blood Test May Have Power to Predict Alzheimer's Disease

MONDAY, March 10, 2014 (HealthDay News) -- A blood test has been developed that can predict with 90 percent certainty whether a senior will suffer from dementia such as Alzheimer's disease within the next few years, according to a study published online March 9 in Nature Medicine. The test relies on levels of 10 lipids in the bloodstream to estimate the chances of either mild cognitive impairment or the beginnings of Alzheimer's disease.

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Comprehensive Geriatric Test Predicts Long-Term Mortality

MONDAY, March 10, 2014 (HealthDay News) -- For older patients hospitalized with heart failure, a comprehensive geriatric assessment (CGA) score is associated with mortality over two years, according to a study published online March 4 in Circulation: Cardiovascular Quality and Outcomes.

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Nocturnal Respiratory Rate Predicts Cardiac Risk After MI

MONDAY, March 10, 2014 (HealthDay News) -- Among survivors of acute myocardial infarction (MI), nocturnal respiratory rate (NRR) is significantly associated with cardiac mortality, particularly non-sudden cardiac death, according to research published online March 5 in the Journal of the American College of Cardiology.

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Hearing Impairment in Adults Linked to Depression

MONDAY, March 10, 2014 (HealthDay News) -- Hearing impairment (HI) is associated with depression, especially for older women, according to a study published online March 6 in JAMA Otolaryngology-Head & Neck Surgery.

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Consultant Offers Tips for Evaluating Staff Pay

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

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Keeping Salaries Secret Harms Worker Performance

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

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Higher Cardiovascular Events Risk After Outbursts of Anger

FRIDAY, March 7, 2014 (HealthDay News) -- There is a heightened risk of cardiovascular events in the hours following an angry outburst, according to research published online March 3 in the European Heart Journal.

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FDA: Pfizer Voluntarily Recalls Certain Lots of Antidepressant

FRIDAY, March 7, 2014 (HealthDay News) -- Two lots of Pfizer's Effexor XR (venlafaxine HCl) are being recalled because they may contain capsules of another drug, Tikosyn (dofetilide), used to treat heart rhythm disorders.

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Palliative Chemo for Terminal Cancer Linked to Death in ICU

FRIDAY, March 7, 2014 (HealthDay News) -- Terminally ill patients with cancer who receive chemotherapy at the end of life are at increased risk of dying in an intensive care unit (ICU) and receiving cardiopulmonary resuscitation (CPR) and/or mechanical ventilation, according to research published March 4 in BMJ.

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Women More Sensitive Than Men to Sublingual Zolpidem

FRIDAY, March 7, 2014 (HealthDay News) -- Clearance of zolpidem (administered as a sublingual tablet; ZST) is lower in females compared to males, according to a study published in the March issue of The Journal of Clinical Pharmacology.

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AMA Grants Curriculum Efforts to Address Health Disparities

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

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Physicians Better Able to Recall Narratives About Rx Guidelines

FRIDAY, March 7, 2014 (HealthDay News) -- Physicians show better recall after reading evidence-based narratives, rather than summaries, of opioid prescribing guidelines, according to a study published online Feb. 20 in Academic Emergency Medicine.

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Gender Gap Exists in Domestic Duties of Working Physicians

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

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Relative Value Units Useful In Evaluating Practice Finances

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

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New Guidelines Issued for Valvular Heart Disease in Adults

THURSDAY, March 6, 2014 (HealthDay News) -- New recommendations have been issued for the diagnosis and management of valvular heart disease (VHD) in adults, according to the American Heart Association/American College of Cardiology guidelines published online March 4 in the Journal of the American College of Cardiology.

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Drop in Compensation Gap for Primary Care Docs, Specialists

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

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Web-Based Mental Health Screening Feasible, Acceptable

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

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Alcohol, Especially Wine, May Reduce CV Risk in Diabetes

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

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Prostatectomy Cuts Mortality in Early Prostate Cancer

THURSDAY, March 6, 2014 (HealthDay News) -- Surgical treatment reduces long-term mortality among men with localized prostate cancer compared with those who undergo watchful waiting, according to research published in the March 6 issue of the New England Journal of Medicine.

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Alzheimer's Disease Deaths May Be More Than Reported

WEDNESDAY, March 5, 2014 (HealthDay News) -- About half a million deaths in the United States may be attributable to Alzheimer's disease (AD), more than five times as many as previously reported and similar to the number of deaths from heart disease and cancer, according to a study published online March 5 in Neurology.

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Value-Based Insurance Plans Can Up Rx Adherence

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

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Gap in Regulatory Coverage Affects 5 to 16 Percent of Trials

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

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WHO Program Improves U.S. Medical Facility Hand Hygiene

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

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Docs Nominate Top U.S. Internal Medicine Residency Programs

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

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Women-Specific Research Is Still Inadequate

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

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Patient Activation Predicts Bowel Preparation Quality

MONDAY, March 3, 2014 (HealthDay News) -- Lower patient activation, but not limited health literacy, is an independent predictor of suboptimal colonoscopy bowel preparation quality, according to a study published in the March issue of Clinical Gastroenterology and Hepatology.

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Persistent Post-Cardiac Surgery Pain Seen at 24 Months

MONDAY, March 3, 2014 (HealthDay News) -- For patients undergoing cardiac surgery, persistent postoperative pain decreases over time and is 9.5 percent at 24 months after surgery, according to a study published online Feb. 24 in CMAJ, the journal of the Canadian Medical Association.

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CMS: No More Delays to ICD-10 Implementation Deadline

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

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