April 2007 Briefing - Internal Medicine

Here are what the editors at HealthDay consider to be the most important developments in Internal Medicine for April 2007. 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.

Implantable Defibrillator Leads Often Fail in First 10 Years

MONDAY, April 30 (HealthDay News) -- The failure rate of implantable cardioverter-defibrillator leads is as high as 20 percent after 10 years, with high failure rates in females and in younger patients, according to a report published online April 30 in Circulation: Journal of the American Heart Association. The most common problems are insulation defects and lead fractures.

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FDA Approves Humate-P for Von Willebrand Surgery

MONDAY, April 30 (HealthDay News) -- The U.S. Food and Drug Administration has approved Humate-P (Antihemophilic Factor/von Willebrand Factor Complex) to help prevent excessive bleeding in patients with von Willebrand disease who are undergoing surgery.

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Interferon-β Slows Multiple Sclerosis Progression

MONDAY, April 30 (HealthDay News) -- In patients with relapsing-remitting multiple sclerosis, treatment with interferon-β significantly slows disease progression, according to a report published in the April issue of the Annals of Neurology.

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Socioeconomic Status Health Gap Increases with Age

FRIDAY, April 27 (HealthDay News) -- The health-related gap between low-income and high-income patients tends to widen with age, with individuals in lower occupational grades aging faster, according to the results of a study published online April 27 in BMJ.

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Hepatitis Antigen Levels Guide Dosing Post Liver Transplant

FRIDAY, April 27 (HealthDay News) -- The preoperative level of hepatitis B surface antigen (HBsAg) in hepatitis B virus-infected patients undergoing liver transplantation determines the dose of hepatitis B immunoglobulin (HBIG) required to reduce HBsAg levels and raise anti-HBs postoperatively, researchers report in the April issue of the Journal of Hepatology.

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Bronchiolitis Obliterans Seen in California Workers

FRIDAY, April 27 (HealthDay News) -- Seven cases of bronchiolitis obliterans, also known as "popcorn worker's lung" due to previous cases reported in the microwave popcorn industry, have been diagnosed from 2004 to 2007 among workers in the flavor-manufacturing industry in California, according to a report in the April 27 issue of the Morbidity and Mortality Weekly Report.

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Aspirin Does Not Improve Cognition in Elderly Women

FRIDAY, April 27 (HealthDay News) -- Long-term low-dose aspirin does not improve overall cognition in elderly women, although it may reduce the risk of decline in category fluency, according to a report published online April 27 in BMJ.

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Piperazines Are New, Potentially Dangerous Party Drugs

FRIDAY, April 27 (HealthDay News) -- Physicians should be aware of the potential side effects of a new type of party drug containing 1-benzylpiperazine because commercially available urine toxicology screening kits may not detect it, according to a case report published in the April 28 issue of The Lancet.

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New Candida Drug Efficacious for Invasive Infections

FRIDAY, April 27 (HealthDay News) -- A new treatment for invasive candidosis and candidemia is as effective as liposomal amphotericin B but with fewer side effects, including fewer kidney function problems, researchers report online April 26 in The Lancet.

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FDA Says PharmaFab Inc. to Halt Illegal Manufacturing

THURSDAY, April 26 (HealthDay News) -- The U.S. Food and Drug Administration has announced that PharmaFab Inc. will cease manufacturing more than 100 prescription and over-the-counter drugs. The company and its subsidiary, PFab LP, manufactured unapproved drugs under conditions that did not meet current good manufacturing practice.

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New Biomarker Spots Prostate Cancer

THURSDAY, April 26 (HealthDay News) -- A new biomarker for prostate cancer, early prostate cancer antigen-2, or EPCA-2, is so sensitive it can tell the difference between organ-confined and metastasized prostate cancer, researchers report in the April issue of Urology.

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Study of 30 Countries Finds Alcohol Policies Reduce Use

THURSDAY, April 26 (HealthDay News) -- Countries with stronger alcohol control policies do indeed have lower alcohol consumption, which should provide useful information for policymakers trying to reduce alcohol-related harm, researchers report in the April issue of PLoS Medicine.

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Physician-Industry Relationships Common

WEDNESDAY, April 25 (HealthDay News) -- Nearly all physicians have some relationship with industry, with about one-third being reimbursed for professional meetings or continuing medical education and more than one-quarter receiving payments for consulting and other activities, according to the results of a nationwide survey published in the April 26 New England Journal of Medicine.

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East Asian Lung Cancer Patients Often Over-Produce EGFR

WEDNESDAY, April 25 (HealthDay News) -- In general, healthy patients who are East Asian are less likely than other patients to have genetic variations that produce high levels of epidermal growth factor receptor (EGFR), according to a report in the April issue of PLoS Medicine. However, among patients with non-small cell lung cancer, East Asians are more likely to have a polymorphism that over-expresses EGFR, which may explain their better response to EGFR-targeting chemotherapy.

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ResMed Recalls Generators Used in Sleep Apnea Therapy

WEDNESDAY, April 25 (HealthDay News) -- ResMed, of San Diego, has initiated a worldwide voluntary recall of approximately 300,000 units of its S8 flow generators, used to treat obstructive sleep apnea. A short circuit in the power supply connector made by another company can cause the unit to fail.

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Heart Guidelines Still Beneficial for 90-Year-Olds

WEDNESDAY, April 25 (HealthDay News) -- Elderly patients, aged 90 years and older, with non-ST-segment elevation acute coronary syndromes can still benefit from following guideline-recommended therapies, according to a report in the May 1 issue of the Journal of the American College of Cardiology.

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Drug Reps Befriend Physicians to Increase Sales

TUESDAY, April 24 (HealthDay News) -- Pharmaceutical company representatives use various tactics to gain "friendships" with physicians, each depending on the personality of the doctor, in order to sway prescription sales, according to a Policy Forum report in the April issue of PLoS Medicine.

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Non-PCV7 Pneumococcal Serotypes Emerging in Alaska

TUESDAY, April 24 (HealthDay News) -- Non-vaccine serotypes of invasive Streptococcus pneumoniae are emerging in Alaska Native children where 7-valent pneumococcal conjugate vaccine (PCV7) coverage is high, researchers report in the April 25 issue of the Journal of the American Medical Association.

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Early Menarche Linked to Offspring's Obesity Risk

TUESDAY, April 24 (HealthDay News) -- Women who enter menarche at an early age may be twice as likely to have children who become obese as women with later menarche, researchers report in the April issue of PLoS Medicine.

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Breast-Feeding Doesn't Reduce Children's Obesity Risk

TUESDAY, April 24 (HealthDay News) -- Contrary to previous research cited by the U.S. Centers for Disease Control and Prevention and other groups, breast-feeding in infancy does not prevent obesity in adulthood, according to the results of a study published online April 24 in the International Journal of Obesity.

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No Clear Benefit of Obesity Screening in Young Children

TUESDAY, April 24 (HealthDay News) -- There is no inherent benefit of screening children for overweight and obesity unless effective treatments are also made available, according to a report published in the April issue of the Archives of Disease in Childhood.

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Children with Alzheimer Gene Variant Have Thinner Cortex

TUESDAY, April 24 (HealthDay News) -- Children who carry the Alzheimer-related variant of the apolipoprotein E (ApoE) gene have a thinner cortex in the left entorhinal region, which may make them more susceptible to degenerative changes and mental decline in middle and old age, according to study findings published online April 24 in The Lancet Neurology.

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Generic Versions of Ambien Approved by FDA

TUESDAY, April 24 (HealthDay News) -- The U.S. Food and Drug Administration has approved the first generic versions of Ambien for the short-term treatment of insomnia. The patent for zolpidem tartrate, awarded to Sanofi-Aventis, expired in April this year.

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Helicobacter pylori May Lower Asthma and Allergy Risks

MONDAY, April 23 (HealthDay News) -- Children who acquire the stomach bacterium Helicobacter pylori before age 10 may have a lower risk of allergy and asthma than other children, researchers report in the April 23 issue of the Archives of Internal Medicine.

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Memory Declines Less in People with Migraine

MONDAY, April 23 (HealthDay News) -- Memory in individuals diagnosed with migraines is initially worse but declines less with time than individuals without migraine, with the effect specific to individuals with aura and those over 50 years old, according to a report in the April 24 issue of Neurology.

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Obesity May Have Economic Toll in Workplace

MONDAY, April 23 (HealthDay News) -- Overweight individuals file more workers' compensation claims, miss more work and have costlier claims than do individuals with a recommended weight, researchers report in the April 23 issue of the Archives of Internal Medicine. A second study, however, finds that people over age 65 who have a slightly higher body mass index (BMI) have a lower mortality and risk of injury than those with the lowest and highest BMIs.

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Migraine in Men Linked to Cardiovascular Disease Risk

MONDAY, April 23 (HealthDay News) -- Men who experience migraine headaches are at higher risk of developing cardiovascular disease, particularly myocardial infarction, researchers report in the April 23 issue of the Archives of Internal Medicine.

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Chitin in Insects, Fungi, Worms Can Induce Allergy in Mice

MONDAY, April 23 (HealthDay News) -- Chitin, the rigid polymer found in insect exoskeletons, fungal cell walls, crustacean shells and the eggshells of parasitic worms, can induce allergic responses in the lungs of mice and may play a key role in asthma in humans, according to a report published online April 22 in Nature.

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Drug Helps Correct Muscular Dystrophy Defect in Mice

MONDAY, April 23 (HealthDay News) -- A drug that corrects a genetic defect found in some cases of muscular dystrophy and other genetic disorders is effective in improving muscle function in a mouse model of muscular dystrophy, according to a report published online April 22 in Nature.

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Intense Chemotherapy May Not Be Better for Gastric Cancer

FRIDAY, April 20 (HealthDay News) --Despite earlier evidence, a more intensive chemotherapy regimen for gastric cancer has no benefit in terms of survival or relapse than less intensive regimens, according to a study in the April 18 issue of the Journal of the National Cancer Institute.

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AHA Says Most Don't Need Antibiotics Before Dentist Visit

FRIDAY, April 20 (HealthDay News) -- Only patients at the highest risk of infective endocarditis should have prophylactic antibiotic treatment before routine dental procedures, according to updated guidelines from the American Heart Association published in the April 19 issue of Circulation: Journal of the American Heart Association. High-risk patients would include those with a history of endocarditis, a heart transplant or an artificial valve transplant.

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Treatment Fails to Cure Two U.S. Rabies Cases

FRIDAY, April 20 (HealthDay News) -- An experimental treatment that saved a Wisconsin girl who did not have postexposure prophylaxis after contracting rabies in 2004 did not cure two similar children diagnosed in 2006, according to a report in the April 20 Morbidity and Mortality Weekly Report.

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Cognitive Therapy Helps Relatives of Suicide Cases

FRIDAY, April 20 (HealthDay News) -- Relatives and spouses bereaved by suicide who undergo cognitive behavior therapy are less likely to blame themselves for the death, but they still endure complicated feelings of grief and depression and may contemplate their own suicide, according to a study published online April 20 in the BMJ.

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Local IgE Response May Indicate Asthma Outcome

FRIDAY, April 20 (HealthDay News) -- Local measures of IgE-mediated responses in the airway may reflect the mucosal immune response and help predict clinical outcome from asthma, according to a report in the April Journal of Allergy and Clinical Immunology.

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Salt Restriction May Reduce Cardiovascular Disease

FRIDAY, April 20 (HealthDay News) -- Patients who reduce their dietary sodium intake by about one-third could significantly reduce their chances of developing cardiovascular disease, according to a study published online April 20 in the BMJ.

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Global Prevalence of Hypertension Is on the Rise

THURSDAY, April 19 (HealthDay News) -- The prevalence of hypertension is increasing around the world due to aging and obesity, and more research and better application of existing knowledge is needed, according to an editorial in the May issue of Hypertension. The authors noted that May 17 is World Hypertension Day.

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Risk of Drug Interactions High in Cancer Patients

THURSDAY, April 19 (HealthDay News) -- About one-quarter of cancer patients are taking medications that could potentially interact with other drugs, and non-cancer therapeutics such as warfarin and anti-hypertensives are most likely to be a problem, according to a study in the April 18 issue of the Journal of the National Cancer Institute.

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New Esophageal Reflux Testing Guidelines Issued

THURSDAY, April 19 (HealthDay News) -- New technologies such as wireless capsule pH monitoring and bile acid reflux monitoring can help in the diagnosis and treatment of patients with gastroesophageal reflux disease, according to new guidelines from the American College of Gastroenterology. The guidelines are published in the March issue of the American Journal of Gastroenterology.

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Women More Likely to Skip Needed Care Due to Cost

THURSDAY, April 19 (HealthDay News) -- Women have greater difficulty than men in affording health insurance and have greater out-of-pocket expenses even if they do have insurance, leading more women than men to forgo needed care, according to a report from the Commonwealth Fund.

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U.S. Nail-Gun Injuries Have Doubled Since Early 1990s

THURSDAY, April 19 (HealthDay News) -- Nail-gun injuries treated at U.S. emergency departments have increased more than 200 percent since 1991, and tripled among people using them outside of work, according to a report in the April 13 issue of Morbidity and Mortality Weekly Report.

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Pneumonia Raises Long-Term Mortality Risk in Seniors

THURSDAY, April 19 (HealthDay News) -- Hospitalization for community-acquired pneumonia raises the risk of one-year and five-year mortality as much as hospital admission for congestive heart failure, stroke or major fracture, regardless of comorbid conditions, according to a study in the April issue of the Journal of the American Geriatrics Society.

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Rosiglitazone May Worsen Edema in Heart Failure Patients

THURSDAY, April 19 (HealthDay News) -- Rosiglitazone improves glycemic control but does not affect left ventricular ejection fraction in patients with type 2 diabetes and chronic heart failure, according to a report in the April 24 issue of the Journal of the American College of Cardiology. Rosiglitazone-treated patients also tend to have more problems with edema.

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Fewer Transfusions OK in Critically Ill Children

WEDNESDAY, April 18 (HealthDay News) -- A strategy of using a lower hemoglobin threshold before the infusion of red blood-cells can decrease transfusions without increasing adverse outcomes in stable, critically ill children, according to a report in the April 19 issue of the New England Journal of Medicine.

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U.S. Breast Cancer Cases Sharply Declined in 2003

WEDNESDAY, April 18 (HealthDay News) -- Breast cancer incidence in the United States declined sharply in 2003, possibly because many postmenopausal women stopped using hormone-replacement therapy after the 2002 Women's Health Initiative study found it increased the risk of heart disease and breast cancer. The findings are published in the April 19 issue of the New England Journal of Medicine.

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U.S. Report Finds Electronic Prescribing Cuts Errors, Cost

WEDNESDAY, April 18 (HealthDay News) -- Electronic prescribing cuts medication costs and reduces prescribing errors, according to a report on a Medicare e-prescribing pilot project released by the U.S Department of Health and Human Services to Congress this week.

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Autoantibody Response Linked to Dilated Cardiomyopathy

WEDNESDAY, April 18 (HealthDay News) -- The Fcγ receptors IIa on cardiomyocytes may be the reason why autoantibodies generated in patients with dilated cardiomyopathy can trigger negative inotropic effects, according to a report in the April 24 issue of the Journal of the American College of Cardiology.

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Walkable Neighborhood Linked to Less Depression in Elders

WEDNESDAY, April 18 (HealthDay News) -- Older men who live in areas that are walking-friendly are less prone to depression than those who do not, according to a study in the April issue of the Journal of the American Geriatrics Society.

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Shock Wave Lithotripsy Effective for Pancreatitis Pain

WEDNESDAY, April 18 (HealthDay News) -- Treatment with extracorporeal shock wave lithotripsy is safe and effective in select patients with painful, chronic pancreatitis, but combining the treatment with endoscopy does not further reduce pain and is more expensive, according to a study in the April issue of Gut.

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FDA Approves First Vaccine for Avian Influenza

TUESDAY, April 17 (HealthDay News) -- The U.S. Food and Drug Administration has approved the first human vaccine to protect against the avian influenza virus, H5N1. In the case of a pandemic, the vaccine may provide "early limited protection" until a vaccine specific to the circulating strain is produced, according to the agency.

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For-Profit Dialysis Centers May Have Over-Used Epoetin

TUESDAY, April 17 (HealthDay News) -- End-stage renal disease patients treated at large, for-profit dialysis facilities may have received high amounts of red cell-boosting epoetin regardless of anemia status, according to a study published in the April 18 issue of the Journal of the American Medical Association. The U.S. Food and Drug Administration recently issued a warning recommending that the use of such erythropoiesis-stimulating agents be limited due to the potential risks of the drugs.

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Rotavirus Present in Blood of Most Infected Children

TUESDAY, April 17 (HealthDay News) -- Most children with gastroenteritis and rotavirus-positive stools have rotavirus antigens and infectious virus in the blood that is independent of the presence of diarrhea, according to a study published online April 16 in PLoS Medicine.

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Study Finds Chondroitin Not Beneficial for Arthritis Pain

TUESDAY, April 17 (HealthDay News) -- A pooled analysis of well-designed trials examining the use of chondroitin to treat osteoarthritis pain has shown that chondroitin has no clear benefit but does not increase the risk of adverse events, according to a study in the April 17 issue of the Annals of Internal Medicine.

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Tai Chi May Boost Immunity After Vaccination

TUESDAY, April 17 (HealthDay News) -- Older adults who take up the ancient Chinese form of exercise, Tai Chi, have a higher level of cell-mediated immunity after varicella zoster vaccination than adults who do not, according to a randomized, placebo-controlled trial in the April issue of the Journal of the American Geriatrics Society.

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Obesity Linked to Otitis Media in Children

MONDAY, April 16 (HealthDay News) -- Children who are obese may have a higher risk of otitis media with effusion than children who are not, according to a report in the April issue of Archives of Otolaryngology -- Head & Neck Surgery.

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Some U.S. Foodborne Illnesses Drop, But Others Rise

MONDAY, April 16 (HealthDay News) -- Rates of some foodborne illnesses dropped in the United States in 2006, but others increased, including infections from raw seafood, according to preliminary data published in the April 13 issue of the Morbidity and Mortality Weekly Report.

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Allele Increases Proteinuria Risk in Lupus Patients

MONDAY, April 16 (HealthDay News) -- Patients with systemic lupus erythematosus have a higher risk of new or worsening proteinuria if they are younger, have anti-dsDNA antibodies, or have the HLA-DRB1*1503 allele, according to a study in the April issue of Rheumatology.

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High Intake of Cured Meats May Impair Lung Function

MONDAY, April 16 (HealthDay News) -- High consumption of cured meats is associated with impaired respiratory function and a higher risk of developing chronic obstructive pulmonary disease (COPD), according to a study in the April 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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Six U.S. Deaths Due to MRSA Pneumonia in Children, Adults

FRIDAY, April 13 (HealthDay News) -- Influenza complicated by severe methicillin-resistant Staphylococcus aureus (MRSA) community-acquired pneumonia caused six deaths among previously healthy children and adults in Louisiana and Georgia in December 2006 and January 2007, according to a report in the April 13 issue of the Morbidity and Mortality Weekly Report. The U.S. Centers for Disease Control and Prevention said such cases may be on the rise and physicians should be vigilant for the signs and symptoms.

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Fluoroquinolones No Longer Recommended for Gonorrhea

FRIDAY, April 13 (HealthDay News) -- Fluoroquinolones are no longer recommended for the treatment of gonorrhea due to increasing antibiotic resistance, according to updated guidelines from the U.S. Centers for Disease Control and Prevention published in the April 13 issue of the Morbidity and Mortality Weekly Report.

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FDA Approves New Type of Antibiotic for Impetigo

FRIDAY, April 13 (HealthDay News) -- The U.S. Food and Drug Administration has approved a new molecular entity, Altabax (retapamulin ointment), for the treatment of impetigo caused by Staphylococcus aureus or Streptococcus pyogenes in patients 9 months of age and older.

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Depression, Stress Linked to Risk for Metabolic Syndrome

FRIDAY, April 13 (HealthDay News) -- Middle-aged women who are depressed, have experienced very stressful life events or often feel angry and tense are at greater risk than other women of developing metabolic syndrome, according to a report in the April issue of Diabetes Care.

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Audiovisual Reminder Helps Asthmatics Adhere to Meds

FRIDAY, April 13 (HealthDay News) -- An audiovisual reminder function incorporated into a standard metered-dose inhaler helps asthma patients adhere to their inhaled corticosteroid therapy, according to study findings published in the April issue of the Journal of Allergy and Clinical Immunology.

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Microscopic Colitis May Be More Common Than Thought

FRIDAY, April 13 (HealthDay News) -- The incidence of microscopic colitis may be increasing, researchers report in the April issue of Gut. In a Minnesota study, cases of microscopic colitis increased from 1.1 per 100,000 in 1985 to 19.6 per 100,000 in 2001.

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Young Smokers Have Impaired Left Ventricular Function

FRIDAY, April 13 (HealthDay News) -- In otherwise healthy young adults, smoking has chronic and acute adverse effects on left ventricular diastolic function, according to the results of a study published in the April issue of Chest.

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FDA Adds Warning to Zanaflex Label

FRIDAY, April 13 (HealthDay News) -- The U.S. Food and Drug Administration has changed the label for the spasticity drug Zanaflex (tizanidine hydrochloride) to warn that its use is contraindicated in patients taking fluvoxamine, ciprofloxacin or other CYP1A2 inhibitors due to a potentially dangerous increase in the risk of sedation and hypotension.

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Telemonitoring Improves Heart Failure Patient Outcome

FRIDAY, April 13 (HealthDay News) -- Remote monitoring that includes structured telephone support or telemonitoring helps improve clinical outcomes in community-dwelling patients with heart failure, researchers report in the April 10 online edition of BMJ. Remote monitoring may help those with poor access to health care due to geography, transport or infirmity.

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H. pylori Eradication Reverses B-12 Deficiency in Elderly

THURSDAY, April 12 (HealthDay News) -- In elderly patients with vitamin B-12 deficiency, the eradication of Helicobacter pylori infection increases serum levels of B-12 and decreases serum levels of homocysteine, according to a study published in the April issue of Gut.

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Lung Adenocarcinoma Declining in U.S. Men, Women

THURSDAY, April 12 (HealthDay News) -- Since 1999, the incidence of adenocarcinoma of the lung has declined in both men and women in the United States, but the reasons for this trend remain unclear, according to a study published in the April issue of Chest.

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Common Gene Variant Linked to Obesity Risk

THURSDAY, April 12 (HealthDay News) -- A common variant in the FTO gene, which currently has an unknown function, increases the risk for obesity by 67 percent for homozygous carriers, according to a report published April 12 in Science. An analysis of mostly European adults and children suggests that about 16 percent of people are homozygous for the variant.

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More States Planning Medicaid Pay-for-Performance Plans

THURSDAY, April 12 (HealthDay News) -- More than half of U.S. state Medicaid programs have pay-for-performance plans, a proportion expected to increase to 85 percent in five years, according to a report published by The Commonwealth Fund. Some states may offer greater reimbursement to providers because of concerns that such programs will cause physicians to limit or exclude Medicaid patients.

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FDA Warns of Counterfeit Labels on HIV Drugs

THURSDAY, April 12 (HealthDay News) -- The U.S. Food and Drug Administration and GlaxoSmithKline issued a warning on Wednesday that tampering may have resulted in the misbranding of the HIV drug Ziagen (abacavir sulfate) as Combivir (lamividine and zidovudine).

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CRP Levels Higher in Children of Hypertensive Parents

THURSDAY, April 11 (HealthDay News) -- Children whose parents have essential hypertension are more likely to have high levels of C-reactive protein (CRP) than their counterparts whose parents do not have high blood pressure, according to the results of a study published in the April issue of the Archives of Disease in Childhood.

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Community Hospital Stays Often Due to Mental Health

THURSDAY, April 12 (HealthDay News) -- About one-fourth of community hospital patients who are admitted have substance abuse or a mental health problems such as depression or schizophrenia, according to an analysis of 2004 data by the Agency for Healthcare Research and Quality.

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Cost-Sharing Not Likely to Reduce Health Care Costs

THURSDAY, April 12 (HealthDay News) -- Efforts to reduce health care spending by involving the patient in cost-sharing will probably have a limited effect because many physicians don't consider patient out-of-pocket costs when making clinical decisions, researchers report in the April 9 issue of the Archives of Internal Medicine.

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Statins May Reduce Influenza and COPD Death Risk

WEDNESDAY, April 11 (HealthDay News) -- Patients who take statins in moderate doses have a reduced risk of death from chronic obstructive pulmonary disease (COPD) and influenza compared to those who do not, according to the results of a study published in the April issue of Chest.

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Pain Control Often Inadequate in End-Stage Osteoarthritis

WEDNESDAY, April 11 (HealthDay News) -- Patients with advanced osteoarthritis of the hips or knees who are waiting for joint replacement surgery experience high levels of pain but many do not discuss their pain or osteoarthritis with their physician, according to a report in the April issue of Rheumatology.

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Four Genes Key in Breast Cancer Metastasis to Lung

WEDNESDAY, April 11 (HealthDay News) -- The expression of four genes, which produce epiregulin, cyclooxygenase-2 (COX2) and the matrix metalloproteinases 1 and 2, collectively spur the growth of breast tumors as well as metastasis to the lung, according to a study in the April 12 issue of Nature. Animal studies suggest that blocking the genes with RNA interference or a combination of cetuximab (Erbitux) and celecoxib (Celebrex) may help prevent metastasis.

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Knowledge of tPA for Stroke Low Among Rural Physicians

WEDNESDAY, April 11 (HealthDay News) -- Non-neurologist rural physicians are becoming more knowledgeable about the use of recombinant tissue plasminogen activator (tPA) for the treatment of stroke, but the level of knowledge is still relatively low and physicians need more education, researchers report in the April issue of the Archives of Neurology.

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Nursing Home Environment Related to Antipsychotic Therapy

WEDNESDAY, April 11 (HealthDay News) -- Residents who live in nursing homes that tend to be high prescribers of antipsychotic drugs are three times more likely to receive such a drug than are their counterparts in nursing homes with low prescribing rates, regardless of whether or not they actually need antipsychotics, according to a report in the April 9 issue of the Archives of Internal Medicine.

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Genetic Links to Acute Coronary Syndromes Debunked

TUESDAY, April 10 (HealthDay News) -- Gene variations may not be risk factors for acute coronary syndromes, according to the results of a study published in the April 11 issue of the Journal of the American Medical Association.

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Type 2 Diabetes Linked to Risk of Mild Cognitive Impairment

TUESDAY, April 10 (HealthDay News) -- Patients with type 2 diabetes mellitus are at greater risk of developing mild cognitive impairment than non-diabetic patients, researchers report in the April issue of the Archives of Neurology.

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Postoperative Corticosteroids May Benefit Heart Patients

TUESDAY, April 10 (HealthDay News) -- In patients who undergo cardiac surgery, postoperative corticosteroid therapy may reduce the risk of atrial fibrillation, according to study findings published in the April 11 issue of the Journal of the American Medical Association.

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Experimental Flu Vaccine Created in Insect Cells

TUESDAY, April 10 (HealthDay News) -- An experimental influenza vaccine produced in insect cells appears to be safe and effective in early testing, making it a possible alternative to vaccines made using embryonated hen's eggs, researchers report in the April 11 issue of the Journal of the American Medical Association.

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Size of Protein Indicates Risk in Monoclonal Gammopathy

TUESDAY, April 10 (HealthDay News) -- Patients with monoclonal gammopathy of undetermined significance, or MGUS, are more likely to progress to malignancy if their M protein increases in size over time, according to a report in the April issue of the Mayo Clinic Proceedings.

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One-Year Survival Less than 50 Percent for Calciphylaxis

TUESDAY, April 10 (HealthDay News) -- Calciphylaxis is a multifactorial disease characterized by ischemic cutaneous ulceration with a one-year mortality rate of less than 50 percent, according to a report in the April issue of the Journal of the American Academy of Dermatology.

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Retigabine Reduces Partial-Onset Seizures

TUESDAY, April 10 (HealthDay News) -- Treatment with the investigational drug retigabine, which opens potassium channels, is a safe and effective adjunctive therapy for patients with partial-onset seizures, according to study findings published in the April 10 issue of Neurology.

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Statin Usage Affected by Insurance Coverage

MONDAY, April 9 (HealthDay News) -- Elderly patients reduce their usage of statins after switching from full insurance coverage to copayment and coinsurance, according to a report in the April 9 issue of Circulation: Journal of the American Heart Association.

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Most Doctors Say Religion Plays Role in Patient Health

MONDAY, April 9 (HealthDay News) -- More than half of physicians believe that religion and spirituality affect patient health in some way, according to the results of a survey published in the April 9 issue of the Archives of Internal Medicine.

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Polyphenol-Rich Cocoa May Help Lower Blood Pressure

MONDAY, April 9 (HealthDay News) -- Foods rich in cocoa, a common source of heart-healthy polyphenols, may help reduce blood pressure, while tea, another major source of polyphenols, has no effect, researchers report in the April 9 issue of the Archives of Internal Medicine.

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Questionnaire Predicts Mortality After Heart Failure

MONDAY, April 9 (HealthDay News) -- A simple health assessment questionnaire given regularly can help predict the risk of mortality and hospitalization in patients with heart failure, according to a report in the April 9 issue of Circulation: Journal of the American Heart Association.

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Restless Legs Syndrome Increases Blood Pressure

MONDAY, April 9 (HealthDay News) -- In patients with restless legs syndrome, blood pressure spikes associated with periodic leg movements during sleep could increase the risk of cardiovascular disease, especially in the elderly, according to the results of a small study published in the April 10 issue of Neurology.

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FDA Halts Sale of Suppositories with Trimethobenzamide

MONDAY, April 9 (HealthDay News) -- The U.S. Food and Drug Administration has warned drug manufacturers to stop making and marketing suppositories containing trimethobenzamide hydrochloride for nausea and vomiting. The suppositories have been sold under the names Tigan, Trimethobenz, Tebamide, T-Gen and Trimazide, but the FDA states that they are not approved and there is no proof that they work.

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Public Health Policies Cut Flu Deaths in 1918 Pandemic

MONDAY, April 9 (HealthDay News) -- Non-pharmacological public health interventions, such as closing schools, churches and theaters, helped reduce mortality during the 1918 influenza virus pandemic, according to two reports published online April 6 in the Proceedings of the National Academy of Sciences Early Edition. However, some cities had only a small benefit because they started restrictions too late or lifted them too early.

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Chest Tubes, Fibrinolytics Effective for Pleural Infection

FRIDAY, April 6 (HealthDay News) -- Image-guided placement of chest tubes and intrapleural urokinase or tissue-type plasminogen activator are highly effective in treating pleural infection, researchers report in the April issue of the Mayo Clinic Proceedings.

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Newborn Screening for Cystic Fibrosis Saves Money

FRIDAY, April 6 (HealthDay News) -- Newborn screening for cystic fibrosis saves money in treatment costs in the long run and such programs should be adopted internationally, according to the results of a study published in the April 7 issue of The Lancet.

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Many MS Patients Lack Immunomodulatory Drugs

FRIDAY, April 6 (HealthDay News) -- Only 8 percent of multiple sclerosis patients in the United States who consulted an internist or a family physician and fewer than half of those who consulted a neurologist between 1998 and 2004 were treated with advanced immunomodulatory agents, according to a report published online April 5 in BMC Medicine.

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Pneumococcal Vaccine Cuts Hospitalizations in Children

FRIDAY, April 6 (HealthDay News) -- Routine vaccination with the seven-valent pneumococcal conjugate vaccine resulted in a 40 percent drop in pneumonia-related hospital admissions in children under age 2 in the United States, according to a new analysis published in the April 7 issue of The Lancet.

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Ibuprofen May Boost Heart Risk in Some Arthritis Patients

THURSDAY, April 5 (HealthDay News) -- Arthritis patients with a high risk of cardiovascular events who take high-dose ibuprofen in addition to aspirin are more likely to have a myocardial infarction or stroke than similar patients taking aspirin and a COX-2 inhibitor or naproxen, according to a report published online April 5 in the Annals of the Rheumatic Diseases.

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New Drug May Improve Therapy for Type 2 Diabetes

THURSDAY, April 5 (HealthDay News) -- Patients with type 2 diabetes who show suboptimal disease control with thiazolidinediones may benefit from added exenatide therapy, researchers report in the April 3 issue of the Annals of Internal Medicine.

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Mediterranean Diet May Protect Against Childhood Asthma

THURSDAY, April 5 (HealthDay News) -- Children living on the Greek island of Crete, whose diet is rich in fruits, vegetables and nuts, have fewer symptoms of asthma and other respiratory allergies than children in other populations, according to study findings published online April 5 in Thorax.

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Centenarian Survey Suggests Many Follow Current Events

WEDNESDAY, April 4 (HealthDay News) -- Strong faith, a healthy lifestyle and keeping current with popular culture are all characteristics of Americans turning 100 years old and older this year who are in good health, according to the results of a survey conducted by Evercare, a company that offers care coordination programs for people with advanced or chronic illness.

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Low Birth Weight Linked to Later Infection Risk

WEDNESDAY, April 4 (HealthDay News) -- Children with a low birth weight have a higher risk of being hospitalized for infectious diseases throughout childhood than their normal birth weight peers, and this is true even in infants who were not premature, researchers report in the April 1 issue of the American Journal of Epidemiology. The risk is highest at 2 to 6 months of age, but continues up to age 10.

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Exercise May Reduce Arthritis Risk in Older Women

WEDNESDAY, April 4 (HealthDay News) -- Women in their 70s may be less likely to develop arthritic joints if they perform even low levels of exercise, according to study findings published online March 29 in the open-access journal Arthritis Research & Therapy.

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Study Suggests Free RNA is Key Trigger of Clot Formation

WEDNESDAY, April 4 (HealthDay News) -- Free RNA is a natural coagulant that activates the blood-clotting cascade after damaged cells spill their intracellular contents, according to the results of an animal study published online April 3 in the Proceedings of the National Academy of Sciences. The finding suggests that RNase or other factors that break down RNA could have therapeutic potential as antithrombotics.

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Kidney Disease Management Poor in Black Neighborhoods

WEDNESDAY, April 4 (HealthDay News) -- The racial composition of a community is associated with time to kidney transplantation for those with end-stage renal disease and to the performance of the kidney dialysis facility that serves the community, according to a report in the April 3 issue of the Annals of Internal Medicine.

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Testicular Cancer Linked to Risk of Non-Cancer Death

WEDNESDAY, April 4 (HealthDay News) -- Men who survive testicular cancer for at least a year are at higher risk of death from infections as well as circulatory and digestive disorders, compared with the general population, according to the results of a study published in the April 4 issue of the Journal of the National Cancer Institute.

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Timing of Hormone Therapy May Affect Heart Risk

TUESDAY, April 3 (HealthDay News) -- A secondary analysis of data from the Women's Health Initiative suggests that the timing of hormone therapy may play a role in its cardiac risk. When started soon after menopause, hormone therapy appears to be associated with a non-significant reduction in coronary heart disease risk, according to a study in the April 4 issue of the Journal of the American Medical Association.

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Combination Therapy Found Effective in Migraine

TUESDAY, April 3 (HealthDay News) -- Combination treatment with sumatriptan and naproxen sodium is more effective for migraine than treatment with either agent alone, according to a report in the April 4 issue of the Journal of the American Medical Association.

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Intensive Therapy Speeds Bipolar Depression Recovery

TUESDAY, April 3 (HealthDay News) -- Patients who take medication for bipolar disorder are likely to recover from an episode of bipolar depression more quickly if they receive intensive psychotherapy instead of brief psychoeducational sessions, according to study findings published in the April issue of the Archives of General Psychiatry.

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Influenza B Viruses Showing Some Drug Resistance

TUESDAY, April 3 (HealthDay News) -- Influenza B viruses may be developing resistance against zanamivir and oseltamivir, according to a study published in the April 4 issue of the Journal of the American Medical Association.

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Alcohol Linked to Abdominal Aortic Aneurysm Risk

TUESDAY, April 3 (HealthDay News) -- Men who consume two or more alcoholic drinks per day have a higher risk of developing abdominal aortic aneurysm than those who drink less, according to a report in the April 1 issue of the American Journal of Epidemiology.

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Guidelines Say Not All Women in 40s Need Mammogram

TUESDAY, April 3 (HealthDay News) -- The risk of breast cancer can vary significantly in women in their 40s, and not all women in that age group may need annual mammograms, according to new guidelines from the American College of Physicians. Women and physicians should weigh the risks and benefits of mammography screening before age 50, researchers report in the April 3 issue of the Annals of Internal Medicine.

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False-Positive Mammograms May Affect Feelings, Actions

TUESDAY, April 3 (HealthDay News) -- False-positive results on screening mammography may have long-term effects on women's feelings and health behaviors, according to a review of 23 studies published in the April 3 issue of the Annals of Internal Medicine.

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Two-in-One Type 2 Diabetes Drug Gets Approval

TUESDAY, April 3 (HealthDay News) -- The U.S. Food and Drug Administration has approved a diabetes drug called Janumet that combines metformin and the dipeptidyl peptidase-4 inhibitor, sitagliptin. Janumet has been approved for patients with type 2 diabetes who already take both components separately or who take only one of the components and have not achieved adequate blood sugar control.

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Smokers Lose More Days of Work Than Non-Smokers

MONDAY, April 2 (HealthDay News) -- Smokers take an average of eight days' more sick leave per year than their non-smoking colleagues, according to the results of a Swedish study published in the April issue of Tobacco Control.

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Societal Per Capita Cost of Autism in U.S. is $3.2 Million

MONDAY, April 2 (HealthDay News) -- The estimated lifetime per capita cost of autism to society is $3.2 million, and the costs extend into adulthood with lost productivity and the need for adult care, according to study findings published in the April issue of the Archives of Pediatrics & Adolescent Medicine.

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Suicide Risk Warnings Have Cut Pediatric Antidepressant Use

MONDAY, April 2 (HealthDay News) -- The U.S. Food and Drug Administration's health advisory on the risk of suicidality associated with antidepressants resulted in a drop in such prescriptions in children and teens, according to a study in the April issue of the Archives of General Psychiatry. In addition, there was a small shift toward prescribing the non-selective serotonin reuptake inhibitor bupropion hydrochloride, despite the fact that it carries the same FDA warning as selective serotonin reuptake inhibitors.

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Amphetamine, Cocaine Users at Greater Risk of Stroke

MONDAY, April 2 (HealthDay News) -- Young adults who abuse amphetamines, cocaine and cannabis are at increased risk of stroke compared with their same-age counterparts who do not use illicit drugs, according to a report in the April issue of the Archives of General Psychiatry. Amphetamine users have twice the risk of hemorrhagic stroke as cocaine users.

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Infants Who Don't Respond to Name at Risk of Autism

MONDAY, April 2 (HealthDay News) -- Infants who fail to respond when their name is called at age 1 are at higher risk of developing autism or a related disorder compared to infants who do respond, researchers report in the April issue of the Archives of Pediatrics & Adolescent Medicine.

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Many Adolescent Urine Drug Tests Misinterpreted

MONDAY, April 2 (HealthDay News) -- Many adolescent urine drug tests are susceptible to misinterpretation due to overdilution or an inability to detect oxycodone that results in false negatives, or the use of prescription medications that result in false positives, researchers report in the April issue of Pediatrics.

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Stem Cell Therapy May Help Inflammatory Bowel Disease

MONDAY, April 2 (HealthDay News) -- Stem cell therapy may enhance tissue regeneration in inflammatory bowel disease by promoting the growth of new blood vessels, according to the results of a study in mice published in the March issue of Gastroenterology.

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FDA Approves Ceprotin to Treat Severe Protein C Deficiency

MONDAY, April 2 (HealthDay News) -- The U.S. Food and Drug Administration has licensed a new drug, Ceprotin, to treat patients with severe, inherited protein C deficiency. Ceprotin can be used in life-threatening events in patients with the rare disorder, including venous thromboembolism or Purpura fulminans.

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