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August 2014 Briefing - Neurology

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

Report Highlights Progress, Challenges in Health IT

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

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Teens Regress After Return-to-Activity Post-Concussion

FRIDAY, Aug. 29, 2014 (HealthDay News) -- High school athletes who return to the field with medical clearance within 60 days often experience a significant regression in their abilities to simultaneously walk and do simple mental tasks, according to a study published online Aug. 5 in Medicine & Science in Sports & Exercise.

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High Salt Intake May Worsen Multiple Sclerosis Symptoms

FRIDAY, Aug. 29, 2014 (HealthDay News) -- High sodium intake is associated with increased disease activity in multiple sclerosis (MS), according to research published online Aug. 28 in the Journal of Neurology, Neurosurgery & Psychiatry.

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Doctors Frequently Experience Ethical Dilemmas

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

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AMGA: Physician Turnover Still High in 2013

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

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Age Doesn't Impact Deep Brain Stimulation Complications

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

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CSF Biomarkers ID Alzheimer's, Independent of APOE Genotype

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

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Sensory Deficits Common in Patients With Multiple Myeloma

THURSDAY, Aug. 28, 2014 (HealthDay News) -- Treatment-naive patients with multiple myeloma (MM) frequently have sensory deficits, according to a study published online Aug. 25 in the Journal of Clinical Oncology.

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New MS Treatment Found Safe in Early Trials

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- A new monoclonal antibody treatment for multiple sclerosis (MS) is safe, according to a phase I trial published online Aug. 27 in Neurology: Neuroimmunology & Neuroinflammation.

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Team Approach Improves Practice Efficiency

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

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Video Game Improves Balance in Multiple Sclerosis Patients

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- Training with a video game balance board results in changes shown in brain magnetic resonance imaging (MRI) as well as clinical improvement in balance in patients with multiple sclerosis (MS), according to research published online Aug. 26 in Radiology.

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Reduced Risk of Brain Injury on MRI With Early EPO in Preemies

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- Early administration of high-dose erythropoietin is associated with a reduced risk of brain injury on magnetic resonance imaging (MRI) in premature infants, according to research published in the Aug. 27 issue of the Journal of the American Medical Association.

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FDA: Steer Clear of Dietary Supplements for Concussions

TUESDAY, Aug. 26, 2014 (HealthDay News) -- As the fall sports season starts and young players face the risk of concussions, the U.S. Food and Drug Administration warns that dietary supplements that claim to prevent, treat, or cure concussions are untested, unproven, and possibly dangerous.

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Confusional Arousal Common, Linked to Other Disorders

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

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Cognitive Impairment May Increase Subsequent Stroke Risk

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

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Restrictive, Non-Solicitation Covenants Are Valid

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

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More Galanin-Immunoreactive Neurons Linked to Better Sleep

MONDAY, Aug. 25, 2014 (HealthDay News) -- For older adults, more galanin-immunoreactive intermediate nucleus neurons are associated with less fragmented sleep, according to a study published online Aug. 20 in Brain.

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U.S. to Tighten Access to Certain Narcotic Painkillers

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

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Organizations Can Help Docs Retain Their Independence

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

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Telemedicine Improves Stroke Care in Rural Areas

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Telemedicine can improve stroke care in rural areas, according to a study published online Aug. 21 in Stroke.

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Infections May Up Pediatric Stroke Risk in Short Term

THURSDAY, Aug. 21, 2014 (HealthDay News) -- Minor infections appear to have a strong, but short-lived, effect on pediatric stroke risk, according to a study published online Aug. 20 in Neurology.

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Age Affects Link Between Obesity, Dementia Risk

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

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Organized Processes Help Practices Hire Well

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

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Aerobic Fitness Linked to White Matter Integrity in Preteens

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- For preadolescent children, white matter structure varies with fitness level, according to a study published online Aug. 19 in the Frontiers of Neuroscience.

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Docs Must Consider Liability When Ordering Screening Tests

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

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Boxed Warnings Are Common in Novel Therapeutics

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

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Hospitalizations for Acute CVD, Stroke Down From 1999 to 2011

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

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Bidirectional Association for Cognitive Function, Stroke

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

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Less Educated Smokers at Greatest Risk for Stroke

FRIDAY, Aug. 15, 2014 (HealthDay News) -- Poorly educated adults who smoke face a higher stroke risk, as do those who smoke and have hypertension, according to a study published online Aug. 14 in Stroke.

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Gene ID'd Which Regulates Nerve Conduction Velocity

FRIDAY, Aug. 154, 2014 (HealthDay News) -- A novel gene has been identified as having a regulatory role in nerve conduction velocity, according to an experimental study published online Aug. 12 in The Journal of Pathology.

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Childhood Growth Hormone Use Tied to Later Stroke

THURSDAY, Aug. 14, 2014 (HealthDay News) -- There is a strong relationship between growth hormone (GH) treatment during childhood and subsequent hemorrhagic stroke, according to a study published online Aug. 13 in Neurology.

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Extra Time Spent Counseling, Coordinating Care Billable

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

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

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

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Delayed Cardioversion With A-Fib Ups Thromboembolic Risk

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- A delay to cardioversion of 12 hours or longer from onset of acute atrial fibrillation symptoms is associated with a greater risk of thromboembolic complications, according to a research letter published in the Aug. 13 issue of the Journal of the American Medical Association.

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Evidence Weak for Drugs to Help Shift Workers Sleep, Wake

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Evidence for the efficacy and safety of pharmacologic interventions to treat sleep disturbances and sleepiness caused by shift work is lacking, according to a review published online Aug. 12 in The Cochrane Library.

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Perioperative A-Fib Ups Long-Term Stroke Risk

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Perioperative atrial fibrillation is associated with an increased risk of subsequent stroke, especially after noncardiac surgery, according to a study published in the Aug. 13 issue of the Journal of the American Medical Association.

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Meta-Analysis Strategy Impacts Estimation of Tx Outcome

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

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EHR Adoption Increasing, But Stage 2 Criteria Often Not Met

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

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Impact Location Has Limited Effect on Concussion Outcome

MONDAY, Aug. 11, 2014 (HealthDay News) -- For high school football players who sustain concussion due to player-to-player collisions, impact location has a minimal effect on outcome, according to a study published online Aug. 11 in Pediatrics.

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Issues to Consider With Integration of Telemedicine

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

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Manipulative Therapy Linked to Cervical Artery Dissection

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Evidence suggests there may be an association between cervical manipulative therapy and cervical artery dissections (CDs), according to an American Heart Association/ American Stroke Association scientific statement published online Aug. 7 in Stroke.

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VA Health Care Reform Bill Signed Into Law

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

Health Highlights: Aug. 7, 2014

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

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

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HIV Infection Linked to Lower Risk of Multiple Sclerosis

THURSDAY, Aug. 7, 2014 (HealthDay News) -- HIV infection is associated with a significantly decreased risk of developing multiple sclerosis (MS), according to a study published online Aug. 4 in the Journal of Neurology, Neurosurgery & Psychiatry.

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Centralizing Stroke Services Improves Outcomes

THURSDAY, Aug. 7, 2014 (HealthDay News) -- Centralizing acute stroke services in urban areas can cut morality and length of hospital stay, according to a study published online Aug. 5 in BMJ.

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Researchers Closer to Test for Creutzfeldt-Jakob Disease

THURSDAY, Aug. 7, 2014 (HealthDay News) -- Two newly developed tests -- one using a urine sample, the other nasal brushings -- seem to reliably detect Creutzfeldt-Jakob disease (CJD), according to separate reports published in the Aug. 7 issue of the New England Journal of Medicine.

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Clues to How Heavy Drinking in Pregnancy Harms Child's Brain

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- When a woman drinks heavily during pregnancy, the harmful effects on her child's brain development appear to continue over time, a new study indicates. The study was published online Aug. 4 in the journal Cerebral Cortex.

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Hypertension in Middle Age May Speed Cognitive Decline

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

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Review: Earlier Alteplase Benefits Acute Ischemic Stroke More

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

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Variants ID'd in Phenytoin-Related Adverse Skin Reactions

TUESDAY, Aug. 5, 2014 (HealthDay News) -- CYP2C variants have been identified as being involved in phenytoin-related severe cutaneous adverse reactions, according to a study published in the Aug. 6 issue of the Journal of the American Medical Association.

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Many Physicians Have Secondary Income

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

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Review: Ketamine Does Not Adversely Affect Outcomes

MONDAY, Aug. 4, 2014 (HealthDay News) -- For intubated patients, ketamine is unlikely to adversely affect patient outcomes compared with other intravenous sedatives, according to a review published online July 22 in the Annals of Emergency Medicine.

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Hx of Alcohol Use Disorder Ups Odds of Memory Impairment

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

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CT Effective in Detection of Significant Cervical Spine Injury

MONDAY, Aug. 4, 2014 (HealthDay News) -- Computed tomography (CT) is effective in detecting clinically significant cervical spine (CS) injuries in patients with neurologic deficit or CS pain, according to a study published online July 30 in JAMA Surgery.

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Optimal Red Blood Cell Folate Level About 1,000 nmol/L

MONDAY, Aug. 4, 2014 (HealthDay News) -- The optimal population red blood cell folate level for prevention of neural tube defects could be defined as approximately 1,000 nmol/L, according to research published online July 29 in BMJ.

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CMS Recognizes Telehealth in New Physician Fee Schedule

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

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CDC: Some Jobs Harder on the Heart Than Others

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Stress at work may raise your risk of heart attack and stroke, particularly if you work in the service industry or have a blue-collar job, U.S. health officials reported Thursday. But being unemployed might be just as unhealthy, they added. The study was published in the Aug. 1 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Older Adults With Dementia More Likely to Receive Pacemaker

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

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Each Chronic Condition Further Reduces Life Expectancy

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

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