December 2013 Briefing - Neurology

Here are what the editors at HealthDay consider to be the most important developments in Neurology for December 2013. 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.

Troubled Launch of ACA Tops Health News for 2013

TUESDAY, Dec. 31, 2013 (HealthDay News) -- As 2013 nears to a close, the year's top health news story -- the fumbled debut of the Affordable Care Act continues to grab headlines. President Barack Obama, in November, said he was "sorry" to hear that some Americans were being dropped from their health plans due to the advent of reforms -- even though he had repeatedly promised that this would not happen.

CDC: More Than One in 10 Kids Diagnosed With ADHD
FDA Urges Tighter Controls on Certain Prescription Painkillers
CDC: Evocative Campaign Motivates Smokers to Quit
Lower Microbial Diversity for Infants Who Develop Colic
Low Gut Bacterial Richness Linked to Obesity
Donor Fecal Infusion Effective for C. difficile Infection
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Extra Steps Urged for Regulating Compounding Pharmacies

MONDAY, Dec. 30, 2013 (HealthDay News) -- Additional steps are needed for regulating compounding pharmacies, according to a perspective piece published online Dec. 25 in the New England Journal of Medicine.

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High Fiber, Fruit/Vegetable Intake Cuts Stroke Risk in T2DM

MONDAY, Dec. 30, 2013 (HealthDay News) -- For Japanese patients with type 2 diabetes, increased dietary fiber and fruit and vegetable intake is associated with reduced risk of stroke, according to a study published in the December issue of Diabetes Care.

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Inosine Safe, Effective for Raising Urate Levels in Parkinson's

MONDAY, Dec. 30, 2013 (HealthDay News) -- For patients with early Parkinson's disease (PD), inosine seems safe and effective for raising urate levels, according to a study published online Dec. 23 in JAMA Neurology.

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Uncertainty Noted in Seemingly Stable Medical Liability Climate

MONDAY, Dec. 30, 2013 (HealthDay News) -- Although the medical liability climate seems stable, the impact of health care reform on the market is uncertain, according to an article based on two reports published by the American Medical Association (AMA).

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Surge in Federal Health Insurance Exchange Enrollments

MONDAY, Dec. 30, 2013 (HealthDay News) -- More than 1.1 million people enrolled in a qualified health plan through the federally operated marketplace, or exchange, from Oct. 1 through Dec. 24, government officials said Sunday. More than 975,000 of those enrollments came in December, Marilyn Tavenner, administrator for the Centers for Medicare & Medicaid Services, said in a blog post.

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AMA IDs Five Issues Relating to Progress in SGR Repeal

FRIDAY, Dec. 27, 2013 (HealthDay News) -- The implications of progress toward repeal of the Medicare sustained growth rate (SGR) formula are discussed in a report published by the American Medical Association (AMA).

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Head Trauma Linked to Amyloid Deposition in MCI

FRIDAY, Dec. 27, 2013 (HealthDay News) -- For individuals with mild cognitive impairment (MCI), but not those with normal cognition, self-reported head trauma involving at least a momentary loss of consciousness is associated with greater amyloid deposition, according to a study published online Dec. 26 in Neurology.

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Addition of Cognitive Therapy Benefits Youth With Migraine

FRIDAY, Dec. 27, 2013 (HealthDay News) -- Cognitive behavioral therapy (CBT) is superior to headache education, when combined with amitriptyline, for the treatment of chronic migraine in children and adolescents, according to research published in the Dec. 25 issue of the Journal of the American Medical Association.

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Most Dementia Patients Living at Home Have Unmet Needs

FRIDAY, Dec. 27, 2013 (HealthDay News) -- Most individuals with dementia residing in the community -- and their caregivers -- have unmet needs, according to research published in the December issue of the Journal of the American Geriatrics Society.

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Odds of Uncontrolled and Unreported HTN Up for Blacks

FRIDAY, Dec. 27, 2013 (HealthDay News) -- Blacks are more likely to have hypertension and to have uncontrolled and unreported hypertension than whites, according to a study published online Dec. 23 in Circulation: Cardiovascular Quality and Outcomes.

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Impact of Planned Medicaid Expansion Discussed

THURSDAY, Dec. 26, 2013 (HealthDay News) -- The planned expansion of Medicaid will offer benefits to those in participating states, according to an article published online Dec. 24 in the Annals of Internal Medicine.

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ACA Success Hinges on Young Adult Enrollment

THURSDAY, Dec. 26, 2013 (HealthDay News) -- Enrollment of young adults is a crucial component of the viability of the Affordable Care Act (ACA), according to a health policy brief published Dec. 16 in Health Affairs.

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Physician Pay Increasingly Tied to Quality Metrics

THURSDAY, Dec. 26, 2013 (HealthDay News) -- Physician groups are increasingly incorporating quality metrics into their internal reimbursement structure, according to an article published Nov. 25 in Medical Economics.

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Toxic Employees Are Damaging to Medical Practices

THURSDAY, Dec. 26, 2013 (HealthDay News) -- Toxic behavior can harm medical practices and should not be tolerated, according to an article published Dec. 10 in Medical Economics.

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Public Tends to Follow Celebrities Even on Medical Issues

MONDAY, Dec. 23, 2013 (HealthDay News) -- Celebrities have credibility as sources of medical advice, even if they are ill-informed or are spreading potentially harmful information, according to research published online Dec. 17 in BMJ.

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Burden of Heart Disease, Stroke Quantified in United States

MONDAY, Dec. 23, 2013 (HealthDay News) -- The burden of heart disease and stroke is considerable in the United States, according to a American Heart Association Statistical Update published online Dec. 18 in Circulation.

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Cardiovascular Disease Linked to Cognitive Decline in Older Women

MONDAY, Dec. 23, 2013 (HealthDay News) -- For elderly, postmenopausal women, cardiovascular disease (CVD) is associated with increased risk of cognitive decline, according to a study published online Dec. 18 in the Journal of the American Heart Association.

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New Rule May Exempt Many From Health Plan Penalty

FRIDAY, Dec. 20, 2013 (HealthDay News) -- Consumers whose individual health insurance policies have been cancelled for failing to meet the minimum requirements of the Affordable Care Act may now apply for a "hardship exemption," Obama administration officials announced late Thursday.

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High Patient Satisfaction With Patient-Centered Medical Homes

FRIDAY, Dec. 20, 2013 (HealthDay News) -- A significant majority of patients report experiencing a high quality of care at federally-supported health centers, according to a study published in the November/December issue of the Annals of Family Medicine.

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Evidence-Based Guidelines Issued for Hypertension Management

FRIDAY, Dec. 20, 2013 (HealthDay News) -- Evidence-based guidelines for the management of hypertension in adults for 2014 have been issued by the Eighth Joint National Committee, according to a special communication published online Dec. 18 in the Journal of the American Medical Association.

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Higher Levels of Anxiety Linked to Incident Stroke Risk

FRIDAY, Dec. 20, 2013 (HealthDay News) -- Higher anxiety symptom levels are independently associated with increased risk for incident stroke, according to a study published online Dec. 19 in Stroke.

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Docs Must Help Patients Take Responsibility for Medical Costs

FRIDAY, Dec. 20, 2013 (HealthDay News) -- Given that increasing numbers of patients have high-deductible health insurance, doctors and practice staff need to help patients assume financial responsibility for costs relating to medical services and procedures, according to an article published Dec. 10 in Medical Economics.

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Physicians Must Be Proactive in Risk Management

THURSDAY, Dec. 19, 2013 (HealthDay News) -- Risk is inherent in the practice of medicine, but physicians can take steps to prevent patient injury and avoid lawsuits, according to an article published Dec. 10 in Medical Economics.

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Deep Brain Stimulation Aids Driving With Parkinson's

THURSDAY, Dec. 19, 2013 (HealthDay News) -- Deep brain stimulation (DBS) of the of subthalamic nucleus (STN) seems to have a beneficial effect on driving ability in patients with Parkinson's disease (PD), according to a study published online Dec. 18 in Neurology.

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Pre-Op Depression Linked to Narcotic Use Before Spinal Sx

THURSDAY, Dec. 19, 2013 (HealthDay News) -- For patients undergoing spinal surgery for a structural lesion, preoperative depression and anxiety are associated with increased preoperative narcotic use, according to a study published in the Dec. 1 issue of Spine.

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Marijuana Use Linked to Changes in Brain Morphology

WEDNESDAY, Dec. 18, 2013 (HealthDay News) -- A history of marijuana use is associated with changes in brain morphology and poorer working memory both in healthy people and particularly in patients with schizophrenia, according to a study published online Dec. 15 in the Schizophrenia Bulletin.

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CDC Highlights Achievements of 2013, Goals for 2014

WEDNESDAY, Dec. 18, 2013 (HealthDay News) -- The top five gains made in improving health security at home and around the world in 2013, and the top five areas for improvement in 2014 have been highlighted in an end-of-year report from the U.S. Centers for Disease Control and Prevention.

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Few Residency Programs Teach Cost-Conscious Medicine

WEDNESDAY, Dec. 18, 2013 (HealthDay News) -- Few residency programs have a formal cost-conscious care curriculum, according to a research letter published online Dec. 16 in JAMA Internal Medicine.

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Funding for Medical Communication Firms Analyzed

TUESDAY, Dec. 17, 2013 (HealthDay News) -- Medical communication companies (MCCs), responsible for medical education programs, may receive substantial financial support from pharmaceutical and medical device companies, according to research published in the Dec. 18 issue of the Journal of the American Medical Association.

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GlaxoSmithKline to End Payments to Prescribing Doctors

TUESDAY, Dec. 17, 2013 (HealthDay News) -- GlaxoSmithKline (GSK) says it will stop paying doctors to market its drugs at conferences and will no longer reward sales agents whose physician customers write the most prescriptions. Monday's announcement is apparently a first for a major drug company. But other companies may be considering similar moves, The New York Times reported.

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Many Physicians Will Stop Practicing Due to ACA

TUESDAY, Dec. 17, 2013 (HealthDay News) -- About half of physicians say that they plan to practice medicine for a shorter time or leave as soon as feasibly possible due to the Affordable Care Act (ACA), according to an article published Nov. 29 in Medical Economics.

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Gene Expression Changes Seen After Mindfulness Meditation

TUESDAY, Dec. 17, 2013 (HealthDay News) -- Proficient meditators experience changes in specific gene expression after intensive mindfulness meditation, according to a study published in the February issue of Psychoneuroendocrinology.

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Physician Access Challenges Up for Those With Public Insurance

TUESDAY, Dec. 17, 2013 (HealthDay News) -- Adverse experiences with physician availability are more likely among those with public insurance, and almost 15 percent of people in the United States were uninsured in the first half of 2013, according to two December data briefs issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

Report - Gindi
Report - Martinez and Cohen

FDA Questions Effectiveness, Safety of Antibacterial Soap

TUESDAY, Dec. 17, 2013 (HealthDay News) -- The U.S. Food and Drug Administration has issued a proposed rule requiring antibacterial soap manufacturers to demonstrate that their products are both effective at preventing illness and safe for long-term daily use.

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FDA Approves First Device to Treat Migraine With Aura

MONDAY, Dec. 16, 2013 (HealthDay News) -- The first device to treat migraine pain when the headache is preceded by an aura has been approved by the U.S. Food and Drug Administration.

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No Cognitive Benefit for Long-Term Multivitamin Supplement

MONDAY, Dec. 16, 2013 (HealthDay News) -- For older male physicians, long-term multivitamin supplementation is not associated with cognitive benefit, according to a study published in the Dec. 17 issue of the Annals of Internal Medicine.

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Bills for SGR Repeal Pass Senate, House Committees

MONDAY, Dec. 16, 2013 (HealthDay News) -- The U.S. House Ways and Means Committee and the U.S. Senate Finance Committee have passed their versions of the bill to repeal Medicare's failed sustainable growth rate (SGR) formula, according to a report from the American Medical Association (AMA).

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Word of Mouth Still Tops Ways People Find Physicians

MONDAY, Dec. 16, 2013 (HealthDay News) -- Roughly three-quarters of young adults use personal recommendations to select a physician, according to an article published in Medical Economics.

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Medicare's Graduate Medical Education Spending Imbalanced

MONDAY, Dec. 16, 2013 (HealthDay News) -- There is an "imbalance" in how Medicare distributes its $10 billion a year for graduate medical education (GME), according to a study published in the November issue of Health Affairs.

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Determinants of Patient Loyalty to Provider Identified

MONDAY, Dec. 16, 2013 (HealthDay News) -- Determinants of patient loyalty have been identified and include confidence in care provider and coordination of care, according to a report published by Press Ganey.

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New Rule Tweaks Affordable Care Act Deadline

FRIDAY, Dec. 13, 2013 (HealthDay News) -- The Obama administration is taking steps to prevent consumers who buy health plans sold through state and federal exchanges from experiencing any gap in coverage this January. Under new rules, health insurers must accept payment up until Dec. 31 for coverage that begins the following day. Earlier guidance did not establish a payment deadline, allowing insurers to set their own dates. "And we're recommending that insurers extend this deadline further," U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius said during a Thursday news conference to announce the changes.

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Race Affects Risk of Dementia in Older Diabetes Patients

FRIDAY, Dec. 13, 2013 (HealthDay News) -- Racial and ethnic differences influence the risk of dementia in older individuals with type 2 diabetes, according to research published online Nov. 22 in Diabetes Care.

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Deployment-Related Brain Injury Predicts PTSD Risk

FRIDAY, Dec. 13, 2013 (HealthDay News) -- Traumatic brain injury (TBI) during a recent military deployment is a strong predictor of posttraumatic stress disorder symptoms (PTSD), according to a study published Dec. 11 in JAMA Psychiatry.

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Study Quantifies Male Dominance in Scientific Production

FRIDAY, Dec. 13, 2013 (HealthDay News) -- Men dominate scientific production worldwide, accounting for a higher percentage of authorships and greater impact, according to research published in the Dec. 12 issue of Nature.

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Injunction Stops Insurer From Dropping Physicians

THURSDAY, Dec. 12, 2013 (HealthDay News) -- United Healthcare has been given a last-minute temporary restraining order preventing it from removing thousands of physicians from its Medicare Advantage networks in Connecticut, according to an article published Dec. 6 in Medical Economics.

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Head Impact Affects Diffusivity Measures, Without Concussion

WEDNESDAY, Dec. 11, 2013 (HealthDay News) -- For college athletes, head impact exposure is associated with white matter diffusion measures and poorer cognition, even without concussion, according to a study published online Dec. 11 in Neurology.

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Physician Practices Often Do Not Plan for Future

WEDNESDAY, Dec. 11, 2013 (HealthDay News) -- Most physician practices do not treat their practices as businesses and plan for the future, but they should develop and follow a strategic plan, according to an article published Nov. 10 in Medical Economics.

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CDC: Health Insurance Among Young Increased After ACA

WEDNESDAY, Dec. 11, 2013 (HealthDay News) -- Since the Affordable Care Act extended dependent health coverage to young adults up to 26 years old, the percentage of this age group with private health insurance has increased and the percentage with gaps in insurance coverage has decreased, according to a December data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Outpatient Docs Report More Burnout Than Inpatient Docs

TUESDAY, Dec. 10, 2013 (HealthDay News) -- Outpatient physicians report more emotional exhaustion than inpatient physicians, according to a review published in the November issue of the Journal of Hospital Medicine.

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Health Information Technology May Cut Demand for Physicians

MONDAY, Dec. 9, 2013 (HealthDay News) -- Health information technology (IT) may cut demand for physicians in the future, according to a review published in the November issue of Health Affairs.

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With Looming ACA Uncertainty, Budget Exercise Necessary

MONDAY, Dec. 9, 2013 (HealthDay News) -- Constructing a budget for 2014 is critical for physicians even with the uncertainties surrounding the Affordable Care Act, according to an article published Nov. 10 in Medical Economics.

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Global Burden of Dementia Shifting to Poorer Countries

MONDAY, Dec. 9, 2013 (HealthDay News) -- In the coming decades, the global burden of dementia will shift even further from richer countries to poorer countries, especially rapidly developing middle-income countries, according to an Alzheimer's Disease International policy brief. The brief is being published ahead of the G8 Dementia Summit, which will be held in London on Dec. 11.

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Meta-Analysis: Healthier Diet Patterns Do Cost More

MONDAY, Dec. 9, 2013 (HealthDay News) -- Healthy food/diet patterns cost more, according to a meta-analysis published online Dec. 5 in BMJ Open.

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CMS Finalizes 2014 Physician Payment Rates, Policies

MONDAY, Dec. 9, 2013 (HealthDay News) -- The final payment rules for 2014 include a proposal to support care management outside the routine office interaction and policies to promote high quality care and efficiency, according to a report from the Centers for Medicare & Medicaid Services (CMS).

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Medical Students Find Mind-Body Regulation Training Helpful

FRIDAY, Dec. 6, 2013 (HealthDay News) -- A practical approach may be used to offer mind-body regulation training to medical students, according to research published in the Fall issue of the Annals of Behavioral Science and Medical Education.

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Issues Surround Hospital Readmissions Reduction Program

FRIDAY, Dec. 6, 2013 (HealthDay News) -- Concerns surround implementation of the Medicare Hospital Readmissions Reduction Program (HRRP), according to a policy brief published online Nov. 12 in Health Affairs.

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Serum 25(OH)D Marker of Ill Health, Not Causative Agent

FRIDAY, Dec. 6, 2013 (HealthDay News) -- Serum 25-hydroxyvitamin D (25[OH]D) seems to be a marker of ill health and not a causal factor, according to a review published online Dec. 6 in The Lancet Diabetes & Endocrinology.

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Final Rule Aims to Lower Costs, Simplify Outpatient Payments

FRIDAY, Dec. 6, 2013 (HealthDay News) -- The final hospital outpatient and ambulatory surgical center (ASC) payment rule will give hospitals and ASCs the ability to lower costs, according to a report from the Centers for Medicare & Medicaid Services (CMS).

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Preventive Measures, Better Treatment Cut Stroke Deaths

FRIDAY, Dec. 6, 2013 (HealthDay News) -- A combination of factors, including public health programs and clinical interventions designed to reduce cardiovascular risks, has contributed to the decline in stroke mortality in the United States, according to a statement from the American Heart Association and the American Stroke Association published online Dec. 5 in Stroke.

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Handoff Program Cuts Medical Errors, Adverse Events

THURSDAY, Dec. 5, 2013 (HealthDay News) -- Implementation of a multifaceted handoff program can reduce medical errors and preventable adverse events, according to a study published in the Dec. 4 issue of the Journal of the American Medical Association, a theme issue on medical education.

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Exercise May Improve Cognition in Dementia

THURSDAY, Dec. 5, 2013 (HealthDay News) -- Exercise programs may improve cognition and the ability to perform daily tasks in older adults with dementia, according to a review published online Dec. 4 in The Cochrane Library.

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TB Vaccine Beneficial After Clinically Isolated Syndromes

THURSDAY, Dec. 5, 2013 (HealthDay News) -- For individuals with clinically isolated syndromes (CIS), a first demyelinative episode that often precedes multiple sclerosis (MS), Bacille Calmette-Guérin (BCG) vaccination correlates with reduced development of gadolinium-enhancing lesions, according to a study published online Dec. 4 in Neurology.

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AMA's RUC Committee to Work on Improving Transparency

WEDNESDAY, Dec. 4, 2013 (HealthDay News) -- The 31-member Relative Value Scale Update Committee (RUC) of the American Medical Association will begin publishing minutes, dates and locations of meetings, and votes for individual current procedural codes, according to an article published Nov. 11 in Medical Economics.

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Health Reform in Mass. Didn't Change ICU Utilization

WEDNESDAY, Dec. 4, 2013 (HealthDay News) -- Initiation of health care reform in Massachusetts correlated with a reduction in intensive care unit (ICU) patients without insurance but did not significantly change ICU use or mortality among ICU patients, according to a study published online Nov. 22 in Critical Care Medicine.

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Investment Program Can Cut Global Health Disparities by 2035

WEDNESDAY, Dec. 4, 2013 (HealthDay News) -- Global health disparities could be reduced considerably by 2035 using an investment framework, according to a report published Dec. 3 in The Lancet.

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Physician Texting While 'Doctoring' May Be Hazardous

TUESDAY, Dec. 3, 2013 (HealthDay News) -- Physician texting while doctoring could be hazardous, according to an ideas and opinions piece published in the Dec. 3 issue of the Annals of Internal Medicine.

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Modest Increases in Minority Faculty Seen at Med Schools

TUESDAY, Dec. 3, 2013 (HealthDay News) -- Underrepresented minority faculty made only modest gains in increasing their presence at U.S. medical schools from 2000 to 2010, according to a study published in the Journal of the American Medical Association, a theme issue on medical education.

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FDA Starts Regulating Compounding Pharmacies

TUESDAY, Dec. 3, 2013 (HealthDay News) -- The U.S. Food and Drug Administration on Monday began the process of regulating compounding pharmacies. Under the Drug Quality and Security Act, signed into law Nov. 27 by President Barack Obama, these pharmacies are being encouraged to register with the FDA. The agency will then classify them as outsourcing pharmacies, enabling them to sell bulk drugs to hospitals and other health care facilities.

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Volunteering Overseas Revives Physicians' Outlooks

MONDAY, Dec. 2, 2013 (HealthDay News) -- Physician volunteer programs can revive doctors' passion for medicine, according to an article published Nov. 11 in Medical Economics.

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Oral Disease May Be Linked to Lower Cognitive Function

MONDAY, Dec. 2, 2013 (HealthDay News) -- Markers of oral disease seem to be associated with lower cognitive status, according to a study published in the Dec. 1 issue of the Journal of the American Dental Association.

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Comorbidities, Meds Factor Into Recurrent Syncope

MONDAY, Dec. 2, 2013 (HealthDay News) -- Certain comorbidities, age, gender, and use of multiple medications that cause orthostatic hypotension are associated with increased risk of recurrent syncope, according to research published in the Nov. 15 issue of The American Journal of Cardiology.

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Physician's Briefing