September 2013 Briefing - Neurology

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

Lower National Health Spending Due to Slow Economy

MONDAY, Sept. 30 (HealthDay News) -- National health care expenditures remain sluggish but are expected to grow at a rate of approximately 6.2 percent per year after 2014, with federal, state, and local governments accounting for half, according to research published online Sept. 18 in Health Affairs.

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Only One-Third of Voters Think Congress Should Delay ACA

MONDAY, Sept. 30 (HealthDay News) -- With a government shutdown impending, only one-third of voters think that Congress should delay, defund, or repeal the health care laws set to take effect imminently, according to a report from The Morning Consult.

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Medicare, Medicaid Will Still Run If Government Shuts Down

MONDAY, Sept. 30 (HealthDay News) -- According to U.S. officials, veterans and Medicare and Medicaid recipients will continue to receive health care benefits even if the federal government shuts down on Tuesday.

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DOL Clarifies Employer Health Insurance Notification Duty

MONDAY, Sept. 30 (HealthDay News) -- The U.S. Department of Labor has provided clarification in the form of a frequently-asked-questions (FAQ) document, relating to employer obligations to provide employees with written notice about the Affordable Care Act's health insurance marketplaces by Oct. 1, 2013.

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No Change in Admissions for Pediatric Sports-Related TBI

MONDAY, Sept. 30 (HealthDay News) -- Over the last 10 years there has been an increase in the number of emergency department visits for sports-related traumatic brain injury (TBI) in children, but no increase in the percentage of children admitted, according to a study published online Sept. 30 in Pediatrics.

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Health Worker Roles Impacted When 'Undervalued' by Patients

FRIDAY, Sept. 27 (HealthDay News) -- Job satisfaction among nurse practitioners and other professionals can suffer when clientele lack a clear understanding of what they do, according to research published in the Aug. 1 issue of the Academy of Management Journal.

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Practical Tips Offered for Medical Employee Satisfaction

FRIDAY, Sept. 27 (HealthDay News) -- Managing staff is a learned skill, and one for which physicians are often ill-equipped. An article published Sept. 25 in Medical Economics lays out some practical tips and advice for motivating staff to excel.

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HEALTH REFORM: ACA Impact on Medicare Recipients Unclear

FRIDAY, Sept. 27 (HealthDay News) -- The Affordable Care Act (ACA) will help millions of uninsured Americans access affordable health care coverage, but it's unclear what effect the law will have on people covered by Medicare.

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HEALTH REFORM: Medicaid Expansion Will Up Coverage

THURSDAY, Sept. 26 (HealthDay News) -- Two aspects of the Affordable Care Act (ACA) have the potential to extend health insurance coverage to those who do not qualify for government-sponsored health care but cannot afford to purchase private plans.

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CDC: Flu Shot Coverage of Health Care Personnel Increasing

THURSDAY, Sept. 26 (HealthDay News) -- Influenza vaccination coverage has increased among health care personnel but varies by occupation type and occupational setting, according to a report published in the Sept. 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Dementia Needs to Become a Government Priority

THURSDAY, Sept. 26 (HealthDay News) -- Governments must make dementia a priority, according to a report published by Alzheimer's Disease International.

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High Sensitivity for Ottawa Subarachnoid Hemorrhage Rule

THURSDAY, Sept. 26 (HealthDay News) -- For patients presenting to the emergency department with headache peaking within one hour and no neurologic deficits, the Ottawa Subarachnoid Hemorrhage Rule is highly sensitive for identifying subarachnoid hemorrhage, according to a study published in the Sept. 25 issue of the Journal of the American Medical Association.

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No Cognitive Protective Role Seen for Omega-3 Fatty Acids

THURSDAY, Sept. 26 (HealthDay News) -- There is no evidence of a protective effect for omega-3 fatty acids on age-associated cognition or the rate of cognitive decline in older dementia-free women, according to research published online Sept. 25 in Neurology.

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More Options, Lower Premiums With Insurance Exchanges

WEDNESDAY, Sept. 25 (HealthDay News) -- Consumers are likely to find insurance options more plentiful and more affordable than expected in the new Health Insurance Marketplace that goes into effect Oct. 1, according to a report released Sept. 25 by the U.S. Department of Health and Human Services.

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HEALTH REFORM: Exchanges Offer Options for the Uninsured

WEDNESDAY, Sept. 25 (HealthDay News) -- Millions of part-time, seasonal, self-employed workers and other individuals currently without health insurance may find a solution to their vulnerable status when the new health care exchanges go into effect on Oct. 1.

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EMG Signals Can Improve Robotic Leg Prostheses Control

WEDNESDAY, Sept. 25 (HealthDay News) -- Electromyographic signals can be used in conjunction with mechanical sensor data to improve control of robotic leg prostheses, according to a case report published in the Sept. 26 issue of the New England Journal of Medicine.

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Prenatal Antiepileptic Drugs Affect Fine Motor Skills in Infants

WEDNESDAY, Sept. 25 (HealthDay News) -- Prenatal exposure to antiepileptic drugs is associated with impaired fine motor skills at 6 months of age, according to a study published online Sept. 23 in JAMA Neurology.

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ACP Provides Overview of Health Insurance Marketplaces

WEDNESDAY, Sept. 25 (HealthDay News) -- The opportunities and challenges presented by health care reform are discussed in an article published online Sept. 24 in the Annals of Internal Medicine.

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HEALTH REFORM: Health Care Reform a Mixed Bag for Workers

TUESDAY, Sept. 24 (HealthDay News) -- Much discussion of the Affordable Care Act revolves around the dramatic changes in store for America's uninsured, but the health care reform law will also have an impact on individuals with employer-based coverage.

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FDA Gives Final Guidance on Mobile Medical App Oversight

TUESDAY, Sept. 24 (HealthDay News) -- The U.S. Food and Drug Administration issued final guidance for mobile application (app) developers, and is focusing its oversight on medical apps that will be used as accessories to regulated medical devices, or that transform a mobile device into a regulated medical device.

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Medicare Managed Care More Apt for Nursing Home Residents

TUESDAY, Sept. 24 (HealthDay News) -- For nursing home residents with advanced dementia, Medicare managed care is associated with more appropriate, less burdensome care, according to a study published online Sept. 23 in JAMA Internal Medicine.

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FDA Issues Final Rule for Device Identification System

MONDAY, Sept. 23 (HealthDay News) -- The U.S. Food and Drug Administration has released a final rule for the unique device identification system (UDI) that, when implemented, will improve patient safety by providing a consistent way to identify approved medical devices.

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HEALTH REFORM: Young People Likely to Be Key to Success

MONDAY, Sept. 23 (HealthDay News) -- Young, healthy adults are considered key to the success of health insurance reform, but many are not even aware of state insurance exchanges.

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HEALTH REFORM: Health Care Exchanges Going Into Effect

MONDAY, Sept. 23 (HealthDay News) -- As of Oct. 1, consumers looking for health insurance will be able to turn to state-based health care exchanges, a centerpiece of the Affordable Care Act intended to help the uninsured and small businesses find affordable coverage.

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Majority of U.S. Consumers Want Full Access to EMR

MONDAY, Sept. 23 (HealthDay News) -- Most U.S. consumers want to have full access to their electronic medical records (EMR), and 41 percent would be willing to switch doctors to gain access, according to a survey published by Accenture.

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Metformin May Increase Risk of Cognitive Impairment

FRIDAY, Sept. 20 (HealthDay News) -- Metformin may increase the risk of cognitive impairment in patients with diabetes; however, calcium supplementation may attenuate this risk, according to research published online Sept. 5 in Diabetes Care.

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Physical Exams Commonly Lacking in Low Back Pain Care

FRIDAY, Sept. 20 (HealthDay News) -- Among adults with low back pain (LBP) visiting a physician, 43 percent report no inspection and 20 percent report no palpation at physician encounters, according to a study published in the Sept. 15 issue of Spine.

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Little Correlation Between Care Quality, Patient Experience

FRIDAY, Sept. 20 (HealthDay News) -- There is little correlation between quality of care assessed by clinical measures versus by patient experience, according to research published in the September/October issue of the Annals of Family Medicine.

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Rosacea Risk Higher in Female Migraine Sufferers

FRIDAY, Sept. 20 (HealthDay News) -- There is a slight increased risk of rosacea among females with migraines, according to a study published in the September issue of the Journal of the American Academy of Dermatology.

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New Medicaid Enrollees Under ACA May Be Healthier

THURSDAY, Sept. 19 (HealthDay News) -- Adults potentially eligible for Medicaid under the Patient Protection and Affordable Care Act (ACA) are expected to have equal or better health status than current beneficiaries, according to research published in the September/October issue of the Annals of Family Medicine.

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Exposure to Tamoxifen Causes CNS Cell Death

THURSDAY, Sept. 19 (HealthDay News) -- Tamoxifen causes central nerve system (CNS) cell cytotoxicity, and MEK1/2 inhibition can prevent tamoxifen-induced cell death, according to a study published in the Sept. 18 issue of The Journal of Neuroscience.

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Pros and Cons of Shortening Medical School Discussed

THURSDAY, Sept. 19 (HealthDay News) -- The pros and cons of shortening medical school to three years are discussed in two perspective pieces published in the Sept. 19 issue of the New England Journal of Medicine.

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Millions Are Harmed by Unsafe Medical Care Each Year

THURSDAY, Sept. 19 (HealthDay News) -- Adverse events caused by inferior medical care are a major source of morbidity and mortality globally, according to research published in the October issue of BMJ Quality & Safety.

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Vitamin B Supplements May Reduce the Risk of Stroke

WEDNESDAY, Sept. 18 (HealthDay News) -- Vitamin B supplements may help reduce the risk of stroke, according to a meta-analysis published online Sept. 18 in Neurology.

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~11 Percent of Combat Wounded Have Spinal Injuries

WEDNESDAY, Sept. 18 (HealthDay News) -- Spine injuries account for more than 11 percent of all casualties among U.S. combat-wounded military in Iraq and Afghanistan, according to a study published in the Sept. 15 issue of Spine.

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Enhanced Care Program Set Up at Six Mayo Clinic Hospitals

WEDNESDAY, Sept. 18 (HealthDay News) -- A new program has been developed and implemented at six Mayo Clinic Health System hospitals to improve care and shorten hospital stays using remote monitoring, according to a press release issued by the Mayo Clinic.

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Payment for Routine Office Visits Varies Substantially

WEDNESDAY, Sept. 18 (HealthDay News) -- There is substantial variation in private insurance payment to physicians for routine office visits, according to research published in the September issue of Health Affairs.

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EHR Systems Meeting Meaningful Use Criteria Beneficial

WEDNESDAY, Sept. 18 (HealthDay News) -- Most electronic health record (EHR) systems meet meaningful use criteria, and these systems are associated with time-saving and other benefits, according to a September data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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More Than 1.6 Million Americans Expected to Get Cancer in 2013

TUESDAY, Sept. 17 (HealthDay News) -- Although significant progress has been made in treating cancer, more than 1.6 million Americans are projected to receive a cancer diagnosis in 2013, according to the third American Association for Cancer Research's Cancer Progress Report 2013.

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Kids With Neuro Disorders No More Likely to Get Flu Vaccine

MONDAY, Sept. 16 (HealthDay News) -- Although children with neurologic conditions are at high risk for complications of influenza infection, only half were vaccinated during the 2011 to 2012 influenza season, according to a report published in the Sept. 13 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Mediterranean Diet Tied to Less Age-Related Cognitive Decline

THURSDAY, Sept. 12 (HealthDay News) -- Greater adherence to a Mediterranean diet is associated with slower cognitive decline in older adults, according to a review published in the July issue of Epidemiology.

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Mindfulness Training Beneficial for Clinicians, Patients

THURSDAY, Sept. 12 (HealthDay News) -- Mindfulness training is associated with improvements in physician burnout; and, clinicians who rate themselves as more mindful engage in more patient-centered communication, according to two studies published in the September/October issue of the Annals of Family Medicine.

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Whole-Body MRI Helps Predict CVD Burden in Diabetes Patients

THURSDAY, Sept. 12 (HealthDay News) -- Whole-body magnetic resonance imaging (MRI) predicts cardiac and cerebrovascular disease burden in patients with diabetes mellitus (DM), according to a study published online Sept. 10 in Radiology.

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Episodic Migraines Linked to Obesity

WEDNESDAY, Sept. 11 (HealthDay News) -- The odds of episodic migraine (EM) are increased in obese individuals, compared to normal-weight individuals, according to a study published online Sept. 11 in Neurology.

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Maternal Opioid Use Ups Risk of Neural Tube Defects

WEDNESDAY, Sept. 11 (HealthDay News) -- A higher rate of periconceptional opioid use has been observed among mothers of infants with neural tube defects, according to research published online Sept. 6 in Obstetrics & Gynecology.

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FDA Stipulates Safety Label Update for Opioid Analgesics

TUESDAY, Sept. 10 (HealthDay News) -- In an attempt to reduce the risks of misuse, abuse, addiction, and other complications associated with extended-release and long-acting (ER/LA) opioid pain relievers, the U.S. Food and Drug Administration is requiring changes to safety labeling as well as post-market studies of the drugs.

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Prevalence of Hospitalization Due to Hypertensive Disease Up

TUESDAY, Sept. 10 (HealthDay News) -- From 1980 to 2007, the prevalence of hospitalization attributable to hypertensive disease increased for U.S. adults, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Treatment in Critical Care Often Perceived As Futile

TUESDAY, Sept. 10 (HealthDay News) -- Intensive care unit (ICU) treatment is frequently perceived as futile by critical care specialists, and entails considerable costs, according to a study published online Sept. 9 in JAMA Internal Medicine.

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About Half of Health Care Providers Are 'Digital Omnivores'

TUESDAY, Sept. 10 (HealthDay News) -- About half of health care providers are "digital omnivores," meaning they use a tablet, smartphone, and laptop/desktop computer routinely in a professional capacity, according to a report published by Epocrates.

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'Meaningful Use' Achievement Not Uniform Across Hospitals

MONDAY, Sept. 9 (HealthDay News) -- In regard to the adoption of electronic health records (EHRs), achievement of "meaningful use" criteria is not uniform across all hospitals, according to a study published in the August issue of Health Affairs.

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Most Physicians Report Being Satisfied With Career Choice

MONDAY, Sept. 9 (HealthDay News) -- Most physicians report being satisfied with their career choice, although 40 percent would rethink their path given the chance to choose again, according to the 2013 Great American Physician Survey published in Physicians Practice.

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No Link of Mediterranean Diet With Huntington's Onset

THURSDAY, Sept. 5 (HealthDay News) -- Adherence to a Mediterranean diet has no effect on the time of onset to Huntington's disease in individuals at high risk, although individual components such as high caloric intake are associated with increased risk, according to a study published online Sept. 2 in JAMA Neurology.

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Processing Speed Drops After Medulloblastoma Diagnosis

THURSDAY, Sept. 5 (HealthDay News) -- Among key cognitive functions, processing speed (PS) shows the poorest outcomes five years after diagnosis of pediatric medulloblastoma, according to a study published online Aug. 26 in the Journal of Clinical Oncology.

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Low Cardiovascular Fitness Early in Life Linked to Later Epilepsy

WEDNESDAY, Sept. 4 (HealthDay News) -- Low cardiovascular fitness early in life is associated with an increased risk of epilepsy later in life, according to a study published online Sept. 4 in Neurology.

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Only Half of Hypertensive Adults Aware of Diagnosis

WEDNESDAY, Sept. 4 (HealthDay News) -- Among adults in 17 countries of varying incomes, only about half with hypertension are aware of the diagnosis, and among those treated, only about a third achieve blood pressure control, according to a study published in the Sept. 4 issue of the Journal of the American Medical Association.

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Docs' Confidence in Diagnosis Unrelated to Diagnostic Accuracy

TUESDAY, Sept. 3 (HealthDay News) -- Physicians' confidence in their diagnostic accuracy is not associated with actual diagnostic accuracy or with case difficulty, according to a study published online Aug. 26 in JAMA Internal Medicine.

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Male-Female Physician Earnings Gap Has Persisted for 20 Years

TUESDAY, Sept. 3 (HealthDay News) -- For physicians, the male-female earnings gap has not changed significantly since 1987, according to a research letter published online Sept. 2 in JAMA Internal Medicine.

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Workaholics Have Poorer Physical and Mental Health

MONDAY, Sept. 2 (HealthDay News) -- Workaholics, defined as those who work more than 50 hours per week, have reduced physical and mental well-being, according to researchers from Kansas State University.

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Employer-Based Health Insurance Premiums Rose Modestly in 2013

MONDAY, Sept. 2 (HealthDay News) -- Employer-sponsored health insurance premiums rose only modestly in 2013, according to research published in the August issue of Health Affairs.

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Physician's Briefing