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March 2014 Briefing - Pathology

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

Azithromycin, Levofloxacin Up Cardiac Risk in Study of Veterans

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

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CDC: Invasive Cancer Diagnoses Down Slightly in 2010

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

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FDA Recommends Approval of At-Home Colon Cancer Test

FRIDAY, March 28, 2014 (HealthDay News) -- A panel of U.S. Food and Drug Administration experts on Thursday unanimously recommended approval of a new at-home stool test that screens for colorectal cancer with more than 90 percent accuracy.

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Bipolar Disorder-Derived Neurons Have Distinct Transcripts

FRIDAY, March 28, 2014 (HealthDay News) -- Neurons differentiated from bipolar disorder patient-derived induced pluripotent stem cells (iPSCs) have a significantly different transcription profile than those from controls, according to a study published online March 25 in Translational Psychology.

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NCHS Estimates Health Insurance Coverage for 2013

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

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Interferon Beta Tied to Spike in Thrombotic Microangiopathy

THURSDAY, March 27, 2014 (HealthDay News) -- There has been an unusually high number of cases of thrombotic microangiopathy associated with severe or malignant hypertension in patients with multiple sclerosis who were receiving therapy with recombinant interferon beta, according to a letter to the editor published in the March 27 issue of the New England Journal of Medicine.

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Physicians Lack Consensus on Use of Genetic Testing

THURSDAY, March 27, 2014 (HealthDay News) -- Physicians vary in attitudes about predictive multiplex somatic genetic testing and their plans to incorporate its use into practice, according to research published online March 24 in the Journal of Clinical Oncology.

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Galanin System Genes Linked to Risk of Depression in Stress

THURSDAY, March 27, 2014 (HealthDay News) -- Variants of the stress-inducible neuropeptide and cotransmitter in serotonin and norepinephrine neurons, galanin, and its receptors confers increased risk of depression and anxiety among highly stressed individuals, according to a study published online March 24 in the Proceedings of the National Academy of Sciences.

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1 in 25 Inpatients Has Health Care-Associated Infection Daily

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

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White House Extends Affordable Care Act Enrollment Deadline

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

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Focal Disruption of Cortical Laminar Architecture in Autism

WEDNESDAY, March 26, 2014 (HealthDay News) -- Most young children with autism have focal disruption of cortical laminar architecture, according to a study published in the March 27 issue of the New England Journal of Medicine.

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Glycated Hemoglobin Values Add Little to CVD Risk Prediction

WEDNESDAY, March 26, 2014 (HealthDay News) -- Addition of information on hemoglobin A1c (HbA1c) to conventional cardiovascular risk factors provides little benefit in terms of cardiovascular disease (CVD) risk prediction, according to a study published in the March 26 issue of the Journal of the American Medical Association.

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Genetic Variants Modify Bladder Cancer Prognosis

WEDNESDAY, March 26, 2014 (HealthDay News) -- Certain genetic variants may modify bladder cancer prognosis, according to a study published online March 26 in BJU International.

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Americans Seem Unprepared for Health Insurance Exchanges

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

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AMA Introduces Medical Education Initiative

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

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JC Virus Detectable in Natalizumab-Treated MS Patients

TUESDAY, March 25, 2014 (HealthDay News) -- Mononuclear cells from natalizumab-treated multiple sclerosis (MS) patients harbor JC virus (JCV), according to a study published online March 24 in JAMA Neurology.

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Most Bloodstream Infections Are Community-Onset

TUESDAY, March 25, 2014 (HealthDay News) -- Most bloodstream infections (BSIs) are community-onset and health care-associated, and Staphylococcus aureus is the most common pathogen, according to a study published online March 18 in PLOS ONE.

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Oropharyngeal Cancer Symptoms May Differ Based on HPV-Status

MONDAY, March 24, 2014 (HealthDay News) -- Initial symptom presentation seems to differ for human papillomavirus (HPV)-positive versus HPV-negative patients with oropharyngeal squamous cell carcinoma (OPSCC), according to a study published online March 20 in JAMA Otololaryngology.

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

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

Health Highlights: March 20, 2014
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Fried Food Consumption Interacts With Gene-Adiposity Link

FRIDAY, March 21, 2014 (HealthDay News) -- Consumption of fried foods may influence the genetic association with adiposity, according to a study published March 19 in BMJ.

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USPSTF Recommendations Have Led to Decrease in PSA Screening

FRIDAY, March 21, 2014 (HealthDay News) -- Prostate-specific antigen screening has decreased since publication of the U.S. Preventive Services Task Force Recommendations against screening, according to a study published in The Journal of Urology.

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CDC: Tuberculosis in the United States Hits Record Low

THURSDAY, March 20, 2014 (HealthDay News) -- Rates of tuberculosis in the United States are falling, with cases at a historic low, health officials from the U.S. Centers for Disease Control and Prevention reported Thursday, noting that improved screening of immigrants has helped reduce incidence.

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BRCAPRO Model Underestimates BRCA1/2 Mutation Risk

THURSDAY, March 20, 2014 (HealthDay News) -- Use of the BRCAPRO model for assessment of the likelihood of having a germline BRCA1/BRCA2 mutation, based on age, ethnicity, and family history, may underestimate the risk of mutations, according to a study published online March 17 in the Journal of Clinical Oncology.

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Marker in Spinal Fluid Predicts Course in Parkinson's Disease

THURSDAY, March 20, 2014 (HealthDay News) -- Levels of α-synuclein in cerebrospinal fluid (CSF) might predict cognitive decline in patients with Parkinson's disease, according to research published online March 13 in the The American Journal of Pathology.

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Exercise Ups Mitochondrial Biogenesis in Adipose Tissue

THURSDAY, March 20, 2014 (HealthDay News) -- Exercise training increases mitochondrial biogenesis, mitochondrial DNA (mtDNA) content, and glucose uptake in the subcutaneous adipose tissue of wild type, but not endothelial nitric oxide synthase (eNOS) knockout mice, according to research published online March 12 in Diabetes.

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Multitarget DNA Test Sensitive for ID'ing Colorectal Cancer

WEDNESDAY, March 19, 2014 (HealthDay News) -- For patients at average risk of colorectal cancer, a multitarget DNA assay has greater sensitivity, but worse specificity than a fecal immunochemical test (FIT), according to a study published online March 19 in the New England Journal of Medicine.

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CT Scans Can ID Gemcitabine Response in Pancreatic Cancer

WEDNESDAY, March 19, 2014 (HealthDay News) -- Transport properties identified on routine computed tomography (CT) scans correlate with clinically relevant end points for patients with pancreatic ductal adenocarcinoma (PDAC) who receive preoperative gemcitabine chemoradiotherapy, according to a study published online March 10 in the Journal of Clinical Investigation.

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Haemophilus Influenzae Infection Up in Pregnancy

WEDNESDAY, March 19, 2014 (HealthDay News) -- The incidence of Haemophilus influenzae (H. influenzae) disease is increased during pregnancy, and infection correlates with poor pregnancy outcomes, according to a study published in the March 19 issue of the Journal of the American Medical Association.

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Same Meningitis Strain Behind Drexel, Princeton Outbreaks: CDC

TUESDAY, March 18, 2014 (HealthDay News) -- The strain of bacterial meningitis that killed a Drexel University student earlier this month is the same strain behind a Princeton University outbreak last year, federal health officials said Tuesday. This suggests that the outbreak strain might still be present in the Princeton community and that the situation requires close monitoring, according to the U.S. Centers for Disease Control and Prevention.

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Elevated Levels of Brain Injury Biomarkers in Concussion

TUESDAY, March 18, 2014 (HealthDay News) -- Ice hockey players with sports-related concussion have elevations in the axonal injury biomarker total tau and the astroglial injury biomarker S-100 calcium-binding protein B, according to a study published online March 13 in JAMA Neurology.

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Hepatic Decompensation Higher With HIV, HCV Co-Infection

TUESDAY, March 18, 2014 (HealthDay News) -- Patients co-infected with HIV and hepatitis C virus (HCV) have higher rates of hepatic decompensation than those with HCV monoinfection, according to a study published in the March 18 issue of the Annals of Internal Medicine.

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Penicillin 'Allergy' Complicates Inpatient Care

TUESDAY, March 18, 2014 (HealthDay News) -- Patients with a history of penicillin "allergy," even though that may be inaccurate, spend more time in the hospital and have a greater risk of acquiring antibiotic-associated infections, according to research published in the Journal of Allergy and Clinical Immunology.

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No Evidence Fatty Acid Guidelines Cut Coronary Risk

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

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Rx Expenditures Expected to Rise in 2014

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

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Insurers Must Offer Same-Sex Couples Spousal Benefits

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

Other Health Highlights: March 17, 2014

Most Influenza Infections Seem to Be Asymptomatic

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

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Improving EHR Interoperability Is a National Priority: HHS

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

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CDC: Most Alcohol-Linked Deaths Occur Among Working-Age Adults

FRIDAY, March 14, 2014 (HealthDay News) -- Americans' excessive alcohol use contributes to thousands of deaths each year, and the majority who die are working-age adults, according to a report published in the March 14 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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High Serum 25(OH)D Linked to Lower Breast Cancer Mortality

FRIDAY, March 14, 2014 (HealthDay News) -- Higher concentrations of serum 25-hydroxyvitamin D (25[OH]D) are associated with lower mortality from breast cancer, according to a meta-analysis published in the March issue of Anticancer Research.

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Gel May Offer Postexposure Protection Against HIV Infection

FRIDAY, March 14, 2014 (HealthDay News) -- Use of a vaginal integrase inhibitor-containing gel may be able to protect against vaginal HIV infection in a macaque model, according to an experimental study published in the March 12 issue of Science Translational Medicine.

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Body Mass Index Linked to Methylation at HIF3A Locus

THURSDAY, March 13, 2014 (HealthDay News) -- For adults of European origin, increased body mass index (BMI) is associated with methylation at three sites in intron 1 of HIF3A, according to a study published online March 13 in The Lancet.

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CDC: Woman to Woman HIV Transmission Rare, but Possible

THURSDAY, March 13, 2014 (HealthDay News) -- A case report of a woman who was infected with HIV during sex with another woman shows that such transmission of the virus is possible, health officials say. The report is published in the March 14 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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FDA Panel Recommends HPV Test As Replacement for Pap

THURSDAY, March 13, 2014 (HealthDay News) -- A U.S. Food and Drug Administration advisory panel voted unanimously on Wednesday that a new human papillomavirus (HPV) test could be used before or instead of the Pap smear as a first step in cervical cancer screening.

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Probable Link for Excess Body Fat, Ovarian Cancer Risk

THURSDAY, March 13, 2014 (HealthDay News) -- Body fatness, marked by body mass index, is probably associated with an increased risk of ovarian cancer, according to a report published March 11 by the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR).

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FDA Experts Debate Timing of Pap Test

WEDNESDAY, March 12, 2014 (HealthDay News) -- A U.S. Food and Drug Administration advisory panel is considering whether to delay the Pap test and use an human papillomavirus (HPV) test as a first step in cervical cancer screening. Specifically, the agency's Medical Devices Advisory Committee Microbiology Panel is being asked to evaluate the cobas HPV test made by Roche Molecular Systems.

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Resistant Strain of Head Lice Prevalent in North America

WEDNESDAY, March 12, 2014 (HealthDay News) -- Widespread use of pyrethrins- or pyrethroid-based products appears to have resulted in selection pressure for a highly-resistant strain of human head lice in North America, according to research published in the March issue of the Journal of Medical Entomology.

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

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

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

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

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Blood Test May Have Power to Predict Alzheimer's Disease

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

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Keeping Salaries Secret Harms Worker Performance

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

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Outpatient Abx Culprit in Most Childhood C. Difficile Cases

FRIDAY, March 7, 2014 (HealthDay News) -- Antibiotics prescribed in doctors' offices are linked with a majority of Clostridium difficile (C. difficile) infection cases in children, according to a new study published online March 3 in the Pediatrics.

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AMA Grants Curriculum Efforts to Address Health Disparities

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

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Gender Gap Exists in Domestic Duties of Working Physicians

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

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Relative Value Units Useful In Evaluating Practice Finances

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

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Drop in Compensation Gap for Primary Care Docs, Specialists

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

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Cautious Optimism for 'Cure' of HIV-Infected Babies

THURSDAY, March 6, 2014 (HealthDay News) -- The hope that newborns can be "cured" of HIV with early, aggressive drug treatment was bolstered this week with the announcement that a second baby appears to be free of the virus following therapy that began just four hours after her birth.

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Long-Acting Injectable Drug May Protect Against HIV

THURSDAY, March 6, 2014 (HealthDay News) -- A long-acting, injectable drug can protect monkeys from repeated exposure to the simian/human immunodeficiency virus, according to an animal study published online March 4 in Science.

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Personalized Gene Therapy Shows Promise in HIV Patients

THURSDAY, March 6, 2014 (HealthDay News) -- Immune cells of HIV positive patients can be safely genetically engineered to resist infection, decreasing the viral loads in some patients no longer taking antiretroviral drugs and even dropping the viral load to undetectable levels in others, according to a study published in the March 6 issue of the New England Journal of Medicine.

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Assay Has High Specificity for Variant Creutzfeldt-Jakob Disease

THURSDAY, March 6, 2014 (HealthDay News) -- A prototype blood-based assay shows high specificity for variant Creutzfeldt-Jakob disease (vCJD), according to a study published online March 3 in JAMA Neurology.

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Fewer Positive Margins With Robot-Assisted Prostatectomy

THURSDAY, March 6, 2014 (HealthDay News) -- Robot-assisted radical prostatectomy (RARP) is associated with improved surgical margin status compared with open radical prostatectomy (ORP) for intermediate- and high-risk disease and with less use of additional cancer therapy, according to a study published online March 4 in European Urology.

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Frameshift Mutation Identified in Premature Ovarian Failure

WEDNESDAY, March 5, 2014 (HealthDay News) -- A frameshift mutation in a gene encoding a cohesin subunit has been identified in a large consanguineous family with premature ovarian failure, according to a brief report published in the March 6 issue of the New England Journal of Medicine.

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HPV Vaccine Protects Against Cervical Abnormalities

WEDNESDAY, March 5, 2014 (HealthDay News) -- The human papillomavirus (HPV) vaccine is effective at protecting against cervical abnormalities in young women, according to a study published March 4 in BMJ.

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WHO Program Improves U.S. Medical Facility Hand Hygiene

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

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Gap in Regulatory Coverage Affects 5 to 16 Percent of Trials

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

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Warfarin Linked to Lower Cardiac Risk in CKD With A-Fib

TUESDAY, March 4, 2014 (HealthDay News) -- For patients with established cardiovascular disease and atrial fibrillation, warfarin treatment correlates with a lower risk of a composite of death, myocardial infarction (MI), and ischemic stroke, with no increased risk of bleeding, regardless of chronic kidney disease (CKD) severity, according to a study published in the March 5 issue of the Journal of the American Medical Association.

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Sex Hormone-Binding Globulin Tied to Gestational Diabetes Risk

TUESDAY, March 4, 2014 (HealthDay News) -- Low prepregnancy sex hormone-binding globulin (SHBG) concentrations correlate with increased risk of gestational diabetes mellitus (GDM), according to a study published online Feb. 21 in Diabetes Care.

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Study Quantifies Prevalence of Chronic HCV Infection

TUESDAY, March 4, 2014 (HealthDay News) -- The prevalence of hepatitis C virus (HCV) infection is about 1 percent, with 2.7 million U.S. residents estimated as having chronic HCV infection, according to a study published in the March 4 issue of the Annals of Internal Medicine.

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Women-Specific Research Is Still Inadequate

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

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CMS: No More Delays to ICD-10 Implementation Deadline

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

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