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March 2014 Briefing - Pharmacy

Here are what the editors at HealthDay consider to be the most important developments in Pharmacy 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.

Topamax Approval for Migraines Expanded to Younger Users

MONDAY, March 31, 2014 (HealthDay News) -- U.S. Food and Drug Administration approval of the drug Topamax (topiramate) to prevent migraine headaches has been expanded to include adolescents 12 years to 17 years, the agency said Friday.

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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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Allopurinol Modestly Cuts Death Risk With Hyperuricemia, Gout

MONDAY, March 31, 2014 (HealthDay News) -- Allopurinol initiation is associated with a modestly reduced risk of death in patients with hyperuricemia and gout, according to a study published online March 24 in the Annals of the Rheumatic Diseases.

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Pre-Op Pregabalin Best for Pain in Spinal Surgery

FRIDAY, March 28, 2014 (HealthDay News) -- Preoperative pregabalin is superior to either gabapentin or placebo for the relief of pain in patients undergoing lumbar discectomy, according to a study published in the March 15 issue of Spine.

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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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Adjunct Social Media Improves Contraceptive Knowledge

THURSDAY, March 27, 2014 (HealthDay News) -- Use of social media in addition to standard contraceptive education is associated with improved patient contraceptive knowledge, according to research published in the April issue of Obstetrics & Gynecology.

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Nitroglycerin Shortage Has Medical Community Worried

WEDNESDAY, March 26, 2014 (HealthDay News) -- An ongoing shortage of the drug nitroglycerin is causing problems and concerns for doctors and hospitals in the United States. The drug is often the first therapy used by emergency room doctors when treating a heart attack patient.

Health Highlights: March 26, 2014

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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AAN Releases Alternative Medicine Guide for MS

WEDNESDAY, March 26, 2014 (HealthDay News) -- The American Academy of Neurology (AAN) has released evidence-based recommendations for complementary and alternative medicine (CAM) for multiple sclerosis (MS). The guideline was published in the March 25 issue of Neurology.

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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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E-Cigarette Use Does Not Up Quitting, Reduce Smoking

TUESDAY, March 25, 2014 (HealthDay News) -- Use of electronic-cigarettes (e-cigarettes) does not increase the rate of smoking cessation or reduce cigarette consumption after one year, according to a study published online March 24 in JAMA Internal Medicine.

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Opioid Prescriptions in the Emergency Room Rising

TUESDAY, March 25, 2014 (HealthDay News) -- Prescriptions for opioid analgesics in the emergency department have risen dramatically over the last decade, according to a study published in the March issue of Academic Emergency Medicine.

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Pharmacokinetics of Cetrorelix Altered in Obese Women

TUESDAY, March 25, 2014 (HealthDay News) -- The pharmacokinetics of the gonadotropin-releasing hormone (GnRH) antagonist, cetrorelix, are altered in obese women, according to a study published online March 20 in the Journal of Clinical Endocrinology & Metabolism.

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Valproic Acid Use May Reduce Incidence of Head, Neck Cancer

MONDAY, March 24, 2014 (HealthDay News) -- Long-term use of valproic acid (VPA) is associated with a reduced risk of smoking-related cancers of the head and neck, according to a study published online March 24 in Cancer.

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Nicotine 'E-Liquids' Pose Serious Health Threat

MONDAY, March 24, 2014 (HealthDay News) -- A potent, liquid form of nicotine poses a serious and potentially deadly threat, but is sold legally in stores across the United States and online. The so-called "e-liquids" -- the key ingredients in e-cigarettes -- are extracted from tobacco and enhanced with flavorings, colorings, and various chemicals, The New York Times reported.

Health Highlights: March 24, 2014

Patient Request Impacts Doc Prescribing Behavior

MONDAY, March 24, 2014 (HealthDay News) -- Patients requesting specific medications are more likely to be prescribed those medications, according to research published in the April issue of Medical Care.

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Practices Can Take Steps to Improve Care Transitions

FRIDAY, March 21, 2014 (HealthDay News) -- Implementation of a rigorous process can improve transitions of care, according to an article published March 10 in Medical Economics.

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Statin Costs Impact Value of Coronary Artery Calcium Test

FRIDAY, March 21, 2014 (HealthDay News) -- For patients at intermediate risk of coronary heart disease (CHD), coronary artery calcium (CAC) measurement and targeted statin treatment is cost-effective if statin assumptions are less favorable (costly or impact quality of life), according to research published online March 11 in Circulation: Cardiovascular Quality and Outcomes.

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Phenylephrine + Acetaminophen Ups Plasma Phenylephrine

FRIDAY, March 21, 2014 (HealthDay News) -- The combination of phenylephrine and acetaminophen results in a pharmacokinetic interaction triggering increased plasma phenylephrine levels, according to a letter to the editor published in the March 20 issue of the New England Journal of Medicine.

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FDA Approves Impavido to Treat Tropical Parasitic Disease

THURSDAY, March 20, 2014 (HealthDay News) -- Impavido (miltefosine) has been approved by the U.S. Food and Drug Administration to treat adults with leishmaniasis, a tropical disease caused by a parasite that's transmitted by the bites of sand flies.

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Guidelines Developed for Pulmonary HTN in Sickle Cell Dz

THURSDAY, March 20, 2014 (HealthDay News) -- Evidence-based guidelines have been developed for adult patients with sickle cell disease (SCD) and pulmonary hypertension. The guidelines have been published in the March 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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New Guidelines Expand Statin Eligibility by 13 Million

THURSDAY, March 20, 2014 (HealthDay News) -- The American College of Cardiology and the American Heart Association (ACC-AHA) new cholesterol guidelines would increase the number of Americans eligible for statin therapy by nearly 13 million, according to research published online March 19 in the New England Journal of Medicine.

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Simvastatin Might Help Slow Multiple Sclerosis Progression

WEDNESDAY, March 19, 2014 (HealthDay News) -- High-dose simvastatin appears to slow brain shrinkage in patients with multiple sclerosis, according to a small, early study from England, published online March 19 in The Lancet.

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Review: Tamiflu Saved Lives During Swine Flu Pandemic

WEDNESDAY, March 19, 2014 (HealthDay News) -- The antiviral drug Tamiflu (oseltamivir) reduced the risk of death by 25 percent among adults hospitalized during the 2009 H1N1 swine flu pandemic, according to a review published online March 19 in The Lancet Respiratory Medicine. In addition, antiviral treatment within 48 hours of developing flu symptoms halved the risk of death compared with starting treatment later or receiving no treatment.

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TB Control Program in China Linked to Drop in Prevalence

TUESDAY, March 18, 2014 (HealthDay News) -- The implementation of a tuberculosis control program in China was associated with a reduction in prevalence and increased treatment, according to a study published online March 18 in The Lancet.

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Way Cleared for Study on Marijuana for Vets With PTSD

TUESDAY, March 18, 2014 (HealthDay News) -- A long-delayed study to examine the use of marijuana in treating U.S. veterans with posttraumatic stress disorder will finally begin after the federal government removed a major roadblock.

Other Health Highlights: March 18, 2014

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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Oxytocin Seems Beneficial for Patients With Anorexia

MONDAY, March 17, 2014 (HealthDay News) -- For females with anorexia nervosa, oxytocin attenuates attentional vigilance to eating and fat shape stimuli and affects attentional processes to social emotional stimuli, according to two studies published online in Psychoneuroendocrinology and PLOS ONE.

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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

Study Shows Stimulant Use Impacts ADHD, BMI Link

MONDAY, March 17, 2014 (HealthDay News) -- Children with attention-deficit/hyperactivity disorder (ADHD) not treated with stimulants have higher body mass index (BMI), while those treated with stimulants have lower BMI earlier in childhood and more rapid rebound to higher BMI in late adolescence, according to a study published online March 17 in Pediatrics.

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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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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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Benefits of Faster Thrombolysis Time Quantified

FRIDAY, March 14, 2014 (HealthDay News) -- Faster thrombolysis treatment is associated with improved stroke outcome, with each minute of onset-to-treatment time saved correlating with an additional 1.8 days of healthy life, according to a study published online March 13 in Stroke.

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Nicotine Patches Deemed Ineffective for Pregnant Smokers

FRIDAY, March 14, 2014 (HealthDay News) -- Use of nicotine patches, compared with placebo patches, does not increase the smoking cessation rate among pregnant women, according to research published March 11 in BMJ.

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Oldest Old at High Risk for Insulin-Related Hypoglycemia

THURSDAY, March 13, 2014 (HealthDay News) -- Among insulin-treated patients, those 80 years of age and older have the highest rate of emergency department visits and subsequent hospitalizations for insulin-related hypoglycemia and errors (IHEs), according to research published online March 10 in JAMA Internal Medicine.

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Glucosamine Fails to Prevent Knee Cartilage Deterioration

THURSDAY, March 13, 2014 (HealthDay News) -- Oral glucosamine supplementation is not associated with a decrease in knee cartilage deterioration among individuals with chronic knee pain, according to a study published online March 10 in Arthritis & Rheumatology.

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Health Education Not Routinely Provided to Patients

THURSDAY, March 13, 2014 (HealthDay News) -- For patients with chronic disease, health providers do not routinely provide health education, according to a study published March 6 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Idelalisib Active in Non-Hodgkin's Lymphoma

WEDNESDAY, March 12, 2014 (HealthDay News) -- The phosphatidylinositol-3-kinase delta (PI3Kδ) inhibitor idelalisib shows antitumor activity in patients with indolent non-Hodgkin's lymphoma and chronic lymphocytic leukemia (CLL), according to two studies published in the March 13 issue of the New England Journal of Medicine.

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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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Info, Motivation, Behavioral Skill Affect Med Adherence

WEDNESDAY, March 12, 2014 (HealthDay News) -- Patients' adherence-related information, motivation, and behavioral skills (IMB) are important targets for interventions promoting adherence to diabetes medications, according to a study published online March 5 in Diabetes Care.

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Medicare Drug Plan Changes Withdrawn by White House

TUESDAY, March 11, 2014 (HealthDay News) -- Proposed changes to the Medicare prescription drug program have been withdrawn by the Obama administration after strong opposition from patient groups.

Other Health Highlights: March 11, 2014

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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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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Marijuana Use Up, Cocaine Use Down, U.S. Report Finds

MONDAY, March 10, 2014 (HealthDay News) -- Americans' use of cocaine fell by half from 2006 to 2010, but marijuana use increased by more than 30 percent during that time, according to a new report. The spike in pot use may be due to an increase in the number of people who said they use the drug on a daily or near-daily basis, said the researchers, whose study covered drug trends from 2000 to 2010. Heroin use remained fairly stable during the decade, while methamphetamine use rose sharply during the first half of the decade and then fell.

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Promise for Erlotinib + Cisplatin Chemoradiation in Cervical CA

MONDAY, March 10, 2014 (HealthDay News) -- Treatment with epidermal growth factor receptor inhibitor erlotinib combined with cisplatin-based chemoradiation seems safe and effective for locally advanced cervical cancer, according to a study published online March 10 in Cancer.

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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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FDA: Pfizer Voluntarily Recalls Certain Lots of Antidepressant

FRIDAY, March 7, 2014 (HealthDay News) -- Two lots of Pfizer's Effexor XR (venlafaxine HCl) are being recalled because they may contain capsules of another drug, Tikosyn (dofetilide), used to treat heart rhythm disorders.

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CDC: Child Care Flu Vaccination Requirements Seem Effective

FRIDAY, March 7, 2014 (HealthDay News) -- Requiring the flu vaccination for child care admission seems to have increased vaccination rates and led to lower hospitalization rates for influenza in young children, according to a report published in the March 7 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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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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Palliative Chemo for Terminal Cancer Linked to Death in ICU

FRIDAY, March 7, 2014 (HealthDay News) -- Terminally ill patients with cancer who receive chemotherapy at the end of life are at increased risk of dying in an intensive care unit (ICU) and receiving cardiopulmonary resuscitation (CPR) and/or mechanical ventilation, according to research published March 4 in BMJ.

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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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Women More Sensitive Than Men to Sublingual Zolpidem

FRIDAY, March 7, 2014 (HealthDay News) -- Clearance of zolpidem (administered as a sublingual tablet; ZST) is lower in females compared to males, according to a study published in the March issue of The Journal of Clinical Pharmacology.

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Physicians Better Able to Recall Narratives About Rx Guidelines

FRIDAY, March 7, 2014 (HealthDay News) -- Physicians show better recall after reading evidence-based narratives, rather than summaries, of opioid prescribing guidelines, according to a study published online Feb. 20 in Academic Emergency Medicine.

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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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Value-Based Insurance Plans Can Up Rx Adherence

WEDNESDAY, March 5, 2014 (HealthDay News) -- Value-based insurance design (VBID) plans with certain features aside from solely lowering cost sharing can increase medication adherence, according to a study published in the March issue of Health Affairs.

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CDC: Antibiotics Often Prescribed During Hospitalization

WEDNESDAY, March 5, 2014 (HealthDay News) -- Inpatients frequently receive antibiotics, and in many cases antibiotic prescribing could be improved, according to a report published in the March 4 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly.

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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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Nivolumab May Improve Survival in Advanced Melanoma

TUESDAY, March 4, 2014 (HealthDay News) -- For patients with advanced melanoma, nivolumab may improve overall survival and has an acceptable long-term safety profile, according to a study published online March 3 in the Journal of Clinical Oncology.

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Opioid-Related Overdose Death Tied to High-Risk Rx Patterns

TUESDAY, March 4, 2014 (HealthDay News) -- The risk of opioid-related overdose death is associated with certain opioid-prescribing patterns, and nonmedical opioid sources vary with the frequency of use, according to a study and research letter, respectively, published online March 3 in JAMA 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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Single-Patient Trials Determine Statin Tolerability

MONDAY, March 3, 2014 (HealthDay News) -- In patients with statin-related myalgia, single-patient randomized trials of statin and placebo can determine whether the myalgia is actually due to the statin, according to a small study published in the March 4 issue of the Annals of Internal Medicine.

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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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