September 2013 Briefing - Pharmacy

Here are what the editors at HealthDay consider to be the most important developments in Pharmacy 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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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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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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FDA Approves Perjeta for Early-Stage Breast Cancer

MONDAY, Sept. 30 (HealthDay News) -- The drug Perjeta (pertuzumab) has been approved by the U.S. Food and Drug Administration to treat early-stage breast cancer before surgery, the agency said Monday.

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Vitamin D Alone Doesn't Better Postmenopausal Bone Health

MONDAY, Sept. 30 (HealthDay News) -- Vitamin D supplementation alone does not improve bone health in postmenopausal women, but calcium alone or in combination with vitamin D does appear to reduce bone turnover, according to a study published online Sept. 24 in the Journal of Clinical Endocrinology & Metabolism.

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Trends in Psychotropic Med Use in Young Children Explored

MONDAY, Sept. 30 (HealthDay News) -- For children aged 2 to 5 years, the likelihood of psychotropic medication use peaked in 2002 to 2005, according to a study published online Sept. 30 in Pediatrics.

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Non-Medical Exemptions One Factor in Pertussis Resurgence

MONDAY, Sept. 30 (HealthDay News) -- Non-medical exemptions (NMEs) are likely to have been one of the factors that contributed to the resurgence of pertussis in California in 2010, according to a study published online Sept. 30 in Pediatrics.

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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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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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Bioinformatics Approach IDs Approved Drugs for Repurposing

FRIDAY, Sept. 27 (HealthDay News) -- Bioinformatics-based drug approaches have identified U.S. Food and Drug Administration-approved drugs and a novel class of molecules that can be repurposed to treat patients with small cell lung cancer (SCLC), according to research published online Sept. 26 in Cancer Discovery.

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Effect of Testosterone on CV Disease in Men Uncertain

FRIDAY, Sept. 27 (HealthDay News) -- Further research is required to determine the relationship between testosterone levels and cardiovascular disease in men and to explore the risk-benefit of testosterone therapy, according to a review published online Sept. 24 in the Journal of Clinical Endocrinology & Metabolism.

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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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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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Combo Approach Ups Flu Vaccine Receipt Among Pregnant Women

THURSDAY, Sept. 26 (HealthDay News) -- The combination of a health care provider recommending an influenza vaccination and offering the vaccine increases uptake among pregnant women, 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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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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Juvenile Idiopathic Arthritis Tx Recommendations Updated

THURSDAY, Sept. 26 (HealthDay News) -- Recommendations for treatment of systemic juvenile idiopathic arthritis (JIA), including those cases with or without active systemic features, have been updated to reflect an extensive literature review and evaluation of more than 1,000 scenarios, according to a special article published in the October issue of Arthritis & Rheumatism.

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Antibiotic Protocol Selects Against Drug Resistance

THURSDAY, Sept. 26 (HealthDay News) -- Cycling between antibiotics can select against the development of drug resistance, according to a study published in the Sept. 25 issue of Science Translational Medicine.

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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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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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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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Sensor-Augmented Insulin Pump Cuts Hypoglycemia in T1DM

TUESDAY, Sept. 24 (HealthDay News) -- For patients with type 1 diabetes, a sensor-augmented pump with insulin suspension reduces the rate of moderate and severe hypoglycemic events compared with a standard insulin pump, according to a study published in the Sept. 25 issue of the Journal of the American Medical Association.

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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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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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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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USPSTF: Offer Breast CA Risk-Reducing Rx to High-Risk Patients

MONDAY, Sept. 23 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends that women at increased risk of breast cancer be prescribed tamoxifen or raloxifene for risk reduction, according to a final Recommendation Statement published online Sept. 24 in the Annals of Internal Medicine.

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Use of Digoxin Ups Risk of Death in Systolic Heart Failure

MONDAY, Sept. 23 (HealthDay News) -- Digoxin therapy was independently associated with increased mortality in patients with systolic heart failure, according to research published in the September issue of Circulation: Cardiovascular Quality and Outcomes.

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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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Alefacept May Be Useful in Preserving β-Cell Function

MONDAY, Sept. 23 (HealthDay News) -- For patients with type 1 diabetes, alefacept improves four-hour C-peptide area under the curve (AUC), and lowers insulin use and hypoglycemic events, according to a study published online Sept. 23 in The Lancet Diabetes & Endocrinology.

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Statin Use Tied to Increased Risk of Cataracts

FRIDAY, Sept. 20 (HealthDay News) -- Statin users are at increased risk for cataracts, according to a study published online Sept. 19 in JAMA Ophthalmology.

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Monitoring Ups Adherence to Antiretroviral Prophylaxis

FRIDAY, Sept. 20 (HealthDay News) -- High adherence to oral antiretroviral pre-exposure prophylaxis is achieved when HIV serodiscordant couples receive active monitoring and counseling, according to research published online Sept. 10 in PLOS Medicine.

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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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Lawyers File Most Isotretinoin Adverse Drug Reports

FRIDAY, Sept. 20 (HealthDay News) -- Attorneys have submitted a disproportionate number of isotretinoin-associated inflammatory bowel disease (IBD) cases to the U.S. Food and Drug Administration, according to a study published in the September issue of the Journal of the American Academy of Dermatology.

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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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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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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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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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High LDL Cholesterol Remains Common Among U.S. Adults

TUESDAY, Sept. 17 (HealthDay News) -- High low-density lipoprotein (LDL) cholesterol remains common among U.S. adults, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Care Pathway Proposed for Adolescent Depression

TUESDAY, Sept. 17 (HealthDay News) -- Researchers have gathered evidence, developed a care pathway, and identified quality indicators (QIs) for the management of adolescent depression, according to a special article published online Sept. 16 in Pediatrics.

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CDC Report Sheds Light on Antibiotic-Resistant Infections

MONDAY, Sept. 16 (HealthDay News) -- Antibiotic-resistant infections claim the lives of 23,000 people in the United States every year and take a tremendous financial toll on the already overburdened health care system, according to a report issued Sept. 16 by the U.S. Centers for Disease Control and Prevention.

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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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High Burden of Endocarditis in Older Adults

FRIDAY, Sept. 13 (HealthDay News) -- The 2007 American Heart Association guidelines recommending a restriction of antibiotic prophylaxis have not increased the rates of hospitalization or adjusted mortality for endocarditis among Medicare beneficiaries, although the burden of endocarditis is high, according to a study published online Aug. 28 in the Journal of the American College of Cardiology.

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Community-Level Intervention Cuts Antibiotic Prescribing

FRIDAY, Sept. 13 (HealthDay News) -- A community-level intervention targeting residents and health care professionals can influence antibiotic prescribing for outpatients, according to a study published online Sept. 12 in BMJ.

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Nearly a Third of Vaccines at Pharmacies Given Off-Hours

FRIDAY, Sept. 13 (HealthDay News) -- Almost one-third of vaccinations given to adults at community pharmacies are administered during off-clinic hours, according to a study published in the September/October issue of the Annals of Family Medicine.

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Most Children in U.S. Receiving Recommended Vaccinations

THURSDAY, Sept. 12 (HealthDay News) -- Most children in the United States are being immunized against vaccine-preventable diseases at the nationally accepted target rate, but coverage lags in some states and in children whose family incomes fall at or below the federal poverty level, 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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In OCD, Add-On Cognitive Behavior Tx Beats Risperidone

THURSDAY, Sept. 12 (HealthDay News) -- For patients with obsessive-compulsive disorder (OCD), the addition of cognitive behavioral therapy (exposure and ritual prevention [EX/RP]) to a serotonin reuptake inhibitor (SRI) is superior to risperidone or pill placebo, according to a study published online Sept. 11 in JAMA Psychiatry.

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Some Low-T Symptoms May Be Due to Low Estradiol in Men

WEDNESDAY, Sept. 11 (HealthDay News) -- Declines in testosterone levels as well as deficiencies in estradiol account for the clinical manifestations of testosterone deficiency in men, according to a study published in the Sept. 12 issue of the New England Journal of Medicine.

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Combo Therapy Not Superior for Severe Alcoholic Hepatitis

WEDNESDAY, Sept. 11 (HealthDay News) -- Combination therapy with pentoxifylline and prednisolone, compared with prednisolone alone, does not result in a higher rate of six-month survival in patients with alcoholic hepatitis, according to research published in the Sept. 11 issue of the Journal of the American Medical Association.

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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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Individual Physician-Level Incentives Improve BP Control

TUESDAY, Sept. 10 (HealthDay News) -- Individual physician-level financial incentives are associated with greater blood pressure control or appropriate response to uncontrolled blood pressure, but neither physician-level nor practice-level incentives result in greater use of guideline-recommended medications, according to a study published in the Sept. 11 issue of the Journal of the American Medical Association.

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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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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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Non-Medical Use of Prescription Drugs Drops in Young Adults

MONDAY, Sept. 9 (HealthDay News) -- In its latest report, 2012 National Survey on Drug Use and Health, the Substance Abuse and Mental Health Services Administration (SAMHSA) describes the use of illicit drugs, alcohol, and tobacco in the teen and adult civilian population of the United States.

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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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Study of Topical Corticosteroid Use in Pregnancy Reassuring

FRIDAY, Sept. 6 (HealthDay News) -- Topical maternal exposure to corticosteroids during pregnancy is not associated with orofacial cleft, preterm delivery, fetal death, low Apgar score, and mode of delivery, however, low birth weight does correlate with increasing quantity of high potency exposure, according to a study published online Sept. 4 in JAMA Dermatology.

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Response-Guided Neoadjuvant Chemo Beneficial in Breast CA

FRIDAY, Sept. 6 (HealthDay News) -- For patients with early breast cancer, a response-guided neoadjuvant chemotherapy approach seems beneficial, according to a study published online Sept. 3 in the Journal of Clinical Oncology.

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Novel Metabolic Regulator May Benefit Obesity and Diabetes

THURSDAY, Sept. 5 (HealthDay News) -- Treatment of patients with obesity and type 2 diabetes with a variant of a recently identified metabolic regulator has favorable effects on body weight, fasting insulin, and lipid profile, but only somewhat lowers blood glucose levels, according to a study published in the Sept. 3 issue of Cell Metabolism.

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Drug Non-Adherence Linked to Greater Pediatric Health Care Use

THURSDAY, Sept. 5 (HealthDay News) -- In children and adolescents with chronic medical conditions, medication non-adherence is associated with greater health care use, including more hospitalizations and visits to the emergency department, according to a study published online Sept. 2 in Pediatrics.

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Steroids Effective Short Term for Carpal Tunnel Syndrome

THURSDAY, Sept. 5 (HealthDay News) -- Methylprednisolone injections relieve symptoms of carpal tunnel syndrome in the short term, but most patients still have surgery at one year, according to a study published in the Sept. 3 issue of the Annals of Internal Medicine.

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Continuation Phase Cognitive Therapy Beneficial in Depression

THURSDAY, Sept. 5 (HealthDay News) -- For patients with major depressive disorder, continuation phase cognitive therapy (C-CT) and fluoxetine prevent relapse; and, a cognitive behavioral prevention (CBP) program provides lasting benefits for some adolescents at risk for depressive disorders, according to two studies published online Sept. 4 in JAMA Psychiatry.

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Anti-CMV Treatment Shows Promise for Glioblastoma

WEDNESDAY, Sept. 4 (HealthDay News) -- For patients with glioblastoma, treatment with the anti-cytomegalovirus (CMV) agent valganciclovir is associated with improved survival, according to a study published in the Sept. 5 issue of the New England Journal of Medicine.

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Immunization Schedules Don't Impact PCV13 Immunogenicity

WEDNESDAY, Sept. 4 (HealthDay News) -- The immunogenicity of 13-valent pneumococcal conjugate vaccine (PCV13) is not significantly different for most serotypes when administered according to four different primary immunization schedules, according to a study published in the Sept. 4 issue of the Journal of the American Medical Association.

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Medication Adherence Up With Fixed Dose Combo Strategy

WEDNESDAY, Sept. 4 (HealthDay News) -- For patients with or at high risk of cardiovascular disease (CVD), a fixed-dose combination (FDC) strategy for antiplatelet, statin, and blood pressure lowering medications is associated with improved medication adherence and with reductions in systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C), according to a study published in the Sept. 4 issue of the Journal of the American Medical Association.

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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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AAP Updates Recommendations for Flu Prevention in Children

WEDNESDAY, Sept. 4 (HealthDay News) -- Recommendations for routine use of seasonal influenza vaccine in children have been updated, according to an American Academy of Pediatrics (AAP) policy statement published online Sept. 2 in Pediatrics.

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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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No Link Found Between Various Insulins and Breast Cancer

TUESDAY, Sept. 3 (HealthDay News) -- Various types of insulins are not associated with breast cancer risk, according to a study published online Aug. 15 in Diabetes Care.

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Hydroxyurea Cost-Effective for Childhood Sickle Cell Anemia

TUESDAY, Sept. 3 (HealthDay News) -- Treating children with sickle cell anemia with hydroxyurea is associated with lower total medical costs (higher outpatient costs but lower inpatient costs) as compared to placebo, according to a study published online Sept. 2 in Pediatrics.

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Parental Goals Impact ADHD Treatment Preference

TUESDAY, Sept. 3 (HealthDay News) -- Parents of children with attention-deficit/hyperactivity disorder (ADHD) are more likely to choose medication if the goal is academic achievement but more likely to choose behavior therapy if the goal is behavioral compliance, according to a study published online Sept. 2 in Pediatrics.

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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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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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