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April 2014 Briefing - Neurology

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

Established Modifiable Factors Account for Half of Strokes

WEDNESDAY, April 30, 2014 (HealthDay News) -- Established causal and modifiable factors, including hypertension and smoking, account for about half of all strokes, according to a study published online April 29 in PLOS Medicine.

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Medical Marijuana May Aid Some MS Symptoms

TUESDAY, April 29, 2014 (HealthDay News) -- Certain forms of medical marijuana can help treat some symptoms of multiple sclerosis (MS), but there is not enough evidence to support its utility in treating motor problems associated with other conditions, according to a review published in the April 29 issue of Neurology.

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Educational Attainment Affects Brain Injury Recovery

FRIDAY, April 25, 2014 (HealthDay News) -- Educational attainment is a robust, independent predictor of one-year disability-free recovery (DFR) after moderate to severe traumatic brain injury (TBI), according to a study published online April 23 in Neurology.

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CDC: Workplace Ladder Falls a Major Cause of Deaths, Injuries

FRIDAY, April 25, 2014 (HealthDay News) -- Workplace tumbles off of ladders are a major cause of injury and death among American employees, according to a study published in the April 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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One in 13 U.S. Schoolkids Take Psych Meds

FRIDAY, April 25, 2014 (HealthDay News) -- More than 7 percent of American schoolchildren are taking at least one medication for emotional or behavioral difficulties, and more than half of the parents said the drugs are helping their children, according to an April data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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FDA Reconsiders Behavior-Modifying 'Shock Devices'

THURSDAY, April 24, 2014 (HealthDay News) -- The days of electro-shock devices as a tool for managing hard-to-control behavior in people with disabilities may be numbered, U.S. health officials say.

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Physician Groups Find Fault With Medicare Payment Data Release

THURSDAY, April 24, 2014 (HealthDay News) -- Physician groups cite major problems associated with the release of Medicare payment data, according to an article published April 16 in Medical Economics.

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Educational Changes Suggested for Patient-Centered Medicine

THURSDAY, April 24, 2014 (HealthDay News) -- Changes in medical education and training are suggested to help new physicians address the needs of patients and their families, according to an ideas and opinions piece published in the April 22 issue of the Annals of Internal Medicine.

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Research Initiatives Demonstrate Ways to Speed Stroke Care

WEDNESDAY, April 23, 2014 (HealthDay News) -- New efforts to hasten treatment in both ambulances and emergency rooms appear to have significantly improved patients' chances of survival and limited their long-term disability, according to a pair of studies published in the April 23/30 issue of the Journal of the American Medical Association.

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FDA Proposes Accelerated Medical Device Approval Plan

WEDNESDAY, April 23, 2014 (HealthDay News) -- The U.S. Food and Drug Administration has proposed a new program that would provide expedited access to high-risk medical devices intended for patients with serious conditions whose medical needs are not met by current technology.

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Lorazepam No Better Than Diazepam for Epilepsy in Kids

TUESDAY, April 22, 2014 (HealthDay News) -- Lorazepam should not be preferentially used over diazepam in pediatric patients with convulsive status epilepticus, according to a study published in the April 23/30 issue of the Journal of the American Medical Association.

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Acetazolamide and Low-Sodium Diet Improve Vision

TUESDAY, April 22, 2014 (HealthDay News) -- The combination of acetazolamide and a low-sodium weight-reduction diet modestly improves visual field function in patients with idiopathic intracranial hypertension (IIH) and mild visual loss, compared to diet alone, according to a study published in the April 23/30 issue of the Journal of the American Medical Association.

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Conservative Management Better for Arteriovenous Malformations

TUESDAY, April 22, 2014 (HealthDay News) -- For patients with brain arteriovenous malformations (bAVMs), use of conservative management is associated with better clinical outcomes for up to 12 years, compared to interventional treatment, according to a study published in the April 23/30 issue of the Journal of the American Medical Association.

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Considerable Sudden Death in Hypertrophic Cardiomyopathy

TUESDAY, April 22, 2014 (HealthDay News) -- Patients with hypertrophic cardiomyopathy (HC) without traditional risk factors and with no or mild symptoms have a considerable rate of sudden cardiac death, according to a study published in the May 1 issue of The American Journal of Cardiology.

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New Muscular Dystrophy Drug's Chances for Approval Improve

MONDAY, April 21, 2014 (HealthDay News) -- A new drug to treat Duchenne muscular dystrophy may be closer to becoming the first approved treatment for the disease.

Health Highlights: April 21, 2014

Task Force Recommends Ways to Improve Price Transparency

MONDAY, April 21, 2014 (HealthDay News) -- Price transparency frameworks, which provide price information presented in the context of other relevant information, should be developed to meet patients' needs, according to recommendations presented in a report from the Healthcare Financial Management Association (HFMA).

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Primary Care Doctors Must Influence Lifestyle Changes

MONDAY, April 21, 2014 (HealthDay News) -- Primary care physicians (PCPs) are increasingly called upon to manage circulatory and circulatory-related diseases among their patients, according to an article published April 10 in Medical Economics.

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AMA Examines Economic Impact of Physicians

FRIDAY, April 18, 2014 (HealthDay News) -- Physicians who mainly engage in patient care contribute a total of $1.6 trillion in economic output, according to the American Medical Association (AMA)'s Economic Impact Study.

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PET Imaging Aids Diagnosis of Vegetative State

FRIDAY, April 18, 2014 (HealthDay News) -- Positron emission tomography (PET) imaging may be used in conjunction with examinations to assess long-term outcomes in patients in a vegetative state, according to a study published online April 16 in The Lancet.

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Autism Tied to Increased Connectivity in Brain Networks

FRIDAY, April 18, 2014 (HealthDay News) -- Adolescents with autism spectrum disorder (ASD) show atypically increased functional connectivity involving the mentalizing and mirror neuron brain networks, according to a study published online April 16 in JAMA Psychiatry.

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White House: 8 Million People Signed Up for Health Insurance

FRIDAY, April 18, 2014 (HealthDay News) -- Eight million Americans signed up for private health insurance during the just-concluded first enrollment period under the Affordable Care Act, the White House announced Thursday afternoon.

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Reduced Salt Intake Likely Dropped BP Levels in England

FRIDAY, April 18, 2014 (HealthDay News) -- The reduction of dietary salt intake between 2003 and 2011 was likely an important contributor to decreases in blood pressure (BP) in the population of England, according to research published online April 14 in BMJ Open.

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Standard Ultrasound Criteria Needed in Carotid Artery Stenosis

FRIDAY, April 18, 2014 (HealthDay News) -- Standardization of the diagnostic criteria defining the degree of carotid artery stenosis is needed for carotid duplex ultrasonography, according to research published online April 15 in Circulation: Cardiovascular Quality and Outcomes.

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Int'l Medical Education Standards Not Equivalent to U.K. Standards

FRIDAY, April 18, 2014 (HealthDay News) -- International medical graduates passing the Professional and Linguistic Assessments Board (PLAB) of the General Medical Council (GMC) have lower performance on MRCP(UK) (Membership of the Royal Colleges of Physicians) and MRCGP (Membership of the Royal College of General Practitioners) and on annual review of competence progression (ARCP) examinations, according to two studies published online April 17 in BMJ.

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One in 20 U.S. Adults a Victim of Diagnostic Errors

THURSDAY, April 17, 2014 (HealthDay News) -- Diagnostic errors affect at least one in 20 U.S. adults, according to research published online April 17 in BMJ Quality & Safety.

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Apathy Symptoms Tied to Lower Brain Volumes

THURSDAY, April 17, 2014 (HealthDay News) -- Apathy symptoms in older people without dementia are associated with lower brain volumes, according to a study published online April 16 in Neurology.

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Educator Discusses Key Issues for Future Doctors to Consider

THURSDAY, April 17, 2014 (HealthDay News) -- The key issues for future physicians are discussed in an article published by the American Medical Association (AMA).

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Patient-Clinician Relationship Impacts Health Care Outcomes

THURSDAY, April 17, 2014 (HealthDay News) -- The patient-clinician relationship has a small but significant effect on health care outcomes, according to a study published online April 9 in PLOS ONE.

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Considerable Variation in CT Use in Ischemic Stroke

THURSDAY, April 17, 2014 (HealthDay News) -- For patients with ischemic stroke there is considerable variation in the rates of high-intensity computed tomography (CT) use, according to a study published online April 8 in Circulation: Cardiovascular Quality and Outcomes.

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Diabetes-Related Complications Declined, 1990 to 2010

WEDNESDAY, April 16, 2014 (HealthDay News) -- Rates of diabetes-related complications have declined substantially over the past two decades, according to a study published in the April 17 issue of the New England Journal of Medicine.

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CDC: Regional Trends Seen for Complementary Health Services

WEDNESDAY, April 16, 2014 (HealthDay News) -- Yoga and meditation are popular on the West Coast, Midwesterners often turn to chiropractors or osteopathic doctors, and nearly one in every five Americans use herbal supplements. These are among the findings of a new federal government report published in the U.S. Centers for Disease Control and Prevention's April edition of the National Center for Health Statistics Data Brief.

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ILAE Updates Definition of Epilepsy

WEDNESDAY, April 16, 2014 (HealthDay News) -- A new definition of epilepsy resolves some lingering issues from the 2005 definition to improve the practicality of diagnosis for clinicians, according to an International League Against Epilepsy (ILAE) official report published online April 14 in Epilepsia.

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Continued Reliance on Windows XP May Threaten Data Security

WEDNESDAY, April 16, 2014 (HealthDay News) -- Physicians who use Windows XP in their practices may be affected by Microsoft's recent discontinuation of support for the program, according to an article published April 8 in Medical Economics.

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MRI Connects Vestibulopathy and Damage From Brain Injury

WEDNESDAY, April 16, 2014 (HealthDay News) -- Damage to specific brain regions may be linked to the prognosis of concussion patients with vestibulopathy, according to a study published online April 14 in Radiology.

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Patients Paying Much More for Specialty Drugs

TUESDAY, April 15, 2014 (HealthDay News) -- Many Americans are paying less for prescription drugs, but some are having to deal with sharp rises in the cost of specialty medicines for rare or serious diseases, according to a new report.

Health Highlights: April 15, 2014

New Health Secretary to Confront Health Care Reform Hurdles

MONDAY, April 14, 2014 (HealthDay News) -- With the resignation of U.S. Health and Human Services Secretary Kathleen Sebelius on Friday, the Affordable Care Act will get a fresh face. But turning around public perception of the controversial health care reform law in a politically charged mid-term election year poses an enormous challenge for the department's next leader, policy experts said.

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Elderly African-Americans May Have Higher Alzheimer's Burden

MONDAY, April 14, 2014 (HealthDay News) -- Older African-Americans may be disproportionately burdened by Alzheimer's disease, according to a study published in the April issue of Health Affairs.

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Sebelius Stepping Down As HHS Secretary

FRIDAY, April 11, 2014 (HealthDay News) -- U.S. Health and Human Services Secretary Kathleen Sebelius is stepping down from her position, after overseeing the troubled rollout of the Affordable Care Act that remains unpopular with some Americans and virtually all Republican lawmakers.

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In Older Women, Aerobic Training Ups Hippocampal Volume

FRIDAY, April 11, 2014 (HealthDay News) -- For older women with probable mild cognitive impairment (MCI), aerobic training is associated with increased hippocampal volume, while increased left hippocampal volume is linked to reduced verbal memory and learning performance, according to research published online April 7 in the British Journal of Sports Medicine.

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Insomnia Linked to Increased Risk of Subsequent Stroke

FRIDAY, April 11, 2014 (HealthDay News) -- Insomnia is associated with an increased risk of subsequent stroke, especially among younger adults, according to a study published online April 3 in Stroke.

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Brain Neuroinflammation Seen in Chronic Fatigue Syndrome

FRIDAY, April 11, 2014 (HealthDay News) -- Neuroinflammation markers are elevated in the brains of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) patients compared to healthy controls, according to a study published online March 24 in the Journal of Nuclear Medicine.

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Benefits/Risks for Fibrinolytic Therapy in Intermediate-Risk PE

FRIDAY, April 11, 2014 (HealthDay News) -- A single intravenous bolus of tenecteplase reduces early death and hemodynamic decompensation in normotensive patients with intermediate-risk pulmonary embolism, but increases the risk of major hemorrhage and stroke, according to a study published in the April 10 issue of the New England Journal of Medicine.

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Cognitive Decline Inversely Tied to Cancer Mortality Risk

THURSDAY, April 10, 2014 (HealthDay News) -- Elderly individuals who experience faster cognitive decline appear to be at reduced risk of dying from cancer, according to research published online April 8 in Neurology.

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Fewer Americans Overwhelmed by Medical Bills

WEDNESDAY, April 9, 2014 (HealthDay News) -- While millions of Americans still feel hamstrung by medical expenses, a new government report shows that some people are getting relief.

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More Justification Needed for Choosing Wisely Selections

WEDNESDAY, April 9, 2014 (HealthDay News) -- Most services included in specialty medical societies' Top 5 lists for the Choosing Wisely campaign are based on evidence demonstrating equivalent but not superior benefit, with higher risk or higher costs compared to other options, according to a research letter published in the April 9 issue of the Journal of the American Medical Association.

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Depression, Functional Disability Common Post-ICU

WEDNESDAY, April 9, 2014 (HealthDay News) -- For patients with respiratory failure or shock undergoing treatment in medical or surgical intensive care units, depression and functional disability are common, according to a study published online April 7 in The Lancet Respiratory Medicine.

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Some Doctors Paid at Least $3 Million Each by Medicare

WEDNESDAY, April 9, 2014 (HealthDay News) -- A small number of doctors received at least $3 million each in Medicare payments in 2012, for a total of nearly $1.5 billion, according to an analysis of Medicare claims data released Wednesday by the White House. In total, Medicare paid individual physicians nearly $64 billion in 2012. The median payment was just over $30,000, the Associated Press reported.

Health Highlights: April 9, 2014
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'Milestone' Therapy Produces Leg Movement in Paraplegics

TUESDAY, April 8, 2014 (HealthDay News) -- Four men paralyzed below the waist have regained some movement in their legs after a series of electrodes implanted along their spinal cord reawakened nerves long thought deadened, researchers are reporting. The findings were published online April 8 in Brain.

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Stroke Risk May Be Elevated After Herpes Zoster Infection

TUESDAY, April 8, 2014 (HealthDay News) -- Risk of stroke may be increased following herpes zoster infection, according to research published online April 8 in Clinical Infectious Diseases.

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Newly Eligible for Expanded Medicaid Are Healthier

MONDAY, April 7, 2014 (HealthDay News) -- Persons newly eligible for expanded Medicaid coverage under the Affordable Care Act (ACA) are not sicker than pre-ACA enrollees, according to research published online March 26 in Health Affairs.

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Early Elevation of Cardiac Risk Worsens Cognition in Midlife

MONDAY, April 7, 2014 (HealthDay News) -- Higher levels of cumulative exposure to cardiovascular risk factors (CVRFs) from early to middle adulthood may worsen cognition in midlife, according to research published online March 31 in Circulation.

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Patients Select Fewer New Docs at Bottom of Tiered Ranking

MONDAY, April 7, 2014 (HealthDay News) -- Patients are less likely to select a new physician ranked in the bottom of a tiered network, but often don't switch if their current physician is ranked at the bottom, according to research published online March 11 in Health Services Research.

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Mental Work Demands Affect Later Cognitive Functioning

FRIDAY, April 4, 2014 (HealthDay News) -- The mental demands of one's job may have a protective effect on cognitive functioning even after retirement, according to a study published online March 17 in the Journal of Occupational Health Psychology.

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AMA Provides Resources to Aid Physicians' Collections

FRIDAY, April 4, 2014 (HealthDay News) -- The American Medical Association (AMA) has released resources to help doctors confront policy jumpers who may pose a financial risk to physicians during the Affordable Care Act's 90-day premium grace period, according to an article published March 25 in Medical Economics.

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Cardiorespiratory Fitness Impacts Later Cognitive Function

FRIDAY, April 4, 2014 (HealthDay News) -- Cardiorespiratory fitness (CRF) is associated with better verbal memory and faster psychomotor speed 25 years later, according to a study published online April 2 in Neurology.

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Root-Cause Analysis Advised for Neonatal Encephalopathy

WEDNESDAY, April 2, 2014 (HealthDay News) -- The importance of root-cause analysis for neonatal encephalopathy is emphasized in the second edition of the Task Force Report on Neonatal Encephalopathy and Neurologic Outcome, published jointly by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.

Report - Executive Summary
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Half of Uninsured Don't Intend to Sign Up for Health Coverage

WEDNESDAY, April 2, 2014 (HealthDay News) -- About 50 percent of uninsured adults do not intend to sign up for coverage through the Affordable Care Act's health care exchanges, according to an article published March 26 in Medical Economics.

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β-Amyloid Deposits in Brain Linked to Arterial Stiffness

WEDNESDAY, April 2, 2014 (HealthDay News) -- Cerebral β-amyloid (Aβ) deposition increases with age in nondemented individuals, and this deposition is strongly associated with arterial stiffness, according to a study published online March 31 in JAMA Neurology.

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CMS: Medicare Beneficiaries Saved $3.9B on Meds in 2013

TUESDAY, April 1, 2014 (HealthDay News) -- In 2013, 4.3 million seniors and people with disabilities saved an estimated $3.9 billion on prescription drugs, an increase from the 2012 savings, according to a report published by the U.S. Department of Health and Human Services.

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