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November 2012 Briefing - Geriatrics

Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for November 2012. 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.

Editorial: Too Much Vigorous Exercise Can Damage Heart

THURSDAY, Nov. 29 (HealthDay News) -- Limiting vigorous exercise to 30 to 50 minutes a day will ensure cardiovascular benefit, without risking cardiovascular damage, according to an editorial published online Nov. 29 in Heart.

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Wait Time to Breast Cancer Surgery Up in Medicare Patients

THURSDAY, Nov. 29 (HealthDay News) -- The delay between first physician visit and breast cancer surgery increased from 1992 to 2005 for Medicare patients, according to a study published online Nov. 19 in the Journal of Clinical Oncology.

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Aspirin Use Cuts Risk of Hepatocellular Carcinoma

THURSDAY, Nov. 29 (HealthDay News) -- For men and women aged 50 to 71, use of nonsteroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, is associated with a reduced risk of hepatocellular carcinoma (HCC) and death due to chronic liver disease (CLD), according to a study published online Nov. 28 in the Journal of the National Cancer Institute.

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Depression Is Key Contributor to Health Status in Parkinson's

THURSDAY, Nov. 29 (HealthDay News) -- For patients with Parkinson's disease, of all the factors affecting the course of the disease, depression and anxiety have the biggest impact on health status, according to early findings from the largest ongoing study of Parkinson's disease, published online Nov. 28 by the National Parkinson Foundation.

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Removal of Consultation Fees Increased Spending on Doc Visits

WEDNESDAY, Nov. 28 (HealthDay News) -- The 2010 Medicare elimination of consultation payments (mainly billed by specialists) led to a net increase in spending on physician office visits, according to a study published online Nov. 26 in the Archives of Internal Medicine.

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Political Leaders Face Voter Opposition to Medicare Cuts

WEDNESDAY, Nov. 28 (HealthDay News) -- The majority of those who voted for President Obama in the 2012 election favor implementing the Affordable Care Act (ACA), while those who voted for Republican officeholders are likely to oppose parts or all of the implementation of the ACA; both sides oppose cuts to Medicare as a means to balance the budget, according to an analysis of newly released polls published as a Special Report online Nov. 28 in the New England Journal of Medicine.

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Digoxin Found to Increase Mortality in A-Fib Patients

WEDNESDAY, Nov. 28 (HealthDay News) -- Digoxin is linked with a significant increase in mortality in patients with atrial fibrillation (AF), according to results from a study published online Nov. 27 in the European Heart Journal.

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Cigarette Tax Would Cost Federal Government in Long Term

WEDNESDAY, Nov. 28 (HealthDay News) -- A theoretical additional federal excise tax on cigarettes would lead to greater federal outlays over time because of the population's increased longevity, according to a perspective piece published in the Nov. 29 issue of the New England Journal of Medicine.

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Adding Fitness to Statin Rx Significantly Improves Mortality

WEDNESDAY, Nov. 28 (HealthDay News) -- For patients with dyslipidemia, the combination of statin treatment and increased fitness results in substantially lower mortality risk than either alone, according to a study published online Nov. 28 in The Lancet.

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State Cost of Affordable Care Act's Medicaid Expansion Modest

WEDNESDAY, Nov. 28 (HealthDay News) -- Implementation of the Affordable Care Act's (ACA) Medicaid expansion will likely result in modest state costs by 2022, but will gain health care coverage for more than 20 million uninsured Americans, according to report published by the Kaiser Family Foundation.

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USPSTF: Consider Screening Baby Boomers for Hepatitis C Infection

TUESDAY, Nov. 27 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends that certain high-risk people be screened for the hepatitis C virus (HCV) and that screening should be considered for people born between 1945 and 1965. This Recommendation Statement is based on an evidence review published in the Nov. 27 issue of the Annals of Internal Medicine.

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Doc Earnings Growth Lags Behind Other Health Professionals

TUESDAY, Nov. 27 (HealthDay News) -- Compared with other health professionals, in the last 15 years there has been considerably less growth in the earnings of physicians in the United States, according to a research letter published in the Nov. 28 issue the Journal of the American Medical Association.

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Warfarin D/C Within 180 Days Post-Surgery May Up Mortality

TUESDAY, Nov. 27 (HealthDay News) -- Patients who undergo bioprosthetic aortic valve replacement surgery and discontinue anticoagulant treatment within six months have a greater risk of cardiovascular death, according to a study published in the Nov. 28 issue of the Journal of the American Medical Association.

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U.S. Primary Care Doctors Gaining Ground on Health IT

TUESDAY, Nov. 27 (HealthDay News) -- While primary care physicians in the United States and other countries are gaining ground on health information technology use, there continues to be access-to-care barriers and breakdowns in coordination issues with other health care professionals, according to a Commonwealth Fund report published online Nov. 15 in Health Affairs.

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Growing Number of Drugs Possibly Inhibited by Grapefruit

TUESDAY, Nov. 27 (HealthDay News) -- There are increasing numbers of newly marketed drugs that have the potential to interact with grapefruit, all of which are metabolized by the cytochrome P450 3A4 enzyme (CYP3A4), according to a review published online Nov. 26 in CMAJ, the journal of the Canadian Medical Association.

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Zolpidem Linked to Increased Risk of Inpatient Falls

TUESDAY, Nov. 27 (HealthDay News) -- Zolpidem, a commonly used hypnotic drug, is independently associated with an increased risk of inpatient falls, according to a study published online Nov. 19 in the Journal of Hospital Medicine.

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Hemorrhage Rates Highest Within 30 Days of Warfarin Tx

MONDAY, Nov. 26 (HealthDay News) -- For older patients with atrial fibrillation starting on warfarin, the rates of hemorrhage are highest within the first 30 days, according to a study published online Nov. 26 in CMAJ, the journal of the Canadian Medical Association.

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Ranbaxy Issues Recall of 41 Batches of Atorvastatin

MONDAY, Nov. 26 (HealthDay News) -- Ranbaxy Laboratories Ltd., one of India's biggest pharmaceutical companies, has issued a voluntary recall for 41 batches of its generic version of atorvastatin calcium (Lipitor), with the full knowledge of the U.S. Food and Drug Administration.

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Prevalence of COPD About 6 Percent Across the U.S.

MONDAY, Nov. 26 (HealthDay News) -- The prevalence of chronic obstructive pulmonary disease (COPD) is about 6 percent across the United States, and its impact on health care utilization and quality of life creates a substantial public health care burden that needs to be addressed, according to research published in the Nov. 23 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Growth in Health Benefit Cost Per Employee Slowed in 2012

FRIDAY, Nov. 23 (HealthDay News) -- In 2012, growth in the average total health benefit cost per employee slowed to 4.1 percent, according to the National Survey of Employer-Sponsored Health Plans, published Nov. 14 by Mercer.

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Obama Administration Moving Forward With Health Care Law

WEDNESDAY, Nov. 21 (HealthDay News) -- Three rules have been proposed by the Obama administration to further facilitate implementation of the Affordable Care Act, according to a Nov. 20 press release from the U.S. Centers for Medicare & Medicaid Services.

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Aspirin Resistance Ups Severity in Acute Ischemic Stroke

WEDNESDAY, Nov. 21 (HealthDay News) -- In patients with acute ischemic stroke, aspirin resistance is associated with increased stroke severity and infarct size, according to research published online Nov. 19 in the Archives of Neurology.

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Nearly 40 Percent of Adults Take Dietary Supplements

WEDNESDAY, Nov. 21 (HealthDay News) -- Nearly 40 percent of adults in the United States take dietary supplements such as fish oil, and most report that they would not stop taking them even if they were shown to be ineffective, according to a research letter published online Nov. 19 in the Archives of Internal Medicine.

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HIV Screening Recommended for All 15- to 65-Year Olds

TUESDAY, Nov. 20 (HealthDay News) -- New recommendations propose HIV screening for all individuals aged 15 to 65 years, and for all pregnant women, according to a draft recommendation statement issued Nov. 20 by the U.S. Preventive Services Task Force (USPSTF).

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Online Access by Patients to Health Records Ups Utilization

TUESDAY, Nov. 20 (HealthDay News) -- Patients having online access to medical records and clinicians correlates with an increase in health care utilization, according to a study published in the Nov. 21 issue of the Journal of the American Medical Association.

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Positive View of Aging Aids Recovery From Disability

TUESDAY, Nov. 20 (HealthDay News) -- Older people with positive age stereotypes are significantly more likely to recover from disability than those with negative age stereotypes, according to a study published in the Nov. 21 issue of the Journal of the American Medical Association.

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Repeat Testing Common Among Medicare Beneficiaries

MONDAY, Nov. 19 (HealthDay News) -- For Medicare beneficiaries, repeat testing within three years is common, according to a study published online Nov. 19 in the Archives of Internal Medicine.

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Testosterone Doesn't Add to Erectile Response With Sildenafil

MONDAY, Nov. 19 (HealthDay News) -- For men with erectile dysfunction and low testosterone levels, the addition of testosterone to sildenafil is not superior to sildenafil alone for improving erectile function, according to a study published in the Nov. 20 issue of the Annals of Internal Medicine.

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Decreased Renal Function Linked to Cognitive Decline

MONDAY, Nov. 19 (HealthDay News) -- Decreased estimated glomerular filtration rates (eGFR) correlate with cognitive decline, according to a study published online Nov. 19 in Nephrology Dialysis Transplantation.

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Mental Illness, Job Stress Both Factors in Physician Suicides

FRIDAY, Nov. 16 (HealthDay News) -- The presence of mental illness or job problems may make physicians more vulnerable to suicide than non-physicians, according to a study published online Nov. 5 in General Hospital Psychiatry.

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Hearing Impairment More Prevalent in Diabetes

FRIDAY, Nov. 16 (HealthDay News) -- Hearing impairment is approximately twice as prevalent in people with diabetes compared with individuals who do not have diabetes, according to research published online Nov. 12 in the Journal of Clinical Endocrinology & Metabolism.

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New Genetic Variant Implicated in Alzheimer's Disease

THURSDAY, Nov. 15 (HealthDay News) -- A missense mutation in the gene encoding the triggering receptor expressed on myeloid cells 2 (TREM2) correlates with increased risk of Alzheimer's disease, according to two studies published online Nov. 14 in the New England Journal of Medicine.

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Pilates Is Beneficial Adjunctive Therapy in Heart Failure

THURSDAY, Nov. 15 (HealthDay News) -- Pilates exercises may be a beneficial adjunctive treatment for patients with heart failure, offering functional capacity improvements, according to a study published in the December issue of Cardiovascular Therapeutics.

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Room to Improve Order, Length of Doc Handoff Discussions

THURSDAY, Nov. 15 (HealthDay News) -- In handoff discussions between attending physicians in an intensive care unit, more time is allocated to patients discussed early in each session compared with those discussed last, despite the order of cases being unrelated to severity or complexity of illness, according to research published online Nov. 12 in the Archives of Internal Medicine.

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Survival Improving After In-Hospital Cardiac Arrest

WEDNESDAY, Nov. 14 (HealthDay News) -- Over the past decade, there has been a trend toward improved survival and a decrease in neurologic disability following in-hospital cardiac arrest, according to a study published in the Nov. 15 issue of the New England Journal of Medicine.

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Predictors ID'd for Mortality in Elderly With Cervical Spine Injury

WEDNESDAY, Nov. 14 (HealthDay News) -- Preexisting comorbidities (PECs), spinal cord injury (SCI), and age are all strong predictors of mortality in elderly patients with trauma-related cervical spine injury (CSI), although the evidence is not conclusive, according to research published online Nov. 2 in Spine.

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Efficacy of Corticosteroid Injection for Sciatica Reviewed

TUESDAY, Nov. 13 (HealthDay News) -- Epidural corticosteroid injections offer a small but significant degree of short-term relief of leg pain and disability for patients with sciatica, but the long-term effects are even smaller and not significant, according to a review published online Nov. 13 in the Annals of Internal Medicine.

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Communication Dilemmas ID'd Within Alzheimer's Care

TUESDAY, Nov. 13 (HealthDay News) -- For nurses and care assistants, specific communication dilemmas surround the provision of social support to families of patients with Alzheimer's disease, according to a study published online Nov. 12 in the Journal of Applied Communication Research.

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Social Network Profile May Harm Medical Applicants

MONDAY, Nov. 12 (HealthDay News) -- Social networking profiles may harm an applicant's chances of admission to medical school or a residency program, according to a study published online Nov. 8 in the Postgraduate Medical Journal.

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Increased Risk of Carotid Artery Wall Thickening in COPD

MONDAY, Nov. 12 (HealthDay News) -- For older adults with chronic obstructive pulmonary disease (COPD), the likelihood of carotid artery thickening is increased and vulnerable lipid core plaques are more frequent than in controls with normal lung function, according to a study published online Nov. 9 in the American Journal of Respiratory and Critical Care Medicine.

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Higher Pulse Wave Velocity Seen in Well-Controlled Diabetes

FRIDAY, Nov. 9 (HealthDay News) -- Pulse wave velocity is higher among patients with well-controlled type 2 diabetes when compared to controls, and is associated with white matter lesions, according to a study published online Nov. 5 in Diabetes Care.

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Disc Disease Severity Doesn't Predict Surgical Outcomes

THURSDAY, Nov. 8 (HealthDay News) -- Increasing severity of degenerative disc disease (DDD) does not impact outcomes in total lumbar disc replacement (TDR), according to a study published in the November issue of the European Spine Journal.

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Racial Variation in Pain in Knee OA Linked to Vitamin D Levels

THURSDAY, Nov. 8 (HealthDay News) -- For patients with knee osteoarthritis, racial differences in experimental pain are associated with levels of vitamin D, according to a study published online Nov. 7 in Arthritis & Rheumatism.

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Steroids Up Probability of Facial Nerve Recovery in Bell's Palsy

THURSDAY, Nov. 8 (HealthDay News) -- Updated guidelines recommend steroids for patients with new-onset Bell's palsy, which increases the probability of recovery of facial nerve function, while the addition of antivirals is associated with a modest benefit, according to evidence-based guidelines published online Nov. 7 in Neurology.

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Even Physically Active Women Found to Sit Too Much

THURSDAY, Nov. 8 (HealthDay News) -- Healthy, middle- and older-aged women who meet the current exercise recommendations spend as much time sitting each week as women who do not exercise regularly, according to a study published online Oct. 4 in the International Journal of Behavioral Nutrition and Physical Activity.

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Few PT Interventions Effective for Knee Osteoarthritis

TUESDAY, Nov. 6 (HealthDay News) -- Only a few physical therapy (PT) interventions are effective for knee pain secondary to osteoarthritis, specifically exercise and ultrasonography, according to a review published in the Nov. 6 issue of the Annals of Internal Medicine.

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FDA Approves Expanded Use of Xarelto

MONDAY, Nov. 5 (HealthDay News) -- Approval of the anti-clotting drug Xarelto (rivaroxaban) has been expanded by the U.S. Food and Drug Administration to include treating deep vein thrombosis (DVT) or pulmonary embolism (PE), and to reduce the risk of recurrent DVT and PE following initial treatment.

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AHA Reaffirms Sodium Reduction Advice

MONDAY, Nov. 5 (HealthDay News) -- The American Heart Association (AHA) is reaffirming its 2011 advisory limiting sodium consumption to less than 1,500 mg per day, according to a scientific statement published online Nov. 2 in Circulation.

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Revision Hip Replacement Risk Highest During First 18 Months

FRIDAY, Nov. 2 (HealthDay News) -- Among elderly patients receiving total hip replacements for osteoarthritis, the risk of revision hip replacement is highest in the 18 months after surgery and among those aged 65 to 75 years at time of surgery, according to research published in the Oct. 17 issue of The Journal of Bone & Joint Surgery.

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Exercise Cuts Cognitive Deficit Risk for At-Risk Seniors

FRIDAY, Nov. 2 (HealthDay News) -- For older people with white matter changes living independently, physical activity lowers the risk of cognitive impairment, according to a study published online Nov. 1 in Stroke.

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Factors Impacting Benefit of Exercise in Knee OA Identified

FRIDAY, Nov. 2 (HealthDay News) -- For patients with knee osteoarthritis, self-reported knee instability and fear of physical activity correlate with the likelihood of treatment response following a therapeutic exercise program, according to a study published in the November issue of Arthritis Care & Research.

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NSAIDS Don't Affect C-Reactive Protein Levels in RA Patients

THURSDAY, Nov. 1 (HealthDay News) -- Overall, oral nonsteroidal anti-inflammatory drugs (NSAIDs) do not have an effect on C-reactive protein (CRP) levels in patients with rheumatoid arthritis (RA), according to research published in the November issue of Arthritis & Rheumatism.

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Anticoagulation Therapy Appears to Be Safe After TAVI

THURSDAY, Nov. 1 (HealthDay News) -- After transcatheter aortic valve implantation (TAVI) there is no increased risk of bleeding or other adverse outcomes for those patients who have an indication for anticoagulant therapy, according to a study published online Oct. 29 in The American Journal of Cardiology.

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