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March 2013 Briefing - Pharmacy

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

Hormone Therapy Ups Breast Cancer Risk, Mortality

FRIDAY, March 29 (HealthDay News) -- Postmenopausal hormone therapy with estrogen plus progestin is associated with an increased risk of breast cancer, according to a study published online March 29 in the Journal of the National Cancer Institute.

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Many Uninsured Vets Will Be Eligible for Medicaid Under ACA

FRIDAY, March 29 (HealthDay News) -- A large proportion of uninsured veterans and their spouses will be eligible for Medicaid or new subsidies for coverage under the Affordable Care Act (ACA), according to a report published by the Robert Wood Johnson Foundation.

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Greater Vaccine Exposure Not Tied to Increased Autism Risk

FRIDAY, March 29 (HealthDay News) -- Increased exposure to vaccines during the first two years of life is not associated with an increased risk of autism, according to a study published online March 29 in The Journal of Pediatrics.

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Study Examines Physician Prescription of Teen IUDs

FRIDAY, March 29 (HealthDay News) -- Primary care physicians are more or less likely to prescribe long-acting reversible contraception such as intrauterine devices (IUDs) to adolescents based on their knowledge, skills, clinical environment, and attitudes, according to research published in the March/April issue of the Annals of Family Medicine.

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Study: Primary Care Extension Program Should Be Funded

THURSDAY, March 28 (HealthDay News) -- The Primary Care Extension Program (PCEP) has the potential to transform primary care and needs to be funded, according to a study published in the March/April issue of the Annals of Family Medicine.

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Using Internet Search Logs Can Help Identify Drug Interactions

THURSDAY, March 28 (HealthDay News) -- Search logs can be used to inexpensively mine for anonymized signals that may alert authorities to potential drug interactions and add new Web-scale pharmacovigilance capabilities, according to research published online March 6 in the Journal of the American Medical Informatics Association.

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H. pylori Status May Affect Recurrent Ulcer Bleeding

THURSDAY, March 28 (HealthDay News) -- Risk of recurrent ulcer bleeding is low in long-term low-dose aspirin (ASA) users with a history of ulcer bleeding and eradication of Helicobacter pylori (H. pylori), but high in ASA users with a history of ulcer bleeding and negative for H. pylori, according to research published in the March issue of Gastroenterology.

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Texts Do Not Promote Flu Vaccination During Pregnancy

WEDNESDAY, March 27 (HealthDay News) -- Text messages encouraging pregnant women to get an influenza vaccination are ineffective, according to a study published in the April issue of Obstetrics & Gynecology. A related study in the same journal examines factors predicting influenza vaccination among pregnant women.

Abstract - Henninger
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Abstract - Moniz
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Management of Short Stature in Childhood Discussed

WEDNESDAY, March 27 (HealthDay News) -- Short stature in childhood warrants evaluation, and various treatment options should be considered, according to a case vignette published in the March 28 issue of the New England Journal of Medicine.

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Trial Shows Miravirsen Decreases HCV RNA Levels

WEDNESDAY, March 27 (HealthDay News) -- Subcutaneous injections of miravirsen, an miRNA inhibitor, result in significant virologic responses in patients with chronic hepatitis C virus (HCV) infection, according to a study published online March 27 in the New England Journal of Medicine.

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Novel Approach Found for Treating Hypertrophic Scars

WEDNESDAY, March 27 (HealthDay News) -- Same-session therapy with fractional ablative laser treatment followed immediately with topical application of triamcinolone acetonide suspension is effective in treating patients with hypertrophic and restrictive cutaneous scars, according to research published in the March issue of Lasers in Surgery and Medicine.

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Submitting Peer-Review Reports Could Expedite Process

WEDNESDAY, March 27 (HealthDay News) -- Attaching previous peer-review reports during the next submission of the same paper to a different journal could optimize the peer-review process, according to research published in the March/April issue of the Annals of Family Medicine.

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Sublingual Immunotherapy Effective for Allergies

TUESDAY, March 26 (HealthDay News) -- Current studies show moderate evidence that sublingual immunotherapy is effective for allergic rhinitis, although the optimal dosing is unclear, according to a review published in the March 27 issue of the Journal of the American Medical Association.

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Certified Primary Stroke Centers Use More Rt-PA

TUESDAY, March 26 (HealthDay News) -- Joint Commission certified primary stroke centers (PSCs) use more recombinant tissue plasminogen activator (rt-PA) for ischemic stroke than non-PSCs, according to a study published online March 26 in the Journal of the American Heart Association.

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Macrolide Antibiotics Are Effective for Bronchiectasis

TUESDAY, March 26 (HealthDay News) -- Macrolide antibiotics are effective in reducing exacerbations in patients with non-cystic fibrosis bronchiectasis, although the resistance rate increases, according to two studies published in the March 27 issue of the Journal of the American Medical Association.

Abstract - Altenburg
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Abstract - Serisier
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Supplement Aids Age-Related Macular Degeneration

TUESDAY, March 26 (HealthDay News) -- A supplement containing a combination of lutein, zeaxanthin, and ω-3 long-chain polyunsaturated fatty acids (LC-PUFAs) significantly benefits patients with age-related macular degeneration (AMD), according to a study published online March 21 in JAMA Ophthalmology.

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Residency Reforms Reduced Duty Hours, Increased Sleep

TUESDAY, March 26 (HealthDay News) -- Additional residency reforms implemented in 2011 have reduced duty hours and increased sleep duration, but with perceived reductions in quality of patient care, according to research published online March 25 in JAMA Internal Medicine.

Abstract - Sen
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Abstract - Desai
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FDA Approves Inhaler for Cystic Fibrosis Patients

MONDAY, March 25 (HealthDay News) -- The TOBI Podhaler (tobramycin inhalation powder) has been approved by the U.S. Food and Drug Administration to treat cystic fibrosis patients infected with Pseudomonas aeruginosa, a bacterium that can damage the lungs.

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Antiplatelet Drugs Don't Up ICH Risk in New Study

MONDAY, March 25 (HealthDay News) -- Pre-existing antiplatelet use does not seem to be associated with an increased risk of ischemic hemorrhage (ICH), according to an observational study published in the February issue of Academic Emergency Medicine.

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Telehealth in Addition to Usual Care Not Cost-Effective

FRIDAY, March 22 (HealthDay News) -- For adults with chronic health conditions, a telehealth intervention in addition to standard support and treatment is associated with increased costs, with no significant benefit in terms of quality adjusted life years (QALYs), according to a study published online March 22 in BMJ.

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Engineered Immune Cells Lead to Leukemia Remission

FRIDAY, March 22 (HealthDay News) -- Five patients with relapsed B cell acute lymphoblastic leukemia (B-ALL) quickly achieved complete remission after treatment with autologous engineered T cells, according to research published in the March 20 issue of Science Translational Medicine.

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Clarithromycin May Be Linked to Cardiovascular Events

FRIDAY, March 22 (HealthDay News) -- For patients with acute exacerbations of chronic obstructive pulmonary disease or community-acquired pneumonia, use of clarithromycin correlates with increased risk of cardiovascular events, according to a study published online March 22 in BMJ.

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Impact of Budget Sequestration on Health Care Discussed

THURSDAY, March 21 (HealthDay News) -- The impact of sequestration will have far-reaching consequences in health care, according to a perspective piece published online March 20 in the New England Journal of Medicine.

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ERCC1 Not Effective for Guiding Therapeutic Decisions

THURSDAY, March 21 (HealthDay News) -- Currently available antibodies for the excision repair cross-complementation group 1 (ERCC1) protein are not adequate for therapeutic decision-making regarding the potential efficacy of cisplatin-containing treatment in patients with non-small-cell lung cancer, according to a study published the March 21 issue of the New England Journal of Medicine.

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Endocrine Society Urges Better Standards for Estradiol Testing

THURSDAY, March 21 (HealthDay News) -- A new position statement published by The Endocrine Society recommends that estradiol measurement assays and reference ranges be standardized and that the health care community work toward improving the accessibility of accurate estradiol testing methods; the position statement was published online March 5 in the Journal of Clinical Endocrinology & Metabolism.

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Effect of Immigration Status on Medicaid Eligibility Discussed

WEDNESDAY, March 20 (HealthDay News) -- Under the Affordable Care Act, a considerable proportion of low-income uninsured adults will be ineligible for Medicaid coverage due to their immigration status, and their main providers are likely to be safety-net health care providers, according to a March report published by the State Health Access Data Assistance Center.

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Intensive Glycemic Control Linked to Highest Weight Gains

WEDNESDAY, March 20 (HealthDay News) -- Weight gain is higher in patients with type 2 diabetes mellitus (T2DM) who receive more intensive glycemic control treatment and is associated with a reduction of A1C from baseline, according to research published online Feb. 14 in Diabetes Care.

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High-Potency Statins Up Acute Kidney Injury Hospitalizations

WEDNESDAY, March 20 (HealthDay News) -- For patients with non-chronic kidney disease, high-potency statin treatment is associated with an increased risk of hospitalization for acute kidney injury, according to a study published online March 19 in the BMJ.

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Chlorthalidone No Better Than Hydrochlorothiazide for HTN

WEDNESDAY, March 20 (HealthDay News) -- For older adults with hypertension, chlorthalidone is not associated with fewer adverse cardiovascular events or death, but correlates with increased hypokalemia compared with hydrochlorothiazide, according to a study published in the March 19 issue of the Annals of Internal Medicine.

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Docs Decide on Duration of Antibiotics in Long-Term Care

WEDNESDAY, March 20 (HealthDay News) -- Prescriber preference rather than patient characteristics influences the duration of antibiotic courses in long-term care residents, according to research published online March 18 in JAMA Internal Medicine.

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Manual Osteopathic Treatment Improves Chronic Back Pain

WEDNESDAY, March 20 (HealthDay News) -- Treatment of nonspecific chronic low back pain with osteopathic manual treatment (OMT) is associated with moderate or substantial improvements in low back pain, according to a study published in the March/April issue of the Annals of Family Medicine.

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Sepsis Drug Eritoran Not Superior to Placebo

TUESDAY, March 19 (HealthDay News) -- Eritoran, a synthetic analog of lipid A and a toll-like receptor 4 antagonist, is no better than placebo in reducing mortality in patients with severe sepsis, according to a study published in the March 20 issue of the Journal of the American Medical Association.

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Conflict-of-Interest Disclosures Common at 2011 AAOS Meeting

TUESDAY, March 19 (HealthDay News) -- At the 2011 American Academy of Orthopaedic Surgeons (AAOS) annual meeting, voluntarily disclosed conflicts of interest were common, especially for featured symposia, according to a study published in the March 6 issue of The Journal of Bone & Joint Surgery.

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Aristolochic Acid Nephropathy, a Global Health Problem

TUESDAY, March 19 (HealthDay News) -- Although the first description of a rapidly progressive nephropathy associated with the consumption of aristolochic acid (AA) found in Chinese herbs was first reported 20 years ago, AA-induced nephropathy remains a worldwide health concern due to the lack of regulation on herbal medication and the easy availability of such medications online, according to a review published in the March 19 issue of the Annals of Internal Medicine.

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Pharmacist-Led Home BP Program Shows Success

MONDAY, March 18 (HealthDay News) -- Compared with usual care, a pharmacist-led home blood pressure monitoring (HBPM) intervention called Heart360 results in greater blood pressure (BP) reductions, superior BP control, and higher patient satisfaction, according to research published online March 5 in Circulation: Cardiovascular Quality and Outcomes.

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Data Insufficient to Link Declines in Breast Cancer, HRT Use

MONDAY, March 18 (HealthDay News) -- Evidence does not definitively link the decline in the use of hormone replacement therapy (HRT) to a fall in the incidence of breast cancer, according to the last in a series of critiques published in the April issue of the Journal of Family Planning & Reproductive Health Care.

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Black Children Less Likely to Be Prescribed Antibiotics

MONDAY, March 18 (HealthDay News) -- Black children are less likely to be prescribed antibiotics and to be diagnosed with conditions that require antibiotics, even when treated by the same doctor, according to research published online March 18 in Pediatrics.

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Reasons for Refusal of HPV Differ From Other Vaccines

MONDAY, March 18 (HealthDay News) -- Parents who do not have their teenagers immunized against human papillomavirus (HPV) most often say that they have safety concerns or that their child is not sexually active, which differs from their refusal of other vaccines, according to a study published online March 18 in Pediatrics.

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Final Rule in Notice of Benefit, Payment Parameters Issued

FRIDAY, March 15 (HealthDay News) -- The final rule of the Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2014, which expands on existing standards, has been released.

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Combining Two Most Common MS Drugs Fails to Cut Relapse Risk

FRIDAY, March 15 (HealthDay News) -- A combination of interferon beta-1a (IFN) and glatiramer acetate (GA) therapy does not provide added clinical benefit to patients with multiple sclerosis (MS), according to a study published online March 11 in the Annals of Neurology.

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Pharmaceutical Companies Are Reducing Promotional Spending

FRIDAY, March 15 (HealthDay News) -- Pharmaceutical companies have been reducing the amount of money they spend on promotion to consumers and providers over the past decade and spend much less to promote biologics compared with small molecule drugs, according to a study published online March 4 in PLOS ONE.

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Drinking Green Tea, Coffee May Help Lower Stroke Risk

FRIDAY, March 15 (HealthDay News) -- People who consume one or more cups of green tea or coffee per day have a lower risk of cardiovascular disease and stroke, according to a study published online March 14 in Stroke.

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Health Insurance Exchanges Will Mainly Be Run by Feds

FRIDAY, March 15 (HealthDay News) -- More than half of the states within the United States will allow the federal government to establish health insurance exchanges, according to a report issued by the Henry J. Kaiser Family Foundation.

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Cardio Risks Need Evaluation Before Prescribing Statins

FRIDAY, March 15 (HealthDay News) -- Physicians may not adequately consider a patient's cardiovascular risk when prescribing statins as preventive therapy, according to a research letter published online March 11 in JAMA Internal Medicine.

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Stimulated Reporting Accounts for High Dabigatran Bleeding

THURSDAY, March 14 (HealthDay News) -- The increased number of post-marketing reports of bleeding associated with use of dabigatran seems to be an example of stimulated reporting and may not represent an increased bleeding risk, according to a perspective piece published online March 13 in the New England Journal of Medicine.

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Rules Must Evolve to Allow New Drugs for Early Alzheimer's

THURSDAY, March 14 (HealthDay News) -- Given the shift in the focus of drug development for Alzheimer's disease toward earlier disease stages, before the onset of dementia, regulatory guidelines need to evolve, according to a perspective piece published online March 13 in the New England Journal of Medicine.

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Vitamin D3 Supplementation Lowers Systolic BP in Blacks

THURSDAY, March 14 (HealthDay News) -- Vitamin D3 (cholecalciferol) supplementation lowers systolic blood pressure in blacks, according to a study published in the April issue of Hypertension.

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Prescribing ADHD Drugs to Healthy Children Not Justified

THURSDAY, March 14 (HealthDay News) -- Prescribing neuroenhancing drugs, such as those used to treat attention-deficit/hyperactivity disorder, to healthy children and teens to improve memory or cognitive function is unjustified and inadvisable, according to position paper published online March 13 in Neurology.

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FDA Reaffirms Azithromycin Tie to Heart Rhythm Abnormalities

WEDNESDAY, March 13 (HealthDay News) -- The drug labels on azithromycin (Zithromax, Zmax) have been updated to strengthen the Warnings and Precautions section with information relating to abnormal changes in the electrical activity of the heart, which may lead to a potentially fatal irregular heart rhythm, according to a March 12 safety announcement issued by the U.S. Food and Drug Administration.

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Small Benefit of Adjunctive Antipsychotics for Depression

WEDNESDAY, March 13 (HealthDay News) -- Atypical antipsychotic drugs for the adjunctive treatment of depression are associated with relatively small benefits, no improvement in function or quality of life, and adverse events, according to research published online March 12 in PLOS Medicine.

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2009 H1N1 Vaccine Tied to Small Risk of Guillain-Barré Syndrome

WEDNESDAY, March 13 (HealthDay News) -- The monovalent inactivated influenza (H1N1) 2009 vaccine is associated with a small but significant increase in the risk of Guillain-Barré syndrome in the United States, according to a meta-analysis published online March 13 in The Lancet.

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Worldwide, Contraceptive Prevalence Up Since 1990

TUESDAY, March 12 (HealthDay News) -- Since 1990, contraceptive prevalence has increased worldwide and the unmet need for family planning has decreased, but the absolute number of women with a demand for contraception is likely to increase by 2015, according to a study published online March 12 in The Lancet.

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$120 Million to Be Sequestered From Health Centers in 2013

TUESDAY, March 12 (HealthDay News) -- Budget sequestration, which is expected to reduce federal spending, is likely to result in a $120 million loss in grant funding for the nation's 1,200 community health centers in 2013, according to a report published by the Geiger Gibson/ RCHN Community Health Foundation Research Collaborative.

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Aspirin Cuts Melanoma Risk in Postmenopausal Caucasians

MONDAY, March 11 (HealthDay News) -- For postmenopausal Caucasian women, aspirin use is associated with a significantly reduced risk of melanoma, according to a study published online March 11 in Cancer.

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More Evidence of Waning Immunity of Pertussis Vaccine

MONDAY, March 11 (HealthDay News) -- Children who receive five doses of the acellular pertussis vaccine (DTaP) have an increasing risk of developing the illness in the six years after the last dose, supporting the concept of waning vaccine immunity and possibly explaining the increasing proportion of cases among 7- to 10-year-old children, according to a study published online March 11 in Pediatrics.

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FDA Encourages Opioid Prescribers to Pursue Training

MONDAY, March 11 (HealthDay News) -- Prescribers of extended-release/long-acting (ER/LA) opioid analgesics are encouraged to participate in continuing medical education (CME) provided by manufacturers of these analgesics, according to an open letter published March 1 by the U.S. Food and Drug Administration.

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Opioid Guidelines for ER Docs Help, But More Study Needed

FRIDAY, March 8 (HealthDay News) -- Local recommendations like those recently released in New York City aimed at improving opioid prescribing are good first steps but unlikely on their own to address the full problem, according to a viewpoint published in the March 6 issue of the Journal of the American Medical Association.

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Neonatal Size Unaffected by Gestational Diabetes Drugs

FRIDAY, March 8 (HealthDay News) -- Women with gestational diabetes mellitus treated with metformin or insulin have similar changes in markers of metabolic status and no differences in offspring birth weight, according to a study published in the March issue of Diabetes Care.

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Sleep Meds Up Hip Fracture Risk Among Nursing Home Residents

THURSDAY, March 7 (HealthDay News) -- There is an increased risk for hip fracture among nursing home residents using a nonbenzodiazepine hypnotic drug, according to a study published online March 4 in JAMA Internal Medicine.

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Cochrane Group Skeptical About Latest Roche Pledges

THURSDAY, March 7 (HealthDay News) -- Following requests from Cochrane researchers, Roche has pledged to release full clinical study reports for Tamiflu, although there appear to be conditions attached, according to correspondence published in BMJ.

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Nonheme Iron Intake Linked to Reduced Risk of PMS

WEDNESDAY, March 6 (HealthDay News) -- Intake of specific minerals seem to be associated with the risk of premenstrual syndrome (PMS), with high intake of nonheme iron linked to reduced risk of PMS, according to research published online Feb. 26 in the American Journal of Epidemiology.

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Two Drug Classes Found Effective for Restless Legs Syndrome

WEDNESDAY, March 6 (HealthDay News) -- In patients with restless legs syndrome, dopamine agonists and calcium channel alpha-2-delta ligands are effective in reducing symptoms and improving sleep and quality of life, although adverse events are common and often lead to treatment withdrawals, according to a review published online March 4 in JAMA Internal Medicine.

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Most Docs Report Information Overload in EHR-Setting

WEDNESDAY, March 6 (HealthDay News) -- Primary care practitioners (PCPs) using electronic health records (EHRs) are susceptible to information overload and feel that the EHR notification system makes it possible to miss test results, according to a research letter published online March 4 in JAMA Internal Medicine.

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Clinical Trials Published Almost Two Years After Completion

WEDNESDAY, March 6 (HealthDay News) -- Clinical trials are published, on average, almost two years after completion, with time to publication affected by the funding source, number of trial participants, and journal impact factor, according to a research letter published online March 4 in JAMA Internal Medicine.

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Anti-TNF Therapy Not Linked to Herpes Zoster Risk in RA

TUESDAY, March 5 (HealthDay News) -- For patients with rheumatoid arthritis (RA) and other inflammatory diseases, use of anti-tumor necrosis factor (TNF) therapy is not associated with an increased risk of herpes zoster, according to a study published in the March 6 issue of the Journal of the American Medical Association.

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U.K. Health Performance Worse Than Comparable Countries

TUESDAY, March 5 (HealthDay News) -- The United Kingdom has worse health performance than other comparable countries, according to a study published online March 5 in The Lancet.

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Single Combo Inhaler Beats Standard Rx in Asthma

TUESDAY, March 5 (HealthDay News) -- Maintenance and reliever therapy with a single inhaled corticosteroid plus a rapid-onset, long-acting, β2 agonist (formoterol) seems beneficial for patients with asthma, according to two studies published in the March issue of The Lancet Respiratory Medicine.

Abstract - Papi
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Abstract - Patel
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Panel Recommends 10 Patient Safety Strategies

MONDAY, March 4 (HealthDay News) -- An expert panel is strongly encouraging the immediate adoption of 10 patient safety strategies and encouraging the adoption of a further 12, according to a supplement published in the March 5 issue of the Annals of Internal Medicine.

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CMS Reports on Progress Toward Improved Health Care

MONDAY, March 4 (HealthDay News) -- Considerable progress has already been made toward improving the quality and delivery of health care, according to a Centers for Medicare and Medicaid Services (CMS) bulletin published online Feb. 28.

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Computerized Provider Order Entry System Cuts Rx Errors

MONDAY, March 4 (HealthDay News) -- Electronic prescribing through computerized provider order entry (CPOE) systems can substantially reduce medication errors in inpatient acute-care settings, according to a study published online Feb. 20 in the Journal of the American Medical Informatics Association.

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Impact of Osteoporosis Tx on Spinal Fusion Unclear

FRIDAY, March 1 (HealthDay News) -- The effect of osteoporosis therapies (bisphosphonate drugs and intermittent parathyroid hormone [PTH]) on spinal fusion is unclear, according to a review published in the February issue of The Spine Journal.

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Sequestration to Impact Health Care-Related Programs

FRIDAY, March 1 (HealthDay News) -- The $85 billion of mandatory cuts in federal spending that take effect March 1 as part of sequestration will be felt across health care and related programs, with cuts to Medicare providers and to the budgets of federal agencies.

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