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Category: Geriatrics | Monthly Briefing

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March 2012 Briefing - Geriatrics

Last Updated: April 02, 2012.

 

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

Swimming Improves Vascular Function, BP in Older Adults

FRIDAY, March 30 (HealthDay News) -- Swimming exercise is associated with a decrease in blood pressure (BP) and improvements in vascular function in older adults with early hypertension, according to a study published in the April 1 issue of The American Journal of Cardiology.

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Cardiac Shock Wave Therapy Improves Angina Symptoms

FRIDAY, March 30 (HealthDay News) -- Cardiac shock wave therapy (CSWT) can significantly improve symptoms, ischemic threshold during exercise, and specific quality-of-life parameters for patients with chronic refractory angina pectoris, according to a study published online March 23 in Cardiovascular Therapeutics.

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Statin Discontinuation Linked to Mortality in RA Patients

THURSDAY, March 29 (HealthDay News) -- Patients with rheumatoid arthritis are at higher risk of death from cardiovascular and non-cardiovascular causes if they discontinue statin treatment, according to a study published online March 29 in Arthritis Care & Research.

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Ratio of Amyloid Biomarkers Predicts Alzheimer's Risk

THURSDAY, March 29 (HealthDay News) -- The ratio of two plasma amyloid-β (Aβ) biomarkers is associated with the development of Alzheimer's disease (AD) and dementia, according to a review published online March 26 in the Archives of Neurology.

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Prophylaxis With Apixaban Feasible for Cancer Patients

THURSDAY, March 29 (HealthDay News) -- Primary venous thromboembolism prophylaxis with apixaban, an oral direct Factor Xa inhibitor, in ambulatory cancer patients undergoing first- or second-line chemotherapy for advanced or metastatic cancer, is safe and well tolerated, according to a phase II study published online March 12 in the Journal of Thrombosis and Haemostasis.

Abstract
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Pay for Performance Does Not Improve Mortality Rates

WEDNESDAY, March 28 (HealthDay News) -- Participation in the Medicare Premier Hospital Quality Incentive Demonstration (Premier HQID) program does not lead to lower 30-day mortality rates, according to a study published online March 28 in the New England Journal of Medicine.

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Change in Health Insurance Status Linked to ER Use

WEDNESDAY, March 28 (HealthDay News) -- Recent changes in health insurance status are linked to greater emergency department use by newly insured and newly uninsured adults, according to a study published online March 26 in the Archives of Internal Medicine.

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Lifestyle Intervention Helps Overweight Diabetes Patients

WEDNESDAY, March 28 (HealthDay News) -- An intensive lifestyle intervention leads to a significant reduction in the risk of mobility-related disability in overweight type 2 diabetes patients, as compared with diabetes support and education, according to a study published in the March 29 issue of the New England Journal of Medicine.

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Antipsychotic Medications Increase Risk of Heart Attack

WEDNESDAY, March 28 (HealthDay News) -- For older patients treated with cholinesterase inhibitors, taking antipsychotic agents (APs) for dementia is associated with a modest and time-limited increased risk of myocardial infarction (MI), according to a study published online March 26 in the Archives of Internal Medicine.

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Moderate Drinking Cuts Mortality in MI Survivors

WEDNESDAY, March 28 (HealthDay News) -- Men who have survived a myocardial infarction (MI) benefit from moderate alcohol consumption, with long-term consumption inversely associated with all-cause and cardiovascular mortality, according to a study published online March 27 in the European Heart Journal.

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Non-HDL Cholesterol Tied to Risk of Cardiovascular Event

TUESDAY, March 27 (HealthDay News) -- On-treatment levels of non-high-density lipoprotein cholesterol (non-HDL-C) and, to a lesser extent, low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) are each associated with risk of future major cardiovascular events for patients on statin therapy, according to a study published in the March 28 issue of the Journal of the American Medical Association.

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Prolonged Sitting Increases All-Cause Mortality Risk

TUESDAY, March 27 (HealthDay News) -- People over the age of 45 years who sit for prolonged periods of time each day are at an increased risk of death due to all causes, compared with those who sit for less than four hours/day, according to research published in the March 26 issue of the Archives of Internal Medicine.

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New Guidelines Issued for Red Blood Cell Transfusions

MONDAY, March 26 (HealthDay News) -- A restrictive red blood cell transfusion strategy should be employed for hemodynamically stable adults and children, according to a clinical practice guideline issued by the AABB (formerly the American Association of Blood Banks) and published online March 26 in the Annals of Internal Medicine.

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Transneuronal Spread Model Fits Neurodegenerative Disease

FRIDAY, March 23 (HealthDay News) -- Neurodegenerative diseases may be characterized by specific regions of the brain that are critical network epicenters, with disease-related vulnerability associated with shorter paths to the epicenter and greater total connectional flow, according to a study published in the March 22 issue of Neuron.

Abstract
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Drug-Eluting Stents Reduce Risk of Thrombosis

FRIDAY, March 23 (HealthDay News) -- Cobalt-chromium everolimus eluting stents (CoCr-EES) are associated with a significantly lower rate of stent thrombosis within two years of implantation, compared with other bare-metal and drug-eluting stents, according to a meta-analysis published online March 23 in The Lancet.

Abstract
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In Older Adults, Extra Fat Tied to Poor Cognitive Function

FRIDAY, March 23 (HealthDay News) -- In older adults (aged 60 to ≤70 years), obesity and high visceral adiposity are associated with poor cognitive function, according to a study published online March 22 in Age and Ageing.

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Aspirin Enhances Platelet Isoprostanes in Type 2 Diabetes

FRIDAY, March 23 (HealthDay News) -- For patients with type 2 diabetes mellitus (T2DM) who are treated with aspirin, isoprostanes are overproduced, which is linked with enhanced platelet recruitment, according to a study published online March 16 in Diabetes.

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Thigh Fat Area, Muscle Density Linked to RA Indicators

FRIDAY, March 23 (HealthDay News) -- Thigh fat area and muscle density, but not muscle area, are indicators of disability and physical performance in patients with rheumatoid arthritis (RA), according to a study published online March 5 in Arthritis & Rheumatism.

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Health Care Team Members Key for Antimicrobial Stewardship

THURSDAY, March 22 (HealthDay News) -- Antimicrobial stewardship programs (ASPs) that use health care epidemiologists (HEs) and infection preventionists (IPs) have a crucial role to play in the effort to combat health care-associated infections (HAIs), including those caused by multidrug-resistant organisms (MDROs), according to the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America position paper published in the March issue of the American Journal of Infection Control.

Abstract
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Tenecteplase Superior to Alteplase for Stroke Treatment

WEDNESDAY, March 21 (HealthDay News) -- Tenecteplase is superior to alteplase for the treatment of acute ischemic stroke for select patients, according to a study published in the March 22 issue of the New England Journal of Medicine.

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Cognitive Decline Seen in Elderly After Hospitalization

WEDNESDAY, March 21 (HealthDay News) -- Older people may have an increased risk of memory problems after being discharged from the hospital, according to a study published online March 21 in Neurology.

Abstract
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Antioxidants Don't Impact Most CSF Biomarkers in Alzheimer's

TUESDAY, March 20 (HealthDay News) -- For patients with mild-to-moderate Alzheimer's disease, antioxidant supplements do not affect cerebrospinal fluid (CSF) biomarkers related to amyloid or tau pathology, according to a study published online March 19 in the Archives of Neurology.

Abstract
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Survey Describes Docs' Online Professionalism Violations

TUESDAY, March 20 (HealthDay News) -- Most medical licensing authorities receive and act upon reports of physicians' online professionalism violations, according to a research letter published in the March 21 issue of the Journal of the American Medical Association.

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Anesthesia During Endoscopy, Colonoscopy on the Rise

TUESDAY, March 20 (HealthDay News) -- Use of gastroenterology anesthesia services increased considerably from 2003 to 2009 among both Medicare and commercially-insured patients, according to a study published in the March 21 issue of the Journal of the American Medical Association.

Abstract
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Antimicrobial Stewardship Saves Millions of Dollars

TUESDAY, March 20 (HealthDay News) -- Antimicrobial stewardship programs save hospitals millions of dollars, according to a study published in the April issue of Infection Control and Hospital Epidemiology.

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Statin Use May Reduce Pneumonia Incidence

MONDAY, March 19 (HealthDay News) -- Treatment with statins, such as rosuvastatin, is associated with a modest reduction in the incidence of pneumonia, according to a study published online March 19 in CMAJ, the journal of the Canadian Medical Association.

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Generic Boniva Approved for Osteoporosis

MONDAY, March 19 (HealthDay News) -- The first generic versions of the once-monthly osteoporosis drug Boniva (ibandronate) have been approved by the U.S. Food and Drug Administration.

this drug

Most California Hospitals Implementing Infection Control

FRIDAY, March 16 (HealthDay News) -- Most California hospitals implement some policies to improve infection control for multidrug-resistant organisms (MDRO), primarily methicillin-resistant Staphylococcus aureus (MRSA), but few policies are associated with lower MDRO rates, according to a study published in the March issue of the American Journal of Infection Control.

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Hip Fracture Surgery Type Impacts Future Fracture Risk

FRIDAY, March 16 (HealthDay News) -- Patients with a primary proximal femoral fracture who undergo closed reduction and percutaneous pinning have a significantly increased risk of subsequent contralateral hip fracture compared with those who undergo arthroplasty, according to a study published in the March 7 issue of The Journal of Bone & Joint Surgery.

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Poorer Health Literacy Linked to Increased Mortality

FRIDAY, March 16 (HealthDay News) -- A considerable proportion of older adults in England have medium or low health literacy, which is associated with increased mortality, according to a study published online March 15 in BMJ.

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Hyperammonemia Disrupts Sleep in Patients With Cirrhosis

FRIDAY, March 16 (HealthDay News) -- For patients with cirrhosis, hyperammonemia induced by an amino acid challenge (AAC) leads to an increase in daytime subjective sleepiness and changes in sleep patterns, according to a study published in the March issue of Hepatology.

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Analgesic Use After Surgery Linked to Long-Term Use

THURSDAY, March 15 (HealthDay News) -- Older patients prescribed opioids or nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief after short-stay surgery appear to be at increased risk for becoming long-term analgesic users, according to a study published in the March 12 issue of the Archives of Internal Medicine.

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Retinopathy Linked to Cognitive Impairment in Older Women

WEDNESDAY, March 14 (HealthDay News) -- The presence of retinopathy in older women is associated with cognitive decline and greater ischemic brain volumes, according to a study published online March 14 in Neurology.

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Causal Link for IL-6 Receptor, Coronary Heart Disease

WEDNESDAY, March 14 (HealthDay News) -- Genetic data indicate that the interleukin-6 receptor (IL6R) has a causal link with coronary heart disease, according to two studies published online March 14 in The Lancet.

Abstract - Sarwar
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Abstract - Swerdlow
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Personal Mobile Computers Improve Resident Efficiency

WEDNESDAY, March 14 (HealthDay News) -- The use of personal mobile computers (Apple iPads) by internal medicine residents improves efficiency, according to a research letter published in the March 12 issue of the Archives of Internal Medicine.

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Survival Up for Hispanics With Preserved Ejection Fraction

TUESDAY, March 13 (HealthDay News) -- Hispanic heart failure patients with preserved left ventricular ejection fraction (EF) have better survival than non-Hispanic whites, according to a study published online March 13 in Circulation: Heart Failure.

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Higher Spending by Hospitals Improves Outcomes

TUESDAY, March 13 (HealthDay News) -- Hospitals that are part of the universal health care system in Canada that spend more on inpatient care have lower rates of deaths and hospital readmissions, according to a study published in the March 14 issue of the Journal of the American Medical Association.

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U.S. Mortality Rates Dropped 60 Percent From 1935 to 2010

TUESDAY, March 13 (HealthDay News) -- From 1935 to 2010, the death rate in the United States decreased considerably, although the single-year improvements in mortality were often small, according to a March data brief issued by the National Center for Health Statistics (NCHS).

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Poor Survival of Metal-on-Metal Total Hip Replacement

TUESDAY, March 13 (HealthDay News) -- For total hip replacement (THR), metal-on-metal stemmed articulations have poor survival rates compared with alternatives, such as metal-on-polyethylene and ceramic-on-ceramic, according to a review published online March 13 in The Lancet.

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MRI Use Increasing for Evaluating Stroke Patients

MONDAY, March 12 (HealthDay News) -- The use of magnetic resonance imaging (MRI) in the evaluation of hospitalized stroke patients has dramatically increased over the past decade, according to an article published in the February issue of the Annals of Neurology.

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Calcium, Vitamin D Modulate Human Energy Metabolism

MONDAY, March 12 (HealthDay News) -- There is considerable evidence that calcium and vitamin D intake are influential in modulating energy metabolism in humans, according to a study published online March 2 in Obesity Reviews.

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Aggressive Care Improves QoL in Traumatic Brain Injury

MONDAY, March 12 (HealthDay News) -- Compared with routine care, an aggressive-care approach to the treatment of patients with severe traumatic brain injury (TBI), which follows the Brain Trauma Foundation guidelines, is estimated to improve quality of life and significantly lower associated costs, regardless of patient age, according to research published online March 6 in the Journal of Neurosurgery.

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Flu Vaccine Up Among Medical Staff When They Believe It Works

FRIDAY, March 9 (HealthDay News) -- Hospital health care workers (HCWs) are more likely to receive the seasonal influenza vaccination if they believe it works and are committed to preventing this highly contagious virus, according to research published in the April issue of Occupational & Environmental Medicine.

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Race and Socioeconomic Status Linked to Chronic Pain

FRIDAY, March 9 (HealthDay News) -- Chronic pain is worse for black patients and for those living in a neighborhood with low socioeconomic status (SES), according to research published in the February issue of The Journal of Pain.

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Surrogates Tend to Misinterpret Poor Prognosis Information

FRIDAY, March 9 (HealthDay News) -- Surrogate decision makers for critically ill patients interpret prognostic statements expressing a low risk of death accurately, but interpret statements conveying poor prognosis optimistically, according to a study published in the March 6 issue of the Annals of Internal Medicine.

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Tibial Trabecular Bone Texture Predicts OA Progression

THURSDAY, March 8 (HealthDay News) -- Changes in medial and lateral trabecular bone texture can predict joint space narrowing (JSN) and progression of knee osteoarthritis (OA), according to research published in the March issue of Arthritis & Rheumatism.

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Obesity Not Linked to Mortality in Elderly People Over 85

THURSDAY, March 8 (HealthDay News) -- Obesity does not increase mortality in elderly adults aged 85 years and older, according to an article published in the Journal of Aging Research.

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Buprenorphine Maintenance Therapy Not Recommended

THURSDAY, March 8 (HealthDay News) -- Opioid substitution therapy with buprenorphine is not recommended for opioid-addicted health care professionals (HCPs), according to research published in the March issue of the Mayo Clinic Proceedings.

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Cognitive Benefits With Continued Donepezil in Alzheimer's

WEDNESDAY, March 7 (HealthDay News) -- For patients with moderate-to-severe Alzheimer's disease, continuation of treatment with donepezil is linked to significant cognitive benefits, according to a study published in the March 8 issue of the New England Journal of Medicine.

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Financial Burden of Medical Care Affects One in Three

WEDNESDAY, March 7 (HealthDay News) -- In the first half of 2011, one in three individuals was in a family that experienced the financial burden of medical care in the United States, according to the results of the National Health Interview Survey published March 7 by the National Center for Health Statistics (NCHS).

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Electronic Test Result Access Does Not Reduce Test Ordering

TUESDAY, March 6 (HealthDay News) -- For office-based physicians, electronic access to patient imaging and laboratory test results does not decrease -- and may actually increase -- the number of diagnostic tests ordered, according to research published in the March issue of Health Affairs.

Abstract
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Depression, Cognitive Decline Linked in Elderly With CAD

TUESDAY, March 6 (HealthDay News) -- Older patients with coronary artery disease who have persistent depression have a significantly increased risk of cognitive decline, according to a study published in the March issue of the Archives of General Psychiatry.

Abstract
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ACP Issues Guidance on Colorectal Cancer Screening

MONDAY, March 5 (HealthDay News) -- Screening of average-risk individuals for colorectal cancer (CRC) should begin at age 50 with a stool-based test, flexible sigmoidoscopy, or colonoscopy, according to a guidance statement from the American College of Physicians (ACP) published in the March 6 issue of the Annals of Internal Medicine.

Abstract
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AHA Supports Shared Decision Making in Heart Failure

MONDAY, March 5 (HealthDay News) -- Shared decision making in advanced heart failure has become more challenging and more important, with increased disease duration and available treatment options, according to a scientific statement from the American Heart Association (AHA) published online March 5 in Circulation.

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Complementary Meds Used by 17 Percent of Elderly With Cancer

FRIDAY, March 2 (HealthDay News) -- The prevalence of older people with cancer using complementary medications as they start a chemotherapy regimen is 17 percent, and is associated with less advanced disease and higher functional status, according to a study published online Feb. 22 in Cancer.

Abstract
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Sleep Quality Found to Actually Improve With Age

THURSDAY, March 1 (HealthDay News) -- Contrary to popular belief, sleep quality, as measured by sleep disturbances and daytime fatigue, actually improves with age, according to a study published in the March issue of SLEEP.

Abstract
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Trans Fat Intake Tied to Stroke in Postmenopausal Women

THURSDAY, March 1 (HealthDay News) -- Higher trans fat intake increases the risk of ischemic stroke independent of other lifestyle factors, but the adverse effects of trans fat on ischemic stroke may be mitigated by aspirin, according to a study published online March 1 in the Annals of Neurology.

Abstract
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Risk of Stroke Increases With Each Year of Having Diabetes

THURSDAY, March 1 (HealthDay News) -- The risk of stroke increases with the length of time a patient has diabetes, according to a study published online March 1 in Stroke.

Abstract
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Phone Counseling Doesn't Up Osteoporosis Meds Adherence

THURSDAY, March 1 (HealthDay News) -- Use of a telephone-based motivational interviewing intervention does not improve adherence to an osteoporosis medication regimen, according to research published online Feb. 27 in the Archives of Internal Medicine.

Abstract
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