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March 2013 Briefing - Neurology

Last Updated: April 01, 2013.

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

Time to Pregnancy Is Linked to Neurological Dysfunction

FRIDAY, March 29 (HealthDay News) -- Increased time to pregnancy (TTP) and not fertility treatment is associated with suboptimal neurological dysfunction in 2-year-old children born to subfertile parents, according to research published online March 25 in the Archives of Disease in Childhood -- Fetal & Neonatal Edition.

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Cervical Discectomy, Fusion Is Durable and Cost-Effective

FRIDAY, March 29 (HealthDay News) -- Single-level instrumented anterior cervical discectomy and fusion (ACDF) is durable and cost-effective after five years of follow-up, according to a study published in the March 15 issue of Spine.

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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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Higher Fiber Intake Tied to Lower Risk of First Stroke

THURSDAY, March 28 (HealthDay News) -- Higher fiber intake is associated with a lower risk of first stroke, according to a meta-analysis published online March 28 in Stroke.

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FDA Approves Tecfidera for Multiple Sclerosis

THURSDAY, March 28 (HealthDay News) -- Tecfidera (dimethyl fumarate) capsules have been approved by the U.S. Food and Drug Administration to treat relapsing forms of multiple sclerosis (MS).

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Regional Variation Noted in Prevalence of Delayed Care

THURSDAY, March 28 (HealthDay News) -- There is considerable county-wide variation in the prevalence of delayed care, with high prevalence linked to a weaker health care infrastructure, according to a letter published in the March 28 issue of the New England Journal of 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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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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Inpatient Deaths Fell by 8 Percent in Last Decade

WEDNESDAY, March 27 (HealthDay News) -- The number of inpatient hospital deaths declined by 8 percent over the last decade, although the total number of hospitalizations increased by 11 percent during the same period, according to a March data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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MRI Detects Cortical Brain Abnormalities for Migraines

WEDNESDAY, March 27 (HealthDay News) -- Patients with migraines have cortical thickness and surface area abnormalities that may represent both a predisposition to the condition as well as disease-related processes, according to a study published online March 26 in Radiology.

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Majority of Lumbar Spine MRIs Are Inappropriately Ordered

WEDNESDAY, March 27 (HealthDay News) -- There is substantial overuse of lumbar magnetic resonance imaging (MRI) scans, according to a research letter published online March 25 in JAMA Internal Medicine.

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Mild Impairment at Diagnosis of Parkinson's Ups Dementia Risk

WEDNESDAY, March 27 (HealthDay News) -- Mild cognitive impairment (MCI) at the time of a diagnosis of Parkinson's disease (PD) predicts a highly increased risk for early dementia, according to a study published online March 25 in JAMA Neurology.

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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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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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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.

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Exposure to Common Germs Linked to Worse Cognition

MONDAY, March 25 (HealthDay News) -- Infectious burden, a composite serologic measure of exposure to common pathogens, is associated with worse cognition, according to a study published in the March 26 issue of Neurology.

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White Matter Diffusivity Linked to Gulf War Illness Symptoms

MONDAY, March 25 (HealthDay News) -- Fatigue, pain, and hyperalgesia are associated with increased axial diffusivity in the right inferior fronto-occipital fasciculus in veterans with Gulf War Illness, according to a study published online March 20 in PLOS ONE.

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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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Reading, Writing, Ranting Online Could Be a Web of Rage

MONDAY, March 25 (HealthDay News) -- Reading and writing on rant websites seems to be an unhealthy practice, according to a study published Feb. 20 in Cyberpsychology, Behavior, and Social Networking.

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Sports Concussion Management Recommendations Updated

FRIDAY, March 22 (HealthDay News) -- Recommendations for sports concussion and its management have been updated, according to a consensus statement published in the April issue of the British Journal of Sports Medicine.

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Mobility Impaired May Have Difficulty Accessing Docs

FRIDAY, March 22 (HealthDay News) -- Many U.S. subspecialty practices cannot accommodate patients with mobility impairment, according to a study published in the March 19 issue of the Annals of Internal Medicine.

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FDA Approves Dotarem for Nervous System MRIs

THURSDAY, March 21 (HealthDay News) -- Dotarem (gadoterate meglumine) has been approved by the U.S. Food and Drug Administration as a contrast agent for use in MRIs of the brain, spine, and other parts of the central nervous system.

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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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Hypertension, APOE Genotype Add to Amyloid Deposits

THURSDAY, March 21 (HealthDay News) -- Hypertension in combination with the apolipoprotein E (APOE) genotype increases amyloid deposits in cognitively healthy middle-aged and older adults, according to a study published online March 18 in JAMA Neurology.

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Suicide Ideation, Attempts Higher in Children With Autism

THURSDAY, March 21 (HealthDay News) -- Children with autism have much higher rates of suicide ideation and suicide attempts than typical children, according to a study published in the January issue of Research in Autism Spectrum Disorders.

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Heart-Healthy Lifestyle Can Also Reduce Cancer Risk

THURSDAY, March 21 (HealthDay News) -- Subjects who are enrolled in the Atherosclerosis Risk in Communities (ARIC) study and are meeting goals for six to seven ideal health metrics have a 51 percent lower risk of incident cancer than those not meeting any goals for ideal health metrics, according to research published online March 18 in Circulation.

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Closure of Patent Foramen Ovale Doesn't Beat Medical Tx

WEDNESDAY, March 20 (HealthDay News) -- For patients with patent foramen ovale, percutaneous closure is not superior to medical therapy for the risk of recurrent embolic events or death, or for reducing recurrent ischemic stroke, according to two studies published in the March 21 issue of the New England Journal of Medicine.

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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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One in Three U.S. Seniors Dies With Alzheimer's or Dementia

TUESDAY, March 19 (HealthDay News) -- Alzheimer's deaths are increasing, with one in three seniors currently expected to die with Alzheimer's or another form of dementia, according to a report published by the Alzheimer's Association.

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Long-Term Mortality Up for Under-50s With First Stroke

TUESDAY, March 19 (HealthDay News) -- For adults aged 18 to 50 years with acute stroke, 20-year mortality is higher than expected, according to a study published in the March 20 issue of the Journal of the American Medical Association.

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ER Discharge Dx/Disposition Discordant With Chief Complaint

TUESDAY, March 19 (HealthDay News) -- A considerable proportion of patients with emergency department visits with the same presenting complaint as those ultimately given a primary care-treatable diagnosis require immediate emergency care or hospital admission, 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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AAN Updates Guidelines for Sports Concussion Management

MONDAY, March 18 (HealthDay News) -- The risks, diagnosis, and management of sports concussion have been reviewed in updated guidelines published online March 18 by the American Academy of Neurology (AAN) in Neurology.

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Telemedicine Is Useful for Parkinson's Disease Patients

MONDAY, March 18 (HealthDay News) -- Providing specialty care for patients with Parkinson's disease (PD) using Web-based video conferencing is feasible, provides value to patients, and offers clinical benefits similar to those of in-person visits, while saving patients time and travel, according to research published online March 11 in JAMA Neurology.

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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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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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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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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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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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Amyloid Deposition Linked to Worse Sleep Quality

THURSDAY, March 14 (HealthDay News) -- Sleep quality is associated with β-amyloid (Aβ) deposition among older adults; and Aβ oligomers are associated with tau prior to onset of overt symptoms of Alzheimer's disease, according to two studies published online March 11 in JAMA Neurology.

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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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Primary Care Noninferior for Management of Sleep Apnea

WEDNESDAY, March 13 (HealthDay News) -- Management of obstructive sleep apnea in a primary care setting is noninferior to care at specialist sleep centers, according to a study published in the March 13 issue of the Journal of the American Medical Association.

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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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Post-Stroke Walking Improves Survivors' Quality of Life

WEDNESDAY, March 13 (HealthDay News) -- Walking improves the physical health component of quality of life measures in stroke survivors, according to a study published online March 7 in Stroke.

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AMA Files Brief Contesting Insurer's Payment Practices

WEDNESDAY, March 13 (HealthDay News) -- A landmark case examining the question of whether physicians can bring a class arbitration against a health insurer who has underpaid them is currently before the U.S. Supreme Court, in a brief filed by the Litigation Center of the American Medical Association and State Medical Societies and the Medical Society of New Jersey.

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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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Acute Physical Exercise Improves Executive Function

MONDAY, March 11 (HealthDay News) -- Acute physical exercise improves executive function in children, adolescents, and young adults, according to a meta-analysis published online March 6 in the British Journal of Sports Medicine.

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Deep Brain Stimulation May Be Option in Chronic Anorexia

THURSDAY, March 7 (HealthDay News) -- For patients with chronic, severe, treatment-refractory anorexia nervosa, deep brain stimulation (DBS) seems to be a safe treatment option, according to a phase 1 pilot trial published online March 7 in The Lancet.

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Improving Eating Habits Cuts Depression in Dementia

WEDNESDAY, March 6 (HealthDay News) -- For elderly adults with dementia, symptoms of depression can be improved through nutritional improvement interventions, according to a study published online Feb. 28 in the Journal of Advanced Nursing.

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White Matter Integrity Varies With MS Cognitive Impairment

WEDNESDAY, March 6 (HealthDay News) -- Diffusion tensor imaging (DTI) metrics reveal distinct white matter (WM) integrity in patients with cognitively preserved (CP) and cognitively impaired (CI) multiple sclerosis (MS), according to research published online March 6 in Neurology.

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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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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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Portable Device May Help Diagnose Vertebrobasilar Stroke

WEDNESDAY, March 6 (HealthDay News) -- A portable device that measures eye movements may help non-specialist physicians diagnose stroke in high-risk patients with acute vertigo or dizziness, according to a study published online March 5 in Stroke.

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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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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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Diagnostic Testing Does Little to Reassure Patients

TUESDAY, March 5 (HealthDay News) -- Although further primary care visits may be reduced, diagnostic tests for symptoms with a low risk of serious illness actually do little to reassure patients, decrease their anxiety, or resolve their symptoms over the short or long term, according to research published online Feb. 25 in JAMA Internal Medicine.

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Proportion of Black Males in U.S. Medical Schools Dropping

MONDAY, March 4 (HealthDay News) -- The proportion of black males in medical school is decreasing, according to a report published by the Association of American Medical Colleges (AAMC).

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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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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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