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February 2014 Briefing - Surgery

Last Updated: March 03, 2014.

Here are what the editors at HealthDay consider to be the most important developments in Surgery for February 2014. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

CT Scans Don't Interfere With Cardiac Rhythm Devices

FRIDAY, Feb. 28, 2014 (HealthDay News) -- Cardiac rhythm management devices should not be a cause for delaying computed tomography (CT) imaging procedures, according to research published online Feb. 26 in the Journal of the American College of Cardiology.

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Going Live With EHR Leads to Frustrations, Productivity Hit

FRIDAY, Feb. 28, 2014 (HealthDay News) -- Implementing an electronic health record (EHR) system takes excessive physician and staff time and disrupts practice, according to survey results published Feb. 24 in Medical Economics.

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Funding Tied to Spinal Study Outcomes, Levels of Evidence

FRIDAY, Feb. 28, 2014 (HealthDay News) -- Source of funding for spinal research is significantly associated with study outcome and level of evidence (LOE), according to a review published in the Feb. 1 issue of The Spine Journal.

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Hospital Size, Market Share Affect Inpatient Care Prices

FRIDAY, Feb. 28, 2014 (HealthDay News) -- Size and market share are the greatest differentiators between hospitals receiving low prices and high prices for inpatient care, according to a study published in the February issue of Health Affairs.

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Stethoscopes Contaminated After Single Physical Exam

FRIDAY, Feb. 28, 2014 (HealthDay News) -- Stethoscopes get contaminated after a single physical exam, with the contamination greater than that seen on most of the physician's dominant hand, barring the fingertips, according to a study published online Feb. 27 in the Mayo Clinic Proceedings.

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Nurse Education, Workload Impact Patient Post-Op Mortality

FRIDAY, Feb. 28, 2014 (HealthDay News) -- Nurse staffing and education are associated with in-hospital mortality after common surgical procedures, according to a study published online Feb. 26 in The Lancet.

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Myocardial Injury Predicts Death After Noncardiac Surgery

THURSDAY, Feb. 27, 2014 (HealthDay News) -- Myocardial injury after noncardiac surgery (MINS) is common and is an independent predictor of mortality, according to a study published in the March issue of Anesthesiology.

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U.S. Cosmetic, Reconstructive Surgery Procedures Up in 2013

THURSDAY, Feb. 27, 2014 (HealthDay News) -- The number of cosmetic surgery procedures increased 3 percent, and reconstructive surgery procedures increased 2 percent in 2013, according to an annual report published by the American Society of Plastic Surgeons (ASPS).

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Smoking Adversely Impacts Renal Cell Carcinoma Survival

THURSDAY, Feb. 27, 2014 (HealthDay News) -- For patients with clear cell renal cell carcinoma, smoking exposure adversely impacts cancer-specific survival and increases the risk of death from another cause, according to a study published in the March issue of The Journal of Urology.

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Regional Anesthesia Doesn't Up Falls After Knee Replacement

WEDNESDAY, Feb. 26, 2014 (HealthDay News) -- Regional anesthesia, including peripheral nerve block (PNB), does not increase the risk of inpatient falls (IFs) after total knee arthroplasty (TKA), according to a study published in the March issue of Anesthesiology.

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Hysterectomy and Ovary Removal Linked to Diabetes Development

WEDNESDAY, Feb. 26, 2014 (HealthDay News) -- Postmenopausal women are at higher risk of developing diabetes if they have both a hysterectomy and bilateral oophorectomy, according to a study published in the March issue of Diabetes Care.

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Doctors Pleased With Congress' Medicare Payment Agreement

TUESDAY, Feb. 25, 2014 (HealthDay News) -- Physician groups are expressing optimism over the Congressional agreement to revamp the Medicare physician payment system, according to an article published Feb. 26 in Medical Economics.

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Earlier Ovary Removal Provides Greatest BRCA-Associated Benefit

TUESDAY, Feb. 24, 2014 (HealthDay News) -- Among women with mutations in BRCA1 or BRCA2, oophorectomy reduces the risk of developing ovarian, fallopian tube, or peritoneal cancer by 80 percent and reduces the risk of death by 77 percent, with greater BRCA1 benefit seen with earlier removal, according to a study published online Feb. 24 in the Journal of Clinical Oncology.

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More Than Seven Million Patient Record Breaches in 2013

TUESDAY, Feb. 25, 2014 (HealthDay News) -- The number of patient records breached increased more than 137 percent and affected over seven million records in 2013, according to an annual report published by Redspin.

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Quality Measures Data Added to Physician Compare Website

MONDAY, Feb. 24, 2014 (HealthDay News) -- Data for quality measures have been added to Physician Compare, the website that helps consumers search for information about physicians, according to a report published by the Centers for Medicare & Medicaid Services (CMS).

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Obstetricians Target Primary Cesarean Delivery Rate

MONDAY, Feb. 24, 2014 (HealthDay News) -- Primary cesarean delivery rates can be safely reduced by implementing various interventions, according to a consensus statement published online in the March issue of Obstetrics & Gynecology.

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Obese Patients Affected by Perceived Judgment of Doctor

MONDAY, Feb. 24, 2014 (HealthDay News) -- Patients who discuss weight loss with their physicians but do not feel judged may be more likely to attempt and succeed in losing weight, according to research published online Feb. 9 in Preventive Medicine.

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FDA to Step Up Oversight of Indian Drug Makers

MONDAY, Feb. 24, 2014 (HealthDay News) -- The U.S. Food and Drug Administration is to increase monitoring of drugs from pharmaceutical companies in India, FDA Commissioner Margaret Hamburg, M.D., said during a Friday afternoon news conference.

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Psychological Factors Affect Skeletal Trauma Recovery

FRIDAY, Feb. 21, 2014 (HealthDay News) -- For patients recovering from musculoskeletal trauma, psychological factors, especially catastrophic thinking, are associated with pain intensity and disability, according to a study published in the Feb. 5 issue of The Journal of Bone & Joint Surgery.

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Mesh Ventral Hernia Repair Has Lower Recurrence Rate

FRIDAY, Feb. 21, 2014 (HealthDay News) -- For primary ventral hernias, mesh repair results in a small reduction in recurrence rates compared with suture, but carries an increased risk of seroma and surgical site infections (SSIs), according to a review published online Feb. 19 in JAMA Surgery.

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Concurrent Opioid Prescribing by Multiple Providers Common

THURSDAY, Feb. 20, 2014 (HealthDay News) -- For Medicare beneficiaries, concurrent opioid prescribing is common among those with four or more opioid providers, according to a study published Feb. 19 in BMJ.

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Surgeons Can Up Outcomes for Work-Related Lumbar Surgery

THURSDAY, Feb. 20, 2014 (HealthDay News) -- In patients with chronic disabling occupational lumbar disorder (CDOLD) and workers' compensation claims, lumbar fusion outcomes can be improved if opioid dependence and excessive length of disability after surgery are controlled through care, according to a study published in the Feb. 1 issue of The Spine Journal.

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Unfilled Hospital Openings for Doctors Growing, Survey Finds

THURSDAY, Feb. 20, 2014 (HealthDay News) -- The need for hospital physicians is growing, according to an article published Jan. 3 in Medical Economics.

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Total Vaginal Hysterectomy Generates Net Hospital Income

THURSDAY, Feb. 20, 2014 (HealthDay News) -- Compared with total vaginal hysterectomy (TVH), hospital costs are greater with laparoscopic assisted vaginal hysterectomy (LAVH), total laparoscopic hysterectomy (TLH), and robotic hysterectomy (RH), according to a study published in the February issue of the American Journal of Obstetrics and Gynecology.

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Obesity Complicates Elbow Fractures in Children

THURSDAY, Feb. 20, 2014 (HealthDay News) -- Obesity is associated with more complex supracondylar humeral fractures in children, as well as with a greater risk of postoperative complications, according to research published in the Feb. 5 issue of The Journal of Bone & Joint Surgery.

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Breast Reconstructions Up in U.S. Breast Cancer Patients

THURSDAY, Feb. 20, 2014 (HealthDay News) -- The use of breast reconstruction in breast cancer patients undergoing mastectomy has been increasing in the United States, according to research published online Feb. 18 in the Journal of Clinical Oncology.

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Before Implementation, Full EHR Cost Needs Consideration

WEDNESDAY, Feb. 19, 2014 (HealthDay News) -- From the outset of electronic health record implementation, hospitals and governments need to understand the major cost categories involved and identify the factors that may impact these costs, according to research published online Feb. 12 in the Journal of the American Medical Informatics Association.

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Home Exercise Program Improves Physical Function After Rehab

WEDNESDAY, Feb. 19, 2014 (HealthDay News) -- For older patients, a home-based exercise program is beneficial after formal hip fracture rehabilitation has ended, according to a study published in the Feb. 19 issue of the Journal of the American Medical Association.

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Post-Op Visits for Surgical Site Infections Generally Low

WEDNESDAY, Feb. 19, 2014 (HealthDay News) -- For patients at low surgical risk undergoing ambulatory surgery, the rates of postsurgical visits for clinically significant surgical site infections (CS-SSIs) are low relative to all-cause postsurgical visits, according to research published in the Feb. 19 issue of the Journal of the American Medical Association.

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E. cuniculi Can Cause Febrile Illness After Transplant

WEDNESDAY, Feb. 19, 2014 (HealthDay News) -- Solid organ transplant recipients who become febrile weeks after transplantation may have acquired microsporidiosis from Encephalitozoon cuniculi, according to a case series published in the Feb. 18 issue of the Annals of Internal Medicine.

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'Talking' Medical Devices, Apps Continue to Evolve

WEDNESDAY, Feb. 19, 2014 (HealthDay News) -- "Talking" medical devices and apps, among other techy health-focused inventions, can help people manage everyday wellness routines, such as taking pills and checking blood sugar levels, as well as dire medical circumstances, say experts.

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Compression Device Noninferior to Meds Post-Arthroplasty

TUESDAY, Feb. 18, 2014 (HealthDay News) -- For patients undergoing lower-extremity arthroplasty, a mobile compression device is noninferior to pharmacological protocols for the prevention of venous thromboembolism, according to a study published in the Feb. 5 issue of The Journal of Bone & Joint Surgery.

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Online Ratings Do Affect Patient Choice of Physician

TUESDAY, Feb. 18, 2014 (HealthDay News) -- About two-thirds of the general U.S. population is aware of online physician rating sites, according to a research letter published in the Feb. 19 issue of the Journal of the American Medical Association.

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Physicians More Likely to Be Burned Out Than Non-Doc Peers

TUESDAY, Feb. 18, 2014 (HealthDay News) -- Trainees and early-career physicians are more likely to be burned out than control population samples, according to research published online Jan. 20 in Academic Medicine.

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Best Practice Alerts Up Screening for Abdominal Aortic Aneurysm

TUESDAY, Feb. 18, 2014 (HealthDay News) -- An abdominal aortic aneurysm (AAA) screening program using electronic medical records (EMR) can increase AAA screening, according to research published online Feb. 10 in the Journal of Vascular Surgery.

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Kidney Donors Have Slightly Higher Risk of Kidney Disease

MONDAY, Feb. 17, 2014 (HealthDay News) -- Live kidney donors have a slightly increased risk of end-stage renal disease (ESRD) in the years following donation compared with healthy nondonors, according to a study published in the Feb. 12 issue of the Journal of the American Medical Association.

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Non-Traditional Office Hours Can Reap Big Financial Benefits

MONDAY, Feb. 17, 2014 (HealthDay News) -- Physicians can reap significant financial benefits by extending their office hours to include non-traditional hours, according to an article published Jan. 8 in Medical Economics.

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Bilateral Mastectomy Cuts Mortality for BRCA-Related CA

FRIDAY, Feb. 14, 2014 (HealthDay News) -- Women with BRCA-associated early-stage breast cancer who receive bilateral mastectomy are less likely to die from breast cancer than those who receive a unilateral mastectomy, according to research published Feb. 11 in BMJ.

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Low Rates of Recurrence With 'No Ink' As Margin in Breast CA

FRIDAY, Feb. 14, 2014 (HealthDay News) -- Positive margins (ink on invasive carcinoma or ductal carcinoma in situ) are associated with increased risk of ipsilateral breast tumor recurrence (IBTR), according to consensus guidelines published online Feb. 10 in the Journal of Clinical Oncology.

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Annual Mammography Doesn't Reduce Breast Cancer Mortality

FRIDAY, Feb. 14, 2014 (HealthDay News) -- Annual mammography does not reduce mortality from breast cancer among 40- to 59-year-old women, according to research published Feb. 11 in BMJ.

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Clonidine Premedication Relieves Post-Op Pain in Children

FRIDAY, Feb. 14, 2014 (HealthDay News) -- Clonidine premedication at adequate dosage (4 µg/kg) seems likely to have a beneficial effect on postoperative pain in children, according to a review published online Jan. 28 in The Cochrane Library.

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CMS Extends 2013 Meaningful Use Attestation Deadline

THURSDAY, Feb. 13, 2014 (HealthDay News) -- The Centers for Medicare & Medicaid Services (CMS) have extended another deadline for the Medicare electronic health record (EHR) Incentive Program, according to an article published Feb. 11 in Medical Economics.

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Congress Agrees on Legislation to Replace SGR Formula

THURSDAY, Feb. 13, 2014 (HealthDay News) -- Congress has agreed on legislation to repeal the Sustainable Growth Rate (SGR) formula, which will guarantee Medicare providers annual 0.5 percent reimbursement increases as new payment models are introduced, according to an article published Feb. 11 in Medical Economics.

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ICD-10 Implementation Likely to Be Financial Disaster

THURSDAY, Feb. 13, 2014 (HealthDay News) -- The American Medical Association (AMA) is continuing its efforts to stop implementation of the International Classification of Diseases, 10th Revision (ICD-10), citing the huge financial burden for physicians.

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Affordable Care Act Enrollment Nears 3.3 Million

THURSDAY, Feb. 13, 2014 (HealthDay News) -- 3.3 million Americans have signed up for health insurance through the state and federal marketplaces created by the Affordable Care Act, the Obama administration announced Wednesday.

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U.S. Officials Target Escalating Drug Overdoses

WEDNESDAY, Feb. 12, 2014 (HealthDay News) -- As deaths from heroin and prescription painkillers mount across the United States, government officials are searching for ways to stem the toll of addiction.

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Predictors of Post-Op Pain ID'd in Adolescent Idiopathic Scoliosis

WEDNESDAY, Feb. 12, 2014 (HealthDay News) -- Higher preoperative levels of pain and anxiety may be risk factors for chronic postsurgical pain for patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion, according to a study published in the Feb. 1 issue of Spine.

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FDA Panel Sees No Heart-Safety Advantage With Naproxen

TUESDAY, Feb. 11, 2014 (HealthDay News) -- The science isn't convincing enough to say that naproxen is safer for the heart than other popular nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, U.S. health advisers ruled Tuesday.

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30-Day Readmission From Postacute Rehab 11.8 Percent

TUESDAY, Feb. 11, 2014 (HealthDay News) -- For patients discharged from inpatient rehabilitation facilities, 30-day readmission rates are 11.8 percent overall, according to a study published in the Feb. 12 issue of the Journal of the American Medical Association.

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Mid-Sized Companies Get Extra Year to Comply With ACA

TUESDAY, Feb. 11, 2014 (HealthDay News) -- Medium-sized companies will have another year before they have to provide employees with health insurance or face tax penalties, the Obama administration announced Monday.

Other Health Highlights: Feb. 10, 2014

Guidelines Issued for Managing Hospital Medicine Groups

TUESDAY, Feb. 11, 2014 (HealthDay News) -- A new assessment guide comprising 10 principles has been developed for effective management of hospital medicine groups (HMGs), according to research published in the February issue of the Journal of Hospital Medicine.

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New Rule Allows Patients to Access Laboratory Test Results

MONDAY, Feb. 10, 2014 (HealthDay News) -- In a final rule relating to the Health Insurance Portability and Accountability Act (HIPAA), a patient or their personal representative can access their completed test reports directly from the laboratory, according to a report from the U.S. Department of Health & Human Services (HHS).

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FDA Advisers Revisit Heart Risks Posed by NSAIDs

MONDAY, Feb. 10, 2014 (HealthDay News) -- Naproxen seems safer for the heart than other nonsteroidal anti-inflammatory drugs (NSAIDs), U.S. health officials say. And it's possible that labeling will soon reflect that finding.

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Residents Concerned About Lack of Time With Patients

MONDAY, Feb. 10, 2014 (HealthDay News) -- Many U.S. medical residents are concerned about reduced face-time with patients and report that engaging patients in their own care is more challenging than anticipated, according to a report from the American Resident Project, sponsored by ThinkWellPoint.

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Corrective Nasal Surgery Seems Safe in Pediatric Patients

MONDAY, Feb. 10, 2014 (HealthDay News) -- Nasal corrective surgery prior to adolescence is safe for select pediatric patients with nasal obstruction and deformity, according to research published online Feb. 6 in JAMA Facial Plastic Surgery.

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Diabetes Does Not Worsen Outcomes of Cervical Laminoplasty

FRIDAY, Feb. 7, 2014 (HealthDay News) -- Patients with or without diabetes experienced similar outcomes of laminoplasty for cervical spondylotic myelopathy, according to research published in the Feb. 1 issue of Spine.

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Drugs Increasingly Detected in Fatally Injured Drivers

FRIDAY, Feb. 7, 2014 (HealthDay News) -- Fatally injured drivers increasingly test positive for drugs, especially marijuana, according to a study published online Jan. 29 in the American Journal of Epidemiology.

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Laparoscopic Sleeve Gastrectomy Not Reliable for Resolving GERD

THURSDAY, Feb. 6, 2014 (HealthDay News) -- Among patients with gastroesophageal reflux disease (GERD), laparoscopic sleeve gastrectomy (LSG) does not resolve symptoms for most patients and can even induce symptoms, while gastric bypass (GB) is effective for many patients, according to a study published online Feb. 5 in JAMA Surgery.

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CLER Pathways to Excellence Document Issued

THURSDAY, Feb. 6, 2014 (HealthDay News) -- The Clinical Learning Environment Review (CLER) Pathways to Excellence document has been released for graduate medical education as a foundation for preparing the physician workforce in patient safety and quality improvement, according to a report from the Accreditation Council for Graduate Medical Education (ACGME).

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Amputee 'Feels' Objects With Prosthetic Hand

THURSDAY, Feb. 6, 2014 (HealthDay News) -- A Danish man who lost his left hand in an accident almost a decade ago recently was able to "feel" an object using a state-of-the-art prosthetic hand, researchers are reporting. Dennis Aabo Sorensen is the first amputee to feel what researchers call "sensory-rich information" in real time, according to the authors of a study published in the Feb. 5 issue of Science Translational Medicine.

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Choosing Wisely Tips Should Prompt Doc-Patient Discussion

WEDNESDAY, Feb. 5, 2014 (HealthDay News) -- The Choosing Wisely recommendations can form a starting point for discussing cost and appropriate use of testing with patients, according to an article from the American Medical Association (AMA).

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ICD-10 Transition May Impact Practice Cash Flow

WEDNESDAY, Feb. 5, 2014 (HealthDay News) -- Physicians and health plans remain unprepared for the disruption that implementation of the International Classification of Diseases, 10th Revision (ICD-10) will bring to their cash flow, according to an article published Jan. 14 in Medical Economics.

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Dietary Counseling Has Little Effect After Gastric Bypass

WEDNESDAY, Feb. 5, 2014 (HealthDay News) -- Dietary and behavioral counseling can help improve nutrient intake in patients who have had gastric bypass surgery, but nutrient intake still remains inadequate in many patients, according to a study published in the December issue of the Journal of Investigative Medicine.

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CVS Caremark to Stop Selling Tobacco Products

WEDNESDAY, Feb. 5, 2014 (HealthDay News) -- The national drug store chain CVS Caremark said Wednesday that it's phasing out the sale of tobacco products at its more than 7,600 stores across the United States.

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Patients Are 'Myth'-Informed About Their Risk of Cancer

TUESDAY, Feb. 4, 2014 (HealthDay News) -- Fewer than half of Americans are aware that body weight and physical activity affect cancer risk, according to the results of a survey commissioned by the American Institute for Cancer Research (AICR).

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Online Medical Records Trump Colleagues As Docs' Info Source

TUESDAY, Feb. 4, 2014 (HealthDay News) -- Online patient medical records are the top source of information for doctors, based on the mean annual exposure, according to the results of a survey conducted by Kantar Media.

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Health Reform Differs Across States: Report

MONDAY, Feb. 3, 2014 (HealthDay News) -- California is one of 10 states that have done the most to roll out provisions of the Affordable Care Act, according to a new Commonwealth Fund report. These states, including Colorado, Connecticut, Hawaii, Maryland, Massachusetts, Minnesota, New York, Oregon, and Vermont, have committed to implementing "the most significant aspects of health reform," the report states.

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