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July 2014 Briefing - Cardiology

Last Updated: August 01, 2014.

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

Advanced Care Decision Aids Underutilized

THURSDAY, July 31, 2014 (HealthDay News) -- Decision aids are underutilized for advanced care planning and their effectiveness is not well documented, according to a review published online July 29 in the Annals of Internal Medicine.

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Large Variation in Lipid Reduction With High-Dose Statin Tx

THURSDAY, July 31, 2014 (HealthDay News) -- There is considerable interindividual variation in the magnitude of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (apoB) reductions achieved with statin therapy, which affects cardiovascular disease risk, according to a study published in the August 5 issue of the Journal of the American College of Cardiology.

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Higher Risk of Vascular Events With Polymyalgia Rheumatica

THURSDAY, July 31, 2014 (HealthDay News) -- Polymyalgia rheumatica is associated with an increased risk of vascular events, according to research published online July 28 in CMAJ, the journal of the Canadian Medical Association.

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Slow Progress Toward Meaningful Use Stage 2

WEDNESDAY, July 30, 2014 (HealthDay News) -- Providers and hospitals are making slow progress toward achieving meaningful use stage 2, according to an article published July 10 in Medical Economics.

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Heat Stroke Bigger Issue Than Cardiac Events in Runners

WEDNESDAY, July 30, 2014 (HealthDay News) -- Athletes participating in long-distance races more frequently experience serious events related to heat stroke than serious cardiac adverse events, according to a study published in the August 5 issue of the Journal of the American College of Cardiology.

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IOM Recommends Restructuring GME Financing

TUESDAY, July 29, 2014 (HealthDay News) -- Medicare support for graduate medical education (GME) should be restructured and based on its value and contribution to the nation's health needs, according to a report published July 29 by the Institute of Medicine (IOM).

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Healthy Habits May Slow Cellular Signs of Aging

TUESDAY, July 29, 2014 (HealthDay News) -- Exercise, a healthy diet and good sleep can protect the body against the negative effects of stress and slow down the aging process at a cellular level, researchers report. The findings are published online July 29 in Molecular Psychiatry.

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Decline in Stroke Incidence for Senior Medicare Beneficiaries

TUESDAY, July 29, 2014 (HealthDay News) -- In the Medicare population aged 65 years and older there was a decrease in incidence strokes and in mortality from strokes from 1988 to 2008, according to research published in the July issue of The American Journal of Medicine.

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Menopausal Hormone Therapy Does Not Affect Atherosclerosis

TUESDAY, July 29, 2014 (HealthDay News) -- For menopausal women, hormone therapy does not affect progression of atherosclerosis, according to a study published online July 29 in the Annals of Internal Medicine.

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Any Amount of Running Tied to Lower Risk of Death

TUESDAY, July 29, 2014 (HealthDay News) -- Regardless of length, duration, or speed, running reduces the risk of death, according to a study published in the August 5 issue of the Journal of the American College of Cardiology.

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Access for Pharmaceutical Sales Reps Continuing to Decline

MONDAY, July 28, 2014 (HealthDay News) -- Pharmaceutical sales representatives' access to physicians is continuing to decrease, even in previously rep-friendly specialties, according to a report published by ZS Associates.

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Sodium Intake Linked to Cardiovascular Disease in T2DM

MONDAY, July 28, 2014 (HealthDay News) -- For patients with type 2 diabetes, high dietary sodium intake is associated with cardiovascular disease (CVD), according to a study published online July 22 in the Journal of Clinical Endocrinology & Metabolism.

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Survey IDs Patients' Views on Health Care Provider Quality

FRIDAY, July 25, 2014 (HealthDay News) -- Most Americans focus on provider quality related to doctor-patient interactions rather than effectiveness of care when defining provider quality, according to a report published by the Associated Press-NORC (AP-NORC) Center for Public Affairs Research.

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Radial Artery Pulse Measurement Feasible Screen for A-Fib

FRIDAY, July 25, 2014 (HealthDay News) -- Measurement of the peripheral pulse (MPP) at the radial artery is feasible as a simple noninvasive screening tool for paroxysmal atrial fibrillation (pAF) in patients after acute ischemic stroke, according to a study published online July 23 in Neurology.

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Empiric Potassium Cuts Death in Loop Diuretic Users

FRIDAY, July 25, 2014 (HealthDay News) -- For new starters of loop diuretics, empiric potassium supplementation is associated with reduced risk of all-cause death, according to a study published online July 16 in PLOS ONE.

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Number of Uninsured Down After ACA Open Enrollment

THURSDAY, July 24, 2014 (HealthDay News) -- There has been a decrease in the number of uninsured following the open enrollment period of the Affordable Care Act (ACA), according to a report published online July 23 in the New England Journal of Medicine.

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Patients Give High Marks to Shared Medical Appointments

THURSDAY, July 24, 2014 (HealthDay News) -- Shared medical appointments (SMAs) improve patient satisfaction with primary care, according to research published in the July/August issue of the Annals of Family Medicine.

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Predictors Identified for Stroke Post-Cardiac Surgery

THURSDAY, July 24, 2014 (HealthDay News) -- For patients undergoing cardiac surgery, the strongest predictors of stroke up to two years postoperatively include advanced age, history of stroke, and peripheral vascular disease, according to a study published online July 21 in CMAJ, the journal of the Canadian Medical Association.

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Consumption of Probiotics May Lower Blood Pressure

WEDNESDAY, July 23, 2014 (HealthDay News) -- Regular consumption of probiotics may improve control of blood pressure (BP), according to research published online July 21 in Hypertension.

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American Red Cross Issues Urgent Call for Blood Donations

WEDNESDAY, July 23, 2014 (HealthDay News) -- Blood donations to the American Red Cross are down substantially, and the agency says an "emergency situation" could arise within weeks.

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New Remote Patient Monitoring Devices Available

WEDNESDAY, July 23, 2014 (HealthDay News) -- Several new remote patient monitoring devices with useful applications are available or under development, according to an article published July 8 in Medical Economics.

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Utility of CIMT Varies With Thoroughness of Assessment

TUESDAY, July 22, 2014 (HealthDay News) -- The usefulness of carotid intima-media thickness (CIMT) varies with the comprehensiveness of the assessment, according to a study published online July 16 in JACC: Cardiovascular Imaging.

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Online Reviews Show Patients Value Docs' Interpersonal Skills

TUESDAY, July 22, 2014 (HealthDay News) -- Patient reviews indicate that the attributes most valued in physicians include interpersonal skills and bedside manner, according to a report published online July 16 by Vitals.

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New Strategy IDs Patients With Undiagnosed Hypertension

TUESDAY, July 22, 2014 (HealthDay News) -- A technology-based program may be used to identify patients with undiagnosed hypertension in the primary care setting, according to research published in the July/August issue of the Annals of Family Medicine.

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Weight Loss Over Two Years Predicts Reduced Diabetes Risk

TUESDAY, July 22, 2014 (HealthDay News) -- Weight loss over two years is associated with reduced diabetes incidence and improvement in cardiometabolic risk factors, according to a study published online July 14 in Diabetes Care.

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Use of Catheter-Directed Thrombolysis Increasing

TUESDAY, July 22, 2014 (HealthDay News) -- Utilization of catheter-directed thrombolysis (CDT) has increased in patients with deep vein thrombosis (DVT), according to a study published online July 21 in JAMA Internal Medicine.

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No Change in Heart Attack Rates for Younger U.S. Adults

MONDAY, July 21, 2014 (HealthDay News) -- Heart attack hospitalization rates among young and middle-aged adults have remained stable during the previous decade, even as seniors of Medicare age experienced a better than 20 percent decline in heart attacks, Yale University researchers have found. The study appears in the July 29 issue of the Journal of the American College of Cardiology.

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Beta-Blockers in New Onset CHD Reduce Cardiac Risk Only Post-MI

TUESDAY, July 22, 2014 (HealthDay News) -- Use of beta-blockers among patients with new-onset coronary heart disease (CHD) appears to lower risk of cardiac events only among patients with a recent myocardial infarction (MI), according to a study published in the July 22 issue of the Journal of the American College of Cardiology.

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Physician Offices Investing in Patient Portals for EHRs

THURSDAY, July 10, 2014 (HealthDay News) -- Practitioners are continuing to invest in electronic health records (EHRs), specifically to improve access for patients, according to an article published June 13 in Medical Economics.

Medical Economics Article
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National Survey Finds Most U.S. Physicians Are Satisfied

MONDAY, July 21, 2014 (HealthDay News) -- Most U.S. physicians are satisfied, with satisfied physicians more likely to report positive trends in medicine, according to a report published by Jackson Healthcare.

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Physician Continuity Is Key After ER Visit for Heart Failure

MONDAY, July 21, 2014 (HealthDay News) -- Heart failure patients who follow up with a familiar physician after release from the emergency department have better outcomes, according to research published online July 9 in the Journal of the American College of Cardiology: Heart Failure.

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Pregnancy Loss Ups Future Risk of Cardiovascular Disease

MONDAY, July 21, 2014 (HealthDay News) -- The risk of cardiovascular disease is increased among postmenopausal women with prior pregnancy loss, according to research published in the July/August issue of the Annals of Family Medicine.

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Fasting May Not Be Necessary for Cholesterol Tests

FRIDAY, July 18, 2014 (HealthDay News) -- Fasting and non-fasting measurements of low-density lipoprotein cholesterol (LDL-C) have similar prognostic value for identifying patients at risk for all-cause or cardiovascular mortality, according to a study published online July 11 in Circulation.

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Patients, Caregivers Struggle With Advanced Multimorbidity

FRIDAY, July 18, 2014 (HealthDay News) -- A better understanding of the needs of patients with advanced multimorbidity may offer insights into how to improve care, according to research published online May 28 in BMJ Supportive & Palliative Care.

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Seriously Ill Patients Have Limited Facial Expression

FRIDAY, July 18, 2014 (HealthDay News) -- Decreased variability of facial expression may help identify patients with serious cardiopulmonary disease in the emergency care setting, according to research published online July 14 in the Emergency Medicine Journal.

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Legal Risks for Providing Financial Assistance to Patients

THURSDAY, July 17, 2014 (HealthDay News) -- Physicians need to be aware of the ramifications of providing financial assistance to patients, according to an article published July 8 in Medical Economics.

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Nurses Expand Outpatient Care for Chronically Ill Adults

THURSDAY, July 17, 2014 (HealthDay News) -- Team care involving nurse-managed protocols is one model that may improve outpatient care for adults with chronic conditions, according to research published in the July 15 issue of the Annals of Internal Medicine.

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Doctors More Likely Than Public to Be Registered Organ Donors

THURSDAY, July 17, 2014 (HealthDay News) -- Physicians are more likely to register to be organ donors than the general public, according to a research letter published in the July 16 issue of the Journal of the American Medical Association.

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Survival Up With Successful PCI to a Chronic Total Occlusion

THURSDAY, July 17, 2014 (HealthDay News) -- For patients with chronic total occlusion, successful percutaneous coronary intervention (PCI) is associated with improved long-term survival, according to a study published in the July 22 issue of the Journal of the American College of Cardiology.

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Mortality Up With Low BMI After Coronary Revascularization

THURSDAY, July 17, 2014 (HealthDay News) -- After coronary revascularization procedures, the risk of mortality is highest among patients with a low body mass index (BMI). In addition, body composition (lean mass index [LMI] and body fat) may account for the inverse J shape of the mortality curve with increasing BMI. These findings were published online July 16 in the Mayo Clinic Proceedings.

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Vascular Risk Not Lowered With ER Niacin, Laropiprant

WEDNESDAY, July 16, 2014 (HealthDay News) -- Extended-release niacin with laropiprant does not reduce the risk of major vascular events in adults with vascular disease; and extended-release niacin may be associated with increased risk of certain serious adverse events, according to research published in the July 17 issue of the New England Journal of Medicine.

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Review: Aspirin Use in Primary Cardiovascular Prevention

WEDNESDAY, July 16, 2014 (HealthDay News) -- Low-dose aspirin can be used for primary cardiovascular prevention for patients at high cardiovascular risk, without increased bleeding risk, according to a review article published in the July 22 issue of the Journal of the American College of Cardiology.

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Stroke History Heightens Risk for Adverse Surgical Outcomes

WEDNESDAY, July 16, 2014 (HealthDay News) -- A history of a stroke is associated with worse outcomes following elective surgery, according to a study published in the July 16 issue of the Journal of the American Medical Association.

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Increasing Flow of Information Has Impact on Patient Consent

WEDNESDAY, July 16, 2014 (HealthDay News) -- The increasing flow of information as part of health information exchanges raises certain issues for patient consent, according to an article published July 8 in Medical Economics.

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Increased Stroke Risk With Stress, Hostility, Depression

WEDNESDAY, July 16, 2014 (HealthDay News) -- For middle-aged and older adults, stress, hostility, and depressive symptoms are associated with increased risk of incident stroke and transient ischemic attack, according to a study published online July 10 in Stroke.

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Alcohol Consumption Tied to Higher A-Fib Risk

WEDNESDAY, July 16, 2014 (HealthDay News) -- Alcohol consumption is a risk factor for atrial fibrillation (AF), according to a study published in the July 22 issue of the Journal of the American College of Cardiology.

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Stroke Incidence, Mortality Down From 1987 to 2011

TUESDAY, July 15, 2014 (HealthDay News) -- From 1987 to 2011 there was a decrease in stroke incidence and mortality rates in four U.S. communities, according to a study published in the July 16 issue of the Journal of the American Medical Association.

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Review: Organic Foods May Be Healthier

TUESDAY, July 15, 2014 (HealthDay News) -- Organic produce and grains contain more protective antioxidants, less pesticide residue, and lower levels of the toxic metal cadmium than food raised in traditional ways, according to a new review. However, it's not clear what this means for health, and several agriculture experts claim the analysis missed some important points.

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Home BP Monitoring Could Financially Benefit Insurers

TUESDAY, July 15, 2014 (HealthDay News) -- Reimbursement of home blood pressure (BP) monitoring is cost beneficial to insurers, according to a study published online July 14 in Hypertension.

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Neighborhood Environment Linked to Cardiovascular Health

TUESDAY, July 15, 2014 (HealthDay News) -- Neighborhood environment is associated with ideal cardiovascular health, according to a study published online July 8 in Circulation: Cardiovascular Quality and Outcomes.

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Change in Appearance of Generic Pills Ups Nonadherence

TUESDAY, July 15, 2014 (HealthDay News) -- For patients with cardiovascular disease, a change in color or shape of generic drugs is associated with increased odds of medication nonpersistence, according to research published in the July 15 issue of the Annals of Internal Medicine.

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Modifiable Risk Factors Impact CVD Mortality in T2DM

MONDAY, July 14, 2014 (HealthDay News) -- Modifiable risk factors can be targeted for early and continued intervention to reduce the risk of adverse outcomes in patients with type 2 diabetes mellitus and cardiovascular disease, according to research published online July 2 in Diabetes Care.

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NSAID Use Ups Cardiovascular Event Risk Post-Menopause

MONDAY, July 14, 2014 (HealthDay News) -- Regular nonsteroidal anti-inflammatory drug (NSAID) use is associated with increased risk of cardiovascular events in postmenopausal women, according to a study published online July 8 in Circulation: Cardiovascular Quality and Outcomes.

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Medical Schools Being Challenged to Find Training Sites

MONDAY, July 14, 2014 (HealthDay News) -- Medical schools are working to find solutions to ensure their students can continue to receive clinical training in spite of the escalating shortage of training sites, according to an article published by the American Academy of Family Physicians (AAFP).

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Diabetes Incidence Increases With Statin Therapy Adherence

MONDAY, July 14, 2014 (HealthDay News) -- The risk of new-onset diabetes increases with increasing adherence to statin therapy, according to a study published online June 26 in Diabetes Care.

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A Little Alcohol May Not Be Good for Your Heart After All

FRIDAY, July 11, 2014 (HealthDay News) -- Cutting alcohol intake -- even for light-to-moderate drinkers -- may benefit heart health, according to research published July 10 in BMJ.

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Survival >80 Percent After Valve-in-Valve Implantation

FRIDAY, July 11, 2014 (HealthDay News) -- For patients with failed surgical bioprosthetic valves, one-year survival after transcatheter valve-in-valve implantation is 83.2 percent, according to a study published in the July 9 issue of the Journal of the American Medical Association.

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Stimulant Use Ups Subsequent Cardiovascular Event Risk

FRIDAY, July 11, 2014 (HealthDay News) -- Stimulant use in children and adolescents is associated with an increased risk of a subsequent cardiovascular event, according to a study published online June 23 in the Journal of Child and Adolescent Psychopharmacology.

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Class III Obesity Substantially Increases Mortality Rate

FRIDAY, July 11, 2014 (HealthDay News) -- Class III obesity, defined as a body mass index (BMI) of 40 kg/m² or higher, is associated with a substantially higher total mortality compared with normal weight, according to research published online July 8 in PLOS Medicine.

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FIRS: Governments Should Limit or Ban Use of E-Cigarettes

THURSDAY, July 10, 2014 (HealthDay News) -- Governments should ban or limit the use of electronic cigarettes until more is known about their health effects, say experts from the world's leading lung organizations. The position statement was issued Wednesday by the Forum of International Respiratory Societies (FIRS), which includes more than 70,000 members worldwide.

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Dark Chocolate May Up Walking Distance in PAD Patients

THURSDAY, July 10, 2014 (HealthDay News) -- Consumption of dark chocolate may improve walking autonomy in patients with peripheral artery disease (PAD), according to research published online July 2 in the Journal of the American Heart Association.

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Fetal Cardiovascular Risk Score Predicts Infant HTN in IUGR

THURSDAY, July 10, 2014 (HealthDay News) -- For intrauterine growth restricted (IUGR) fetuses, a cardiovascular risk score is highly predictive of infant hypertension and arterial remodeling, according to a study published in the June issue of the American Journal of Obstetrics & Gynecology.

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Prevalence of PAD Higher With Lower Socioeconomic Status

THURSDAY, July 10, 2014 (HealthDay News) -- The prevalence of peripheral artery disease (PAD) is higher in individuals with lower socioeconomic status, according to a study published online July 1 in Circulation: Cardiovascular Quality and Outcomes.

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ACOs Require Overhaul to Health Care Delivery System

WEDNESDAY, July 9, 2014 (HealthDay News) -- The accountable care organization (ACO) model requires an overhaul for health care delivery, according to an article published June 24 in Medical Economics.

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Lifestyle Changes in Youth Can Lower Later CVD Risk

WEDNESDAY, July 9, 2014 (HealthDay News) -- Healthy lifestyle changes in young adults may reduce the risk of later development of coronary artery disease, according to research published in the July 1 issue of Circulation.

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Review: Combined Training Seems Best in Type 2 Diabetes

WEDNESDAY, July 9, 2014 (HealthDay News) -- For patients with type 2 diabetes, combined training seems better than aerobic exercise training or resistance training for glycemic control and blood lipids, according to a study published online July 2 in Diabetologia.

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Varenicline, Nicotine Patch Combo Aids in Smoking Cessation

TUESDAY, July 8, 2014 (HealthDay News) -- Varenicline in combination with nicotine replacement therapy (NRT) is more effective than varenicline alone in achieving tobacco abstinence at 12 weeks and at six months, according to a study published in the July 9 issue of the Journal of the American Medical Association.

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Most Docs Find M.B.A. Training Advantageous to Their Careers

TUESDAY, July 8, 2014 (HealthDay News) -- Graduates with dual training in medicine and business increasingly pursue leadership roles and report greater career acceleration, according to a study published online June 20 in Academic Medicine.

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USPSTF Recommends Against Carotid Artery Stenosis Screening

MONDAY, July 7, 2014 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends against screening for carotid artery stenosis in adults without a history of transient ischemic attack, stroke, or other neurological symptoms. These findings are presented in a final recommendation statement published online July 8 in the Annals of Internal Medicine.

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Don't Forget Patient Privacy When Marketing Your Practice

MONDAY, July 7, 2014 (HealthDay News) -- Use of marketing by health care providers must be in accordance with federal and state regulations relating to patient privacy, according to an article published June 24 in Medical Economics.

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Substantial Variation in Infection Rates Post-CABG

MONDAY, July 7, 2014 (HealthDay News) -- For patients undergoing isolated coronary artery bypass grafting surgery, the variation in observed health care-acquired infection (HAI) rates across centers is 18.2 percent, according to a study published online July 1 in Circulation: Cardiovascular Quality and Outcomes.

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Heparin Cuts Major Adverse Ischemic Events in Primary PCI

MONDAY, July 7, 2014 (HealthDay News) -- For patients undergoing emergency angiography in the context of primary percutaneous coronary intervention (PPCI), use of unfractionated heparin is associated with a reduction in major adverse ischemic events versus bivalirudin, with no increase in major bleeding, according to a study published online July 5 in The Lancet.

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Late Referral for About One in Four Neonates With Critical CHD

THURSDAY, July 3, 2014 (HealthDay News) -- A considerable proportion of neonates with critical congenital heart disease (CCHD) are not referred to a cardiac center by age 4 days, according to a study published online June 30 in Pediatrics.

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Three Opportunities Presented for Practice Growth

THURSDAY, July 3, 2014 (HealthDay News) -- Maximizing the growth potential of a practice over time requires physicians to consider various opportunities, including increasing the size of medical groups, embracing technology, and use of marketing, according to an article published June 24 in Medical Economics.

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AMA: Tips for Managing Medical School Loans

THURSDAY, July 3, 2014 (HealthDay News) -- Creating a budget and other tips can help medical school graduates to manage their loan repayments, according to an article published by the American Medical Association (AMA).

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Recommendations Made for Partnering Patients in Health Care

THURSDAY, July 3, 2014 (HealthDay News) -- Changes need to be implemented in the education system in order to fully integrate patients and their families as equal partners in health care, according to a report based on recommendations made at a conference convened by the Macy Foundation.

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Malnutrition in Childhood Raises Later Risk of Hypertension

THURSDAY, July 3, 2014 (HealthDay News) -- Malnutrition survivors are at increased risk of developing hypertension later in life, according to research published online June 30 in Hypertension.

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No Link for Testosterone Supplements, Heart Attack

WEDNESDAY, July 2, 2014 (HealthDay News) -- Although recent research has linked testosterone therapy with a higher risk for heart attack and stroke, a new study involving more than 25,000 older men suggests otherwise. The study, funded by the U.S. National Institutes of Health, was published July 2 in the Annals of Pharmacotherapy.

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Tips Offered for Improving Practice Financial Management

WEDNESDAY, July 2, 2014 (HealthDay News) -- Establishing clear financial policies for practices and making it easy for patients to pay are two suggestions for improving practices' financial management, according to an article published online June 24 in Medical Economics.

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Health Care Expenditure Has Slowed in United States

WEDNESDAY, July 2, 2014 (HealthDay News) -- The growth in U.S. health care expenditure has slowed in recent years, coming some way toward closing the gap with other countries of the Organisation for Economic Co-operation and Development (OECD), according to an article in the health of Americans series published online July 1 in The Lancet.

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Mental Stress Affects Ischemia Prognosis in Patients With CAD

WEDNESDAY, July 2, 2014 (HealthDay News) -- Mental stress-induced myocardial ischemia (MSIMI) is associated with increased risk of adverse cardiovascular events in patients with coronary artery disease (CAD), according to research published in the July 15 issue of The American Journal of Cardiology.

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Vitamin D Does Not Improve Glycemic Control in Prediabetes

WEDNESDAY, July 2, 2014 (HealthDay News) -- Supplementation with vitamin D does not appear to improve glycemic indices or cardiovascular risk factors in individuals with prediabetes, according to research published online June 19 in Diabetes Care.

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ACA Offers Opportunities for Prevention, Public Health

TUESDAY, July 1, 2014 (HealthDay News) -- The Patient Protection and Affordable Care Act is fostering collaboration between the public health and health care systems and can improve quality of care and advance population health, according to an article in the health of Americans series published online July 1 in The Lancet.

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Women Gain More From CRT-D at Shorter QRS Duration

TUESDAY, July 1, 2014 (HealthDay News) -- Women with left bundle branch block (LBBB) benefit from cardiac resynchronization therapy-defibrillators (CRT-D) at a shorter QRS duration than men, according to a study published online June 23 in JAMA Internal Medicine.

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