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August 2014 Briefing - Cardiology

Last Updated: September 02, 2014.

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

Report Highlights Progress, Challenges in Health IT

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Progress has been made toward widespread adoption of electronic health records (EHRs), although there are still barriers to adoption of advanced use of EHRs, according to a report published by the Robert Wood Johnson Foundation.

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Long-Term Use of Sulfonylureas Tied to Coronary Heart Disease

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Among women with diabetes, long-term use of sulfonylureas is associated with a significantly higher risk of incident coronary heart disease (CHD), according to a study published online Aug. 22 in Diabetes Care.

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AMGA: Physician Turnover Still High in 2013

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For the second year running, physician turnover remains at the highest rate since 2005, according to a report published by the American Medical Group Association (AMGA).

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Doctors Frequently Experience Ethical Dilemmas

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For physicians trying to balance various financial and time pressures, ethical dilemmas are common, according to an article published Aug. 7 in Medical Economics.

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More Cardiovascular Deaths Seen in Low-Income Countries

THURSDAY, Aug. 28, 2014 (HealthDay News) -- Although the burden of risk factors is lower, more deaths from major cardiovascular disease occur in low-income countries, according to research published in the Aug. 28 issue of the New England Journal of Medicine.

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Team Approach Improves Practice Efficiency

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- The increasing administrative requirements of a medical practice are requiring a team-based approach to care, and physicians must learn to manage the team, according to an article published Aug. 7 in Medical Economics.

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Pay-for-Performance Not Found to Impact Access to CABG

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- For patients with acute myocardial infarction (AMI), treatment at pay-for-performance (P4P) hospitals is not associated with a change in the rate of coronary artery bypass graft (CABG) surgery, according to a study published online Aug. 26 in Circulation: Cardiovascular Quality and Outcomes.

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Aspirin Post-Anticoagulation Tx Cuts Risk of VTE Recurrence

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- For patients with first unprovoked venous thromboembolism (VTE), aspirin after anticoagulant treatment reduces the risk of recurrence, according to a study published online Aug. 25 in Circulation.

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Low Enrollment Raises Doubts About Cardio Trial Findings

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- Low levels of enrollment and more favorable risk profiles for participants raise questions about whether the findings of clinical trials are generalizable to typical patients with myocardial infarction (MI), according to research published in the Aug. 27 issue of the Journal of the American Medical Association.

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HTN Self-Management Beneficial in High-Risk Patients

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Self-monitoring with self-titration of antihypertensive medications is associated with lower blood pressure for patients with hypertension at risk for cardiovascular disease, according to a study published in the Aug. 27 issue of the Journal of the American Medical Association.

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Ban Indoor Use of E-Cigarettes, U.N. Health Agency Says

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Joining a number of other health agencies, the United Nations' World Health Organization (WHO) on Tuesday recommended that countries regulate electronic cigarettes and ban their use indoors until studies prove that "vaping" is harmless to bystanders.

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Frequent ER Visits for Heart Failure Cause Majority of Costs

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Individuals with frequent emergency department visits for acute heart failure syndrome (AHFS) account for the majority of hospitalizations and hospital charges for AHFS, according to a study published online Aug. 19 in Circulation: Cardiovascular Quality and Outcomes.

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Cognitive Impairment May Increase Subsequent Stroke Risk

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Cognitive impairment is associated with an increased risk of subsequent stroke, according to a meta-analysis published online Aug. 25 in CMAJ, the journal of the Canadian Medical Association.

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Restrictive, Non-Solicitation Covenants Are Valid

MONDAY, Aug. 25, 2014 (HealthDay News) -- Restrictive and non-solicitation covenants are valid and can be enforced, according to an article published Aug. 5 in Medical Economics.

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USPSTF Recommends Counseling for Adults at Risk for CVD

MONDAY, Aug. 25, 2014 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends offering or referring overweight and obese adults with cardiovascular disease risk factors to intensive behavioral counseling. These findings are presented in a final recommendation statement published online Aug. 26 in the Annals of Internal Medicine.

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Analytic Strategy Can Cut Bias in Large Observational Studies

MONDAY, Aug. 25, 2014 (HealthDay News) -- In multicenter observational studies, bias from variability in treatment selection between clinical centers can be reduced by matching recalibrated propensity scores within clinical centers, according to a study published online Aug. 12 in Circulation: Cardiovascular Quality and Outcomes.

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EPA: Air in U.S. Cities Getting Cleaner

MONDAY, Aug. 25, 2014 (HealthDay News) -- The air in American cities is getting safer to breathe, the U.S. Environmental Protection Agency reported Thursday.

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Guidelines Presented for Electronic Cigarette Use

MONDAY, Aug. 25, 2014 (HealthDay News) -- Recommendations have been developed regarding electronic cigarette (e-cigarette) use and published online Aug. 24 as an American Heart Association (AHA) policy statement in Circulation.

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U.S. to Tighten Access to Certain Narcotic Painkillers

FRIDAY, Aug. 22, 2014 (HealthDay News) -- The U.S. Drug Enforcement Administration (DEA) is going ahead with tough new controls on painkillers containing hydrocodone, which has been tied to a surge in dangerous addictions across the United States.

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Organizations Can Help Docs Retain Their Independence

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Ways for physicians to remain in independent practice are highlighted in an article published Aug. 7 in Medical Economics.

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Educational Intervention Helps Ensure Appropriate ECHO Use

THURSDAY, Aug. 21, 2014 (HealthDay News) -- An appropriate use criteria (AUC)-based educational intervention can improve the appropriate use of outpatient transthoracic echocardiography (TTE), according to a study published online Aug. 13 in the JACC Cardiovascular Imaging.

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Physical Activity Protects Against Atrial Fibrillation

THURSDAY, Aug. 21, 2014 (HealthDay News) -- Greater physical activity is associated with lower rates of incident atrial fibrillation (AF) in women, according to a study published online Aug. 20 in the Journal of the American Heart Association.

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Organized Processes Help Practices Hire Well

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- A defined process is necessary to help physicians hire the right staff for their practice, according to an article published July 24 in Medical Economics.

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CRT, ICD Therapies Benefit Heart Failure Patients of All Races

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- For patients with heart failure with reduced ejection fraction, cardiac resynchronization therapy (CRT) and implantable cardioverter-defibrillator (ICD) therapies are associated with clinical benefit, irrespective of patient race/ethnicity, according to a study published in the Aug. 26 issue of the Journal of the American College of Cardiology.

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Clarithromycin Linked to Increased Risk of Cardiac Death

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- There is a significantly increased risk of cardiac death associated with clarithromycin use, according to a study published online Aug. 19 in BMJ.

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Docs Must Consider Liability When Ordering Screening Tests

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Physicians and health care providers must be aware of their potential liability when ordering screening tests, according to an article published July 24 in Medical Economics.

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Boxed Warnings Are Common in Novel Therapeutics

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Boxed warnings are common on recent drug approvals, and many occur years after approval, according to a research letter published online Aug. 15 in JAMA Internal Medicine.

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Hospitalizations for Acute CVD, Stroke Down From 1999 to 2011

TUESDAY, Aug. 19, 2014 (HealthDay News) -- From 1999 through 2011 there were considerable declines in hospitalizations for acute cardiovascular disease and stroke, outpacing those of other conditions, according to a study published online Aug. 18 in Circulation.

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Fenofibrate Effective for Women and Men With T2DM

TUESDAY, Aug. 19, 2014 (HealthDay News) -- For patients with type 2 diabetes, fenofibrate is effective in women, improving their lipoprotein profile more than in men, according to a study published online Aug. 18 in Diabetologia.

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Urban Food Initiative Ethical for Addressing Food Issues

TUESDAY, Aug. 19, 2014 (HealthDay News) -- The urban food initiative (UFI) seems to be a safe and ethical approach to addressing obesity and food insecurity, according to a viewpoint piece published online Aug. 18 in JAMA Pediatrics.

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Sleep Apnea Tied to Increased Odds of Resistant Elevated BP

TUESDAY, Aug. 19, 2014 (HealthDay News) -- There is a strong association between severe untreated obstructive sleep apnea (OSA) and resistant elevated blood pressure (BP), despite treatment with an aggressive antihypertensive medication regimen, according to a study published in the August issue of the Journal of Clinical Sleep Medicine.

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Article IDs Barriers to Pregnancy in Cardiology Fellowship

MONDAY, Aug. 18, 2014 (HealthDay News) -- There are many barriers to pregnancy during cardiology fellowship, which may contribute to the gender discrepancy, according to an article published in the Aug. 19 issue of the Journal of the American College of Cardiology.

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SSRI Meds Up Bleeding Risk in A-Fib Patients Taking Warfarin

MONDAY, Aug. 18, 2014 (HealthDay News) -- In patients with atrial fibrillation taking warfarin, use of selective serotonin reuptake inhibitor (SSRI) medications is associated with an increased risk of major hemorrhage, according to a study published in the Aug. 15 issue of The American Journal of Cardiology.

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Less Educated Smokers at Greatest Risk for Stroke

FRIDAY, Aug. 15, 2014 (HealthDay News) -- Poorly educated adults who smoke face a higher stroke risk, as do those who smoke and have hypertension, according to a study published online Aug. 14 in Stroke.

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Moderate Exercise Tied to Lower Mortality After Cardiac Event

FRIDAY, Aug. 15, 2014 (HealthDay News) -- Moderate exercise is associated with reduced mortality for heart attack survivors, and elite athletes have lower cardiovascular disease (CVD) and cancer death, according to two studies published online Aug. 12 in the Mayo Clinic Proceedings.

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Women, Blacks Hit Harder by Heart Disease Risk Factors

THURSDAY, Aug. 14, 2014 (HealthDay News) -- Traditional risk factors contribute to incident cardiovascular disease more in blacks and women, compared to other populations, according to a study published online Aug. 11 in Circulation.

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ACA Incentives May Promote Cardiac Rehab in the Workplace

THURSDAY, Aug. 14, 2014 (HealthDay News) -- Financial incentives and the emphasis on outcomes in the current era of health reform in the United States may encourage delivery of preventive care services, such as cardiac rehabilitation, in the workplace, according to research published in the August issue of the Journal of Occupational and Environmental Medicine.

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Extra Time Spent Counseling, Coordinating Care Billable

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Extra time spent counseling patients and coordinating care can be billed using evaluation and management (E/M) and prolonged service codes, according to an article published July 24 in Medical Economics.

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Studies Examine Link Between Sodium Intake, Cardiac Health

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- The association between sodium intake and cardiovascular outcomes is complex, according to three studies published online in the Aug. 14 issue of the New England Journal of Medicine.

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Delayed Cardioversion With A-Fib Ups Thromboembolic Risk

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- A delay to cardioversion of 12 hours or longer from onset of acute atrial fibrillation symptoms is associated with a greater risk of thromboembolic complications, according to a research letter published in the Aug. 13 issue of the Journal of the American Medical Association.

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Most U.S. Patients With MI Discharged on High-Dose Aspirin

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Most U.S. patients with myocardial infarction (MI) are discharged on high-dose aspirin, according to a study published online Aug. 12 in Circulation: Cardiovascular Quality and Outcomes.

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Meta-Analysis Strategy Impacts Estimation of Tx Outcome

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Estimation of treatment outcome varies with the meta-analysis strategy, according to a study published in the Aug. 13 issue of the Journal of the American Medical Association.

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Perioperative A-Fib Ups Long-Term Stroke Risk

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Perioperative atrial fibrillation is associated with an increased risk of subsequent stroke, especially after noncardiac surgery, according to a study published in the Aug. 13 issue of the Journal of the American Medical Association.

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Digoxin Ups Death Risk in Newly Diagnosed A-Fib Patients

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Among patients with newly diagnosed atrial fibrillation (AF), the use of digoxin is associated with increased risk of death, according to research published in the Aug. 19 issue of the Journal of the American College of Cardiology.

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EHR Adoption Increasing, But Stage 2 Criteria Often Not Met

MONDAY, Aug. 11, 2014 (HealthDay News) -- Most U.S. hospitals and office-based physicians have adopted electronic health records (EHR), according to two studies published in the August issue of Health Affairs.

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Review: Troponin Has Prognostic Value in CKD Without ACS

MONDAY, Aug. 11, 2014 (HealthDay News) -- For patients with chronic kidney disease (CKD) without suspected acute coronary syndrome (ACS), troponin levels may have prognostic and diagnostic value, according to two reviews published online Aug. 12 in the Annals of Internal Medicine.

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Guidelines Updated for Contrast Agent Use in Clinical Echoes

MONDAY, Aug. 11, 2014 (HealthDay News) -- Initiatives have been developed to improve the appropriate use of contrast media in echocardiography. The guidelines were published in the August issue of the Journal of the American Society of Echocardiography.

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CT Perfusion Imaging Better IDs CAD Than SPECT

MONDAY, Aug. 11, 2014 (HealthDay News) -- Computed tomographic (CT) perfusion imaging shows higher overall diagnostic performance than single photon emission computed tomography (SPECT) perfusion imaging for the diagnosis of coronary artery disease (CAD), according to a study published in the August issue of Radiology.

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Neighborhood's Socioeconomic Status Tied to Readmissions

MONDAY, Aug. 11, 2014 (HealthDay News) -- Neighborhood socioeconomic status (SES) is linked to six-month, all-cause readmission among patients with heart failure, even after adjustment for patient-level factors, according to a study published online July 29 in Circulation: Cardiovascular Quality and Outcomes.

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Dining Out Equals More Calories Consumed

FRIDAY, Aug. 8, 2014 (HealthDay News) -- For adults, fast-food and full-service restaurant consumption correlates with increased daily total energy intake, according to a study published online July 30 in Public Health Nutrition.

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Issues to Consider With Integration of Telemedicine

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Integrating telemedicine raises various considerations, including operational and legal issues, according to an article published July 24 in Medical Economics.

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Manipulative Therapy Linked to Cervical Artery Dissection

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Evidence suggests there may be an association between cervical manipulative therapy and cervical artery dissections (CDs), according to an American Heart Association/ American Stroke Association scientific statement published online Aug. 7 in Stroke.

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Polypill Can Potentially Offer Global Cardiovascular Benefit

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Use of a polypill can potentially improve global cardiovascular health, according to research published in the Aug. 12 issue of the Journal of the American College of Cardiology.

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VA Health Care Reform Bill Signed Into Law

THURSDAY, Aug. 7, 2014 (HealthDay News) -- A bill signed into law Thursday by President Barack Obama is meant to provide veterans with easier access to government-paid health care.

Health Highlights: Aug. 7, 2014

Statins May Improve Wound Healing

THURSDAY, Aug. 7, 2014 (HealthDay News) -- Statin therapy can improve wound healing, according to a review published in the August issue of the Annals of Thoracic Surgery.

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Prophylactic Aspirin Use May Help Prevent Cancer

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Prophylactic aspirin use seems to be beneficial for men and women between ages 50 and 65 in the general population, with increased benefits seen for long-term use, according to a review published online Aug. 5 in the Annals of Oncology.

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Hypertension in Middle Age May Speed Cognitive Decline

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Hypertension during midlife is associated with greater cognitive decline during a 20-year period, according to research published online Aug. 4 in JAMA Neurology.

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Mortality Up With CKD in PCI Contrast-Induced Nephropathy

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Contrast-induced nephropathy (CIN) is associated with long-term mortality in patients with, but not those without, chronic kidney disease (CKD), according to a study published in the Aug. 1 issue of The American Journal of Cardiology.

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Favorable Resource Use With Long-Detection Interval for ICD

TUESDAY, Aug. 5, 2014 (HealthDay News) -- A long-detection interval for implantable cardioverter-defibrillators (ICDs) is associated with favorable results in terms of hospitalization and costs, according to a research letter published in the Aug. 6 issue of the Journal of the American Medical Association.

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Desert Dust Events May Trigger Myocardial Infarctions

TUESDAY, Aug. 5, 2014 (HealthDay News) -- Exposure to Asian dust (AD), a windblown sand dust originating from mineral soil in China and Mongolia, a few days before symptom onset is associated with the incidence of acute myocardial infarction (AMI), according to a study published online July 29 in Circulation: Cardiovascular Quality & Outcomes.

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Very Low Carbohydrate Diet Beneficial for Obese With T2DM

TUESDAY, Aug. 5, 2014 (HealthDay News) -- For obese adults with type 2 diabetes mellitus (T2DM), a very low carbohydrate diet is associated with greater improvements in glycemic control and cardiovascular risk markers than an energy-matched high unrefined carbohydrate diet, according to a study published online July 28 in Diabetes Care.

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Five Servings of Fruit and Veggies a Day Cut Mortality

TUESDAY, Aug. 5, 2014 (HealthDay News) -- Consuming five or more servings of fruit and vegetables daily is associated with reduced risk of all-cause mortality, particularly cardiovascular mortality, according to research published online July 29 in BMJ.

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Many Physicians Have Secondary Income

MONDAY, Aug. 4, 2014 (HealthDay News) -- Many physicians report earning income from sources other than their primary practice/employer, according to an article published July 24 in Medical Economics.

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Best Outcomes Seen at Systolic BP of 130 to 139 mm Hg

MONDAY, Aug. 4, 2014 (HealthDay News) -- For patients with treated hypertension, worse outcomes are seen for those with systolic and diastolic blood pressures lower and higher than 130 to 139 mm Hg and 60 to 79 mm Hg, respectively, according to a study published in the Aug. 12 issue of the Journal of the American College of Cardiology.

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New Onset, Post-Op Atrial Fibrillation Ups Mortality

MONDAY, Aug. 4, 2014 (HealthDay News) -- New onset postoperative atrial fibrillation (POAF) is associated with worse patient outcomes, including increased risk-adjusted mortality, according to a study published in the August issue of The Annals of Thoracic Surgery.

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Interventions Avert Contrast-Induced Acute Kidney Injury

MONDAY, Aug. 4, 2014 (HealthDay News) -- A quality improvement program helps prevent contrast-induced acute kidney injury (CI-AKI) in patients undergoing percutaneous coronary intervention, according to research published online July 29 in Circulation: Cardiovascular Quality and Outcomes.

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Guidelines Issued for Cardiac Management of Noncardiac Sx

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Recommendations have been developed for perioperative cardiovascular management of patients undergoing noncardiac surgery. These revised guidelines were published online Aug. 1 in the Journal of the American College of Cardiology.

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CMS Recognizes Telehealth in New Physician Fee Schedule

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Earlier this month, the Centers for Medicare & Medicaid Services issued proposed rules for updates to the Physician Fee Schedule and will accept comments until Sept. 2, according to an article published July 7 in Medical Economics.

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CDC: Some Jobs Harder on the Heart Than Others

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Stress at work may raise your risk of heart attack and stroke, particularly if you work in the service industry or have a blue-collar job, U.S. health officials reported Thursday. But being unemployed might be just as unhealthy, they added. The study was published in the Aug. 1 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Each Chronic Condition Further Reduces Life Expectancy

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Each additional chronic condition among older people diminishes life expectancy, according to a study published in the August issue of Medical Care.

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More Activity, Less Sitting Both Needed to Cut Obesity Risk

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Both high levels of physical activity and low levels of leisure time sitting may be necessary to reduce the risk of obesity, according to research published online July 31 in Diabetologia.

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Older Adults With Dementia More Likely to Receive Pacemaker

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Older adults with dementia are more likely to receive a pacemaker than those without cognitive impairment, according to a research letter published online July 28 in JAMA Internal Medicine.

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Off-Hour Arrival at Hospital Impacts Heart Attack Outcomes

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Time of presentation to the hospital may influence treatment and mortality for patients with myocardial infarction, according to research published online July 29 in Circulation: Cardiovascular Quality and Outcomes.

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