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November 2017 Briefing - Neurology

Last Updated: December 01, 2017.

Here are what the editors at HealthDay consider to be the most important developments in Neurology for November 2017. 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.

Magnesium Boosts Environmental Enrichment in Alzheimer's

THURSDAY, Nov. 30, 2017 (HealthDay News) -- The combination of environmental enrichment (EE) and magnesium-L-threonate (MgT) is more effective than either treatment alone for improving cognition and spatial memory in a mouse model of Alzheimer's disease (AD), according to a study published online Nov. 10 in CNS Neuroscience & Therapeutics.

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Mean Serum Allopregnanolone Low Across Weight Extremes

THURSDAY, Nov. 30, 2017 (HealthDay News) -- Women at both extremes of the weight spectrum have low mean serum allopregnanolone, which has been linked to increased depression and anxiety severity, according to a study published online Nov. 1 in Neuropsychopharmacology.

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Fremanezumab, Erenumab Effective in Treatment of Migraine

THURSDAY, Nov. 30, 2017 (HealthDay News) -- Fremanezumab is effective for the prevention of chronic migraine, and erenumab is beneficial for treatment of episodic migraine, according to two studies published in the Nov. 30 issue of the New England Journal of Medicine.

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Many Seniors Have Not Discussed Avoiding Drug Interactions

WEDNESDAY, Nov. 29, 2017 (HealthDay News) -- Older adults report feeling confident that they know how to avoid drug interactions despite only 35 percent having spoken to someone about it in the past year, according to findings from the National Poll on Healthy Aging, published online Nov. 29.

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Cord Blood Improves Motor Function With Cerebral Palsy

WEDNESDAY, Nov. 29, 2017 (HealthDay News) -- Infusion of autologous umbilical cord blood improves whole brain connectivity and motor function in young children with cerebral palsy (CP), according to a study published online Oct. 28 in Stem Cells Translational Medicine.

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Value-Based Payment Modifier Not Tied to Practice Performance

TUESDAY, Nov. 28, 2017 (HealthDay News) -- The Value-Based Payment Modifier (VM) is not associated with performance differences between practices serving higher-risk and lower-risk patients, according to a study published online Nov. 28 in the Annals of Internal Medicine.

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Clinician Denial of Patient Requests Impacts Satisfaction

TUESDAY, Nov. 28, 2017 (HealthDay News) -- Clinician denial of some types of tests requested by patients is associated with worse patient satisfaction with the clinician, according to a study published online Nov. 27 in JAMA Internal Medicine.

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1998 to 2014 Saw Drop in CVD Hospitalization Rates in Diabetes

TUESDAY, Nov. 28, 2017 (HealthDay News) -- Cardiovascular disease (CVD) hospitalization rates have declined in recent years among individuals with and those without diabetes, according to a study published online Nov. 17 in Diabetes Care.

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Ablation Cuts Risk of Recurrent Stroke in Patients With A-Fib

TUESDAY, Nov. 28, 2017 (HealthDay News) -- For patients with atrial fibrillation (AF) and prior cerebrovascular accident (CVA), ablation is associated with reduced risk of recurrent stroke, according to a study published online Nov. 13 in the Journal of Cardiovascular Electrophysiology.

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Anticholinergic Cognitive Burden Scale IDs Adverse Outcomes

MONDAY, Nov. 27, 2017 (HealthDay News) -- For older adults, the Anticholinergic Cognitive Burden Scale (ACB) shows good dose-response relationships between anticholinergic burden and adverse outcomes, according to a study published in the November/December issue of the Annals of Family Medicine.

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New Workflows Have Potential to Address Provider Burnout

MONDAY, Nov. 27, 2017 (HealthDay News) -- New solutions are needed to address burnout among health care team members, yet, in a catch-22 situation for health industry leaders, change fatigue contributes to burnout, according to a Vocera Communications report entitled In Pursuit of Resilience, Well-Being, and Joy in Healthcare.

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Essay Adds to Discourse on Impact of Suggestive Jokes

MONDAY, Nov. 27, 2017 (HealthDay News) -- Seemingly benign, recurring patterns of joking around a single theme (joke cycles) can contribute to humorizing and legitimizing sexual misconduct, according to an essay published online Nov. 12 in Communication and Critical/Cultural Studies.

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Coffee Consumption Appears to Provide More Benefit Than Harm

MONDAY, Nov. 27, 2017 (HealthDay News) -- Coffee consumption seems safe and is associated with reduced risk for various health outcomes, according to a review published online Nov. 22 in The BMJ.

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Percutaneous Transluminal Angioplasty Ineffective in MS

MONDAY, Nov. 27, 2017 (HealthDay News) -- Percutaneous transluminal angioplasty (PTA) seems to be safe but ineffective for patients with multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency (CCSVI), according to a study published online Nov. 18 in JAMA Neurology.

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Clinician Suspicion Minimally Accurate for Lyme Disease

MONDAY, Nov. 27, 2017 (HealthDay News) -- Clinician suspicion has minimal accuracy for the diagnosis of Lyme disease, according to a study published online Nov. 24 in Pediatrics.

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Gaps Seen Between Hearing Loss, Receipt of Medical Evaluation, Tx

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Many patients with self-reported hearing loss do not receive medical evaluation and recommended treatments, according to a study published online Nov. 22 in JAMA Otolaryngology-Head and Neck Surgery.

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Female Physicians' Spouses More Likely to Work

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Spouses of female physicians are on average more educated and work more hours outside the home than spouses of male physicians, according to a research letter published online Nov. 21 in the Annals of Internal Medicine.

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Cerebral Morphometric Changes Discriminate ADHD, Controls

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Cerebral morphometric alterations can discriminate between children with attention-deficit/hyperactivity disorder (ADHD) and controls, according to a study published online Nov. 22 in Radiology.

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Baby Boomers Have Increased Risk of Rx Opioid Overdose Death

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Individuals born between 1947 and 1964 have a significantly increased risk of prescription opioid overdose death and heroin overdose death, and those born from 1979 to 1992 also have an increased risk of heroin overdose death, according to a study published online Nov. 21 in the American Journal of Public Health.

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High Costs Associated With Physician Burnout, Attrition

TUESDAY, Nov. 21, 2017 (HealthDay News) -- Physicians who are experiencing burnout are more than twice as likely to leave their organization within two years, and this is associated with significant economic costs, according to a report from the American Medical Association.

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No Treatment or Imaging Follow-Up Most Effective for Tiny UIAs

TUESDAY, Nov. 21, 2017 (HealthDay News) -- For patients with unruptured intracranial aneurysms (UIAs) that are 3 mm or smaller, no preventive treatment or imaging follow-up is the most effective management strategy, according to a study published online Nov. 20 in JAMA Neurology.

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NOACs Show Lower Risk of Adverse Renal Outcomes in A-Fib

TUESDAY, Nov. 21, 2017 (HealthDay News) -- For patients with atrial fibrillation (AF), non-vitamin K antagonist oral anticoagulants (NOACs) are associated with lower risks of adverse renal outcomes than warfarin, according to a study published in the Nov. 28 issue of the Journal of the American College of Cardiology.

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NAFLD Linked to Smaller Total Cerebral Brain Volume

MONDAY, Nov. 20, 2017 (HealthDay News) -- Nonalcoholic fatty liver disease (NAFLD) is associated with smaller total cerebral brain volume, according to a study published online Nov. 20 in JAMA Neurology.

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Salivary miRNAs Can ID Duration of Concussion Symptoms

MONDAY, Nov. 20, 2017 (HealthDay News) -- For children with concussion, salivary microRNAs (miRNAs) can accurately identify the duration of symptoms, according to a study published online Nov. 20 in JAMA Pediatrics.

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Spinal Cord Stimulation May Reduce Neuropathic Pain

MONDAY, Nov. 20, 2017 (HealthDay News) -- Spinal cord stimulation (SCS) effectively reduces chronic pain symptoms in individuals with painful diabetic polyneuropathy (PDPN), according to a study published online Nov. 6 in Diabetes Care.

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Chronic Conditions Increasing Among Childbearing Women

MONDAY, Nov. 20, 2017 (HealthDay News) -- Between 2005 and 2014, the prevalence of chronic conditions increased across all segments of the childbearing population, according to a study published online Nov. 7 in Obstetrics & Gynecology.

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Simple Checklist Can Identify Useful Clinical Practice Guidelines

FRIDAY, Nov. 17, 2017 (HealthDay News) -- A simple, easy-to-use checklist, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST), can identify useful clinical practice guidelines, according to a study published in the September/October issue of the Annals of Family Medicine.

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Many Health Care Providers Work While Sick

FRIDAY, Nov. 17, 2017 (HealthDay News) -- More than 40 percent of health care personnel (HCP) with influenza-like illness (ILI) work while ill, according to a study published in the November issue of the American Journal of Infection Control.

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Docs' Preparedness Influences Exercise Recommendations

FRIDAY, Nov. 17, 2017 (HealthDay News) -- Primary care providers who feel prepared are more likely to recommend physical activity to patients with disabilities, according to a study published online Nov. 16 in Preventing Chronic Disease.

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Virtual Reality Effective for Post-Stroke Upper Extremity Rehab

THURSDAY, Nov. 16, 2017 (HealthDay News) -- Virtual reality (VR) training is as effective as conventional training for upper extremity rehabilitation after stroke, according to a study published online Nov. 15 in Neurology.

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Drug Combo Doesn't Lengthen Glioblastoma Survival

THURSDAY, Nov. 16, 2017 (HealthDay News) -- In patients with progressive glioblastoma, treatment with lomustine plus bevacizumab does not confer a survival advantage over treatment with lomustine alone, according to a study published online Nov. 15 in the New England Journal of Medicine.

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Health Care Experts in Favor of Patient Contribution to Notes

WEDNESDAY, Nov. 15, 2017 (HealthDay News) -- Health care experts are supportive of OurNotes, an intervention in which patients and families co-produce medical notes with clinicians, according to a research letter published online Nov. 13 in the Annals of Internal Medicine.

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Poorer Neuropsychological Test Scores for HIV-Positive

WEDNESDAY, Nov. 15, 2017 (HealthDay News) -- HIV-positive individuals treated with combination antiretroviral therapy (cART) have poorer neuropsychological test scores than controls but no significant neuropsychological decline over time, according to a study published online Nov. 13 in JAMA Neurology.

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XR Naltrexone, Sublingual BUP-NX Deemed Equally Effective

WEDNESDAY, Nov. 15, 2017 (HealthDay News) -- Although initiation of extended-release naltrexone (XR-NTX) may be more difficult, XR-NTX and sublingual buprenorphine-naloxone (BUP-NX) are equally safe and effective once initiated for opioid relapse prevention, according to a study published online Nov. 14 in The Lancet.

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Psychostimulant Use Tied to Placental Complications

WEDNESDAY, Nov. 15, 2017 (HealthDay News) -- Psychostimulant use during pregnancy is associated with a small increased relative risk of preeclampsia and preterm birth, according to a study published online Nov. 7 in Obstetrics & Gynecology.

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Outcomes for Atrial Fibrillation Similar With Dabigatran, Warfarin

TUESDAY, Nov. 14, 2017 (HealthDay News) -- In clinical practice, patients starting dabigatran therapy do not have significantly different rates of ischemic stroke or extracranial hemorrhage than those starting warfarin therapy, though they have lower rates of intracranial bleeding, according to a study published online Nov. 13 in the Annals of Internal Medicine.

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LRRK2 Variants Linked to Lower Age at Onset of Parkinson's

TUESDAY, Nov. 14, 2017 (HealthDay News) -- The presence of multiple LRRK2 risk variants is associated with a younger age at onset (AAO) of Parkinson's disease (PD), according to a research letter published online Nov. 13 in JAMA Neurology.

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Thrombectomy May Be Best in Stroke Patients With Mismatch

MONDAY, Nov. 13, 2017 (HealthDay News) -- For patients with acute stroke who were last well six to 24 hours earlier and who had a mismatch between the severity of the clinical deficit and the infarct volume, thrombectomy plus standard care is associated with better outcomes than standard care alone, according to a study published online Nov. 11 in the New England Journal of Medicine to coincide with the annual meeting of the Society of Vascular and Interventional Neurology, held Nov. 8 to 11 in Boston.

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Cardiac Index Linked to Cerebral Blood Flow Regardless of CVD

MONDAY, Nov. 13, 2017 (HealthDay News) -- Among older adults, lower cardiac index is associated with lower resting cerebral blood flow (CBF) in the temporal lobes regardless of cardiovascular disease (CVD) but is not associated with cerebrovascular reactivity (CVR), according to a study published online Nov. 8 in Neurology.

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Prenatal Exposure to ADHD Meds Tied to Neonatal Morbidity

MONDAY, Nov. 13, 2017 (HealthDay News) -- Exposure to attention-deficit/hyperactivity disorder (ADHD) medication during pregnancy is associated with increased risk of neonatal morbidity, according to a study published online Nov. 10 in Pediatrics.

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Eclampsia Tied to Increased Relative Risk of Seizure Disorder

THURSDAY, Nov. 9, 2017 (HealthDay News) -- The relative risk of a seizure disorder after eclampsia is higher than that of women unaffected by eclampsia but remains extremely low, according to a study published online Nov. 7 in Obstetrics & Gynecology.

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CPAP May Be Superior to Gastric Banding for Severe Sleep Apnea

THURSDAY, Nov. 9, 2017 (HealthDay News) -- Continuous positive airway pressure (CPAP) may be a more effective treatment than laparoscopic gastric banding (LGB) for control of severe obstructive sleep apnea (OSA), according to a study published online Oct. 16 in the American Journal of Respiratory and Critical Care Medicine.

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Benefits for New Immunoassays for Measuring Aβ42 in CSF

THURSDAY, Nov. 9, 2017 (HealthDay News) -- Concentrations of cerebrospinal fluid (CSF) β42-amyloid 42 (Aβ42) derived from new immunoassays may show improved agreement with visual flutemetamol F18 ([18F]flutemetamol)-labeled positron emission tomography (PET) assessment, according to a study published online Nov. 6 in JAMA Neurology.

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Overlapping Surgery Appears Safe in Neurosurgical Procedures

THURSDAY, Nov. 9, 2017 (HealthDay News) -- For patients undergoing neurosurgical procedures, overlapping surgery (OS) is not associated with morbidity, mortality, or worsened functional status, according to a study published online Nov. 8 in JAMA Surgery.

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Editorial (subscription or payment may be required)

Doctors Have Extra Two Weeks to Preview Performance Data

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- Physicians have two extra weeks to preview their 2016 performance information as a result of a mistake related to the Centers for Medicare & Medicaid Services' Physician Compare online resource, according to a report published by the American Academy of Family Physicians.

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Sodium Oxybate Promising for Parkinson's, Daytime Sleepiness

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- For patients with Parkinson's disease (PD) and excessive daytime sleepiness (EDS), sodium oxybate seems effective and well-tolerated, according to a study published online Nov. 6 in JAMA Neurology.

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In ER, Combination of Ibuprofen, Acetaminophen Relieves Pain

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- For patients presenting to the emergency department with acute extremity pain, the combination of ibuprofen and acetaminophen does not differ in terms of pain reduction from three different opioid and acetaminophen combination analgesics, according to a study published online Nov. 7 in the Journal of the American Medical Association.

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Editorial (subscription or payment may be required)

Increases in U.S. Health Spending Tied to Health Service Price

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- Factors including increases in health care service price and intensity are associated with increases in U.S. health care spending from 1996 to 2013, according to a study published online Nov. 7 in the Journal of the American Medical Association.

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Cannabidiol Concentration Varies Widely in Online Products

TUESDAY, Nov. 7, 2017 (HealthDay News) -- Among cannabidiol (CBD) products sold online, there is a wide range of CBD concentrations, and many products are under- or overlabeled, according to a research letter published online Nov. 7 in the Journal of the American Medical Association.

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Intensity of Exercise Affects Impact on Mortality Risk

TUESDAY, Nov. 7, 2017 (HealthDay News) -- Total physical activity (PA) and moderate- to vigorous-intensity PA (MVPA) are inversely associated with mortality, though light-intensity PA and sedentary behavior are not associated with mortality, according to a research letter published online Nov. 6 in Circulation.

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Brain Measures Tied to Atrial Pressure in Valvular Heart Dz

TUESDAY, Nov. 7, 2017 (HealthDay News) -- For patients with chronic valvular heart disease, white matter hyperintensity (WMH) volume is associated with mean right atrial (RA) pressure, according to a study published online Nov. 6 in JAMA Neurology.

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Pricing Interventions Increase Sales, Intake of Healthy Foods

FRIDAY, Nov. 3, 2017 (HealthDay News) -- Pricing interventions seem to improve access to healthy food and beverage options with increases in stocking and sales of these items, according to a review published online Nov. 2 in Preventing Chronic Disease.

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Postmenopausal Estradiol Linked to Blunted Cortisol Responses

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Postmenopausal estradiol therapy (ET) may protect certain types of cognition in the presence of stress, according to a study published online Nov. 2 in the Journal of Clinical Endocrinology & Metabolism.

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GLP-1 May Mediate Effects of Gastric Bypass on CNS Activation

THURSDAY, Nov. 2, 2017 (HealthDay News) -- The central effects of glucagon-like peptide-1 (GLP-1) may mediate the effects of Roux-en-Y gastric bypass (RYGB) on central nervous system (CNS) activation in response to visual and gustatory food cues, according to a study published online Oct. 12 in Diabetes Care.

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Driving Impairment Warnings Often Not Given With Rx Meds

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Not all prescription drug users report receiving warnings about driving impairment, according to a study published online Nov. 1 in the Journal of Studies on Alcohol and Drugs.

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Midlife Systemic Inflammation Tied to Late-Life Brain Volume

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Systemic inflammation in midlife is associated with future neurodegeneration and cognitive aging, according to a study published online Nov. 1 in Neurology.

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Race a Factor in Intracranial Atherosclerotic Disease

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Black men have increased prevalence and frequency of multiple intracranial atherosclerotic plaques, according to a study published online Nov. 1 in JAMA Cardiology.

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Gene Replacement Tx Beneficial in Spinal Muscular Atrophy

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Gene replacement therapy is beneficial in spinal muscular atrophy type 1 (SMA1), and nusinersen is beneficial for infants with spinal muscular atrophy, according to two studies published online Nov. 1 in the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required) -- Mendell
Abstract/Full Text (subscription or payment may be required) -- Finkel
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CMS Launches Initiative to Examine Impact of Regulations

WEDNESDAY, Nov. 1, 2017 (HealthDay News) -- The Centers for Medicare & Medicaid Services (CMS) has launched an initiative to examine which provider regulations should be discarded or revamped amid concerns that the regulations are reducing the amount of time that physicians spend with patients, according to an article published in Modern Healthcare.

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