Home Geriatrics December 2018 Briefing – Geriatrics

December 2018 Briefing – Geriatrics

Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for December 2018. 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.

Catheter Ablation Tops Drug Therapy for A-Fib in Heart Failure

MONDAY, Dec. 31, 2018 (HealthDay News) — Catheter ablation is better than drug therapy for the treatment of atrial fibrillation (AF) in patients with heart failure, according to a review published online Dec. 25 in the Annals of Internal Medicine.

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Effect Sizes Uncertain for Meds Versus Placebo in Knee OA

FRIDAY, Dec. 28, 2018 (HealthDay News) — For patients with knee osteoarthritis and at least 12 months of follow-up, there is uncertainty around estimates of effect size for the change in pain in association with medications versus placebo, according to a meta-analysis published in the Dec. 25 issue of the Journal of the American Medical Association.

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Toll on Health From Depression, Anxiety Akin to Smoking, Obesity

FRIDAY, Dec. 28, 2018 (HealthDay News) — Anxiety and depression predict poor future physical health as strongly as obesity and smoking in older adults, according to a study published online Dec. 17 in Health Psychology.

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30-Day Postdischarge Mortality Up With HRRP Implementation

THURSDAY, Dec. 27, 2018 (HealthDay News) — Announcement and implementation of the Hospital Readmissions Reduction Program (HRRP) were associated with increased 30-day postdischarge mortality following hospitalization for heart failure and pneumonia, but not acute myocardial infarction (AMI), according to a study published in the Dec. 25 issue of the Journal of the American Medical Association.

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Low-Priced Generic Drugs Most Likely to Have Shortages

THURSDAY, Dec. 27, 2018 (HealthDay News) — The lowest-priced generic drugs are more likely to experience shortages, according to a study published in the November issue of Value in Health.

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Dancing Tied to Lower Odds of Disability in Activities of Daily Living

THURSDAY, Dec. 27, 2018 (HealthDay News) — For older women, participation in dancing is associated with a reduced likelihood of incident disability in activities of daily living (ADL), according to a study published online Dec. 18 in the Scandinavian Journal of Medicine & Science in Sports.

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ASH Develops Practice Guidelines for Venous Thromboembolism

THURSDAY, Dec. 27, 2018 (HealthDay News) — The American Society of Hematology (ASH) has developed new guidelines for the treatment of venous thromboembolism (VTE); the clinical practice guidelines were recently published in Blood Advances.

Prophylaxis for Hospitalized and Nonhospitalized Medical Patients
Diagnosis of Venous Thromboembolism
Heparin-Induced Thrombocytopenia
Treatment of Pediatric Venous Thromboembolism
Venous Thromboembolism in the Context of Pregnancy
Optimal Management of Anticoagulation Therapy

Initiative Can Cut Gender Gap in Medical School Faculty Salaries

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — An institutional gender equity initiative (GEI) can reduce gender-based salary gaps among medical school faculty, according to a study published online Dec. 21 in JAMA Network Open.

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Updated Guidelines Developed for Diagnosing, Treating Influenza

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — The Infectious Diseases Society of America has updated their recommendations for the care of patients with suspected or diagnosed influenza; the clinical practice guidelines were published online Dec. 19 in Clinical Infectious Diseases.

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Most Nurses Unsatisfied With Hospitals’ End-of-Life Care

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — The majority of nurses have an unfavorable opinion of their hospital’s end-of-life care, according to a study published online Dec. 2 in the Journal of the American Geriatrics Society.

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Appalachia, Western States Have Highest Hep C Prevalence

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — States in the West and in Appalachia have a higher prevalence of hepatitis C virus (HCV) infection than other states, according to a study published online Dec. 21 in JAMA Network Open.

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Fecal Occult Blood Test May Improve CRC Outcomes in Some

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — Fecal occult blood test (FOBT) screening for colorectal cancer (CRC) is associated with several improved outcomes in men but not women, according to a study recently published in the British Journal of Surgery.

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Massage Offers Short-Term Relief of Knee Pain in Arthritis Patients

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — Weekly massage sessions may provide short-term symptom relief for knee osteoarthritis patients, but the benefit is not maintained over one year of follow-up, according to a study published online Dec. 12 in the Journal of General Internal Medicine.

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FDA Warns Companies on Unsafe, Unapproved Stem Cell Treatments

FRIDAY, Dec. 21, 2018 (HealthDay News) — After infections tied to unapproved stem cell treatments sent 12 people to the hospital this past year, the U.S. Food and Drug Administration has issued a stern warning about the products.

FDA News Release
MMWR Report

Infection Control Compliance Not Tied to Knowledge

FRIDAY, Dec. 21, 2018 (HealthDay News) — Home health care workers’ beliefs about infection prevention seem to have a greater influence on prevention protocol compliance than their absolute knowledge of infection control practices, according to a study published in the November issue of the American Journal of Infection Control.

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Number of People With Dementia Rose Twofold From 1990 to 2016

FRIDAY, Dec. 21, 2018 (HealthDay News) — The number of people living with dementia worldwide more than doubled from 1990 to 2016, according to a study published online Nov. 26 in The Lancet Neurology.

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Growth in Use of Telemedicine Seen From 2005 to 2017

THURSDAY, Dec. 20, 2018 (HealthDay News) — From 2005 to 2017, there was a substantial increase in telemedicine use, although use was still uncommon in 2017, according to a research letter published online Nov. 27 in the Journal of the American Medical Association.

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Affordable Care Act Sign-Ups Higher Than Expected

THURSDAY, Dec. 20, 2018 (HealthDay News) — Despite numerous difficulties, early figures show that sign-ups for health coverage next year under the Affordable Care Act are higher than expected.

AP News Article

Restrictive, Obstructive Lung Disease Linked to Dementia Risk

THURSDAY, Dec. 20, 2018 (HealthDay News) — Both restrictive and obstructive lung disease are associated with an increased risk for incident dementia and mild cognitive impairment (MCI), according to a study recently published in the American Journal of Respiratory and Critical Care Medicine.

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ADA 2019 Standards of Care Emphasize Patient-Centered Care

THURSDAY, Dec. 20, 2018 (HealthDay News) — Patient-centered care is emphasized in updated clinical practice recommendations from the American Diabetes Association 2019 Standards of Care, published as a supplement to the January issue of Diabetes Care.

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FDA Advisory Panels: Prescribe Naloxone With Opioid Painkillers

WEDNESDAY, Dec. 19, 2018 (HealthDay News) — The labels of prescription opioid painkillers should advise doctors to consider simultaneously prescribing the opioid overdose antidote naloxone, two U.S. Food and Drug Administration advisory panels recommend.

Washington Post Article

Edentulism Tied to Greater Risk for High BP After Menopause

WEDNESDAY, Dec. 19, 2018 (HealthDay News) — Postmenopausal women with edentulism are at an increased risk for developing hypertension, according to a study published online Dec. 4 in the American Journal of Hypertension.

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Several Factors Tied to Early Readmission After Hip Fracture Sx

WEDNESDAY, Dec. 19, 2018 (HealthDay News) — Several comorbidities are associated with an increased risk for early readmission after hip fracture surgery, according to a study recently published in Injury.

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Modifying Criteria for Amnestic MCI Dx Increases Prognostic Accuracy

WEDNESDAY, Dec. 19, 2018 (HealthDay News) — Modifying diagnostic criteria to require impairment on at least two memory tests for mild cognitive impairment (MCI) diagnosis can improve prediction of medial temporal atrophy and conversion to Alzheimer’s disease (AD), according to a study published online Dec. 4 in Brain Imaging and Behavior.

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High Sodium May Contribute to CVD Deaths in Shandong, China

WEDNESDAY, Dec. 19, 2018 (HealthDay News) — A considerable proportion of cardiovascular disease (CVD) deaths in Shandong Province, China, may be attributable to high sodium intake, according to a study published online Dec. 19 in the Journal of the American Heart Association.

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Cognitive Therapy Helps Reduce Anxiety in COPD Patients

WEDNESDAY, Dec. 19, 2018 (HealthDay News) — Cognitive behavioral therapy (CBT) delivered by respiratory nurses is associated with reduced anxiety symptoms and is cost-effective for patients with chronic obstructive pulmonary disease (COPD), according to a study recently published in ERJ Open Research.

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Failure of Timely Stop to Certain Prescription Drugs Is Common

WEDNESDAY, Dec. 19, 2018 (HealthDay News) — Legacy prescribing of certain drugs, such as antidepressants and proton pump inhibitors (PPIs), is common, according to a study published in the November/December issue of the Annals of Family Medicine.

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Opioids Offer Small Improvement in Pain, Physical Function

TUESDAY, Dec. 18, 2018 (HealthDay News) — Opioid use is associated with small improvements in pain and physical functioning in patients with chronic noncancer pain, according to research published in the Dec. 18 issue of the Journal of the American Medical Association.

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Cognitive Decline Similar After Cardiac Surgery, Catheterization

TUESDAY, Dec. 18, 2018 (HealthDay News) — For older adults, declines in memory after heart surgery and cardiac catheterization are similar, according to a study published online Dec. 18 in the Annals of Thoracic Surgery.

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Fall Risk Factors Vary by Gender in Older Adults

TUESDAY, Dec. 18, 2018 (HealthDay News) — Older men and women have different fall risk profiles, according to a study published online Nov. 29 in the Journal of the American Geriatrics Society.

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Exclusion of Doctors From Public Health Insurance Up 2007 to 2017

TUESDAY, Dec. 18, 2018 (HealthDay News) — From 2007 to 2017, the number of physicians excluded from Medicare and state public insurance programs increased, according to a study published online Dec. 14 in JAMA Network Open.

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EHR Data ID Differences in HTN Control Across Health Systems

TUESDAY, Dec. 18, 2018 (HealthDay News) — An analysis of electronic health record data reveals considerable differences in hypertension control across health systems, according to a study published in the November-December issue of the Journal of the American Board of Family Medicine.

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Routine Supplements to Prevent Chronic Disease Not Advised

TUESDAY, Dec. 18, 2018 (HealthDay News) — Routine use of vitamin and mineral supplements to prevent chronic disease is not recommended, according to an Academy of Nutrition and Dietetics position paper published in the November issue of the Journal of the Academy of Nutrition and Dietetics.

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Follow-Up Within Seven Days of Heart Failure Discharge Beneficial

MONDAY, Dec. 17, 2018 (HealthDay News) — For patients with heart failure, follow-up care within seven days of discharge from the emergency department is associated with lower rates of long-term mortality and subsequent admissions, according to a study published in the Dec. 17 issue of CMAJ, the journal of the Canadian Medical Association.

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Adherence and Intensity of Lipid-Lowering Tx Influence CV Risk

MONDAY, Dec. 17, 2018 (HealthDay News) — Adherent patients receiving high-intensity statin and/or ezetimibe therapy have the lowest cardiovascular risk, according to a study published online Dec. 7 in JAMA Network Open.

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Dementia Often Misclassified With Brief Cognitive Assessments

THURSDAY, Nov. 29, 2018 (HealthDay News) — When using brief cognitive assessments, dementia is often misclassified, according to a study published online Nov. 28 in Neurology Clinical Practice.

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Persistent Discrimination ID’d Among Physician Mothers

FRIDAY, Dec. 14, 2018 (HealthDay News) — Physician mothers experience discrimination in a range of ways, which can impact the medical profession, according to a study published online Dec. 12 in The BMJ.

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BMI May Mediate Inverse Link Between Fiber Intake, Knee OA

FRIDAY, Dec. 14, 2018 (HealthDay News) — The inverse association between fiber intake and the risk for incident symptomatic knee osteoarthritis may be partially mediated by body mass index, according to a study published in the December issue of The Journal of Nutrition.

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Dementia Risk Up in Women With Military-Linked Risk Factors

THURSDAY, Dec. 13, 2018 (HealthDay News) — Women with military-related risk factors have an increased risk for developing dementia, according to a study published online Dec. 11 in Neurology.

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Medication Errors Resulting in Death Most Common in Elderly

THURSDAY, Dec. 13, 2018 (HealthDay News) — Medication errors in acute care that result in death occur most often in patients older than 75 years, with the most common error category being omitted medicine or ingredient, according to a study published online Nov. 22 in Research in Social and Administrative Pharmacy.

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Sleep Length, Quality Linked to Risk for Falls, Fractures

WEDNESDAY, Dec. 12, 2018 (HealthDay News) — Both short and long sleep duration and poor sleep quality are associated with increased odds of recurrent falls in women, according to a study published online Nov. 21 in the Journal of Bone and Mineral Research.

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Enrollment Under the Affordable Care Act Down From Last Year

WEDNESDAY, Dec. 12, 2018 (HealthDay News) — Enrollment for health insurance under the Affordable Care Act is down with just days left to sign up, according to the U.S. Centers for Medicare & Medicaid Services.

AP News Article

2017 Saw Slowing in National Health Care Spending

WEDNESDAY, Dec. 12, 2018 (HealthDay News) — National health care spending slowed in 2017, according to a report published online Dec. 6 in Health Affairs.

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Continuity of Care Tied to Lower Expenditures, Hospitalization

WEDNESDAY, Dec. 12, 2018 (HealthDay News) — Continuity of care scores are significantly associated with lower expenditures and hospitalization rates, according to a study published in the November/December issue of the Annals of Family Medicine.

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Fasting-Evoked Hypoglycemia in Diabetes Is Prevalent

WEDNESDAY, Dec. 12, 2018 (HealthDay News) — About 17 percent of patients with diabetes report experiencing hypoglycemia when fasting for lab tests, according to a study recently published in the International Journal of Endocrinology.

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Paid Childbearing Policies Lacking for Residents

TUESDAY, Dec. 11, 2018 (HealthDay News) — Policies for paid childbearing or family leave for residents are lacking at top-ranking medical schools and may be exacerbated by lack of direction from specialty boards, according to two research letters published in the Dec. 11 issue of the Journal of the American Medical Association.

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U.S. Medical Schools See Increase in Diversity

TUESDAY, Dec. 11, 2018 (HealthDay News) — After implementation of the Liaison Committee on Medical Education (LCME) diversity accreditation standards, U.S. medical schools saw increasing percentages of female, black, and Hispanic matriculants, according to a research letter published in the Dec. 4 issue of the Journal of the American Medical Association.

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Free Flap Breast Reconstruction Safe in Elderly Patients

TUESDAY, Dec. 11, 2018 (HealthDay News) — Free flap breast reconstruction is a viable and safe procedure in elderly patients, according to a study published in the December issue of Plastic and Reconstructive Surgery.

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Consensus Decision Pathway Developed for Tobacco Cessation

TUESDAY, Dec. 11, 2018 (HealthDay News) — An expert consensus decision pathway has been developed for tobacco cessation treatment; the report was published online Dec. 5 in the Journal of the American College of Cardiology.

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Flu Vaccine Linked to Reduced Risk for Death in Heart Failure

TUESDAY, Dec. 11, 2018 (HealthDay News) — After extensive adjustment for confounders, influenza vaccination is associated with a reduced risk for all-cause and cardiovascular death among patients with heart failure, according to a study published online Dec. 10 in Circulation.

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Intellectual Engagement Linked to Cognitive Performance Later

TUESDAY, Dec. 11, 2018 (HealthDay News) — Intellectual engagement is associated with level of cognitive performance in later life but does not influence the trajectory of age-related decline in cognitive performance, according to a study published online Dec. 10 in The BMJ.

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HIT-Related Stress Linked to Burnout Among Physicians

MONDAY, Dec. 10, 2018 (HealthDay News) — Stress related to use of health information technology (HIT) is common and predictive of burnout among physicians, according to a study published online Dec. 5 in the Journal of the American Medical Informatics Association.

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Veterans Health Administration Hospitals Outperform Non-VHAs

MONDAY, Dec. 10, 2018 (HealthDay News) — Veterans Health Administration (VHA) hospitals outperform non-VHA hospitals for 14 of 15 outcome measures in 121 regions, according to a research letter published online Dec. 11 in the Annals of Internal Medicine.

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Cemented Metal-on-Polyethylene Implants Best for Seniors

MONDAY, Dec. 10, 2018 (HealthDay News) — For older patients, small-head cemented metal-on-polyethylene implants are the cost-effective choice for total hip replacements, according to a study recently published in Value in Health.

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AHA Scientific Statement: Low Risk of Side Effects for Statins

MONDAY, Dec. 10, 2018 (HealthDay News) — Statins are associated with a low risk for side effects, according to a scientific statement from the American Heart Association (AHA) published online Dec. 10 in Arteriosclerosis, Thrombosis and Vascular Biology.

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Less Than One Hour of Resistance Training Weekly Tied to Lower CVD Risk

MONDAY, Dec. 10, 2018 (HealthDay News) — Less than an hour a week of resistance exercise (RE) is associated with decreased risks for cardiovascular disease (CVD)-related events and all-cause mortality, independent of aerobic exercise, according to a study recently published in Medicine & Science in Sports & Exercise.

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Most Insured Patients Not Using Online Portals

FRIDAY, Dec. 7, 2018 (HealthDay News) — Nearly two-thirds of insured adults with a previous health care visit did not use an online patient portal in 2017, according to a study published in the December issue of Health Affairs.

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Meds Taken Do Not Vary With ADL Impairment in Heart Failure

FRIDAY, Dec. 7, 2018 (HealthDay News) — For individuals with heart failure, those with impairment in activities of daily living (ADL) take as many medications as those without ADL impairment, according to a study published online Nov. 29 in the Journal of the American Geriatrics Society.

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Pictorial Presentation of Silent Atherosclerosis Helps Cut CV Risk

THURSDAY, Dec. 6, 2018 (HealthDay News) — Pictorial presentation of silent atherosclerosis contributes to the prevention of cardiovascular disease, according to a study published online Dec. 3 in The Lancet.

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Few Physicians Work in Practices That Use Telemedicine

WEDNESDAY, Dec. 5, 2018 (HealthDay News) — Only 15.4 percent of physicians work in practices that use telemedicine for a wide spectrum of patient interactions, with larger practice size being an important correlate of telemedicine use, according to a study published in the December issue of Health Affairs.

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Skin Autofluorescence Predicts T2DM, Heart Disease, Mortality

WEDNESDAY, Dec. 5, 2018 (HealthDay News) — Skin autofluorescence predicts incident type 2 diabetes, cardiovascular disease (CVD), and mortality in the general population, according to a study published online Nov. 21 in Diabetologia.

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Many Patients Withhold Information From Clinicians

TUESDAY, Dec. 4, 2018 (HealthDay News) — Many patients intentionally withhold information from clinicians, according to a study published online Nov. 30 in JAMA Network Open.

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HHS Issues Draft Strategy for Reducing Health IT Burden

TUESDAY, Dec. 4, 2018 (HealthDay News) — The U.S. Department of Health and Human Services has developed a draft strategy to reduce the health information technology (IT) burden, and the strategy is open for public comment through Jan. 28, 2019.

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Exercise Reverses Functional Decline in Hospitalized Elderly

TUESDAY, Dec. 4, 2018 (HealthDay News) — For very elderly patients undergoing acute-care hospitalization, an exercise intervention is associated with benefits in reversing functional decline associated with hospitalization, according to a study published online Nov. 12 in JAMA Internal Medicine.

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New BP Goals Could Prevent 3 Million CVD Events Over 10 Years

MONDAY, Dec. 3, 2018 (HealthDay News) — Achieving and maintaining 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) goals could prevent a greater number of cardiovascular disease (CVD) events than achieving prior U.S. guideline goals, according to a study published online Nov. 19 in Circulation.

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Shifting Pattern Seen for Primary Care Office Visits

MONDAY, Dec. 3, 2018 (HealthDay News) — Among patients with employer-sponsored insurance, there was a decline in visits to primary care physicians (PCPs) from 2012 to 2016, according to a brief released Nov. 15 by the Health Care Cost Institute (HCCI).

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Joint Mobilization Plus Exercise Beneficial for Knee Osteoarthritis

MONDAY, Dec. 3, 2018 (HealthDay News) — Patellar mobilization therapy (PMT) plus exercise has the potential to reduce pain and improve function and quality of life for patients with knee osteoarthritis, according to a phase 2 study published Nov. 12 in the Annals of Family Medicine.

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