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August 2013 Briefing - Diabetes & Endocrinology

Here are what the editors at HealthDay consider to be the most important developments in Diabetes & Endocrinology for August 2013. 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.

Diabetes Apps Among Top 10 Doctors Recommend to Patients

FRIDAY, Aug. 30 (HealthDay News) -- Apps for managing diabetes and calculating the risk of cardiovascular disease are among the top 10 apps doctors recommend to their patients, according to researchers at Medical Economics.

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Eating More Fruits Linked to Lower Diabetes Risk

FRIDAY, Aug. 30 (HealthDay News) -- Greater consumption of particular whole fruits such as blueberries is associated with a lower risk of developing type 2 diabetes, while consuming more fruit juice is associated with a higher risk of type 2 diabetes, according to a study published online Aug. 29 in BMJ.

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Chronic Fatigue Highly Prevalent in Type 1 Diabetes

FRIDAY, Aug. 30 (HealthDay News) -- Patients with type 1 diabetes (DM1) have a high prevalence of chronic fatigue, according to a study published online Aug. 15 in Diabetes Care.

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Hormone Test May Indicate Risk of Gestational Diabetes

THURSDAY, Aug. 29 (HealthDay News) -- Low serum concentrations of adiponectin prior to pregnancy may identify women at high risk for gestational diabetes mellitus (GDM), according to research published online Aug. 29 in Diabetes Care.

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Low Inflammatory Status Linked to Metabolic Health in Obese

THURSDAY, Aug. 29 (HealthDay News) -- Metabolic health is associated with favorable inflammatory status in both obese and non-obese individuals, according to a study published online Aug. 26 in the Journal of Clinical Endocrinology & Metabolism.

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Low Gut Bacterial Richness Linked to Obesity

WEDNESDAY, Aug. 28 (HealthDay News) -- Individuals with low gut bacterial richness have more adiposity and a more pronounced inflammatory phenotype; and weight loss intervention can improve bacterial gene richness, according to two studies published in the Aug. 29 issue of Nature.

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Final Rules Issued for Individual Shared Responsibility Mandate

WEDNESDAY, Aug. 28 (HealthDay News) -- Starting 2014, the individual shared responsibility provision of the Affordable Care Act, which calls for each individual to have basic health insurance coverage, will be implemented, according to a statement from the U.S. Department of the Treasury.

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Researchers Discuss Overdiagnosis of Thyroid Cancer

WEDNESDAY, Aug. 28 (HealthDay News) -- The increasing incidence of small and indolent thyroid cancer and stable mortality rates suggest overdiagnosis, according to an analysis published online Aug. 27 in BMJ.

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Health Care Savings With Early Accountable Care Organizations

WEDNESDAY, Aug. 28 (HealthDay News) -- Early accountable care organization initiatives correlate with lower spending for elderly Medicare beneficiaries, but not necessarily with improved quality, according to a study published in the Aug. 28 issue of the Journal of the American Medical Association.

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Gene Variant Linked to Heart Disease in Type 2 Diabetes

TUESDAY, Aug. 27 (HealthDay News) -- A variant of a gene associated with glutamic acid metabolism is linked to an increased risk of coronary heart disease in patients with type 2 diabetes, according to a study published in the Aug. 28 issue of the Journal of the American Medical Association.

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T2DM Family Hx Tied to Higher Prediabetes Risk in Non-Obese

TUESDAY, Aug. 27 (HealthDay News) -- Having a family member with type 2 diabetes is associated with a higher risk of prediabetes, but only among the non-obese, according to a study published online Aug. 27 in Diabetologia.

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Thyroid Ultrasound May Be Useful in Reducing Unnecessary Biopsies

TUESDAY, Aug. 27 (HealthDay News) -- Thyroid ultrasound imaging can be used to identify patients at low risk of thyroid cancer, according to a study published in the Aug. 26 issue of JAMA Internal Medicine.

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Weight Maintenance Program Effective in Black Women

MONDAY, Aug. 26 (HealthDay News) -- A medium-intensity behavioral intervention that focuses on maintaining rather than losing weight is effective for preventing weight gain among overweight and obese black women, according to a study published online Aug. 26 in JAMA Internal Medicine.

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Intestinal Sweet Taste Receptors Disordered in Diabetes

MONDAY, Aug. 26 (HealthDay News) -- The expression of intestinal sweet taste receptors (STRs) varies according to glycemic status, and is disordered in type 2 diabetes during hyperglycemia, according to a study published online June 12 in Diabetes.

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Leukocyte Telomere Length Linked to Diabetes Risk

FRIDAY, Aug. 23 (HealthDay News) -- For American Indians, leukocyte telomere length is associated with the risk of incident diabetes, with an almost two-fold increased risk for those with the shortest versus the longest length, according to a study published online Aug. 15 in Diabetes.

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Improved Sleep May Improve Exercise Duration

FRIDAY, Aug. 23 (HealthDay News) -- The length of an individual's sleep appears to influence their participation level in exercise the next day, according to a small study published in the August issue of the Journal of Clinical Sleep Medicine.

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Brain Atrophy Seen in Patients With Diabetes

THURSDAY, Aug. 22 (HealthDay News) -- Brain atrophy rather than cerebrovascular lesions may explain the relationship between type 2 diabetes mellitus (T2DM) and cognitive impairment, according to a study published online Aug. 12 in Diabetes Care.

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Pregnancy Linked to Sleep Apnea, Especially With GDM

THURSDAY, Aug. 22 (HealthDay News) -- Pregnancy is associated with sleep disturbances and with obstructive sleep apnea (OSA), especially in the presence of gestational diabetes mellitus (GDM), according to a study published online Aug. 21 in the Journal of Clinical Endocrinology & Metabolism.

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Antipsychotic Use Among Youth Ups Type 2 Diabetes Risk

THURSDAY, Aug. 22 (HealthDay News) -- Among youth aged 6 to 24 years, recent initiation of antipsychotics is associated with a significantly increased risk of type 2 diabetes, according to a study published online Aug. 21 in JAMA Psychiatry.

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Ultrawide Field Retinal Imaging Improves Telehealth Evaluation

WEDNESDAY, Aug. 21 (HealthDay News) -- Implementation of non-mydriatic ultrawide field retinal imaging (UWFI) in a telemedicine program significantly reduces the ungradable rate in evaluation of patients for diabetic retinopathy (DR) and diabetic macular edema (DME), compared to the use of non-mydriatic fundus photography (NMFP), according to a study published online Aug. 12 in Diabetes Care.

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Ideal BP for Kidney Disease Patients May Be 130-159/70-89

WEDNESDAY, Aug. 21 (HealthDay News) -- In patients with chronic kidney disease (CKD), optimal blood pressure (BP) seems to be 130 to 159/70 to 89 mm Hg, according to a study published in the Aug. 20 issue of the Annals of Internal Medicine.

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Large-Scale Program Increases Hypertension Control

TUESDAY, Aug. 20 (HealthDay News) -- A hypertension control program that includes a hypertension registry, performance metrics, evidence-based guidelines, visits for blood pressure measurement, and medication is effective in improving hypertension control, according to a study published in the Aug. 21 issue of the Journal of the American Medical Association.

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Implications, Solutions for U.S. Health Disparities Discussed

TUESDAY, Aug. 20 (HealthDay News) -- Research on health disparities in the United States, the policy implications of these disparities, and suggestions for improvement of disparities are discussed in "Health Policy Brief: Health Gaps," published Aug. 15 in Health Affairs.

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Oral Fluoroquinolones Linked to Dysglycemia Risk in Diabetes

TUESDAY, Aug. 20 (HealthDay News) -- Patients with diabetes using oral fluoroquinolones face an increased risk of severe dysglycemia, according to a study published online Aug. 14 in Clinical Infectious Diseases.

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Lasting Benefits With Insulin Pump Therapy for Children

TUESDAY, Aug. 20 (HealthDay News) -- Insulin pump therapy is associated with sustained improvement in glycemic control as well as reductions in severe hypoglycemia and hospitalization for diabetic ketoacidosis (DKA) in children with type 1 diabetes, according to a study published online Aug. 18 in Diabetologia.

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Increasing Operating Costs Top Concern for Medical Practices

TUESDAY, Aug. 20 (HealthDay News) -- The top five concerns of medical practice executives all relate to financial management, with dealing with increasing operating costs reported as the most difficult daily challenge, according to a report published by the Medical Group Management Association (MGMA).

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Score Predicts 10-Year Risk of Dementia in Type 2 Diabetes

TUESDAY, Aug. 20 (HealthDay News) -- A risk score has been created and validated to predict the 10-year risk of dementia among patients with type 2 diabetes, according to a study published online Aug. 20 in The Lancet Diabetes & Endocrinology.

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Expansion of Pharmacists' Practice Will Benefit Patients

MONDAY, Aug. 19 (HealthDay News) -- The expanding scope of pharmacists' practice will potentially improve patient care but has implications for physicians, according to an article published online Aug. 19 in CMAJ, the journal of the Canadian Medical Association.

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Eating Fruit May Reduce Risk of Abdominal Aortic Aneurysm

MONDAY, Aug. 19 (HealthDay News) -- Consumption of fruit, but not vegetables, may reduce the risk of abdominal aortic aneurysm (AAA), particularly ruptured AAA, according to research published in the Aug. 20 issue of Circulation.

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Increased Phthalates Up Insulin Resistance in Teens

MONDAY, Aug. 19 (HealthDay News) -- Increased urinary phthalates are associated with increased insulin resistance in adolescents; and higher bisphenol A (BPA) levels are associated with obesity and abnormal waist circumference-to-height ratio in children, according to two studies published online Aug. 19 in Pediatrics.

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HHS Awards $67 Million to Marketplace Navigators

MONDAY, Aug. 19 (HealthDay News) -- $67 million is being awarded to Navigator grant applicants and their staff, who will serve as an in-person resource for those requiring additional assistance in shopping for and enrolling in Health Insurance Marketplace plans, according to a report published by the U.S. Department of Health and Human Services.

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Onset of Puberty Is Delayed in HIV-Infected Children

MONDAY, Aug. 19 (HealthDay News) -- Onset of puberty is significantly delayed in perinatally HIV-infected (PHIV) children compared with those who are HIV-exposed but uninfected (HEU), but combination antiretroviral therapy may result in more normal timing of pubertal onset, according to research published in the July 31 issue of AIDS.

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Controversy Surrounding 'Fat Letters' Discussed

MONDAY, Aug. 19 (HealthDay News) -- Despite the potential stigma surrounding "fat letters," school body mass index (BMI) measurement programs may be beneficial, according to a perspective piece published online Aug. 19 in Pediatrics.

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Obesity's Impact on Mortality Previously Underestimated

FRIDAY, Aug. 16 (HealthDay News) -- Previous studies may have underestimated the impact of the obesity epidemic on U.S. mortality, according to a study published online Aug. 15 in the American Journal of Public Health.

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Metformin Usually Adequate for Control of Gestational Diabetes

FRIDAY, Aug. 16 (HealthDay News) -- Among women with gestational diabetes mellitus, those receiving metformin achieve lower mean glucose levels compared with those receiving insulin, but some require supplemental insulin therapy, according to research published in the July issue of the American Journal of Obstetrics & Gynecology.

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Severe Hypoglycemia in Diabetes Tied to Cardiac Disease

FRIDAY, Aug. 16 (HealthDay News) -- For patients with type 1 and type 2 diabetes, severe hypoglycemia is associated with severe hypertension, hypokalemia, and QT prolongation, according to a study published online Aug. 12 in Diabetes Care.

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Daily Calorie Distribution May Affect Fertility in PCOS

FRIDAY, Aug. 16 (HealthDay News) -- In lean women with polycystic ovary syndrome (PCOS), eating about half of total daily calories at breakfast rather than dinner improves insulin sensitivity, reduces testosterone levels, and improves the ovulation rate, which may increase fertility, according to a study published in Clinical Science.

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IOM Describes Themes Relating to Patients' Role in Health Care

FRIDAY, Aug. 16 (HealthDay News) -- Themes and messages relating to the role of patients in informed care decisions, knowledge generation, and value improvement were discussed at the Institute of Medicine's (IOM) Workshop Proceedings, according to a report published Aug. 15 in conjunction with the transcript of the proceedings.

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Depression Linked to Cognitive Decline in Type 2 Diabetes

THURSDAY, Aug. 15 (HealthDay News) -- For patients with type 2 diabetes, depression correlates with greater cognitive decline over 40-months of follow-up, according to a study published online Aug. 14 in JAMA Psychiatry.

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Doctors Pessimistic About Future of U.S. Health Care

THURSDAY, Aug. 15 (HealthDay News) -- Physicians report concerns regarding health care delivery and the future of health care, according to survey findings published by athenahealth.

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Involved Patients Have Better Health Care Experiences

THURSDAY, Aug. 15 (HealthDay News) -- Health care providers and patients shape the care experience, and strategies to improve care interactions should also help patients ensure that their needs are met, according to research published in the July issue of Health Affairs.

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Liraglutide Augments Weight Loss in Pre-Type 2 Diabetes

THURSDAY, Aug. 15 (HealthDay News) -- For patients at high risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), liraglutide in additional to calorie restriction is associated with more weight loss and improvements in insulin resistance, glucose tolerance, and some CVD risk factors, according to a study published online July 8 in Diabetes Care.

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Medicare Reimbursement Drives Procedural Over Cognitive Care

WEDNESDAY, Aug. 14 (HealthDay News) -- Physicians treating Medicare patients are reimbursed three to five times more for performing common procedures versus providing cognitive care, according to a study published online Aug. 12 in JAMA Internal Medicine.

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Novel Soy Germ Pasta Improves Gastric Emptying Time

WEDNESDAY, Aug. 14 (HealthDay News) -- Pasta enriched with biologically active isoflavone aglycons significantly improves gastric emptying time in patients with type 2 diabetes, according to a pilot study published online July 8 in Diabetes Care.

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Physicians Should Consider Social Media As Public Space

WEDNESDAY, Aug. 14 (HealthDay News) -- A new approach is needed for resolving the physician online identity crisis, according to a viewpoint piece published in the Aug. 14 issue of the Journal of the American Medical Association.

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Mediterranean Diet Reduces Stroke Risk in Some People

TUESDAY, Aug. 13 (HealthDay News) -- Among those with a particular genetic variant associated with an increased risk of type 2 diabetes, adherence to a Mediterranean diet reduces increased fasting glucose and lipids and reduces the risk of stroke, according to a study published online Aug. 13 in Diabetes Care.

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New Initiative Announced for Patient-Doc Collaboration

TUESDAY, Aug. 13 (HealthDay News) -- A new Center for Patient Partnership in Healthcare (CPPH) has been launched to advance physician-patient collaboration, according to a report published by the American College of Physicians (ACP).

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Perceived Doc Verbal Abuse Impairs Nurses' Work Attitude

TUESDAY, Aug. 13 (HealthDay News) -- For registered nurses (RNs), perceived verbal abuse by physicians correlates with less favorable work conditions and attitudes, according to a study published in Nursing Outlook.

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U.S. Hospitals Up Exchange of Electronic Health Information

MONDAY, Aug. 12 (HealthDay News) -- Between 2008 and 2012, hospitals significantly increased their exchange of electronic health information with other providers, according to research published in the August issue of Health Affairs.

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Guidelines for Post-HIV Exposure Management Updated

MONDAY, Aug. 12 (HealthDay News) -- Management and prophylaxis recommendations have been updated for health care providers with occupational exposure to HIV, according to guidelines published in the September issue of Infection Control and Hospital Epidemiology.

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Behaviors Associated With Child Obesity Can Differ by Gender

MONDAY, Aug. 12 (HealthDay News) -- Among middle-school children, risk factors and protective behaviors associated with obesity differ according to gender, according to research published online Aug. 12 in Pediatrics.

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Depression Modifies Type A Behavior, Mortality Link in T1DM

MONDAY, Aug. 12 (HealthDay News) -- For individuals with type 1 diabetes, type A personality is associated with lower all-cause mortality, with the correlation modified by depressive symptomatology, according to a study published online July 8 in Diabetes Care.

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Medical Center Farmers Market Aids in Medical Home Goals

MONDAY, Aug. 12 (HealthDay News) -- A seasonal farmers market at a medical center can support the institution's commitment to the goals of the medical home, according to a study published online Aug. 1 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Physicians' Malpractice Concerns Predict More Testing

FRIDAY, Aug. 9 (HealthDay News) -- Physicians' concerns about malpractice risk predict more aggressive diagnostic testing practices in office-based care, according to a study published in the August issue of Health Affairs.

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Obese Youth More Likely to Develop Asthma

FRIDAY, Aug. 9 (HealthDay News) -- Obese youth are more likely to develop asthma, and are more likely to have severe asthma, according to a study published online Aug. 6 in the American Journal of Epidemiology.

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First-Trimester Biomarker May Help Identify Early GDM Risk

FRIDAY, Aug. 9 (HealthDay News) -- Glycosylated fibronectin may be able to identify pregnant women during the first trimester at risk for developing gestational diabetes mellitus (GDM), according to a study published online Aug. 5 in Obstetrics & Gynecology.

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IPAs and PHOs Viable Option for Small Independent Practices

FRIDAY, Aug. 9 (HealthDay News) -- For small and medium-size independent practices, sharing care management and information technology resources with other practices through an independent practice association (IPA) or physician-hospital organization (PHO) is a viable alternative and may improve care for patients with chronic conditions, according to a study published in the August issue of Health Affairs.

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Cardiovascular Health Benefits With Active Travel to Work

THURSDAY, Aug. 8 (HealthDay News) -- Use of active travel to work is associated with lower likelihood of cardiovascular risk factors, according to a study published in the September issue of the American Journal of Preventive Medicine.

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Higher Glucose Levels Linked to Increased Dementia Risk

WEDNESDAY, Aug. 7 (HealthDay News) -- For older adults with and without diabetes, higher glucose levels are associated with an increased risk of dementia, according to a study published in the Aug. 8 issue of the New England Journal of Medicine.

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Italian Study Shows Gender Disparity in Diabetes Care

WEDNESDAY, Aug. 7 (HealthDay News) -- Compared to Italian men, women in Italy receive a poorer quality of diabetes care, and although difficulty attaining an ideal low-density lipoprotein cholesterol (LDL-C) level appears to be mostly related to pathophysiological factors, patient and physician attitudes play an important role in other process measures and outcomes, according to a study published online July 8 in Diabetes Care.

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Obesity Down for Low-Income Preschoolers in Many States

WEDNESDAY, Aug. 7 (HealthDay News) -- From 2008 to 2011, the prevalence of obesity decreased significantly among low-income young children in 18 states and the U.S. Virgin Islands, according to a study published in the Aug. 6 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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AMA, AHA Call for Realignment of Meaningful Use Stage 2

WEDNESDAY, Aug. 7 (HealthDay News) -- The American Medical Association (AMA) and American Hospital Association (AHA) are calling for additional flexibility in the timing of the adoption of stage 2 meaningful use of electronic health records, according to a letter written to the U.S. Department of Health and Human Services (HHS).

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Telephone Health Coaching Service Doesn't Cut Admissions

WEDNESDAY, Aug. 7 (HealthDay News) -- A telephone health coaching service is not associated with reductions in hospital admissions or in secondary care costs over 12 months, according to research published online Aug. 6 in BMJ.

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Cumulative Metformin Linked to Mortality Post-Prostate Cancer

WEDNESDAY, Aug. 7 (HealthDay News) -- Among elderly men with diabetes, increased cumulative duration of metformin following a prostate cancer (PC) diagnosis correlates with decreased all-cause and PC-specific mortality, according to a study published online Aug. 5 in the Journal of Clinical Oncology.

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For Women, Child Abuse Linked to Adult Thyroid Conditions

TUESDAY, Aug. 6 (HealthDay News) -- For women, childhood abuse correlates with significantly higher odds of thyroid conditions in adulthood, according to a study published online July 29 in the Journal of Aggression, Maltreatment & Trauma.

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IOM Describes Model to Evaluate Prevention of Obesity

TUESDAY, Aug. 6 (HealthDay News) -- A framework has been developed for evaluating national obesity prevention efforts, according to a report published by the Institute of Medicine.

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Patient-Specific Priorities May Help Clinicians Optimize Care

TUESDAY, Aug. 6 (HealthDay News) -- A mathematical model could help clinicians determine the choice and ranking of screening and preventive care services that offer the greatest increase in life expectancy for each patient, according to research published in the Aug. 6 issue of the Annals of Internal Medicine.

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Diet Encouragement Linked to Disordered Eating in Youth

TUESDAY, Aug. 6 (HealthDay News) -- Encouragement to diet by a significant other is strongly linked to young adults' disordered eating behaviors, according to a study published in the July/August issue of the American Journal of Health Promotion.

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No Increased Cancer Risk With Glargine Versus Human Insulin

TUESDAY, Aug. 6 (HealthDay News) -- There is no evidence that patients with diabetes who initiate insulin glargine have a higher risk of cancer than similar patients initiating human neutral protamine Hagedorn (NPH) insulin, according to a study published online July 22 in Diabetes Care.

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Participation Increases in Online CME Activities

MONDAY, Aug. 5 (HealthDay News) -- The number of physicians and non-physicians participating in continuing medical education (CME) has increased, especially in online activities, according to a report published by the Accreditation Council for Continuing Medical Education (ACCME).

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Obesity Markers Linked to Cancer Risk in Barrett's Esophagus

MONDAY, Aug. 5 (HealthDay News) -- For patients with Barrett's esophagus (BE), levels of leptin, high-molecular-weight adiponectin, and insulin resistance correlate with esophageal adenocarcinoma (EA) risk, according to a study published in the August issue of Clinical Gastroenterology and Hepatology.

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Sugary Drinks, Obesity Linked Even in Very Young Children

MONDAY, Aug. 5 (HealthDay News) -- Sugar-sweetened beverage consumption has been tightly linked to weight status among older children; children 5 years and younger who consume sugar-sweetened beverages such as soda or sports drinks are also more likely to become overweight or obese, according to a study published online Aug. 5 in Pediatrics.

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Antioxidants Don't Up Fertility Outcomes for Subfertile Women

MONDAY, Aug. 5 (HealthDay News) -- Antioxidant supplementation does not effectively increase rates of live birth or clinical pregnancy in subfertile women, according to a review published online Aug. 5 in The Cochrane Library.

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Electrical Lighting Alters Human Circadian Clock

FRIDAY, Aug. 2 (HealthDay News) -- Reduced exposure to sunlight combined with the widespread use of electrical lighting has altered human circadian physiology, according to a study published online Aug. 1 in Current Biology.

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No MI Rate Advantage for Aggressive T2DM Glucose Control

THURSDAY, Aug. 1 (HealthDay News) -- In patients with type 2 diabetes, more aggressive glucose-control strategies have variable short-term effects on microvascular complications, but they do not reduce the rate of myocardial infarction over four years of follow-up, according to a study published online July 22 in Diabetes Care.

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