Mar 31st, 2021 - Indiana's Medicaid expansion — with its "personal responsibility" provisions that require enrollees to pay monthly premiums and manage health savings accounts — proved no better at improving health and access to care than other state expansions, a federally commissioned study found. Even when compared with states that did not expand Medicaid, Indiana showed only mixed results in improving the h...

Jan 25th, 2021 - Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center. Southern states have higher rates of unreported COVID-related deaths than other regions of the country, according to a new study.

Jul 14th, 2020 - The COVID-19 pandemic has been a testing time for the already testy academic discourse. Decisions have had to be made with partial information. Information has come in drizzles, showers and downpours. The velocity with which new information has arrived has outstripped our ability to make sense of it. On top of that, the science has been politicized in a polarized country with a polarizing presi...

Jul 14th, 2020 - The COVID-19 pandemic has been a testing time for the already testy academic discourse. Decisions have had to be made with partial information. Information has come in drizzles, showers and downpours. The velocity with which new information has arrived has outstripped our ability to make sense of it. On top of that, the science has been politicized in a polarized country with a polarizing presi...

Oct 31st, 2019 - Medicare patients undergoing left atrial appendage (LAA) occlusion with the Watchman device in routine practice tended to be sicker than the trial populations, translating into higher mortality rates in the real world, researchers found. Among more than 13,000 Medicare beneficiaries with atrial fibrillation (Afib) who underwent LAA closure for stroke prevention, death and readmission rates were...

Oct 31st, 2019 - Physical activity appeared to be protective against the development of cognitive impairments among patients with rheumatoid arthritis (RA), a prospective cohort study found. Among patients with RA who met the 2008 U.S. Department of Health and Human Services physical activity guidelines, the odds ratio for worsening of memory was 0.83 (95% CI 0.72-0.96, P=0.01), reported Nancy A. Shadick, MD, o...

Oct 28th, 2019 - It would be wrong to count out death as a risk of catheter ablation of atrial fibrillation (Afib), according to real-world data. Early procedure-related mortality, occurring during index admission or readmission within 30 days after discharge, occurred in 0.46% of the 60,203 cases recorded in the Nationwide Readmissions Database in 2010-2015. That rate "exceeds the rates of procedural death rep...

Oct 27th, 2019 - Palliative care nursing mainly revolves around enhancing the quality of life of seriously ill patients and their families during life-sustaining treatment and at the end of life. Whether or not they have been trained in palliative care, critical care nurses frequently have patients who are in need of such care. How prepared do they feel? Or, what happens when critical care nurses encounter a la...

Oct 23rd, 2019 - Antihypertensive medications are better taken before bed than are upon awakening in the morning, according to a Spanish multicenter trial. Night-time blood pressure (BP) drug regimens nearly halved risk of cardiovascular disease (CVD) death, MI, coronary revascularization, heart failure, or stroke compared with day-time regimens over a median of 6.3 years (adjusted HR 0.55, 95% CI 0.50-0.61). E...

Oct 23rd, 2019 - Patients fresh out of cardiac valve surgery are no exception to the general underutilization of cardiac rehabilitation in the U.S., according to an observational cohort study. Enrolling in a comprehensive program of supervised exercise, cardiac risk factor modification, and psychosocial support was associated with reduced risks of re-hospitalization (adjusted HR 0.66, 95% CI 0.63-0.69) and mort...

Oct 23rd, 2019 - Note that some links may require subscriptions. Another health setback for former President Jimmy Carter, age 95: broken pelvis sustained in a fall at home. (USA Today) Weakening a Trump talking point, CMS says Obamacare policies in 2020 will sport average premiums 4% lower than in 2019. House Republicans are reportedly set to release an Affordable Care Act replacement plan, even as the White H...

Oct 21st, 2019 - Bone fractures are a risk to be considered when choosing the oral anticoagulant for a patient with non-valvular atrial fibrillation (Afib), a study suggested. The risk of poor osteoporotic outcomes was significantly lower with direct oral anticoagulant (DOAC) compared with vitamin K antagonist (VKA) therapy, as follows: Any fracture: 3.09% vs 3.77% (adjusted HR 0.85, 95% CI 0.74-0.97) Major ost...

Oct 20th, 2019 - A new tool for managing delirium and agitation in emergency room patients over age 65 features five steps: assess, diagnose, evaluate, prevent, and treat (ADEPT). Older patients frequently present at emergency rooms with agitation, behavioral changes, or confusion, but delirium is often underrecognized. Research has shown delirium among hospitalized patients is predictive of prolonged hospital ...

Oct 18th, 2019 - Note that some links may require subscriptions. Maternal and newborn complications at Houston hospitals increased dramatically in the 10 months after Hurricane Harvey. (Houston Chronicle) This week's vaping illness count from the CDC: 1,479 cases in 49 states (Alaska still a holdout) and 33 deaths. Increasing women's testosterone levels may improve physical performance, endurance, and muscle ma...

Oct 17th, 2019 - WASHINGTON -- What is often preventable but costs Medicare and Medicaid $37.5 billion annually? The answer: falls and subsequent injuries to beneficiaries. "Falls are the leading cause of fatal and non-fatal injuries for older Americans, often leading to a downward spiral with serious consequences," Sen. Susan Collins (R-Maine), chair of the Senate Aging Committee, said Wednesday at a hearing o...

Oct 17th, 2019 - Circulating tumor DNA (ctDNA) in post-chemotherapy blood samples identified patients with stage III colorectal cancer at high risk of disease recurrence, a prospective study from Australia found. In 96 consecutive patients, 30% of those with detectable ctDNA following adjuvant chemotherapy were disease-free 3 years later versus 77% of those with undetectable ctDNA (HR 6.8, 95% CI 11.0-157.0, P...

Oct 17th, 2019 - Failure to achieve a target serum urate level among patients with gout was associated with a doubling of total and cardiovascular mortality, European researchers reported. Among patients whose serum urate levels remained above the internationally recommended target of 6 mg/dL, the adjusted hazard ratio for overall mortality was 2.33 (95% CI 1.60-3.41, P<0.001), according to Fernando Pérez Ruiz,...

Oct 16th, 2019 - Use of laparoscopic Nissen fundoplication was significantly superior to medical therapy at 1 year in selected patients with true refractory heartburn, although a third of surgery patients did not respond to the procedure, a randomized Veterans Affairs (VA) study found. The study also found that actual proton pump inhibitor (PPI)-refractory and reflux-related heartburn was present in only a mino...

Oct 16th, 2019 - Angiotensin receptor blockers (ARBs) were associated with a higher risk of death by suicide compared with angiotensin-converting enzyme (ACE) inhibitors, according to a Canadian population-based study of seniors. The excess risk (adjusted OR 1.63, 95% CI 1.33-2.00) persisted even after a sensitivity analysis excluding people with a history of self-harm (OR 1.60, 95% CI 1.29-1.98), reported Tony...

Oct 15th, 2019 - Cefiderocol, a new antibiotic, appeared effective and generally safe for treatment of complicated urinary tract infections (cUTI) including pyelonephritis in patients with limited treatment options, FDA staff indicated in briefing documents ahead of an advisory committee meeting scheduled for Wednesday. However, questions remained about its use in critically ill patients with carbapenem-resista...