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In an integrated health plan and care delivery system, before and after a medical home redesign, proportional increases in copay-free secure messaging and telephone encounters were associated with additional primary care office visits for individuals with diabetes.
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The FDA has approved another drug combination for the treatment of chronic weight management, combining two old drugs, naltrexone and bupropion, in a fixed combination. Naltrexone is an opioid antagonist and bupropion is a commonly prescribed antidepressant.
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Since two-thirds of American adults are currently overweight or obese, we would all like to be able to help patients choose the best diet. The list of choices and categories is lengthy, with vocal advocates for the Atkins diet, the Zone diet, South Beach diet, Jenny Craig, Ornish, etc. Of course, were any of these diets sufficiently effective and easily adopted that they could gain widespread advocacy, we wouldnt be faced with such an obesity epidemic in the first place! So, apparently there is no simple answer. Among the choices we have, then, which one might be the best?
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A pooled analysis of four clinical trials concluded that treatment with onabotulinumtoxinA at doses of 75-260 U administered every 12 weeks for up to five treatment cycles was efficacious, safe, and well tolerated for the prophylaxis of headache in adults with chronic migraine.
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The highest morbidity and mortality consequences of influenza occur in senior citizens. The efficacy of standard flu vaccine varies depending on the outcome that is examined
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SYNOPSIS: People who were randomized to a low-carbohydrate diet lost more weight than those who were randomized to a low-fat diet over a year. They also had greater improvements in risk factors for cardiovascular disease.
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SYNOPSIS: The incidence of colorectal cancer is much less in people > 75 years of age compared with ages 50-74, even in patients with a personal history of colon cancer or adenomatous polyps. Complication rates for colonoscopy are high in the elderly ¡Ý age 75 and in patients with comorbidities. Surveillance colonoscopy may be stopped in the advanced elderly and in comorbid elderly patients.
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SYNOPSIS: A meta-analysis and systematic review found vitamin C supplementation improved endothelial function in patients with diabetes, atherosclerosis, and heart failure.
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A new sodium glucose co-transporter 2 (SGLT2) has been approved by the FDA. Empagliflozin follows canagliflozin (Invokana) and dapagliflozin (Farxiga)as the third entry in this group. These drugs reduce plasma glucose levels by reducing renal absorption of filtered glucose. Empagliflozin is marketed by Boehringer Ingelheim as Jardiance.
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In a randomized, double-blind, placebo-controlled trial, clonidine and venlafaxine both proved superior to placebo in reducing hot flashes in breast cancer patients. The study was insufficiently powered to prove superiority of one drug over the other. However, venlafaxine produced earlier reductions and it appeared clonidine had more sustained effect (i.e., at 12 weeks of treatment).
