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Depressed women at increased risk for stroke

Women who were depressed showed a 29% increased risk for having a stroke, according to a study in the September issue of Stroke: Journal of the American Heart Assn. If these women were taking an antidepressant, particularly selective serotonin reuptake inhibitors, the data showed they had a 39% greater chance of having a stroke. But researchers don't believe the medications alone necessarily account for the higher risk. Women taking antidepressants may be more deeply depressed, said An Pan, PhD, the study's lead author. And depression can result in patients having problems controlling other health issues linked to strokes such as diabetes and hypertension. These patients also tend to exercise less, another contributor to increased stroke risk. "[But] we don't want patients to withdraw their medication," said Pan, a research fellow at Harvard School of Public Health in Boston. Instead, he said, physicians should be aware of whether a patient has depression and other conditio ...

More details emerge on insurance tax credits and other reform standards

Washington -- The Dept. of Health and Human Services in August released three proposed rules addressing the enrollment of an estimated 30 million Americans in Medicaid and private health insurance through health insurance exchanges beginning in 2014. The three rules -- co-written by the Depts. of Treasury and Labor -- seek to implement a one-stop process to determine eligibility and enrollment for Medicaid and the Children's Health Insurance Program, and for tax credits to help purchase health insurance. "We are working with states to build a system where the responses will be immediate," said HHS Secretary Kathleen Sebelius. The enrollment systems will rely on electronic databases, including access to the most recent tax returns available to determine whether applicants will be eligible for government assistance. Applicants will provide a single set of information to determine eligibility for Medicaid, CHIP and the tax credits. The health system reform law provides for insura ...

Training helps surgical residents improve some communication skills

With some training, surgical residents can improve the quality of information they communicate to patients about a specific condition, such as prostate cancer. But the training doesn't improve more general communication skills, such as empathy, says a study in the August Archives of Surgery. The study focused on 44 University of Connecticut School of Medicine general surgery residents who participated in a three-part interactive program. The program featured learning principles of patient communication, role-playing, and hearing a surgeon's experience as a physician, patient and patient's spouse. Before the training, residents scored a median 65% on a checklist of items they needed to cover with patients, including explaining what type of cancer the patient has, asking about the patient's emotions and discussing treatment. After training, the median score for what the study called case-specific communication skills jumped to 84%. But improvement was not seen in general communi ...