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February 2018 Briefing - Emergency Medicine

Thu, Mar 1, 2018

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for February 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.

Medical Marijuana Laws Not Tied to Increases in Teen Use

TUESDAY, Feb. 27, 2018 (HealthDay News) -- Current evidence does not show that medical marijuana laws (MMLs) enacted through 2014 have led to increases in adolescent marijuana use, according to a review published online Feb. 22 in Addiction.

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RBC, Plasma Transfusions Drop From 2011 to 2014

TUESDAY, Feb. 27, 2018 (HealthDay News) -- From 2011 to 2014, there were decreases in red blood cell (RBC) and plasma transfusions among hospitalized patients, according to a research letter published in the Feb. 27 issue of the Journal of the American Medical Association.

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Early Studies Often Show Exaggerated Treatment Effect

TUESDAY, Feb. 27, 2018 (HealthDay News) -- Trials to evaluate drugs or devices used to treat chronic medical conditions that are published early in the chain of evidence often show an exaggerated treatment effect compared with subsequent trials, according to research published online Feb. 21 in the Mayo Clinical Proceedings.

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COPD Hospitalizations, Deaths, Prevalence Higher in Rural Areas

TUESDAY, Feb. 27, 2018 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) prevalence, Medicare hospitalizations, and deaths are significantly higher in rural areas, according to research published in the Feb. 23 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Women With Non-Obstructive CAD May Suffer From Myocardial Scars

TUESDAY, Feb. 27, 2018 (HealthDay News) -- Among women with suspected ischemia and no obstructive coronary artery disease (INOCA), the prevalence of baseline late gadolinium enhancement (LGE) indicating presence of myocardial scars is 8 percent, according to a research letter published in the Feb. 20 issue of Circulation, a Go Red For Women issue focused on women's heart health.

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Recommendations for Optimizing Hidden Curriculum in Medicine

MONDAY, Feb. 26, 2018 (HealthDay News) -- In a position paper published online Feb. 27 in the Annals of Internal Medicine, the American College of Physicians (ACP) presents recommendations for optimizing clinical learning environments by fostering a positive hidden curriculum in medicine.

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Understanding Rx Nonadherence Can Improve Adherence

MONDAY, Feb. 26, 2018 (HealthDay News) -- Understanding nonadherence in patients and encouraging a change in attitude toward patients and their medication can improve medication adherence, according to a report published by the American Medical Association (AMA).

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Artificial Intelligence May Help Prevent Physician Burnout

FRIDAY, Feb. 23, 2018 (HealthDay News) -- Artificial intelligence (AI), in which computers can be trained to recognize patterns in large quantities of data, may be able to reduce physicians' burdens, saving them time and energy, according to a report published in Medical Economics.

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FDA Warns of Possible Heart Risks Linked to Clarithromycin

FRIDAY, Feb. 23, 2018 (HealthDay News) -- The antibiotic clarithromycin (brand name: Biaxin) may increase the long-term risk of heart problems and death in patients with heart disease, according to U.S. health officials.

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FDA Cracks Down on Kratom Products

THURSDAY, Feb. 22, 2018 (HealthDay News) -- A number of kratom-containing dietary supplements are being recalled and destroyed by the manufacturer, the U.S. Food and Drug Administration announced Wednesday.

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CDC: No Change in Percentage of Uninsured in U.S. From '16 to '17

THURSDAY, Feb. 22, 2018 (HealthDay News) -- The percentage of uninsured U.S. persons of all ages did not change significantly from 2016 to the first nine months of 2017, according to a report published online Feb. 22 by the National Center for Health Statistics.

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No Evidence Use of SEP-1 Bundle Ups Survival in Sepsis

WEDNESDAY, Feb. 21, 2018 (HealthDay News) -- For adults with sepsis, use of the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) or its hemodynamic interventions is not associated with improved survival, according to a review published online Feb. 19 in the Annals of Internal Medicine.

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Administrative Costs Estimated at Health Care System

TUESDAY, Feb. 20, 2018 (HealthDay News) -- The estimated costs of billing range from $20 for a primary care visit to $215 for an inpatient surgical procedure, according to a study published in the Feb. 20 issue of the Journal of the American Medical Association.

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Burnout Found Prevalent Among Doctors in Single Health System

TUESDAY, Feb. 20, 2018 (HealthDay News) -- Burnout is prevalent among physicians, affecting over one-third of physicians in a single health system, and is associated with health care delivery, according to a research letter published online Feb. 19 in JAMA Internal Medicine.

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Mortality Risks of Exclusive Cigar, Cigarette, Pipe Use ID'd

TUESDAY, Feb. 20, 2018 (HealthDay News) -- Exclusive current cigarette and cigar use is associated with increased risk of all-cause mortality, according to a study published online Feb. 19 in JAMA Internal Medicine.

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Anticoagulants in Seniors With A-Fib, CKD Ups Stroke, ICH Risk

TUESDAY, Feb. 20, 2018 (HealthDay News) -- For older patients with concomitant chronic kidney disease and a new diagnosis of atrial fibrillation, anticoagulants are associated with increased risk of ischemic stroke and hemorrhage, but with reduced risk of all-cause mortality, according to a study published online Feb. 14 in The BMJ.

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Significant Challenges for Developmental-Behavioral Peds

FRIDAY, Feb. 16, 2018 (HealthDay News) -- The developmental-behavioral pediatric (DBP) workforce struggles to meet current service demands, according to a study published online Feb. 16 in Pediatrics.

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Influenza A(H3N2) Viruses Predominate 2017-2018 Season

FRIDAY, Feb. 16, 2018 (HealthDay News) -- Most influenza viruses identified in the 2017 to 2018 season are influenza A, with A(H3N2) viruses predominating, according to research published in the Feb. 16 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Rotating Night Shift Work Tied to Increased Odds of T2DM

FRIDAY, Feb. 16, 2018 (HealthDay News) -- Rotating shift work which includes night shifts is associated with increased odds of type 2 diabetes, according to a study published online Feb. 12 in Diabetes Care.

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Anti-Heroin Vaccine Shows Promise Against Lethal Doses

FRIDAY, Feb. 16, 2018 (HealthDay News) -- A toll-like receptor 9 (TLR9) agonist in the presence of alum is stable over a month and elicits strong anti-heroin antibody titers and blockade of heroin-induced antinociception, according to a study published online Feb. 8 in Molecular Pharmaceutics.

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AAP, POSNA Release 5 Pediatric Orthopedic Recommendations

THURSDAY, Feb. 15, 2018 (HealthDay News) -- As part of the Choosing Wisely campaign, the American Academy of Pediatrics and Pediatric Orthopaedic Society of North America have released a list of five orthopedic tests and procedures that are commonly ordered but are not always necessary for treatment of children with certain musculoskeletal conditions.

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Poor Outcomes With Systolic BP Below 120 mm Hg in HFpEF

WEDNESDAY, Feb. 14, 2018 (HealthDay News) -- For hospitalized patients with heart failure with preserved ejection fraction (HFpEF), poor outcomes are seen in association with a systolic blood pressure (SBP) level below 120 mm Hg, according to a study published online Feb. 14 in JAMA Cardiology.

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FDA Approves First Blood Test to Evaluate Potential Concussions

WEDNESDAY, Feb. 14, 2018 (HealthDay News) -- The first blood test designed to help health care professionals evaluate mild traumatic brain injury has been approved by the U.S. Food and Drug Administration.

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Safety of PERC Tool Validated for Very Low Risk PE Rule Out in ER

WEDNESDAY, Feb. 14, 2018 (HealthDay News) -- For low risk patients with suspected pulmonary embolism (PE), randomization to eight-item PE rule-out criteria (PERC) seems safe, according to a study published in the Feb. 13 issue of the Journal of the American Medical Association.

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Low Dose-Rate Far-UVC Light Can Inactivate Influenza Virus

WEDNESDAY, Feb. 14, 2018 (HealthDay News) -- Very low-dose 222-nm UVC ultraviolet light can inactivate more than 95 percent of aerosolized H1N1 influenza virus, according to a study published online Feb. 9 in Scientific Reports.

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Kidney Stone Incidence Increased Between 1984 and 2012

WEDNESDAY, Feb. 14, 2018 (HealthDay News) -- From 1984 to 2012, there was an increase in the incidence of symptomatic and asymptomatic kidney stones, according to a study published online Feb. 13 in the Mayo Clinic Proceedings.

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Four Best Practices Outlined to Prevent Health Care Cyberattacks

TUESDAY, Feb. 13, 2018 (HealthDay News) -- Four best practices outlined that can help prevent health care cyberattacks, which increased from 2016 to 2017, according to a report published in Managed Healthcare Executive.

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Education About Imaging Most Often Given by Ordering Provider

TUESDAY, Feb. 13, 2018 (HealthDay News) -- For patients undergoing imaging examinations, 78 percent reported receiving some form of pre-examination information, while 52 percent sought information themselves, according to a study published online Feb. 13 in Radiology.

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Opioid Use Linked to Risk of Invasive Pneumococcal Disease

MONDAY, Feb. 12, 2018 (HealthDay News) -- Opioid use is associated with elevated risk of invasive pneumococcal disease (IPD), especially for long-acting, high-potency, and high-dose opioids, according to a study published online Feb. 13 in the Annals of Internal Medicine.

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Risk of Fatal Traffic Crashes Up After April 20 Cannabis Event

MONDAY, Feb. 12, 2018 (HealthDay News) -- The risk of fatal traffic crashes is increased on April 20 in the United States, when many Americans celebrate the intoxicating properties of marijuana, with celebrations featuring synchronized mass consumption of cannabis at 4:20 p.m., according to a research letter published online Feb. 12 in JAMA Internal Medicine.

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EHRs Not Sufficient to Ensure Success in Value-Based Care

MONDAY, Feb. 12, 2018 (HealthDay News) -- Electronic health records (EHRs) are not sufficient to ensure success in value-based care, according to an article published in Medical Economics.

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Injury Scene Characteristics Linked to Injury Mortality

FRIDAY, Feb. 9, 2018 (HealthDay News) -- The characteristics of an injury scene are associated with injury mortality, with increased odds of death linked to increased distance to the nearest trauma center, according to a study published online Feb. 7 in JAMA Surgery.

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Top Consumer Concerns Reported About Physicians

FRIDAY, Feb. 9, 2018 (HealthDay News) -- Health care consumers have four major concerns regarding their physicians, according to a report published by Managed Healthcare Executive.

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CDC: Parent-Reported Head Injuries in 7.0 Percent of Children

FRIDAY, Feb. 9, 2018 (HealthDay News) -- In 2016, 8.3 percent of boys and 5.6 percent of girls aged 3 to 17 years had ever had a significant head injury in their lifetime, according to a February data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Poll: Personal Beliefs Shouldn't Allow Doctors to Refuse to Treat

THURSDAY, Feb. 8, 2018 (HealthDay News) -- Most people do not believe that professionals including health care providers should be allowed to refuse to provide services based on their conscience or beliefs, according to a recent HealthDay/The Harris Poll.

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FDA Says U.S. Will Now Produce Critical MRI Component

THURSDAY, Feb. 8, 2018 (HealthDay News) -- A long-feared shortage of a substance used in millions of medical imaging procedures each year in the United States appears to have been avoided, federal officials report.

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ER Visit Rate 92 Per 1,000 for Diabetes Patients 45 and Older

THURSDAY, Feb. 8, 2018 (HealthDay News) -- In 2015, the rate of diabetes-related visits to the emergency department was 92 per 1,000 persons for those aged 45 and older, according to a February data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Drowsiness May Be Factor in About 10 Percent of Crashes

THURSDAY, Feb. 8, 2018 (HealthDay News) -- Drowsiness may be a factor in about 10 percent of crashes, more than previously indicated in federal estimates, according to a report published by the AAA Foundation for Traffic Safety.

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FDA Says Herbal Drug Kratom Contains Opioids

WEDNESDAY, Feb. 7, 2018 (HealthDay News) -- The popular botanical drug kratom essentially is an opioid, the U.S. Food and Drug Administration declared Tuesday.

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Percentage of Children Having Asthma Attacks Decreasing

WEDNESDAY, Feb. 7, 2018 (HealthDay News) -- From 2001 to 2016 there was a decrease in the proportion of children having asthma attacks in the United States, according to research published in the Feb. 6 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Marked Variation Seen in Care Quality for TIA, Minor Stroke

WEDNESDAY, Feb. 7, 2018 (HealthDay News) -- Care quality for patients with transient ischemic attack (TIA) or minor stroke varies substantially across elements of care and facilities, according to a study published online Feb. 5 in JAMA Neurology.

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Heart Failure Guideline Adherence May Be Best Quality Measure

TUESDAY, Feb. 6, 2018 (HealthDay News) -- Hospital adherence to heart failure guidelines might be the best quality measure, according to a study published online Jan. 29 in Circulation.

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Head, Neck Imaging Uncommon in Patients With Palate Trauma

TUESDAY, Feb. 6, 2018 (HealthDay News) -- Patients presenting to the emergency department with a primary diagnosis of palate trauma often do not undergo head and neck imaging, according to a study published online Feb. 1 in JAMA Otolaryngology-Head and Neck Surgery.

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Opioid Prescribing Trends in the VA Similar to Other Settings

MONDAY, Feb. 5, 2018 (HealthDay News) -- Opioid prescribing trends in the Veterans Health Administration (VHA) from 2010 to 2016 followed similar trajectories as non-VHA settings, peaking around 2012 then declining, according to a study published online Jan. 29 in the Journal of General Internal Medicine.

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Health Care Use Down in Diabetes Patients With High Deductibles

MONDAY, Feb. 5, 2018 (HealthDay News) -- Overall, patients who switch to high-deductible health plans (HDHPs) have a decrease in health care utilization, though high-severity emergency department visit expenditures and hospitalization days increase in members from low-income neighborhoods, according to a study published online Jan. 30 in Diabetes Care.

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Distance From Advanced Cardiac Care Affects Odds of Survival

MONDAY, Feb. 5, 2018 (HealthDay News) -- In patients with acute coronary syndromes (ACS) complicated by cardiogenic shock (CS) in Nova Scotia, Canada, access to cardiac catheterization independently predicts survival, but those farthest from the center offering cardiac catheterization are the least likely to be transferred, according to a study published recently in the Canadian Journal of Cardiology.

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Humanities Exposure Positively Impacts Medical Students

MONDAY, Feb. 5, 2018 (HealthDay News) -- Exposure to the humanities correlates with less burnout and higher levels of positive personal qualities among medical students, according to a study published online Jan. 29 in the Journal of General Internal Medicine.

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Factors Identified That Impact Physicians IT Adoption

FRIDAY, Feb. 2, 2018 (HealthDay News) -- Physicians have considerable concerns about the efficacy and evidence base of health information technology (IT), according to a report published by the American Medical Association (AMA).

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Medicaid Expansion Cuts Out-of-Pocket Spending

THURSDAY, Feb. 1, 2018 (HealthDay News) -- States that expanded Medicaid cut the probability of non-elderly near-poor adults being uninsured and lowered average out-of-pocket spending, according to a study published online Jan. 24 in Health Affairs.

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AHA: Breast Cancer Patients at Increased Risk for CV Disease

THURSDAY, Feb. 1, 2018 (HealthDay News) -- Due to shared risk factors and impact on heart health from cancer treatment, comprehensive care is necessary for breast cancer patients to optimize both cancer treatment and cardiovascular health, according to a scientific statement from the American Heart Association published online Feb. 1 in Circulation.

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NSAID Users Commonly Exceed Daily Limit

THURSDAY, Feb. 1, 2018 (HealthDay News) -- The number of users who exceed the daily limit of nonsteroidal anti-inflammatory drugs (NSAIDs) is "nontrivial," according to a study published online Jan. 26 in Pharmacoepidemiology and Drug Safety.

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