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January 2018 Briefing - Emergency Medicine

Thu, Feb 1, 2018

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

Increased Risk of Appendicitis One Week After Colonoscopy

TUESDAY, Jan. 30, 2018 (HealthDay News) -- The risk of appendicitis is increased in the week following colonoscopy, according to a research letter published in the January issue of JAMA Surgery.

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Glucagon Underutilized in Prehospital, Emergency Settings

TUESDAY, Jan. 30, 2018 (HealthDay News) -- Glucagon is being underutilized in the prehospital and outpatient setting, according to a research letter published recently in the Annals of Internal Medicine.

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Case Report: Fentanyl Use Associated With Amnesia

MONDAY, Jan. 29, 2018 (HealthDay News) -- Another case of unusual amnestic syndrome that includes bilateral hippocampal lesions on magnetic resonance imaging has been described in a case report published online Jan. 30 in the Annals of Internal Medicine.

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Prevalence of PE Low for Patients Presenting to ER With Syncope

MONDAY, Jan. 29, 2018 (HealthDay News) -- For patients presenting to the emergency department with syncope, the prevalence of pulmonary embolism (PE) is low, according to a study published online Jan. 29 in JAMA Internal Medicine.

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Regulators Trying to Reduce Physician Burden Linked to EHR

MONDAY, Jan. 29, 2018 (HealthDay News) -- The Office of the National Coordinator for Health Information Technology (ONC) is trying to address some of the issues relating to physician electronic health record (EHR) burden, partly with the appointment of Don Rucker, M.D., who is skilled in informatics and board-certified in emergency and internal medicine, according to an article published in Medical Economics.

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Health Care Spending Up, Mainly Due to Rising Prices

MONDAY, Jan. 29, 2018 (HealthDay News) -- Americans under age 65 years who were insured through their employer spent more than ever before on health care in 2016, with faster spending growth in 2016 than in recent years, according to the Health Care Cost Institute (HCCI)'s annual Health Care Cost and Utilization Report.

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Pharmacist Education May Cut Junior Doctor Prescription Errors

MONDAY, Jan. 29, 2018 (HealthDay News) -- Pharmacist feedback and education is effective at reducing prescription writing errors by junior doctors in an inpatient setting, according to a study published online Jan. 24 in the Journal of Pharmacy Practice and Research.

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Heart Disease, Stroke Risk Up Even Smoking 1 Cigarette/Day

THURSDAY, Jan. 25, 2018 (HealthDay News) -- Smoking one cigarette per day is still associated with a significant increased risk of coronary heart disease and stroke, according to research published online Jan. 24 in The BMJ.

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Influenza, Some Viral URIs Increase Risk of Acute MI

WEDNESDAY, Jan. 24, 2018 (HealthDay News) -- Certain respiratory infections, especially influenza, are associated with an increased risk of acute myocardial infarction during the first seven days after respiratory specimen collection, according to a study published in the Jan. 25 issue of the New England Journal of Medicine.

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Prescribing of Opioids Adds to Patient Satisfaction With Care

WEDNESDAY, Jan. 24, 2018 (HealthDay News) -- Patients with musculoskeletal conditions who are using prescribed opioids are more likely to be highly satisfied with their care, according to a study published in the January/February issue of the Annals of Family Medicine.

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In-Hospital Cardiac Arrest Survival Differs With Time of Day

WEDNESDAY, Jan. 24, 2018 (HealthDay News) -- Survival after in-hospital cardiac arrest (IHCA) that occurs during off-hours remains lower versus on-hours IHCA, according to a study published in the Jan. 30 issue of the Journal of the American College of Cardiology.

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Housing Instability Linked to Poor Caregiver, Child Health

TUESDAY, Jan. 23, 2018 (HealthDay News) -- Housing instability is associated with adverse caregiver and child health among low-income renter households, according to a study published online Jan. 22 in Pediatrics.

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Available Evidence on Marijuana's Cardiovascular Effects Is Scant

TUESDAY, Jan. 23, 2018 (HealthDay News) -- The evidence examining associations between marijuana use and cardiovascular risk factors and outcomes is limited, according to a review published online Jan. 23 in the Annals of Internal Medicine.

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Closed-Head Injury May Induce TBI Even If No Concussive Sx

TUESDAY, Jan. 23, 2018 (HealthDay News) -- Closed-head impact injuries can induce pathologic traumatic brain injury, independent of concussive signs, according to a study published online Jan. 18 in Brain.

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Out-of-Pocket Expenditures Down With ACA Implementation

TUESDAY, Jan. 23, 2018 (HealthDay News) -- Implementation of the Affordable Care Act (ACA) was associated with reduced out-of-pocket spending, although increases were noted in mean premium spending, according to a study published online Jan. 22 in JAMA Internal Medicine.

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Diabetes Tied to Higher Rates of Serious Infection

TUESDAY, Jan. 23, 2018 (HealthDay News) -- Patients with diabetes, particularly type 1 diabetes mellitus (T1DM), are at increased risk of serious infection, according to a study published online Jan. 12 in Diabetes Care.

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New ACC/AHA Recs Developed for BP Evaluation, Management

MONDAY, Jan. 22, 2018 (HealthDay News) -- New recommendations have been developed for the prevention, detection, evaluation, and management of high blood pressure (BP). The recommendations are summarized in an article published online Jan. 23 in the Annals of Internal Medicine.

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Walmart Launches Disposal Solution for Opioids, Rx Meds

MONDAY, Jan. 22, 2018 (HealthDay News) -- Walmart is launching a first-of-its-kind opioid disposal solution in all company pharmacies, which is available at no cost, according to a press release from the company.

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Older Adults Less Likely to Have Provider-Ordered Flu Testing

MONDAY, Jan. 22, 2018 (HealthDay News) -- Older adults are less likely than younger adults to have provider-ordered influenza testing, according to a study published online Jan. 17 in the Journal of the American Geriatrics Society.

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Confusion Common in Seniors Prescribed Antibiotics for UTI

MONDAY, Jan. 22, 2018 (HealthDay News) -- Urinary tract infections (UTIs) are common in nursing home (NH) residents, and new or worsening confusion is strongly associated with antibiotic treatment for suspected UTI, according to a study published online Jan. 10 in the Journal of the American Geriatrics Society.

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Urinalysis Is Effective for UTIs in Younger Febrile Infants

FRIDAY, Jan. 19, 2018 (HealthDay News) -- For febrile infants age 60 days and younger, urinalysis is highly sensitive and specific for diagnosing urinary tract infections (UTIs), according to a study published online Jan. 16 in Pediatrics.

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24-Hour Primary Care Clinics Would Improve Continuity of Care

FRIDAY, Jan. 19, 2018 (HealthDay News) -- A 24-hour primary care clinic with multiple doctors offering round-the-clock care would actualize better and more sustainable care, according to a report published by the American Academy of Family Physicians.

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Pharmacist Participation in Stroke Response Cuts Door➜Needle Time

FRIDAY, Jan. 19, 2018 (HealthDay News) -- Having a pharmacist at bedside during acute ischemic stroke is associated with significantly shorter door-to-needle (DTN) times, according to a study published recently in the Annals of Pharmacotherapy.

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Telemedicine Tied to Faster ER Care in Rural Areas

THURSDAY, Jan. 18, 2018 (HealthDay News) -- Telemedicine cuts emergency department door-to-provider time in rural hospitals, according to a study published online Jan. 2 in Telemedicine and e-Health.

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Significant Ultrasound Practice Needed to Diagnose Appendicitis

THURSDAY, Jan. 18, 2018 (HealthDay News) -- There is a learning curve among novice emergency medicine residents in using emergency ultrasonography to diagnose acute appendicitis, according to a study published online Jan. 5 in the Journal of Clinical Ultrasound.

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Professionals Disagree About Asking Patients About Sexuality

THURSDAY, Jan. 18, 2018 (HealthDay News) -- National Health Service (NHS) England recently recommended that professionals ask all patients their sexual orientation at every opportunity, although opinions are divided on whether this is appropriate, according to an article published online Jan. 17 in The BMJ.

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Value of Doxylamine-Pyridoxine Questioned in Early Pregnancy

THURSDAY, Jan. 18, 2018 (HealthDay News) -- Doxylamine-pyridoxine may be beneficial for nausea and vomiting symptoms in early pregnancy, but the magnitude of the difference is very small and may indicate no clinically important benefit, according to a study published online Jan. 17 in PLOS ONE.

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Sulfonamides, Nitrofurantoin Being Given for UTI in Pregnancy

WEDNESDAY, Jan. 17, 2018 (HealthDay News) -- For women with urinary tract infections (UTIs), the most frequently prescribed antibiotics during the first trimester are nitrofurantoin, ciprofloxacin, cephalexin, and trimethoprim-sulfamethoxazole, according to research published in the Jan. 12 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Human Rhinovirus Commonly Detected in Febrile Infants

WEDNESDAY, Jan. 17, 2018 (HealthDay News) -- For febrile infants, human rhinovirus (HRV) is common, and detection does not alter risk of concomitant urinary tract infection or invasive bacterial infection, according to a study published online Jan. 17 in Pediatrics.

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Nearly 30 Percent of Veterans Report Current Tobacco Use

WEDNESDAY, Jan. 17, 2018 (HealthDay News) -- Overall, 29.2 percent of veterans report current use of one of five tobacco products, according to research published in the Jan. 12 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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USPSTF: Evidence Lacking for Nontraditional CVD Risk Factors

TUESDAY, Jan. 16, 2018 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) has concluded that current evidence is insufficient to assess the use of nontraditional risk factors for cardiovascular disease (CVD) risk assessment. They also conclude that evidence is lacking for the use of the ankle-brachial index (ABI) to screen for peripheral arterial disease (PAD) in asymptomatic individuals. These findings form the basis of two draft recommendation statements published online Jan. 16 by the USPSTF.

Evidence Review - CVD
Draft Recommendation Statement - CVD
Comment on Recommendation Statement - CVD
Evidence Review - PAD
Draft Recommendation Statement - PAD
Comment on Recommendation Statement - PAD

Increased Risk of Thrombosis in Myeloproliferative Neoplasms

TUESDAY, Jan. 16, 2018 (HealthDay News) -- Patients with myeloproliferative neoplasms (MPNs) have increased risk of arterial thrombosis and venous thrombosis across all age groups and MPN subtypes, according to a study published online Jan. 16 in the Annals of Internal Medicine.

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Spontaneous Pharynx Perforation After Forceful or Stifled Sneeze

TUESDAY, Jan. 16, 2018 (HealthDay News) -- Spontaneous pharyngeal perforation can occur after a forceful sneeze, according to a case report published online Jan. 15 in BMJ Case Reports.

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Non-Ventilator Hospital-Acquired Pneumonia Risk Affects All Ages

FRIDAY, Jan. 12, 2018 (HealthDay News) -- Non-ventilator hospital-acquired pneumonia (NV-HAP) is a significant burden in U.S. acute care hospitals and poses a risk to nonelderly, non-intensive unit (ICU) patients, according to research published in the January issue of the American Journal of Infection Control.

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Tamper-Resistant Oxycodone Misused Less Often in Australia

FRIDAY, Jan. 12, 2018 (HealthDay News) -- The tamper-resistant formulation of controlled-release oxycodone in Australia reduced tampering among high-risk populations, according to a study published online Jan. 10 in The Lancet Psychiatry.

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Worry About Deportation May Increase CV Risk Factors

FRIDAY, Jan. 12, 2018 (HealthDay News) -- Worry about deportation is significantly tied to higher levels of known cardiovascular risk factors, according to a study published online Jan. 8 in the Annals of Behavioral Medicine.

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Considerable Economic Burden for Asthma in United States

FRIDAY, Jan. 12, 2018 (HealthDay News) -- Asthma places a considerable economic burden on the United States, with a total cost of $81.9 billion in 2013, according to a study published online Jan. 12 in the Annals of the American Thoracic Society.

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Progress in Fighting Antibiotic Resistance Shown in CDC Map

THURSDAY, Jan. 11, 2018 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has released new data in its Antibiotic Resistance Investment Map, which shows states' progress in combating antibiotic resistance.

Press Release

AMA Online Tools Address Systems-Level Physician Burnout

THURSDAY, Jan. 11, 2018 (HealthDay News) -- Tools and resources have been developed to help address physician burnout at the systems level, which may affect more than half of doctors, according to a report published by the American Medical Association (AMA).

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More Sought Mental Health Specialty Care in 2008 to 2015

THURSDAY, Jan. 11, 2018 (HealthDay News) -- Between 2008 and 2015 there was an increase in the number of U.S. adults who received outpatient mental health care in the specialty sector, according to a study published in the December issue of Health Affairs.

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Economic Impact of Physicians Quantified for 2015

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- Physicians have a large economic impact across the nation, creating an aggregate of $2.3 trillion of economic activity and supporting employment of nearly 12.6 million Americans, according to a report published by the American Medical Association.

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Some Patients Would Choose Antibiotics for Appendicitis

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- Although most patients would choose surgical intervention for treatment of acute uncomplicated appendicitis, some would opt for antibiotics alone, according to a study published online Jan. 10 in JAMA Surgery.

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High-Risk Plaque on Coronary CTA Linked to Future MACE

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- For outpatients with stable chest pain, high-risk plaque found by coronary computed tomographic angiography (CTA) is associated with subsequent major adverse cardiovascular events (MACE), according to a study published online Jan. 10 in JAMA Cardiology.

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Unstable Housing Tied to More Diabetes-Related ER Visits

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- Unstable housing is associated with an increased likelihood of diabetes-related emergency department visits and hospitalization, according to a study published online Jan. 4 in Diabetes Care.

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AICDs Effective for Symptoms, Lethal Arrhythmia in Brugada

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- Implantable cardioverter-defibrillators (ICDs) are effective in young patients with symptomatic Brugada syndrome, according to a study published in the Jan. 16 issue of the Journal of the American College of Cardiology.

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School-Based Telemedicine Asthma Management Is Effective

WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- A School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) program can improve symptoms for children with persistent asthma, according to a study published online Jan. 8 in JAMA Pediatrics.

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Intense End-of-Life Care Found to Be Less Likely for VA Patients

TUESDAY, Jan. 9, 2018 (HealthDay News) -- Higher-intensity end-of-life care may be driven by financial incentives present in fee-for-service Medicare but not in the Veteran Affairs (VA) integrated system, according to a report published in the January issue of Health Affairs.

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HIV Screening Most Optimal at 25 Years of Age If No Risk Factors

TUESDAY, Jan. 9, 2018 (HealthDay News) -- For young adults without known risk factors, a one-time routine HIV screen at 25 years would optimize clinical outcomes and be cost-effective, according to a study published in the January issue of the Journal of Adolescent Health.

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Idiopathic Thrombocytopenic Purpura Tied to Higher CVD Risk

MONDAY, Jan. 8, 2018 (HealthDay News) -- There is an increased risk of developing cardiovascular disease (CVD) among patients with idiopathic thrombocytopenic purpura (ITP), especially those who undergo splenectomy, according to a study published online Jan. 3 in the Journal of Thrombosis and Haemostasis.

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CV Exercise Betters Cardiac Aging in Sedentary Middle-Aged Adults

MONDAY, Jan. 8, 2018 (HealthDay News) -- Two years of high-intensity exercise training (ExT) is associated with improved maximal oxygen uptake and reduced cardiac stiffness in previously sedentary healthy middle-aged adults, according to a study published online Jan. 8 in Circulation.

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2005 to 2015 Saw Fewer High School Students Having Sex

MONDAY, Jan. 8, 2018 (HealthDay News) -- For high school students, the prevalence of ever having had sexual intercourse decreased from 2005 to 2015, according to research published in the Jan. 5 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Pediatric Sports-, Recreation-Related Eye Injuries Common

MONDAY, Jan. 8, 2018 (HealthDay News) -- Pediatric sports- and recreation-related eye injuries are common, most often occurring among boys, according to a study published online Jan. 8 in Pediatrics.

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Repeated Flu Vaccinations Help Prevent Severe Infection

MONDAY, Jan. 8, 2018 (HealthDay News) -- Vaccination for influenza for multiple seasons is twice as effective in preventing severe influenza -- compared with non-severe influenza -- in older patients admitted to hospital, according to a study published in the Jan. 8 issue of CMAJ, the journal of the Canadian Medical Association.

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Physicians Frequently Continue to Work While Ill

FRIDAY, Jan. 5, 2018 (HealthDay News) -- Many physicians continue working and caring for patients while they are sick, according to an article published in Medical Economics.

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Socioeconomic Factors Associated With Opioid Prescriptions

FRIDAY, Jan. 5, 2018 (HealthDay News) -- Among disabled Medicare beneficiaries, county-level socioeconomic factors are associated with opioid prescriptions, with more prescriptions seen with lower socioeconomic indicators, according to a study published in the January issue of Medical Care.

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For Hospitals, No Benefit for Early Adoption of Financial Incentives

FRIDAY, Jan. 5, 2018 (HealthDay News) -- Hospitals that volunteered to be under financial incentives for more than a decade as part of the Premier Hospital Quality Incentive Demonstration (early adopters) do not have better process scores or lower mortality than hospitals where these incentives were implemented later under the Hospital Value-Based Purchasing program (late adopters), according to a study published online Jan. 4 in The BMJ.

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Half of Gastric Cancer Patients Diagnosed From ER Visit

THURSDAY, Jan. 4, 2018 (HealthDay News) -- Half of patients with gastric cancer (GC) are diagnosed as a result of an emergency department visit, which is independently associated with increased mortality, according to a study published recently in the American Journal of Surgery.

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Certain Stresses, Burnout Causing Some Women to Leave Medicine

THURSDAY, Jan. 4, 2018 (HealthDay News) -- Though equal numbers of men and women are now entering medical schools, the majority of physicians are still male, and female physicians face several unique stressors, according to a report published online in Medical Economics.

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Scripted Callbacks Do Not Prevent 30-Day Returns of ER Discharges

THURSDAY, Jan. 4, 2018 (HealthDay News) -- For older adults discharged to home from the emergency department, telephone follow-up does not improve outcomes, according to a study published online Dec. 22 in the Journal of the American Geriatrics Society.

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Esketamine Safe, Effective for Treatment-Resistant Depression

THURSDAY, Jan. 4, 2018 (HealthDay News) -- Esketamine seems to be efficacious and safe for patients with treatment-resistant depression (TRD), according to a study published online Dec. 27 in JAMA Psychiatry.

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CVD Risk Up With β2-Agonist, Antimuscarinic Antagonist Start

THURSDAY, Jan. 4, 2018 (HealthDay News) -- For patients with chronic obstructive pulmonary disease (COPD), new initiation of inhaled long-acting β2-agonists (LABAs) and long-acting antimuscarinic antagonists (LAMAs) is associated with increased risk of cardiovascular disease (CVD), according to a study published online Jan. 2 in JAMA Internal Medicine.

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Herpes Simplex Infrequently Found in Infant Meningitis Eval

WEDNESDAY, Jan. 3, 2017 (HealthDay News) -- Young infants assessed for central nervous system (CNS) infection rarely have herpes simplex virus (HSV), according to a study published online Jan. 3 in Pediatrics.

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Dasiglucagon Well Tolerated for Severe Hypoglycemia

WEDNESDAY, Jan. 3, 2018 (HealthDay News) -- Dasiglucagon is well tolerated and is associated with an early pharmacodynamic response similar to that of GlucaGen for severe hypoglycemia, according to a study published online Dec. 22 in Diabetes Care.

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Higher Risk of Musculoskeletal Disorders in Some Physicians

WEDNESDAY, Jan. 3, 2018 (HealthDay News) -- The prevalence of work-related musculoskeletal disorders (MSDs) appears to be high for at-risk physicians, according to a review published online Dec. 27 in JAMA Surgery.

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Silent Myocardial Infarction Linked to Heart Failure Risk

WEDNESDAY, Jan. 3, 2018 (HealthDay News) -- Silent myocardial infarction (SMI) is associated with an increased long-term risk of heart failure, according to a study published in the Jan. 2 issue of the Journal of the American College of Cardiology.

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Broader Statin Use Improves Atherosclerotic CVD Prevention

TUESDAY, Jan. 2, 2018 (HealthDay News) -- Guidelines that recommend statins for more people for primary prevention of atherosclerosis are likely to prevent more atherosclerotic cardiovascular disease (ASCVD) events than guidelines that recommend fewer people take statins, according to a study published online Jan. 1 in the Annals of Internal Medicine.

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Increase Seen in Gabapentinoid Use From 2002 to 2015

TUESDAY, Jan. 2, 2018 (HealthDay News) -- From 2002 to 2015 there was a substantial increase in gabapentinoid use, according to a research letter published online Jan. 2 in JAMA Internal Medicine.

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Fractional Exhaled NO Moderately Accurate to Diagnose Asthma

TUESDAY, Jan. 2, 2018 (HealthDay News) -- Fractional exhaled nitric oxide (FeNO) measurement can diagnose asthma in individuals aged 5 years and older with moderate accuracy, according to a review published online Dec. 20 in Mayo Clinic Proceedings.

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