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MONTHLY BRIEFINGS - Nov 2017


September 2017 Briefing - Emergency Medicine

Mon, Oct 2, 2017

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for September 2017. 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.

Embezzlement Widespread in Medical Practices

FRIDAY, Sept. 29, 2017 (HealthDay News) -- Embezzlement is widespread among medical practices, and knowing the warning signs is helpful for preventing it, according to an article published in Medical Economics.

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End-Stage Renal Disease Patients' Readmission Rate High

FRIDAY, Sept. 29, 2017 (HealthDay News) -- Nearly a quarter of hospital admissions among patients with end-stage renal disease (ESRD) on hemodialysis (HD) have a subsequent 30-day unplanned readmission, according to a study published online Sept. 28 in the Clinical Journal of the American Society of Nephrology.

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More Than 78 Percent of Health Care Personnel Receive Flu Shot

THURSDAY, Sept. 28, 2017 (HealthDay News) -- More than 78 percent of health care personnel (HCP) and 53.6 percent of pregnant women received influenza vaccination during the 2016-2017 influenza season, according to two studies published in the Sept. 29 issue of Morbidity and Mortality Weekly Report.

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Optimal Length of Post-Op Opioid Pain Medication Rx Identified

THURSDAY, Sept. 28, 2017 (HealthDay News) -- The optimal length of opioid pain medication prescription after common surgical procedures lies between the observed median prescription length and the early nadir, according to a study published online Sept. 27 in JAMA Surgery.

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Over 25 Million Unsafe Abortions Occur Each Year

THURSDAY, Sept. 28, 2017 (HealthDay News) -- An estimated 25.1 million unsafe abortions were performed worldwide each year between 2010 and 2014, with the vast majority occurring in developing countries, according to a study published online Sept. 27 in The Lancet.

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Individualized SBP Tx Cuts Risk for Post-Op Organ Dysfunction

WEDNESDAY, Sept. 27, 2017 (HealthDay News) -- Management targeting an individualized systolic blood pressure (SBP) is associated with reduced risk of organ dysfunction among patients undergoing major surgery who are at increased risk of postoperative complications, according to a study published in the Sept. 26 issue of the Journal of the American Medical Association.

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Working With a Scribe Improves Physician Satisfaction

WEDNESDAY, Sept. 27, 2017 (HealthDay News) -- Working with a scribe significantly improves physicians' overall satisfaction, satisfaction with chart quality and accuracy, and charting efficiency, according to a study published online Sept. 11 in the Annals of Family Medicine.

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Cancer Risk Up for RA Patients With Venous Thromboembolism

WEDNESDAY, Sept. 27, 2017 (HealthDay News) -- Patients with rheumatoid arthritis (RA) and venous thromboembolism (VTE) have increased risk of cancer in the first year after VTE and during a longer follow-up period, according to a study published online Sept. 15 in the Journal of Thrombosis and Haemostasis.

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Fragmented QRS Predicts Cardiac Death During Exercise

WEDNESDAY, Sept. 27, 2017 (HealthDay News) -- Fragmented QRS complex may predict risk of exercise-related sudden cardiac death, according to a study published online Sept. 20 in the Journal of Cardiovascular Electrophysiology.

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Low-Dose Oxygen No Benefit in Adults With Acute Stroke

TUESDAY, Sept. 26, 2017 (HealthDay News) -- The prophylactic use of low-dose oxygen does not reduce death or disability at three months among patients with acute stroke, according to a study published in the Sept. 26 issue of the Journal of the American Medical Association.

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CDC Launches Campaign to Fight Prescription Opioid Epidemic

TUESDAY, Sept. 26, 2017 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention is launching a communication campaign featuring accounts of people recovering from opioid use disorder, and those who have lost someone to opioid overdose, in an effort to fight the prescription overdose epidemic.

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Blame Common in Patient Safety Incident Reports

TUESDAY, Sept. 26, 2017 (HealthDay News) -- Blame is a common element in family practice patient safety incident reports, according to a study published in the September/October issue of the Annals of Family Medicine.

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Back Pain in Older Men Tied to Incident Vertebral Fractures

TUESDAY, Sept. 26, 2017 (HealthDay News) -- Incident, clinically undiagnosed radiographic vertebral fractures (VFs) are associated with increased likelihood of back pain symptoms, according to a study published online Sept. 7 in the Journal of Bone and Mineral Research.

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Private Vehicle Transport Cuts Death After Penetrating Injury

MONDAY, Sept. 25, 2017 (HealthDay News) -- For patients with gunshot or stab wounds, private vehicle transport is associated with significantly lower likelihood of death than emergency medical services (EMS) transport, according to a study published online Sept. 20 in JAMA Surgery.

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AAP Offers Guidance for Infectious Disease in Sports

MONDAY, Sept. 25, 2017 (HealthDay News) -- Participation in organized sports can potentially expose athletes to infectious diseases, with major risk factors including skin-to-skin contact, environmental exposures and physical trauma, and sharing of equipment, according to a clinical report published online Sept. 25 in Pediatrics.

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Worker Contribution to Health Benefits Up in 2017

MONDAY, Sept. 25, 2017 (HealthDay News) -- In 2017, health benefits coverage remained stable, while workers faced considerable variation in costs, according to a report published online Sept. 19 in Health Affairs.

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Fasting Blood Glucose Trajectory May Predict Future MI

FRIDAY, Sept. 22, 2017 (HealthDay News) -- For individuals without diabetes, certain fasting blood glucose (FBG) trajectories are associated with the risk of future myocardial infarction (MI), according to a study published online Sept. 8 in Diabetes Care.

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Concussion May Increase Multiple Sclerosis Risk

FRIDAY, Sept. 22, 2017 (HealthDay News) -- Concussion during adolescence increases the risk of subsequent multiple sclerosis (MS) diagnosis, according to a study published online Sept. 4 in the Annals of Neurology.

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Montelukast Associated With Nightmares, Depression

THURSDAY, Sept. 21, 2017 (HealthDay News) -- Montelukast appears to be linked to neuropsychiatric side effects, such as depression, aggression, nightmares, and headaches, according to a review published online Sept. 20 in Pharmacology Research and Perspectives.

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Insurer Market Power Lowers Providers' Prices

WEDNESDAY, Sept. 20, 2017 (HealthDay News) -- Insurers have the bargaining power to reduce provider prices in highly concentrated provider markets, according to a report published in the September issue of Health Affairs.

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Type 2 Myocardial Infarction Definition Impacts Prognosis

WEDNESDAY, Sept. 20, 2017 (HealthDay News) -- Definition of type 2 myocardial infarction (T2MI) using a method that does not require the presence of coronary artery disease is associated with a lower event-related mortality rate, according to a study published in the Sept. 26 issue of the Journal of the American College of Cardiology.

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Attempts to Prevent Tongue Swallowing Hinder Resuscitation

WEDNESDAY, Sept. 20, 2017 (HealthDay News) -- For athletes with cardiac arrest, attempts to prevent tongue swallowing are an obstacle to resuscitation, according to a study published online Sept. 19 in HeartRhythm.

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Deaths, Cardiac Arrest Not Rare in Triathlon Participants

TUESDAY, Sept. 19, 2017 (HealthDay News) -- The incidence of deaths or cardiac arrest is 1.74 per 100,000 USA Triathlon participants, according to a study published online Sept. 19 in the Annals of Internal Medicine.

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ACP Does Not Support Legalization of Assisted Suicide

TUESDAY, Sept. 19, 2017 (HealthDay News) -- The American College of Physicians (ACP) does not support the legalization of physician-assisted suicide, a practice that raises ethical, clinical, and other concerns, according to a position paper published online Sept. 19 in the Annals of Internal Medicine.

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Drills Assess ER Response to Communicable Disease

MONDAY, Sept. 18, 2017 (HealthDay News) -- A series of mystery patient drills was used to assess the emergency department response to patients with communicable disease of public health concern in New York City; the results were published in the Sept. 15 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Physicians Tweeting About Drugs May Have Conflict of Interest

FRIDAY, Sept. 15, 2017 (HealthDay News) -- Most physicians on Twitter with a financial conflict of interest (FCOI) and frequent tweets mention specific drugs for which they have a conflict, according to a study published in the September issue of The Lancet Haematology.

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Mental Health, Dental Issues Top Avoidable ER Visits

FRIDAY, Sept. 15, 2017 (HealthDay News) -- Mental health and dental conditions account for a significant number of "avoidable" emergency department visits, according to a study published online Aug. 31 in the International Journal for Quality in Health Care.

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EHR Data May Beat Claims Data in Assessing Sepsis Incidence

FRIDAY, Sept. 15, 2017 (HealthDay News) -- Sepsis is present in 6 percent of adult hospitalizations, with no change in incidence from 2009 to 2014 based on electronic health record (EHR) data in contrast to claims-based analyses, according to a study published online Sept. 13 in the Journal of the American Medical Association.

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Hospital Quality Independently Impacts Readmission Rates

FRIDAY, Sept. 15, 2017 (HealthDay News) -- Hospital quality contributes to readmission rates independent of factors involving patients, according to a study published in the Sept. 14 issue of the New England Journal of Medicine.

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Conjunctivitis Prevalence Higher for Adult Women Than Men

FRIDAY, Sept. 15, 2017 (HealthDay News) -- Adult women have a higher prevalence of conjunctivitis than men, and cases peak in the spring, according to a research letter published online Sept. 14 in JAMA Ophthalmology.

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'Science Spin' Found Prevalent in Biomedical Literature

FRIDAY, Sept. 15, 2017 (HealthDay News) -- Spin in biomedical literature (also referred to as "science hype") is prevalent, with trials having the highest and greatest variability in the prevalence of spin, according to a review published online Sept. 11 in PLOS Biology.

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Suicide Attempts in U.S. Up From 2004-2005 to 2012-2013

WEDNESDAY, Sept. 13, 2017 (HealthDay News) -- From 2004-2005 to 2012-2013 there was an overall increase in suicide attempts among U.S. adults, according to a study published online Sept. 13 in JAMA Psychiatry.

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Some Aspects of Empathy Improve During Medical Training

WEDNESDAY, Sept. 13, 2017 (HealthDay News) -- Certain aspects of empathy improve during medical student training, according to a study published online Sept. 7 in Medical Education.

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Being Heard Key for Women After Gender-Based Violence

TUESDAY, Sept. 12, 2017 (HealthDay News) -- For women who have experienced gender-based violence, feelings of being listened to and respected are important for defining a positive health care encounter, according to research published online Aug. 22 in the Journal of Clinical Nursing.

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Are Physicians Obligated to Help on Planes?

TUESDAY, Sept. 12, 2017 (HealthDay News) -- Does being a physician carry a moral obligation to respond to calls for medical assistance on airplanes? That is the topic of an article published in the Sept. 12 issue of the Journal of the American Medical Association.

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Warfarin, Rivaroxaban Similarly Safe, Effective

TUESDAY, Sept. 12, 2017 (HealthDay News) -- For cases of mild atrial fibrillation (AF)-related acute ischemic stroke, rivaroxaban and warfarin are similarly safe and effective at preventing recurrent stroke, according to a study published online Sept. 11 in JAMA Neurology.

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Chronic Dosing of Apricot Kernel Extract May Lead to Hypoxia

TUESDAY, Sept. 12, 2017 (HealthDay News) -- Chronic dosing of apricot kernel extract can result in hypoxia and cyanide toxicity, according to a report published online Sept. 11 in BMJ Case Reports.

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Antibiotic Rx Adherence Varies Widely in Sickle Cell Care

TUESDAY, Sept. 12, 2017 (HealthDay News) -- Adherence to antibiotic guidelines for acute chest syndrome (ACS) in children with sickle cell disease (SCD) varies widely, according to a study published online Sept. 11 in JAMA Pediatrics.

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Most Opioid Use Concentrated in Top 10 Percent of Users

TUESDAY, Sept. 12, 2017 (HealthDay News) -- The top 10 percent of privately insured U.S. adults without cancer using opioids account for most opioid use, according to a research letter published online Sept. 12 in the Annals of Internal Medicine.

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CDC: Human Campylobacter Linked to Pet Store Puppies

MONDAY, Sept. 11, 2017 (HealthDay News) -- Bacterial infections that have sickened 39 people in seven states have been linked to puppies sold through Petland, a national pet store chain, U.S. health officials say.

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'Modest at Best' Discriminatory Ability for CBC Test in Infants

MONDAY, Sept. 11, 2017 (HealthDay News) -- Complete blood cell count parameters at commonly used or optimal thresholds do not offer high accuracy in identifying invasive bacterial infections (IBIs) in febrile infants (≤60 days of age), according to a study published online Sept. 11 in JAMA Pediatrics.

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Age Legislation Cuts Off-Road-Vehicle-Related Injury Rate

MONDAY, Sept. 11, 2017 (HealthDay News) -- The population-based rate of off-road-vehicle (ORV)-related injuries was reduced following a 2010 Massachusetts law restricting their use by children aged younger than 14 years and regulating their use by children up to age 18 years, according to a study published online Sept. 11 in Pediatrics.

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Diverse Neurological Effects Linked to Anti-PD-1 Therapy

MONDAY, Sept. 11, 2017 (HealthDay News) -- Neurological complications associated with anti-programmed death 1 (PD-1) antibody treatment have a diverse phenotype, according to a study published online Sept. 5 in JAMA Neurology.

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Zoonotic Chlamydia caviae Tied to Community-Acquired Pneumonia

FRIDAY, Sept. 8, 2017 (HealthDay News) -- Three cases of community-acquired pneumonia involving Chlamydia caviae after exposure to ill guinea pigs have been described, according to a research letter published online Sept. 6 in the New England Journal of Medicine.

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Budget Cuts Threaten Research on Antimicrobial Resistance

THURSDAY, Sept. 7, 2017 (HealthDay News) -- Proposed budget cuts could seriously hamper efforts to address antimicrobial resistance (AMR), according to an article published online Sept. 4 in the Annals of Internal Medicine.

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Intervention Beneficial for Acute Gastroenteritis Patients

THURSDAY, Sept. 7, 2017 (HealthDay News) -- Implementation of a clinical pathway to improve care of acute gastroenteritis (AGE) patients is associated with a sustained reduction in intravenous (IV) fluid use and length of stay (LOS) in the pediatric emergency department (ED), according to a study published online Sept. 7 in Pediatrics.

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Clinical Oral Food Challenges Result in Few Reactions

THURSDAY, Sept. 7, 2017 (HealthDay News) -- Open, nonresearch low-risk oral food challenges (OFCs) result in few allergic reactions, according to a study published online Sept. 7 in the Annals of Allergy, Asthma & Immunology.

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Sudden Cardiac Arrest After Food Linked to Brugada Syndrome

WEDNESDAY, Sept. 6, 2017 (HealthDay News) -- Having a sudden cardiac arrest after eating a large bite of food may be an indication of Brugada syndrome, according to a case study published online Sept. 6 in Pediatrics.

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Acute Diverticulitis Recurrence More Likely With Barium Enema

WEDNESDAY, Sept. 6, 2017 (HealthDay News) -- For patients with acute diverticulitis, recurrence is more likely among those undergoing barium enema, according to a study published online Aug. 30 in the Journal of Digestive Diseases.

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Docs Should Be Aware of Family Beliefs Regarding Nondisclosure

WEDNESDAY, Sept. 6, 2017 (HealthDay News) -- Physicians should be aware of societal codes of conduct that affect family beliefs and behaviors regarding information disclosure to pediatric patients, according to a study published online Sept. 5 in JAMA Pediatrics.

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Racial Variation in Antibiotic Prescribing for Viral ARTI

TUESDAY, Sept. 5, 2017 (HealthDay News) -- Non-Hispanic black and Hispanic children are less likely than non-Hispanic white children to receive antibiotics for viral acute respiratory tract infection (ARTI) in the pediatric emergency department (PED), according to a study published online Sept. 5 in Pediatrics.

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CYP2C9 Variants Linked to Clinical Events in VTE

TUESDAY, Sept. 5, 2017 (HealthDay News) -- For elderly patients treated with vitamin K antagonists for venous thromboembolism (VTE), CYP2C9 variants are associated with any clinical event, according to a study published online Aug. 22 in the Journal of Thrombosis and Haemostasis.

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Climate Change May Be the Cause of More Roadway Deaths

FRIDAY, Sept. 1, 2017 (HealthDay News) -- America's roads may become more dangerous as an unexpected consequence of climate change, according to a report published online Aug. 31 in Injury Prevention.

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CDC: Fentanyl Driving Rise in Opioid-Linked Deaths in U.S.

FRIDAY, Sept. 1, 2017 (HealthDay News) -- Fentanyl is a key player in America's continuing epidemic of opioid-related overdose deaths, according to two reports published in the Sept. 1 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Suicide Risk Up in Younger Patients With Chronic Illness

FRIDAY, Sept. 1, 2017 (HealthDay News) -- Young adults with chronic diseases like asthma and diabetes are more than four times as likely to attempt suicide as their healthy peers, according to a study published online Aug. 17 in the Canadian Journal of Psychiatry.

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Electronic Alert Doesn't Up Appropriate Thromboprophylaxis

FRIDAY, Sept. 1, 2017 (HealthDay News) -- A computer-based alert system with a Geneva Risk Score calculation tool in the electronic patient chart does not improve appropriate thromboprophylaxis in patients admitted to general medical wards, according to a study published online Aug. 24 in the Journal of Thrombosis and Haemostasis.

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