November 2016 Briefing - Emergency Medicine

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Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for November 2016. 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.

NIAAA Two-Question Alcohol Screen Valid in Pediatric ERs

WEDNESDAY, Nov. 30, 2016 (HealthDay News) -- The National Institute of Alcohol Abuse and Alcoholism (NIAAA) two-question alcohol screen is valid for use within pediatric emergency departments (PEDs), according to a study published online Nov. 29 in Pediatrics.

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Clinical Practice Guideline on UTI in Febrile Young Reaffirmed

TUESDAY, Nov. 29, 2016 (HealthDay News) -- The 2011 clinical practice guideline (CPG) on urinary tract infection (UTI) in young children has been reaffirmed, according to a report published online Nov. 28 in Pediatrics.

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Older Fallers Have Often Been Administered High-Risk Drugs

MONDAY, Nov. 28, 2016 (HealthDay News) -- Older fallers have often been administered high-risk medications, frequently at higher-than-recommended doses, according to a study published online Nov. 28 in the Journal of the American Geriatrics Society.

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Recommended Tx Adherence Low in Pediatric Acute Seizure

MONDAY, Nov. 28, 2016 (HealthDay News) -- For pediatric patients transported for an acute seizure, adherence to recommended treatment is poor, according to a study published online Nov. 23 in Pediatrics.

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In Acetaminophen-Induced Acute Liver Failure, FABP1 IDs Mortality

MONDAY, Nov. 28, 2016 (HealthDay News) -- Serum liver-type fatty acid binding protein (FABP1) early (day one) or late (day three to five) levels are associated with mortality in patients with acetaminophen (APAP)-induced acute liver failure (ALF), according to a study published online Nov. 18 in Hepatology.

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Survey IDs Factors Influencing Physician Recruitment

WEDNESDAY, Nov. 23, 2016 (HealthDay News) -- Factors that influence whether an internal medicine physician will accept a position include opportunities for improved work-life balance as well as compensation, according to an article published in Medical Economics.

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Initial Hospital Contact for Alcohol Issues Predicts Cirrhosis

WEDNESDAY, Nov. 23, 2016 (HealthDay News) -- An initial hospital contact for alcohol problems is a significant predictor of alcoholic liver cirrhosis, particularly for patients 40 to 59 years and those diagnosed with harmful use or dependence, according to a study published online Nov. 16 in Hepatology.

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Rising Rx, ER Prices Pushing U.S. Health Care Spending Up

TUESDAY, Nov. 22, 2016 (HealthDay News) -- Privately insured Americans spent nearly 5 percent more on health care last year than in 2014; this increase was significantly more than that seen in previous years and reflects higher costs for prescription drugs, emergency department visits, and hospitalizations, according to a report published Nov. 22 by the Health Care Cost Institute.

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Four ER Visits for Adverse Drug Events Per 1,000 People

TUESDAY, Nov. 22, 2016 (HealthDay News) -- In 2013 to 2014, the estimated prevalence of emergency department visits for adverse drug events was four per 1,000 individuals, according to research published in the Nov. 22 issue of the Journal of the American Medical Association.

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Computer Order Entry System Ups Antimicrobial Policy Compliance

TUESDAY, Nov. 22, 2016 (HealthDay News) -- Use of a computerized physician order entry (CPOE) system can improve compliance with antimicrobial restriction policies, according to a study published online Nov. 16 in the Journal of Pharmacy Practice and Research.

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Discussing Opioid Risks With Patients Reduces Misuse

TUESDAY, Nov. 22, 2016 (HealthDay News) -- Discussing the risk of long-term opioid use disorder with patients is associated with reduced misuse of opioids, according to research published in the November/December issue of the Annals of Family Medicine.

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Playing 'Choking Game' Alone Can Indicate Heightened Suicide Risk

MONDAY, Nov. 21, 2016 (HealthDay News) -- About 4 percent of U.S. teens surveyed admit to trying the "choking game," a potentially deadly game of temporary strangulation, and young people who play the game alone are much more likely to harbor thoughts of suicide, according to a study published online Nov. 21 in Pediatrics.

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Retail Clinics Don't Reduce ER Visits for Minor Ailments

MONDAY, Nov. 21, 2016 (HealthDay News) -- Having retail health clinics near hospitals does not reduce emergency department visits for minor health problems, according to a study published online Nov. 10 in the Annals of Emergency Medicine.

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CT Measures Can Accurately Identify Stroke Onset

FRIDAY, Nov. 18, 2016 (HealthDay News) -- Computed tomography (CT) can measure brain water uptake, which can be used to identify stroke patients with symptom onset within 4.5 hours, according to a study published online Nov. 7 in the Annals of Neurology.

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Mortality Risk Up for Hospital Patients With Hypoglycemia

FRIDAY, Nov. 18, 2016 (HealthDay News) -- Hospital patients with hypoglycemia may be at increased mortality risk, according to research published online Nov. 17 in the Journal of Clinical Endocrinology & Metabolism.

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Many Receive Surprisingly High Bills After Visiting In-Network ER

THURSDAY, Nov. 17, 2016 (HealthDay News) -- Many patients visiting an in-network U.S. emergency department end up with major unexpected costs, according to a perspective piece published in the Nov. 17 issue of the New England Journal of Medicine.

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Only Slightly Worse Disease Course for Bacterial LRI

TUESDAY, Nov. 15, 2016 (HealthDay News) -- In patients with acute cough, those with bacterial lower respiratory tract infection (LRTI) have a slightly worse disease course than those without an identified bacterial cause, according to research published in the November/December in the Annals of Family Medicine.

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Novel Diagnostic Method for Concussion Shows Potential

MONDAY, Nov. 14, 2016 (HealthDay News) -- A simple blood test may one day diagnose concussions with more than 90 percent certainty, according to a study published online Oct. 28 in Metabolomics.

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HR Capabilities Positively Linked to Quality of Patient Care

FRIDAY, Nov. 11, 2016 (HealthDay News) -- Human resource (HR) capabilities are positively associated with quality of patient care, with the relationship mediated by proactive work, according to a study published recently in Human Resource Management.

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Survival Lower for Night CPR Events in Children

WEDNESDAY, Nov. 9, 2016 (HealthDay News) -- Hospitalized children have reduced survival odds with cardiopulmonary resuscitation (CPR) events occurring at night compared to other times of the day, according to a study published online Nov. 7 in JAMA Pediatrics.

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Self-Harm Now a Leading Cause of Pregnancy-Related Mortality

WEDNESDAY, Nov. 9, 2016 (HealthDay News) -- In the past decade, self-harm has been the leading cause of pregnancy-related deaths in Colorado, according to research published in the December issue of Obstetrics & Gynecology.

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Report of Recurrent Immune Thrombocytopenia After Flu Shot

WEDNESDAY, Nov. 9, 2016 (HealthDay News) -- In a report published online Nov. 8 in Pediatrics, authors present the case of recurrent immune thrombocytopenia (ITP) after influenza vaccination.

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Better Teamwork Linked to Improved Outcomes for CABG

WEDNESDAY, Nov. 9, 2016 (HealthDay News) -- For patients undergoing coronary artery bypass grafting (CABG), surgical outcomes are better for health systems with physicians who have higher teamwork levels, according to a study published online Nov. 8 in Circulation: Cardiovascular Quality and Outcomes.

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Probable Interaction ID'd for PrOD, Ribavirin With Warfarin

TUESDAY, Nov. 8, 2016 (HealthDay News) -- There is a probable interaction between paritaprevir/ritonavir/ombitasvir+dasabuvir (PrOD) plus ribavirin with warfarin, according to a case report published online Nov. 3 in the Journal of Clinical Pharmacy and Therapeutics.

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AMA Highlights Role of Patient Shame in Opioid Disorders

TUESDAY, Nov. 8, 2016 (HealthDay News) -- Supported by the American Medical Association (AMA), the Providers' Clinical Support System for Opioid Therapies (PCSS-O) has released a collection of resources from a national training and mentoring project developed by physicians to promote the role of self-education and help curb the opioid epidemic.

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Many States Lack 'Return-to-Learn' Concussion Laws

MONDAY, Nov. 7, 2016 (HealthDay News) -- All U.S. states have "return-to-play" laws designed to protect young athletes who've suffered a concussion, but as of May 2016, only eight states had "return-to-learn" laws aimed at managing children's concussion recovery, according to a review published online Nov. 7 in Pediatrics.

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Five Strategies Can Reduce Risk of Medical Lawsuits

MONDAY, Nov. 7, 2016 (HealthDay News) -- Five strategies can be employed by physicians in order to help reduce the risk of lawsuits, according to an article published in Medical Economics.

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New QI Intervention Aids Pain Management for Seniors in the ER

MONDAY, Nov. 7, 2016 (HealthDay News) -- The Improving Pain Relief in Elder Patients (I-PREP) quality improvement (QI) intervention improves pain management in older adults in the emergency department, according to a study published online Nov. 2 in the Journal of the American Geriatrics Society.

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Nonadherence in Nearly One-Third of Patients With HTN

MONDAY, Nov. 7, 2016 (HealthDay News) -- More than 30 percent of patients with hypertension are not adherent to antihypertensive drug therapy, according to a study published online Nov. 3 in the Journal of Evaluation in Clinical Practice.

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Ocular Syphilis Cases May Be Increasing in United States

MONDAY, Nov. 7, 2016 (HealthDay News) -- Ocular syphilis has been identified in jurisdictions in the United States, with reports of increases in five jurisdictions in 2014 and 2015, according to a review published the Nov. 4 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Women Have Worse Outcomes During 36 Months After ACS

FRIDAY, Nov. 4, 2016 (HealthDay News) -- In a study published in the Nov. 1 issue of The American Journal of Cardiology, among patients with acute coronary syndrome (ACS), women were found to have a higher mortality rate than men during 36 months of follow-up.

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Health Anxiety Takes Toll on Cardiovascular Health

FRIDAY, Nov. 4, 2016 (HealthDay News) -- People with high levels of health anxiety have about a 70 percent increased risk of ischemic heart disease (IHD), after taking into account other known risk factors, according to research published online Nov. 3 in BMJ Open.

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About Half of Seniors in ER Willing to Use Tablet Computers

FRIDAY, Nov. 4, 2016 (HealthDay News) -- About half of older adults in the emergency department are willing to provide information using a tablet computer, but few can do so without needing assistance, according to a study published online Nov. 2 in the Journal of the American Geriatrics Society.

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~30K Sports-Related Eye Injuries Yearly in U.S. Emergency Rooms

THURSDAY, Nov. 3, 2016 (HealthDay News) -- Paintball guns pose the greatest risk of vision loss among the sports most commonly associated with eye injuries, according to a study published online Nov. 3 in JAMA Ophthalmology.

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Myocarditis ID'd With Ipilimumab + Nivolumab in Melanoma

THURSDAY, Nov. 3, 2016 (HealthDay News) -- Patients with melanoma treated with a combination of ipilimumab and nivolumab may be at risk for a potentially fatal T-cell-driven drug reaction, according to a report published in the Nov. 3 issue of the New England Journal of Medicine.

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About 30 Percent Misdiagnosed With Lower Extremity Cellulitis

WEDNESDAY, Nov. 2, 2016 (HealthDay News) -- More than 30 percent of patients admitted with a diagnosis of lower extremity cellulitis are misdiagnosed, according to a study published online Nov. 2 in JAMA Dermatology.

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Vague Food Labels Can Place Patients With Allergies at Risk

WEDNESDAY, Nov. 2, 2016 (HealthDay News) -- Shoppers are often confused by food labels that warn of potential allergens, and the consequences can be serious, according to research published online Nov. 1 in the Journal of Allergy and Clinical Immunology: In Practice.

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Acute Hepatitis Described With Excessive Energy Drink Intake

WEDNESDAY, Nov. 2, 2016 (HealthDay News) -- A case of acute hepatitis tied to excessive energy drink consumption is detailed in a report published online Nov. 1 in BMJ Case Reports.

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Outcomes Similar for Rx Dosing Protocols in Ectopic Pregnancy

WEDNESDAY, Nov. 2, 2016 (HealthDay News) -- For ectopic pregnancy, outcomes are similar with a single- and double-dose methotrexate protocol, according to a study published in the November issue of the American Journal of Obstetrics & Gynecology.

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Similar Complication Rate for Transvenous, Subcutaneous ICDs

TUESDAY, Nov. 1, 2016 (HealthDay News) -- For patients at risk for sudden cardiac death, the rate of complications is similar with transvenous implantable cardioverter-defibrillators (TV-ICDs) and subcutaneous ICDs (S-ICDs), although the nature of complications differs, according to a study published in the Nov. 8 issue of the Journal of the American College of Cardiology.

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