April 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 April 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.

First Zika-Related Death in Puerto Rico Reported

FRIDAY, April 29, 2016 (HealthDay News) -- The first known Zika virus-linked death in Puerto Rico was announced Friday by officials of the U.S. territory.

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First Commercial Zika Test Approved by FDA

FRIDAY, April 29, 2016 (HealthDay News) -- The first commercial test to diagnose Zika virus was approved Thursday by the U.S. Food and Drug Administration.

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Wide Variation in Health Care Costs Across the U.S.

FRIDAY, April 29, 2016 (HealthDay News) -- Health care prices vary widely across the United States, even within the same state, according to a study published in the April issue of Health Affairs.

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Acute Diverticulitis No Worse in Younger Patients

FRIDAY, April 29, 2016 (HealthDay News) -- Younger patients do not have worse clinical presentation of acute diverticulitis, according to a study published online April 23 in the Journal of Digestive Diseases.

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Pain Most Frequent Cause of ER Visits Post Ureteroscopy

THURSDAY, April 28, 2016 (HealthDay News) -- Most patients who present to the emergency department after undergoing elective ureteroscopy complain of pain alone, according to a study published in the May issue of The Journal of Urology.

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Article Discusses Workplace Violence in Health Care

THURSDAY, April 28, 2016 (HealthDay News) -- There is a lack of data relating to the prevalence of workplace violence in health care and how to address it, according to a review article published in the April 28 issue of the New England Journal of Medicine.

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Doctors Have a Only a Few Weeks Left to Review Financial Data

WEDNESDAY, April 27, 2016 (HealthDay News) -- Under the Physician Payments Sunshine Act, physicians have only a few weeks left to review and report disputes relating to their financial ties to drug and medical device manufacturers, according to the American Medical Association.

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U.S. Health Report Card Finds Racial, Ethnic Disparities Persist

WEDNESDAY, April 27, 2016 (HealthDay News) -- An update on Americans' health finds that racial and ethnic disparities persist, with significant gaps in obesity, cesarean births, and dental care. But advances have been made in some important areas, including infant mortality rates, women smokers, and numbers of uninsured, according to the new report from the U.S. Department of Health and Human Services.

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Interactions for HIV Drug Combos, Immunosuppressants

WEDNESDAY, April 27, 2016 (HealthDay News) -- HIV-positive transplant recipients and their physicians should be aware of potential interactions between fixed dose combination products used for HIV treatment and immunosuppressant metabolism, according to a case report published online April 18 in the American Journal of Transplantation.

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Coronary Heart Disease Risk Up for Women Working Night Shifts

TUESDAY, April 26, 2016 (HealthDay News) -- Women who work rotating night shifts may face a slightly increased risk of coronary heart disease (CHD), according to a report published in the April 26 issue of the Journal of the American Medical Association.

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Detergent Packets a Growing Poison Danger to Children

TUESDAY, April 26, 2016 (HealthDay News) -- A growing number of small children are getting their hands and mouths on colorful detergent packets, with serious and sometimes fatal consequences, according to a report published online April 25 in Pediatrics.

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AAP: ALTE Now Termed 'Brief Resolved Unexplained Events'

MONDAY, April 25, 2016 (HealthDay News) -- The new term, "brief resolved unexplained events" (BRUE), replaces the previous term, "apparent life-threatening events" (ALTE), per an expert panel from the American Academy of Pediatrics (AAP). The new AAP clinical guideline was published online April 25 in Pediatrics.

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Pathogen Reduction System Prevents Malaria Via Transfusion

MONDAY, April 25, 2016 (HealthDay News) -- The incidence of transfusion-transmitted malaria can be reduced with use of a whole blood pathogen-reduction system, according to a study published in the April 23 issue of The Lancet.

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Alkali Eye Injuries Secondary to Airbag Deployment Reported

MONDAY, April 25, 2016 (HealthDay News) -- In a report published online April 15 in Clinical and Experimental Ophthalmology, two cases are presented of alkali eye injuries secondary to airbag deployment.

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Physicians Can Get Involved in Developing Payment Models

FRIDAY, April 22, 2016 (HealthDay News) -- Doctors can be involved in developing new payment models for their practices, according to the American Medical Association.

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CT CAP Rarely Reveals Acute Injury in Low-Velocity Trauma

FRIDAY, April 22, 2016 (HealthDay News) -- Computed tomographic (CT) chest abdomen pelvis (CAP) examinations rarely show acute traumatic injury in patients who had a low-velocity trauma but have acute head and/or cervical spine trauma without evidence of bodily injury, according to a study published in the May issue of Radiology.

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Preexisting Mental Distress Can Slow Concussion Recovery

THURSDAY, April 21, 2016 (HealthDay News) -- Athletes may take longer to recover after a concussion if they had psychosomatic symptoms before their head injury, according to a study published online April 20 in Neurology.

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No Solid Evidence for Pre-Participation Screens in Athletes

THURSDAY, April 21, 2016 (HealthDay News) -- There is no solid evidence for the effectiveness of pre-participation screening in reducing the number of sudden cardiac deaths among young athletes, according to an analysis published online April 20 in The BMJ.

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Medical Expulsive Therapy Underused for Ureteral Stones

THURSDAY, April 21, 2016 (HealthDay News) -- For patients with ureteral stones, medical expulsive therapy remains underused, according to a study published in the April issue of The Journal of Urology.

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Ten Cases of Rare Bloodstream Infection Reported in Illinois

WEDNESDAY, April 20, 2016 (HealthDay News) -- A cluster of rare bloodstream infections was discovered by Illinois health officials while investigating an outbreak in Wisconsin.

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Better Functional Outcome With Stent Retrievers in Acute Stroke

WEDNESDAY, April 20, 2016 (HealthDay News) -- For patients with acute ischemic stroke, treatment with stent retrievers with quick reperfusion time is associated with improved outcomes, according to a study published online April 19 in Radiology.

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Mineralocorticoid Receptor Antagonists No Benefit Post MI

TUESDAY, April 19, 2016 (HealthDay News) -- For patients with post-myocardial infarction (MI) heart failure, mineralocorticoid receptor antagonists (MRAs) do not improve outcome, according to a study published in the April 26 issue of the Journal of the American College of Cardiology.

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Post-Op Gouty Arthritis Described in Patient Taking Thiazide

TUESDAY, April 19, 2016 (HealthDay News) -- A case of postoperative acute gouty arthritis following laparoscopic cholecystectomy with umbilical hernioplasty, secondary to hydrochlorothiazide use, has been documented in a case report published in the March issue in the Journal of Pharmacy Practice and Research.

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Suboptimal Guideline Adherence for Hematuria After Menopause

TUESDAY, April 19, 2016 (HealthDay News) -- The prevalence of urinary tract malignancy is low among postmenopausal women evaluated for asymptomatic microscopic hematuria, according to a study published in the April issue of The Journal of Urology.

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2016 Match Marks Record Highs for Registrants, Matching

FRIDAY, April 15, 2016 (HealthDay News) -- The 2016 Match was the largest ever recorded by the National Resident Matching Program, with a higher match rate that 2015, according to a report from the American Medical Association.

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Improved Functional Outcomes With Adoption of GWTG-Stroke

FRIDAY, April 14, 2016 (HealthDay News) -- Adoption of the Get With The Guidelines (GWTG)-Stroke program is associated with improved functional outcomes at discharge and reduced post-discharge mortality for Medicare beneficiaries with acute stroke, according to a study published online April 14 in Stroke.

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Decrease in Medicare Spending for 2012 ACO Entrants

FRIDAY, April 15, 2016 (HealthDay News) -- Early reductions in Medicare spending were seen for the first full year of Medicare Shared Savings Program (MSSP) contracts for 2012 Accountable Care Organization (ACO) entrants, according to a study published online April 13 in the New England Journal of Medicine.

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Abdominal Aortic Aneurysm Odds Up for Patients With Psoriasis

FRIDAY, April 15, 2016 (HealthDay News) -- Psoriasis patients may face a higher risk of an abdominal aortic aneurysm, according to a study published online April 14 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Health Care Workers Skip Hand Washing One-Third of the Time

THURSDAY, April 14, 2016 (HealthDay News) -- Staff at many outpatient health care facilities in New Mexico failed to follow recommendations for hand hygiene more than one-third of the time, according to findings published in the April 1 issue of the American Journal of Infection Control.

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Pediatric Pneumonia Can Be Diagnosed Via Lung Ultrasound

THURSDAY, April 14, 2016 (HealthDay News) -- Lung ultrasounds may offer a safer, yet equally effective, alternative to chest X-rays for diagnosing pneumonia in children, according to a study published recently in Chest.

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Coalition Calls for Changes to Hospital Pain Assessments

WEDNESDAY, April 13, 2016 (HealthDay News) -- U.S. hospital procedures and questionnaires used to manage patient pain lead to overprescribing of addictive opioids and need to be changed, critics say.

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Clinical Decision Support Tool Cuts CT Use for Appendicitis

WEDNESDAY, April 13, 2016 (HealthDay News) -- The implementation of a multicomponent electronic clinical decision support tool reduces computed tomography (CT) use for pediatric patients with possible appendicitis, according to a study published online April 13 in Pediatrics.

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Doctors Can Be Misled About FDA 'Breakthrough' Drug Designation

TUESDAY, April 12, 2016 (HealthDay News) -- Use of the word "breakthrough" in the U.S. Food and Drug Administration's expedited approval process could mislead doctors about the new drugs' actual benefits, according to a research letter published in the April 12 issue of the Journal of the American Medical Association.

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Increase in Number of Patients Being Treated for Alpha-Gal

TUESDAY, April 12, 2016 (HealthDay News) -- There has been an increase in the number of patients being treated for Galactose-alpha-1,3-galactose (alpha-gal) syndrome, according to a report from the Vanderbilt University Medical Center's Asthma, Sinus and Allergy Program (ASAP).

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Review Addresses Chest Pain in Young Adults Presenting to ER

TUESDAY, April 12, 2016 (HealthDay News) -- For young adults presenting to the emergency department with acute chest pain, after ruling out cardiac risk, physicians should focus on stress reaction, according to a review published in the March issue of the Journal of Emergency Nursing.

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CCTA Tied to More Appropriate Use of Invasive Angiography

TUESDAY, April 12, 2016 (HealthDay News) -- Coronary computed tomography angiography (CCTA) is associated with more appropriate use of invasive angiography and increased use of preventive therapies, according to a study published online April 11 in the Journal of the American College of Cardiology.

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New-Onset A-Fib Post Acute MI Ups Complications, Readmission

TUESDAY, April 12, 2016 (HealthDay News) -- New-onset atrial fibrillation (AF) after acute myocardial infarction (AMI) is strongly tied to in-hospital complications and higher short-term readmission rates, according to a study published in the April 15 issue of The American Journal of Cardiology.

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Guidance Issued on Use of Direct Oral Anticoagulants in Obese

MONDAY, April 11, 2016 (HealthDay News) -- Recommendations have been issued for the use of direct oral anticoagulants (DOACs) in obese patients; the guideline was published online March 22 in the Journal of Thrombosis and Haemostasis.

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Nurses Play Crucial Role in Identifying Victims of Trafficking

MONDAY, April 11, 2016 (HealthDay News) -- Recommendations have been developed for emergency nurses in terms of recognizing and responding to the needs of victims of human trafficking; the position statement was published in the March issue of the Journal of Emergency Nursing.

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VA Commission on Care: Eliminate VA Medical Centers

MONDAY, April 11, 2016 (HealthDay News) -- A radical proposal has been suggested for eliminating all Veterans Affairs (VA) medical centers and outpatient facilities in the next 20 years, floated by seven of 15 members of the VA Commission on Care, according to an article published in the Military Times.

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Diuretic Dose Not Linked to Outcome in Heart Failure

WEDNESDAY, April 6, 2016 (HealthDay News) -- For patients with worsening heart failure, after adjustment for pre-specified covariates of disease severity, diuretic dose is not associated with mortality and heart failure rehospitalization, according to a study published online March 30 in JACC: Heart Failure.

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Quality of Urgent Health Care Varies for Virtual Visits

TUESDAY, April 5, 2016 (HealthDay News) -- For companies providing virtual visits for management of common acute illness there is significant variation in quality of care, according to a study published online April 4 in JAMA Internal Medicine.

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Are Guidelines Needed to Assess Competence of Aging Physicians?

FRIDAY, April 1, 2016 (HealthDay News) -- The question of whether national guidelines need to be developed for assessing the competence of aging physicians was discussed during a recent meeting of key stakeholders, according to a news release from the American Medical Association (AMA).

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