April 2017 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 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.

Meeting Organizers Overlooking Qualified Female Scientists

FRIDAY, April 28, 2017 (HealthDay News) -- Invited speakers at medical conferences tend to be disproportionately male, a disparity that can be addressed by actively preparing lists of potential speakers, according to a study published online April 18 in Nature Immunology.

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AMA Urges Doctors to Talk About Safe Opioid Storage, Disposal

FRIDAY, April 28, 2017 (HealthDay News) -- Physicians should take three essential steps to reduce the amount of unwanted, unused, and expired medications in an effort to avoid non-medical uses of the drugs, according to a new recommendation from the American Medical Association (AMA) Task Force to Reduce Opioid Abuse.

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Routine Blood Tests Can Harm Patient Care

FRIDAY, April 28, 2017 (HealthDay News) -- Routine blood tests waste money and can damage patient care, according to an opinion piece published online April 27 in the BMJ.

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Risk Factors in Six Areas Tied to Physician Burnout

THURSDAY, April 27, 2017 (HealthDay News) -- Physician burnout factors include control, whether there is time to deliver excellent care, and whether the workplace is fair, according to a presentation at the Medical Group Management Association/American Medical Association 2017 Collaborate in Practice Conference, held April 9 to 11 in Chicago.

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Single-Payer Health System Bill Moves Forward in California

THURSDAY, April 27, 2017 (HealthDay News) -- A proposal to replace private insurance with government-funded health care for all moved forward in California on Wednesday as Democrats on the Senate Health Committee voted to advance the measure.

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EHR Documentation May Help in Harm Reduction Initiatives

THURSDAY, April 27, 2017 (HealthDay News) -- Electronic health record (EHR) documentation can be used to reduce preventable harm in hospitals, according to a study published online April 27 in Pediatrics.

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Higher QT Interval After Energy Drink Consumption Vs. Caffeine

THURSDAY, April 27, 2017 (HealthDay News) -- Consumption of energy drinks is associated with significantly higher corrected QT interval and systolic blood pressure (BP) than consumption of caffeine alone, according to a study published online April 26 in the Journal of the American Heart Association.

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Children With Suspected Child Abuse Present to Hospital Late

WEDNESDAY, April 26, 2017 (HealthDay News) -- Children with suspected child abuse (SCA) present late to the hospital, and most arrive at hospitals that are not designated pediatric-capable major trauma centers, according to a study published online April 24 in the Emergency Medicine Journal.

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Model Predicts Which Pediatric ER Patients Likely to Be Admitted

TUESDAY, April 25, 2017 (HealthDay News) -- A new model can accurately predict pediatric patient hospitalization early in the emergency department encounter by using data commonly available in electronic medical records, according to a study published online April 25 in Pediatrics.

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Use of HEART Score Has Limited Impact for Chest Pain in ER

TUESDAY, April 25, 2017 (HealthDay News) -- Use of the History, Electrocardiogram, Age, Risk factors, and initial Troponin (HEART) score is safe but has a limited effect on health care resource use among patients presenting at the emergency department with chest pain, according to a study published online April 24 in the Annals of Internal Medicine.

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Most Patients Willing to Provide Sexual Orientation Data

MONDAY, April 24, 2017 (HealthDay News) -- Patients are more willing to provide sexual orientation data than providers in the emergency department think they are, according to a study published online April 24 in JAMA Internal Medicine.

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Neutrophil-to-Lymphocyte Ratio Predicts Mortality in CAP

MONDAY, April 24, 2017 (HealthDay News) -- Neutrophil-to-lymphocyte ratio (NLR) can predict 30-day mortality for elderly adults with community-acquired pneumonia (CAP), according to a study published online April 13 in the Journal of the American Geriatrics Society.

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Mortality Up for Opioid Addicts Not Treated in Addiction Clinics

MONDAY, April 24, 2017 (HealthDay News) -- Opioid addicts who get their medical care in settings such as primary care offices and hospitals, rather than addiction centers, are twice as likely to die as opioid addicts treated in addiction clinics, according to a study published online April 20 in the Journal of Addiction Medicine.

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ERs Administering More Medications Intranasally

MONDAY, April 24, 2017 (HealthDay News) -- A growing number of U.S. emergency departments are giving patients medication through the nose instead of via injections or intravenously, according to a study published recently in the Annals of Emergency Medicine.

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Trump Administration Offers Grants to Fight Opioid Crisis

FRIDAY, April 21, 2017 (HealthDay News) -- Nearly half a billion dollars promised by the Obama administration for opioid abuse prevention and treatment programs will be handed out by the Trump administration.

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FDA Warns Against Children Taking Codeine, Tramadol

FRIDAY, April 21, 2017 (HealthDay News) -- Children should not be given any medications containing codeine or tramadol due to risk of life-threatening breathing difficulties, the U.S. Food and Drug Administration warned Thursday.

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1-g IV Acetaminophen Dose May Be Insufficient in Multiple Trauma

FRIDAY, April 21, 2017 (HealthDay News) -- A dosage of 1 g intravenous acetaminophen every six hours yields serum concentrations below 10 µg/mL for critically ill multiple-trauma patients, according to a study published online April 17 in the Journal of Clinical Pharmacology.

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Case Report Describes Adverse Reaction to Clindamycin

FRIDAY, April 21, 2017 (HealthDay News) -- In a case report published online April 17 in the Journal of Clinical Pharmacy and Therapeutics, acute generalized exanthematous pustulosis secondary to clindamycin therapy is described.

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CDC: Salmonella Infection Prevalence Down in 2016

THURSDAY, April 20, 2017 (HealthDay News) -- U.S. health officials have made progress against Salmonella infections, according to research published in the April 21 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Vertical Integration Linked to Reduction in Readmissions

THURSDAY, April 20, 2017 (HealthDay News) -- Vertical integration, merging health care providers of different levels into a single unit, is associated with a reduction in readmissions overall, although the positive effect is seen for a limited number of conditions, according to a study published in the May issue of Medical Care.

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Electronic Drug Administration Record App Cuts Errors

THURSDAY, April 20, 2017 (HealthDay News) -- Use of an electronic medication administration record (eMAR) application can reduce the rate of medication errors in medication administration recording (ME-MAR), according to a study published online April 18 in the Journal of Evaluation in Clinical Practice.

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QI Intervention Aids Medication Safety for Elderly in ER

THURSDAY, April 20, 2017 (HealthDay News) -- A quality improvement initiative that combines education, electronic clinical decision support, and individual provider feedback can positively influence prescribing behavior and improve medication safety for older adults in the emergency department, according to a study published online April 7 in the Journal of the American Geriatrics Society.

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Study Looks at ER Visits for Patients Injured by Police in U.S.

WEDNESDAY, April 19, 2017 (HealthDay News) -- More than 50,000 Americans are treated each year for injuries inflicted by police, according to a research letter published online April 19 in JAMA Surgery.

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Dexamethasone Found to Be of Little Benefit in Acute Sore Throat

WEDNESDAY, April 19, 2017 (HealthDay News) -- A single dose of oral dexamethasone only offers modest benefit in the treatment of acute sore throat, according a study published in the April 18 issue of the Journal of the American Medical Association.

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Single hs-cTnT Measure, Non-Ischemic ECG Can Rule Out AMI

WEDNESDAY, April 19, 2017 (HealthDay News) -- For adults presenting to the emergency department with chest pain, a single high-sensitivity assay for cardiac troponin T (hs-cTnT) below the limit of detection and a non-ischemic electrocardiogram (ECG) can rule out acute myocardial infarction (AMI), according to a meta-analysis published online April 18 in the Annals of Internal Medicine.

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No Proof Azithromycin Ups Odds of Ventricular Arrhythmia

TUESDAY, April 18, 2017 (HealthDay News) -- Azithromycin doesn't appear to increase the risk of ventricular arrhythmia, according to a study published online April 18 in CMAJ, the journal of the Canadian Medical Association.

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Various Diagnostic Tools Available for Ocular Allergy

TUESDAY, April 18, 2017 (HealthDay News) -- There are currently various tools available for diagnosing ocular allergy, although several unmet needs remain, according to a position paper published online April 7 in Allergy.

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Doctors Need to Be Mindful of What They Post on Social Media

MONDAY, April 17, 2017 (HealthDay News) -- Young doctors often have unprofessional or offensive content on their Facebook profiles, according to a study published online April 9 in BJU International.

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Early Invasive Doesn't Beat Selective Strategy in NSTE-ACS

MONDAY, April 17, 2017 (HealthDay News) -- An early invasive strategy has no benefit for reducing the 10-year composite outcomes of death or spontaneous myocardial infarction (MI) for patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and elevated cardiac troponin T, according to a study published in the April 18 issue of the Journal of the American College of Cardiology.

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High Readmission Rates for Critical Limb Ischemia

FRIDAY, April 14, 2017 (HealthDay News) -- Patients with critical limb ischemia (CLI) have a high risk of readmission, with most of the readmissions unplanned, according to a study published in the April 18 issue of the Journal of the American College of Cardiology.

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Delays in Emergency Care Up Mortality During Major Marathons

THURSDAY, April 13, 2017 (HealthDay News) -- Nearby residents appear more likely to die from acute myocardial infarction and cardiac arrest during a marathon, according to research published in the April 13 issue of the New England Journal of Medicine.

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6 Variables Can Predict Mortality Risk in Cardiogenic Shock

THURSDAY, April 13, 2017 (HealthDay News) -- Six variables can be combined to predict short-term mortality risk in patients with cardiogenic shock (CS), according to a study published in the April 18 issue of the Journal of the American College of Cardiology.

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24-Hour Urine Collection of Unclear Benefit in Stone Formers

THURSDAY, April 13, 2017 (HealthDay News) -- Despite guidelines, it has not been established whether all recurrent kidney stone formers benefit from 24-hour urine collection, according to a review published in the April issue of The Journal of Urology.

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Recreational Drug 'Poppers' Linked to Retinal Damage

WEDNESDAY, April 12, 2017 (HealthDay News) -- Use of inhaled "poppers" -- volatile alkyl nitrite compounds inhaled for their psychoactive effects such as transient euphoria and sexual arousal -- might pose a danger to the user's vision, according to a study published online April 10 in the British Journal of Ophthalmology.

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Acute Ischemic Stroke Prevalence Up in Younger Americans

TUESDAY, April 11, 2017 (HealthDay News) -- Acute ischemic stroke is increasingly prevalent in Americans under 65, as is the percentage of those with three or more stroke risk factors, according to a study published online April 10 in JAMA Neurology.

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Integrated E-Prescribing Can Cut Prescribing, Dispensing Errors

MONDAY, April 10, 2017 (HealthDay News) -- An integrated electronic medication prescribing (e-prescribing) and dispensing system can reduce prescribing and dispensing errors, according to a study published online March 30 in the Journal of Pharmacy Practice and Research.

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Surgery May Not Be Necessary in Acute Biliary Pancreatitis

MONDAY, April 10, 2017 (HealthDay News) -- Immediate cholecystectomy may not always be necessary for patients with acute biliary pancreatitis, according to research published in the March issue of the American Journal of Gastroenterology.

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MACRA Changes Government Approach to Doctor Payment

FRIDAY, April 7, 2017 (HealthDay News) -- Implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) has made fundamental changes to the government's approach to physician payment, according to a March 27 policy brief published in Health Affairs.

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Risk Adjustment, Reinsurance Transfer Offer Financial Benefit

THURSDAY, April 6, 2017 (HealthDay News) -- Risk adjustment and reinsurance transfer programs seem to have been effective for increasing revenues at the expense of claims costs, according to research published in the March issue of Health Affairs.

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Physicians Finding Ways to Work Around Cost of Rx Medications

WEDNESDAY, April 5, 2017 (HealthDay News) -- In an effort to mitigate the increasing cost of prescription medications, some physicians are creating novel workaround solutions, according to an article published by Kaiser Health News.

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Doctors Must Be Wary of HIPAA Violations With Online Reviews

TUESDAY, April 4, 2017 (HealthDay News) -- Physicians should be aware that responding to a negative health care review could potentially expose personal medical information, resulting in a Health Insurance Portability and Accountability Act (HIPAA) violation, according to an article published in Medical Economics.

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Geographic Variation in Admission for Opioid Tx Programs

TUESDAY, April 4, 2017 (HealthDay News) -- There is geographic variation in treatment admissions among opioid treatment programs that accept Medicaid, according to a study published online March 27 in Health Services Research.

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Variation in Occupational Influenza Vaccination Coverage

TUESDAY, April 4, 2017 (HealthDay News) -- There is variation in influenza vaccination coverage by industry and occupation, including among health care personnel and other occupational groups who may have first priority to receive influenza vaccination during a pandemic (tier 1), according to a study published in the April 1 issue of the American Journal of Infection Control.

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Mylan Issues Voluntary Recall of Some EpiPen Auto-Injectors

MONDAY, April 3, 2017 (HealthDay News) -- Mylan, the maker of EpiPen, says it is recalling select lots of EpiPen and EpiPen Jr. due to a defect that might render it difficult to activate in an emergency.

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Use of Health Literacy Tools Can Promote Shared Decision Making

MONDAY, April 3, 2017 (HealthDay News) -- Use of health literacy tools is encouraged for facilitating shared decision making (SDM), according to an article published in the March issue of the AMA Journal of Ethics.

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