August 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 August 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.

ACA Is Helping More Americans Afford Prescriptions

WEDNESDAY, Aug. 31, 2016 (HealthDay News) -- Though a growing number of Americans are able to afford prescription medications, millions still have difficulty, according to a study published online Aug. 23 in the American Journal of Public Health.

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Older MI Survivors Have High Event Risk Over Long Term

TUESDAY, Aug. 30, 2016 (HealthDay News) -- Older myocardial infarction (MI) survivors have long-term elevated risks of mortality and cardiovascular events, according to a study published online Aug. 26 in Cardiovascular Therapeutics.

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CDC: Zika Transmitted by Sex Partner With No Symptoms

FRIDAY, Aug. 26, 2016 (HealthDay News) -- U.S. health officials report that the Zika virus can be spread sexually even when a partner shows no signs of infection. The research was published in the Aug. 26 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Heat Illness Risk Highest in Early Preseason College Football

FRIDAY, Aug. 26, 2016 (HealthDay News) -- College football players face greatest risk for exertional heat illness (EHI) during the start of preseason play, according to a study published online Aug. 9 in the Journal of Athletic Training.

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No Impact of Medicaid Expansion on Hospital LOS, Mortality

FRIDAY, Aug. 26, 2016 (HealthDay News) -- State Medicaid expansion as part of the Affordable Care Act (ACA) is not associated with length of stay (LOS) or in-hospital mortality among general medicine patients, according to a study published online Aug. 18 in the Journal of Hospital Medicine.

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Plain Radiography Can ID Changes in Gouty Tophi Size

FRIDAY, Aug. 26, 2016 (HealthDay News) -- For patients with tophaceous gout, plain radiography can assess response to hypouricemic treatment, according to a study published online Aug. 12 in the International Journal of Rheumatic Diseases.

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CDC: Synthetic Fentanyl a Major Factor in Opioid Overdose Deaths

FRIDAY, Aug. 26, 2016 (HealthDay News) -- Deaths from overdoses of illicitly manufactured fentanyl have increased significantly in recent years, according to research published in the Aug. 26 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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In-Hospital Mortality Up With Weekend Admission in NSTEMI

FRIDAY, Aug. 26, 2016 (HealthDay News) -- For patients with non-ST-segment elevation myocardial infarction (NSTEMI), weekend admission is associated with increased in-hospital mortality, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Major Depressive Disorder Ups Acute MI Risk in HIV-Infected

FRIDAY, Aug. 26, 2016 (HealthDay News) -- For HIV-infected adults, major depressive disorder (MDD) is associated with an increased risk of acute myocardial infarction (AMI), according to a study published online Aug. 24 in JAMA Cardiology.

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Intussusception Hospitalization Rate Up at Age 8 to 11 Weeks

THURSDAY, Aug. 25, 2016 (HealthDay News) -- Children aged 8 to 11 weeks have an increased rate of intussusception hospitalization after introduction of rotavirus vaccine, according to a study published online Aug. 24 in Pediatrics.

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Higher Incidence of Edema With Bacteriuria in C1-INH-HAE

THURSDAY, Aug. 25, 2016 (HealthDay News) -- For patients with hereditary angioedema due to C1-inhibitor deficiency (C1-INH-HAE), those with bacteriuria have a higher number of edematous attacks, according to a study published online Aug. 22 in Allergy.

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Decision Support Tools Cut CT Use in Pediatric Appendicitis Workup

THURSDAY, Aug. 25, 2016 (HealthDay News) -- For pediatric patients, passive and active decision support tools can reduce unnecessary computed tomography (CT) imaging among pediatric patients undergoing workup for appendicitis, according to a study published online Aug. 23 in Pediatrics.

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Steep Rise in U.S. Drug Prices Tied to Patent Monopolies

WEDNESDAY, Aug. 24, 2016 (HealthDay News) -- Prescription drug prices are skyrocketing in the United States due in large part to government regulations, according to a study published in the Aug. 23/30 issue of the Journal of the American Medical Association.

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CDC Urges Prevention, Early Recognition of Sepsis

WEDNESDAY, Aug. 24, 2016 (HealthDay News) -- Many cases of life-threatening sepsis could be recognized and treated long before they cause severe illness or death, according to an Aug. 23 Vital Signs report from the U.S. Centers for Disease Control and Prevention.

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Genetics May Help Identify Infection in Febrile Infants

WEDNESDAY, Aug. 24, 2016 (HealthDay News) -- A quick genetic test might one day help doctors determine within hours whether an infant's fever is from a virus or a serious bacterial infection, according to two studies published in the Aug. 23/30 issue of the Journal of the American Medical Association.

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Laryngoscopy Skills Worsen After Month Without Practice

MONDAY, Aug. 22, 2016 (HealthDay News) -- Laryngoscopy skill performance levels change after one month without practice, with worse consistency for C-MAC and A.P. Advance, according to a study published online Aug. 17 in Anaesthesia.

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ACA Has Increased Rx Drug Use, Cut Out-of-Pocket Spending

MONDAY, Aug. 22, 2016 (HealthDay News) -- The Affordable Care Act (ACA) has increased prescription use and reduced out-of-pocket spending, according to a report published online Aug. 17 in Health Affairs.

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Post-Op Doctor Shopping for One in Four With Nephrolithiasis

FRIDAY, Aug. 19, 2016 (HealthDay News) -- Postoperative doctor shopping occurs in about one-quarter of patients with nephrolithiasis undergoing ureteroscopy, according to research published in the September issue of The Journal of Urology.

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Novel Technique Feasible for Clean-Catch Urine in Infants

FRIDAY, Aug. 19, 2016 (HealthDay News) -- A new noninvasive bladder stimulation technique can obtain clean-catch urine (CCU) in infants aged younger than 90 days, according to a study published online Aug. 19 in Pediatrics.

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Cardiac Arrest In-Hospital Death Down in Teaching Hospitals

FRIDAY, Aug. 19, 2016 (HealthDay News) -- Among patients with cardiac arrest (CA), teaching hospital status is associated with decreased in-hospital mortality, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Coronary Heart Disease Risk Up in Patients With Gallstones

FRIDAY, Aug. 19, 2016 (HealthDay News) -- Patients with history of gallstone disease may have a slightly increased risk of developing coronary heart disease (CHD), according to research published online Aug. 18 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Patients Still Risking Eye Damage With Poor Contact Lens Care

FRIDAY, Aug. 19, 2016 (HealthDay News) -- Unsafe use of contact lenses is triggering serious eye injuries for many Americans, according to research published in the Aug. 19 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Legal Issues Impact Delivery of Telehealth

THURSDAY, Aug. 18, 2016 (HealthDay News) -- Telehealth technologies can allow delivery of high-quality care at a lower cost, especially in underserved areas, but there is currently no uniform legal approach to telehealth, hampering its provision, according to a Health Policy Brief published online Aug. 15 in Health Affairs.

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Acetaminophen Appears Safe for Children With Mild Asthma

WEDNESDAY, Aug. 17, 2016 (HealthDay News) -- Acetaminophen does not worsen asthma symptoms in young children, according to a study published in the Aug. 18 issue of the New England Journal of Medicine.

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Residents Often Order Perceived Unnecessary Lab Tests

WEDNESDAY, Aug. 17, 2016 (HealthDay News) -- Residents frequently order perceived unnecessary inpatient laboratory tests, according to a study published online Aug. 13 in the Journal of Hospital Medicine.

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Physician Under-Recognition of Angina Often Occurs

WEDNESDAY, Aug. 17, 2016 (HealthDay News) -- Physicians frequently under-recognize angina in their patients with coronary artery disease, with under-recognition more likely for patients with heart failure and less-frequent angina, according to research published online Aug. 16 in Circulation: Cardiovascular Quality and Outcomes.

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U.S. Female Doctors Reimbursed Significantly Less Than Males

TUESDAY, Aug. 16, 2016 (HealthDay News) -- Female doctors in the United States make much less than their male colleagues, according to a study published online Aug. 15 in the Postgraduate Medical Journal.

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Thrombocytopenia Up With Use of Phosphate-Buffered Tirofiban

TUESDAY, Aug. 16, 2016 (HealthDay News) -- For patients with acute coronary syndrome, phosphate-buffered tirofiban, but not citrate-buffered tirofiban, is associated with an increased risk of thrombocytopenia, according to a study published in the Aug. 22 issue of JACC: Cardiovascular Interventions.

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Unstable Vital Signs for About One in Five Hospital Discharges

MONDAY, Aug. 15, 2016 (HealthDay News) -- Among adults with a hospitalization, vital sign instability on discharge is associated with increased risk of 30-day mortality and readmission, according to a study published online Aug. 8 in the Journal of General Internal Medicine.

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Arhalofenate Beats Allopurinol for Gout Flares

MONDAY, Aug. 15, 2016 (HealthDay News) -- Arhalofenate (800 mg) is safe and significantly decreases gout flares compared to allopurinol (300 mg), according to a study published online July 27 in Arthritis & Rheumatology.

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Topical Iodine Can Cause Overestimation of Blood Glucose

FRIDAY, Aug. 12, 2016 (HealthDay News) -- Use of topical iodine can cause overestimation of blood glucose (BG) readings, according to a case report published online Aug. 8 in the Journal of Clinical Pharmacy and Therapeutics.

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Risk of Post-Op Opioid Abuse Deemed Low for Elderly Patients

WEDNESDAY, Aug. 10, 2016 (HealthDay News) -- Opioid abuse arises in only a very small fraction -- less than half of 1 percent -- of cases involving surgical patients aged 65 or older, according to a research letter published online Aug. 10 in JAMA Surgery.

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Suicide Rate Increased in Patients With Serious Infections

WEDNESDAY, Aug. 10, 2016 (HealthDay News) -- Patients hospitalized for serious infections may face an increased risk of suicide, according to research published online Aug. 10 in JAMA Psychiatry.

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Florida Reports Four More Cases of Local Zika Infection in Miami

WEDNESDAY, Aug. 10, 2016 (HealthDay News) -- Four more cases of Zika infection that were likely spread through mosquito bites have been reported in the Miami area, bringing the total count of cases to 21, Florida Gov. Rick Scott said Tuesday.

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Many U.S. Hospitals Offer Language Services

WEDNESDAY, Aug. 10, 2016 (HealthDay News) -- Overall, 68.8 percent of hospitals offer language services, with the proportion increasing with level of need, according to research published in the August issue of Health Affairs.

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Counterfeit Alprazolam Cut With Fentanyl Can Be Fatal

WEDNESDAY, Aug. 10, 2016 (HealthDay News) -- At least one San Francisco-area individual died and eight more were treated in the emergency department in late 2015 after taking counterfeit alprazolam (Xanax) tablets that had been cut with fentanyl, according to a case report published online Aug. 8 in JAMA Internal Medicine.

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Modest Changes in Practice for High-Sensitivity TnT Reporting

WEDNESDAY, Aug. 10, 2016 (HealthDay News) -- For patients presenting to the emergency department with chest pain, high-sensitivity troponin T (hs-TnT) reporting is associated with modest changes in practice, according to a study published online Aug. 9 in Circulation: Cardiovascular Quality and Outcomes.

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Low Initial Dose, No Refills Can Help Prevent Opioid Dependency

TUESDAY, Aug. 9, 2016 (HealthDay News) -- Patients who are first-time users of opioids should be prescribed a small dose without refills to reduce the risk of long-term use and possible addiction, according to a study published online Aug. 2 in the Journal of General Internal Medicine.

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Need for Medical Care Offers Chance to Aid Trafficking Victims

TUESDAY, Aug. 9, 2016 (HealthDay News) -- Injuries and illness requiring medical care present an opportunity for health care professionals to provide assistance to trafficked persons, according to an article published online Aug. 9 in the Annals of Internal Medicine.

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Young Children in Highest Risk Group for Chemical Eye Injuries

MONDAY, Aug. 8, 2016 (HealthDay News) -- Young children have the highest rates for chemical ocular injuries, according to research published online Aug. 4 in JAMA Ophthalmology.

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ATS Issues Conditional Guidance for Persistent Infantile Wheezing

FRIDAY, Aug. 5, 2016 (HealthDay News) -- A committee sanctioned by the American Thoracic Society has developed conditional guidelines for the diagnostic evaluation of infants with recurrent or persistent wheezing, but more research is needed. The guidelines were published in the Aug. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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About One-Third Have Symptom Spikes After Peds Concussion

FRIDAY, Aug. 5, 2016 (HealthDay News) -- About one-third of pediatric patients with concussion experience symptom spikes over the consecutive days, according to a study published online Aug. 1 in JAMA Pediatrics.

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'Microhospitals' Can Provide Quicker Access to Care

THURSDAY, Aug. 4, 2016 (HealthDay News) -- Some health care systems are opening tiny hospitals which provide comprehensive emergency services but may have fewer than a dozen inpatient beds, according to a report published by Kaiser Health News.

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Amish Farm Environment May Protect Children From Asthma

THURSDAY, Aug. 4, 2016 (HealthDay News) -- The Amish environment seems to provide protection against asthma and allergic sensitization, according to a study published in the Aug. 3 issue of the New England Journal of Medicine.

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Opioid-Related Insurance Claims Rise 3,000 Percent

WEDNESDAY, Aug. 3, 2016 (HealthDay News) -- The number of private health insurance claims for Americans addicted to opioids and heroin rose 3,203 percent from 2007 to 2014, according to a Fair Health report.

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Standardized Cardiac Telemetry IDs Cardiac Rhythm Change

WEDNESDAY, Aug. 3, 2016 (HealthDay News) -- An off-site central monitoring unit (CMU) applying standardized cardiac telemetry is associated with detection and notification of cardiac rhythm and rate changes before emergency response team (ERT) activation, according to a study published in the Aug. 2 issue of the Journal of the American Medical Association.

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Physician Reviews Approaches to Treating Opioid-Use Disorders

TUESDAY, Aug. 2, 2016 (HealthDay News) -- Different approaches to the treatment of opioid-use disorders are addressed in an article published in the July 28 issue of the New England Journal of Medicine.

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Bleeding Risk Up With Aspirin After Lower GI Bleeding

TUESDAY, Aug. 2, 2016 (HealthDay News) -- For patients with a history of lower gastrointestinal (GI) bleeding, continuation of aspirin is associated with increased risk of recurrent bleeding, but reduced risk of cardiovascular events and death, according to a study published in the August issue of Gastroenterology.

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Injuries Up As Trampoline Parks Become More Popular

MONDAY, Aug. 1, 2016 (HealthDay News) -- As trampoline parks spring up across the United States, injuries to children have also increased, according to research published online Aug. 1 in Pediatrics.

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Locally-Transmitted Zika Infection Count in Miami Up to 14

MONDAY, Aug. 1, 2016 (HealthDay News) -- The number of local transmissions of the Zika virus in South Florida has apparently increased to 14, Gov. Rick Scott said Monday.

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European Countries Implementing Cost-Sharing

MONDAY, Aug. 1, 2016 (HealthDay News) -- European health systems are requiring an increase in cost-sharing measures for patients 50 years of age and older, according to research published in the July issue of Health Affairs.

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