June 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 June 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.

Concussions Found to Be Common in Water Polo

THURSDAY, June 30, 2016 (HealthDay News) -- Add water polo to the list of sports where concussions are common, according to findings published online June 27 in Frontiers of Neurology.

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Unsatisfactory Chewing, Poor Diet Up Hospital Stay in Elderly

WEDNESDAY, June 29, 2016 (HealthDay News) -- For older adults, unsatisfactory chewing ability and poor diet are associated with longer hospital stays, according to a study published in the June issue of the Journal of the American Geriatrics Society.

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Electronic Record Demands Are Overwhelming Many Physicians

WEDNESDAY, June 29, 2016 (HealthDay News) -- Physicians using electronic practice tools report higher rates of burnout and increased frustration with the amount of computerized paperwork, according to research published online June 27 in the Mayo Clinic Proceedings.

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Genetic Heart Condition Common Cause of Sudden Death in Sports

WEDNESDAY, June 29, 2016 (HealthDay News) -- About one-third of sudden deaths are caused by hypertrophic cardiomyopathy, according to research published recently in The American Journal of Medicine.

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Pharmacy Programs to ID Opioid Abuse Effective, but Underused

WEDNESDAY, June 29, 2016 (HealthDay News) -- Pharmacy programs to reduce opioid abuse are effective but underused, according to a new study published in the July issue of the Journal of Studies on Alcohol and Drugs.

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Too Many Elderly, Terminal Patients Getting Unnecessary Tx

TUESDAY, June 28, 2016 (HealthDay News) -- Patients dying in old age often receive unnecessary end-of-life medical treatments in hospitals, according to research published online June 27 in the International Journal for Quality in Health Care.

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Coprescribing Naloxone to Opioid Users Helps Reduce ER Visits

TUESDAY, June 28, 2016 (HealthDay News) -- Patients on long-term opioid therapy who receive prescriptions for naloxone are less likely to return for emergency care related to opioid use, according to a study published online June 28 in the Annals of Internal Medicine.

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Guidance Updated for Sedation of Pediatric Patients

TUESDAY, June 28, 2016 (HealthDay News) -- Guidelines have been updated for monitoring and management of pediatric patients before, during, and after sedation, according to a clinical report published online June 27 in Pediatrics.

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Few Young Males Receive HIV Testing at Physician Office Visits

TUESDAY, June 28, 2016 (HealthDay News) -- Few young males receive HIV testing during visits to physicians' offices, although the rates are higher for black and Hispanic males than for white males, according to a report published in the June 24 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Patients Face High Hospital Bills Despite Having Insurance

MONDAY, June 27, 2016 (HealthDay News) -- Costs of hospitalization for privately insured adults rose more than 37 percent over five years, with patients paying more than $1,000 on average by 2013, according to research published online June 27 in JAMA Internal Medicine.

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Mortality Up With No Revascularization in NSTEMI

FRIDAY, June 24, 2016 (HealthDay News) -- Mortality is increased for patients with non-ST-segment elevation myocardial infarction (NSTEMI) who do not undergo coronary revascularization, according to a study published in the July 1 issue of The American Journal of Cardiology.

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Diabetes Increases Mortality Risk After Acute Myocardial Infarction

FRIDAY, June 24, 2016 (HealthDay News) -- Patients with diabetes are much more likely to die after an acute myocardial infarction (AMI) than patients without diabetes, according to a study published online June 15 in the Journal of Epidemiology and Community Health.

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2017 Will Bring Premium Rate Increases Under ACA

FRIDAY, June 24, 2016 (HealthDay News) -- Health insurance premiums under the Affordable Care Act will rise in 2017, analysts and insurance brokers say.

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Misuse of Opioids Doubled in the United States Over a Decade

FRIDAY, June 24, 2016 (HealthDay News) -- Misuse of opioids by American adults more than doubled from the early 2000s to 2013, according to the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA). The study was published online June 22 in the Journal of Clinical Psychiatry.

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Variation in ER Visit Use for the Five Most Populous States

FRIDAY, June 24, 2016 (HealthDay News) -- There is variation in the number of emergency department visits and expected source of payment for visits in the five most populous states (California, Florida, Illinois, New York, and Texas), according to two June data briefs published by the National Center for Health Statistics (NCHS).

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CDC: FluMist Nasal Flu Vaccine Should Not Be Used 2016-2017

THURSDAY, June 23, 2016 (HealthDay News) -- The nasal spray form of the influenza vaccine should not be used next flu season, according to an announcement late Wednesday by the U.S. Centers for Disease Control and Prevention's Advisory Panel on Immunization Practices (ACIP).

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Digital Technology Holds Potential in Emergency CVD Care

THURSDAY, June 23, 2016 (HealthDay News) -- Smartphones, apps, and other digital technology could speed emergency care to patients experiencing an acute myocardial infarction (AMI), stroke, or cardiac arrest, according to a new report issued by the American Heart Association (AHA) and published online June 22 in Circulation.

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Smartphone Use at Night May Result in Monocular 'Blindness'

THURSDAY, June 23, 2016 (HealthDay News) -- A short-lived optical sensation can lead some smartphone users to mistakenly believe they've lost sight in one eye, according to a research letter published in the June 23 issue of the New England Journal of Medicine.

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Zika Infection Also Linked to Uveitis in Adults

THURSDAY, June 23, 2016 (HealthDay News) -- In a letter published online June 22 in the New England Journal of Medicine, researchers describe the case of a man who was infected with Zika and developed uveitis.

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Failure of Dual Antimicrobial Therapy for Gonorrhea Reported

THURSDAY, June 23, 2016 (HealthDay News) -- In a case report published in the June 23 issue of the New England Journal of Medicine, dual antimicrobial therapy failure is described in the treatment of gonorrhea.

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Risk of Cardiovascular Events Up in Black Patients With A-Fib

WEDNESDAY, June 22, 2016 (HealthDay News) -- Black Americans with atrial fibrillation are at higher risk than whites for serious cardiovascular complications and death, according to a study published online June 22 in JAMA Cardiology.

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Male PCPs Less Likely to Assess CVD Risk in Female Patients

WEDNESDAY, June 22, 2016 (HealthDay News) -- Many male primary care physicians regard cardiovascular disease as a man's issue and don't assess risk in female patients, according to research published online June 21 in the European Journal of Preventive Cardiology.

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APCs, Doctors Order Low-Value Services With Similar Frequency

WEDNESDAY, June 22, 2016 (HealthDay News) -- Advanced practice clinicians (APCs) and physicians order low-value health services with similar frequency, according to a study published online June 20 in the Annals of Internal Medicine.

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Reset Room Can Help Address Physician Burnout

MONDAY, June 20, 2016 (HealthDay News) -- The creation of a reset room is one of several solutions that can help physicians and medical providers address burnout, according to a report published by the American Medical Association.

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CDC: New Test May Help Screen Blood Donations for Zika

FRIDAY, June 17, 2016 (HealthDay News) -- The Zika virus is spreading through Puerto Rico, placing hundreds of pregnant women at risk for delivering babies with microcephaly, and blood centers in Puerto Rico have begun testing donations for Zika, the U.S. Centers for Disease Control and Prevention said Friday.

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Strategy Needed to Address Impending Physician Shortage

FRIDAY, June 17, 2016 (HealthDay News) -- Steps should be taken to combat the impending physician shortage of between 61,700 and 94,700 doctors that the United States is expected to face over the next decade, according to an article published in Medical Economics.

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Recombinant tPA Safe for Patients With Wake-Up Stroke

FRIDAY, June 17, 2016 (HealthDay News) -- For patients with wake-up stroke (WUS), treatment with recombinant tissue plasminogen activator (rtPA) seems safe, according to a study published online June 6 in the Annals of Neurology.

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Potential Impact of Single-Payer Health Care Discussed

THURSDAY, June 16, 2016 (HealthDay News) -- Democratic presidential candidate Bernie Sanders is promoting his version of single-payer health care, although the actual impact of such a system is unclear, according to a report published in Medical Economics.

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Unplanned Readmission for ~8 Percent of Surgical Discharges

THURSDAY, June 16, 2016 (HealthDay News) -- Unplanned readmissions occur in about 8 percent of patients discharged from the general surgical service, according to a study published online June 15 in JAMA Surgery.

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Prices for Care Rise Significantly As Multi-Hospital Systems Emerge

THURSDAY, June 16, 2016 (HealthDay News) -- Hospital prices in California increased substantially from 2004 to 2013, with a larger increase in hospitals that are members of multi-hospital systems, according to a study published online June 9 in Inquiry.

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Several Heart Conditions Affected Differently by Alcohol

WEDNESDAY, June 15, 2016 (HealthDay News) -- Texans living in "dry" counties are more likely to suffer myocardial infarction and congestive heart failure than those living in nearby "wet" counties, where alcohol sales are legal; however, atrial fibrillation is less likely in dry counties, according to a study published online June 14 in The BMJ.

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Very Few Cases of Chest Pain Seen in ER Are Life-Threatening

WEDNESDAY, June 15, 2016 (HealthDay News) -- Less than 6 percent of patients presenting to the emergency department with chest pain suffer from life-threatening conditions such as a heart attack, according to a research letter published online June 13 in JAMA Internal Medicine.

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ERs Seeing More Severe Wounds From Gun Violence

WEDNESDAY, June 15, 2016 (HealthDay News) -- Injuries from gun violence may be increasing in severity in emergency departments across the United States, according to a research letter published in the June 14 issue of the Journal of the American Medical Association.

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Hospital Care of Hypertensive Urgency Doesn't Up Outcomes

TUESDAY, June 14, 2016 (HealthDay News) -- Most cases of hypertensive urgency can be safely managed in an outpatient setting, according to research published online June 13 in JAMA Internal Medicine.

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Anaphylaxis Risk Up for Siblings of Peanut Allergic Children

TUESDAY, June 14, 2016 (HealthDay News) -- The risk of anaphylaxis is increased upon peanut introduction in siblings of children with peanut allergy, according to a study published online June 13 in Allergy.

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Many Patients Prescribed Opioids Sharing Leftover Pills

MONDAY, June 13, 2016 (HealthDay News) -- More than half of patients prescribed opioids receive more than they need, and many share the drugs or fail to store them securely, according to research published online June 13 in JAMA Internal Medicine.

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Ambulance Diversion Still a Concern Across the United States

FRIDAY, June 10, 2016 (HealthDay News) -- The use of ambulance diversion for temporarily relieving emergency departments remains a critical issue across the country, according to a health policy brief published online June 2 in Health Affairs.

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Risk of S. aureus Bacteremia Up in Patients on Glucocorticoids

FRIDAY, June 10, 2016 (HealthDay News) -- Patients taking systemic glucocorticoids are at higher risk for community-acquired Staphylococcus aureus bacteremia (CA-SAB), according to research published online June 8 in Mayo Clinic Proceedings.

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Women With A-Fib Less Likely to Receive Oral Anticoagulants

THURSDAY, June 9, 2016 (HealthDay News) -- Among patients with atrial fibrillation, women are less likely than men to receive oral anticoagulant therapy, according to a study published in the May issue of the Journal of the American Geriatrics Society.

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Temporal hs-cTnT Increase Linked to Risk of CHD, CHF

THURSDAY, June 9, 2016 (HealthDay News) -- Temporal increases in high-sensitivity cardiac troponin T (hs-cTnT) are associated with increased risk of coronary heart disease (CHD), heart failure, and all-cause mortality, according to a study published online June 8 in JAMA Cardiology.

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Change in Physician Call System May Up Readmission Rates

THURSDAY, June 9, 2016 (HealthDay News) -- Change in physician call systems may increase hospital readmission rates, according to a study published recently in The American Journal of Medicine.

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FDA Warns of Overdoses of Anti-Diarrhea Drug

WEDNESDAY, June 8, 2016 (HealthDay News) -- Overdoses from common anti-diarrhea drugs are being investigated by the U.S. Food and Drug Administration, which warned the drugs can cause potentially fatal heart problems when taken in higher-than-recommended amounts.

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New Synthetic Drug Linked to Dozens of Deaths Across U.S.

WEDNESDAY, June 8, 2016 (HealthDay News) -- A new synthetic drug called U-47700 has been linked with at least 50 deaths across the United States, and several states are trying to halt the spread of the drug, which can be bought online.

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Shift Work 'Unwinds' Body Clock, May Lead to More Severe Stroke

WEDNESDAY, June 8, 2016 (HealthDay News) -- Circadian rhythm disruption associated with shifted light:dark (LD) cycles exacerbates stroke outcomes in a rat model, according to an experimental study published online June 2 in Endocrinology.

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Army Has the Highest Suicide Risk in U.S. Military

TUESDAY, June 7, 2016 (HealthDay News) -- Suicide rates have been increasing among all active U.S. Navy, Air Force, and Army personnel, but those in the Army appear to be most at risk, according to a study published online June 7 in the Annals of Internal Medicine.

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Severe Hypoglycemia Risk Nearly Doubles With Intensive T2DM Tx

MONDAY, June 6, 2016 (HealthDay News) -- Intensive diabetes mellitus treatment nearly doubles the risk of severe hypoglycemia requiring medical attention in clinically complex patients, according to a study published online June 6 in JAMA Internal Medicine.

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Serious Bleeding Risks Linked to OTC Antacids Containing Aspirin

MONDAY, June 6, 2016 (HealthDay News) -- Antacids that contain aspirin may cause stomach or intestinal bleeding in rare cases, U.S. Food and Drug Administration officials said Monday.

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Ventricular Ectopic QRS Interval May Be Useful Post-MI Marker

MONDAY, June 6, 2016 (HealthDay News) -- The ventricular ectopic QRS interval (VEQSI) can identify post-myocardial infarction (MI) patients with prior serious ventricular arrhythmia, according to a study published online June 1 in JACC: Clinical Electrophysiology.

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Contraindication to Antiplatelet Rx for ~18 Percent With PCI

FRIDAY, June 3, 2016 (HealthDay News) -- About 18 percent of patients undergoing percutaneous coronary intervention (PCI) have a contraindication to commonly used antiplatelet medications, according to a study published online May 31 in Circulation: Cardiovascular Quality and Outcomes.

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High-Sensitivity Cardiac Troponin I Assay Shows Efficiency in ER

FRIDAY, June 3, 2016 (HealthDay News) -- A high-sensitivity cardiac troponin I assay can help identify or exclude the diagnosis of myocardial infarction (MI) in the emergency department, according to two studies published online June 1 in JAMA Cardiology.

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Patients Like to See Physicians Wearing White Coats

THURSDAY, June 2, 2016 (HealthDay News) -- Most patients prefer that physicians wear white coats, according to research published online June 1 in JAMA Dermatology.

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Children With Concussion Often Seen in Primary Care First

WEDNESDAY, June 1, 2016 (HealthDay News) -- Four out of five children with concussion are diagnosed at a primary care practice rather than the emergency department, according to a study published online May 31 in JAMA Pediatrics.

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CVD Risk Appears to Be Increased in Women With Migraine

WEDNESDAY, June 1, 2016 (HealthDay News) -- Women who suffer from migraine headaches may have a slightly increased risk of heart disease or stroke, according to a study published online May 31 in The BMJ.

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More Evidence That Air Pollution Raises Blood Pressure

WEDNESDAY, June 1, 2016 (HealthDay News) -- There is more evidence linking air pollution with increased risk of developing hypertension, according to a review published online May 31 in Hypertension.

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Many Parents Know Too Little About Their Child's Asthma Meds

WEDNESDAY, June 1, 2016 (HealthDay News) -- Only half of parents of children with asthma fully understand the use of their child's asthma medications, according to research published online May 17 in the Journal of Allergy and Clinical Immunology.

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Vigilance Urged for Heparin-Induced Thrombocytopenia

WEDNESDAY, June 1, 2016 (HealthDay News) -- Diagnosis and management of heparin-induced thrombocytopenia (HIT) are discussed in a review published in the May 31 issue of the Journal of the American College of Cardiology.

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Patients With IBS Often Have Negative Health Care Encounters

WEDNESDAY, June 1, 2016 (HealthDay News) -- Patients suffering from severe irritable bowel syndrome (IBS) often have negative experiences of health care encounters, and actively negotiate such professional discourse by presenting a counternarrative describing their own suffering and strengths, according to a study published online May 24 in the Journal of Clinical Nursing.

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