May 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 May 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.

Cephalexin Failure Rate Similar for Morbidly Obese, Non-Obese

TUESDAY, May 31, 2016 (HealthDay News) -- For patients receiving cephalexin monotherapy for non-purulent cellulitis, the rate of therapeutic failure does not differ for morbidly obese and non-obese, according to a study published online May 19 in the Journal of Clinical Pharmacy and Therapeutics.

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DAPT Score Improves Risk Prediction of Continued DAPT

TUESDAY, May 31, 2016 (HealthDay News) -- A decision tool (dual antiplatelet therapy [DAPT] score) improves risk prediction for continued DAPT beyond assessment of myocardial infarction (MI) history, according to a study published in the May 31 issue of the Journal of the American College of Cardiology.

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AHRQ Communication Toolkit Can Help After Patient Harm Occurs

TUESDAY, May 31, 2016 (HealthDay News) -- A new communication toolkit created by the Agency for Healthcare Research and Quality (AHRQ) can help health care organizations and providers communicate with patients and families when harm occurs to patients.

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CDC: Fatal Abusive Head Trauma Among Children Down in the U.S.

FRIDAY, May 27, 2016 (HealthDay News) -- Half as many infants and preschoolers in the United States are dying from abusive head trauma as in 2009, according to research published in the May 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Remaining Uninsured May Be Difficult to Reach Via ACA

FRIDAY, May 27, 2016 (HealthDay News) -- Uninsurance rates have decreased since the introduction of the Affordable Care Act (ACA), but reaching the remaining uninsured may prove challenging, according to a health policy brief published online May 23 in Health Affairs.

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PPI Use Ups NSAID-Induced Small Bowel Injury

FRIDAY, May 27, 2016 (HealthDay News) -- Proton pump inhibitors (PPIs) increase the risk of nonsteroidal anti-inflammatory drug-induced small bowel injury, according to a study published in the June issue of Clinical Gastroenterology and Hepatology.

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HMI Impulses From Ultrasound Transducer Beneficial in STEMI

FRIDAY, May 27, 2016 (HealthDay News) -- High mechanical index (HMI) impulses from a diagnostic ultrasound (DUS) transducer during intravenous microbubble infusion can prevent microvascular obstruction in ST-segment elevation myocardial infarction (STEMI), according to a study published in the May 31 issue of the Journal of the American College of Cardiology.

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Recognition of Patient Expertise Can Improve Adherence

FRIDAY, May 27, 2016 (HealthDay News) -- Recognizing the unique role of patients and their expertise within the physician-patient interaction can help to prevent non-adherence based on disagreement, according to an article published online May 18 in the Journal of Evaluation in Clinical Practice.

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Wells Rule Beats 'Gestalt' in Ruling Out Pulmonary Embolism

WEDNESDAY, May 25, 2016 (HealthDay News) -- Both a physician's own probability estimate ("gestalt") and the Wells rule can be combined with D-dimer testing to safely rule out pulmonary embolism (PE) in primary care; however, the Wells rule is more efficient, according to a study published in the May/June issue of the Annals of Family Medicine.

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Hyperglycemia Tied to Outcomes in Pediatric Stroke

TUESDAY, May 24, 2016 (HealthDay News) -- For children with arterial ischemic stroke, infarct volume and hyperglycemia, but not hypertension and fever, correlate with poor neurological outcome, according to research published online May 23 in JAMA Neurology.

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AAP Recommends at Least One Full-Time Nurse in Every School

MONDAY, May 23, 2016 (HealthDay News) -- Every school should have at least one full-time registered nurse, according to a new American Academy of Pediatrics (AAP) policy statement published online May 23 in Pediatrics.

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Clinicians Should Ask, Counsel About Firearms

MONDAY, May 23, 2016 (HealthDay News) -- Clinicians ask and counsel their patients about firearms less often than recommended, according to an article published online May 17 in the Annals of Internal Medicine.

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Two New Drugs Added to Heart Failure Clinical Practice Guideline

MONDAY, May 23, 2016 (HealthDay News) -- An updated clinical guideline adds two new types of drugs to the list of treatment options for heart failure. The updated guideline was published online May 20 in the Journal of the American College of Cardiology, Circulation, and the Journal of Cardiac Failure.

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Opioid Prescriptions Drop for First Time in Two Decades

MONDAY, May 23, 2016 (HealthDay News) -- In a sign that the opioid epidemic might be waning, new data show that the number of opioid prescriptions has dropped for the first time in 20 years.

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Improved Outcomes With Fast Reperfusion in Acute Stroke

FRIDAY, May 20, 2016 (HealthDay News) -- Among patients with acute stroke treated with stent retrievers, fast reperfusion leads to improved functional outcome, according to a study published in the June issue of Radiology.

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Racism Can Disrupt Physician-Patient Power Dynamics

FRIDAY, May 20, 2016 (HealthDay News) -- A case of racism by a patient that disrupted the power dynamics between a physician and patient is described in a reflection piece published in the May/June issue of the Annals of Family Medicine.

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Last Year Saw 10 Percent Rise in Motorcycle Deaths in U.S

FRIDAY, May 20, 2016 (HealthDay News) -- Motorcyclist deaths in the United States topped 5,000 last year -- a 10 percent increase from 2014, according to a new report from the Governors Highway Safety Association.

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Major Stroke May Be Prevented by Taking Aspirin After TIA

FRIDAY, May 20, 2016 (HealthDay News) -- Taking aspirin immediately after a transient ischemic attack (TIA) significantly reduces the risk of a major stroke, according to research published online May 18 in The Lancet.

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Strategies Can Help Streamline Revenue-Related Processes

THURSDAY, May 19, 2016 (HealthDay News) -- Strategies can be employed to maximize the amount of time available for patient care by streamlining revenue-related processes, according to the American Medical Association (AMA).

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Inaccuracy in Administrative Hospital Coding Data

THURSDAY, May 19, 2016 (HealthDay News) -- Inaccurate coding can introduce biases in studies based on administrative data, according to research published online May 16 in The BMJ.

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Burnout, Lack of Job Satisfaction Driving Doctors to Cut Hours

WEDNESDAY, May 18, 2016 (HealthDay News) -- Full-time physicians reporting worsening burnout or decreased job satisfaction are more likely to reduce their work hours, according to a study published in the April issue of Mayo Clinic Proceedings.

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Diabetic Ketoacidosis Can Occur Post Bariatric Surgery in T2DM

WEDNESDAY, May 18, 2016 (HealthDay News) -- Diabetic ketoacidosis (DKA) can occur after bariatric surgery in patients with type 2 diabetes, according to a report published online May 10 in Diabetes Care.

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Age-Adjusted D-Dimer Testing Improves Ability to Rule Out PE

WEDNESDAY, May 18, 2016 (HealthDay News) -- Compared with fixed D-dimer testing, age-adjusted D-dimer testing is associated with an increase in the proportion of patients with suspected pulmonary embolism (PE) in whom imaging can be withheld, according to a review published online May 17 in the Annals of Internal Medicine.

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Sexual Harassment Experienced by One-Third of Female Doctors

WEDNESDAY, May 18, 2016 (HealthDay News) -- Thirty percent of female physicians face sexual harassment on the job, while close to three-quarters perceive gender bias at work and two-thirds say they have actually experienced it, according to survey findings published in the May 17 issue of the Journal of the American Medical Association.

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About Half of Myocardial Infarctions Are Asymptomatic

TUESDAY, May 17, 2016 (HealthDay News) -- As many as half of all myocardial infarctions (MIs) may be silent, according to a study published online May 16 in Circulation.

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FDA Issues Stronger Warning on Side Effects of Fluoroquinolones

FRIDAY, May 13, 2016 (HealthDay News) -- Stronger warnings about the possible side effects of fluoroquinolones were issued Thursday by the U.S. Food and Drug Administration.

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Recommendations Developed for Management of Drowning

FRIDAY, May 13, 2016 (HealthDay News) -- Recommendations have been developed for prevention and acute management of drowning. The Wilderness Medical Society published the new practice guidelines online April 6 in Wilderness & Environmental Medicine.

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Even Mild Football Head Injury Can Cause Visual Disturbance

FRIDAY, May 13, 2016 (HealthDay News) -- Repeated blows to the head can cause near point of convergence (NPC), even if the individual impacts aren't strong enough to cause a full-fledged concussion, according to research published online May 12 in JAMA Ophthalmology.

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Temporary Skin Tattoos Can Evoke Delayed Hypersensitivity

FRIDAY, May 13, 2016 (HealthDay News) -- Black henna, used in temporary skin tattoos, can evoke type IV delayed hypersensitivity reactions, according to an article published online April 27 in BMJ Case Reports.

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Infection Control Measures Established for Ebola Care

THURSDAY, May 12, 2016 (HealthDay News) -- Infection control measures have been developed to strengthen hospitals' capacity for safely diagnosing and treating patients with Ebola virus disease (EVD), according to a review published online May 10 in the Annals of Internal Medicine.

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U.S. Stroke Hospitalizations Down Overall, but Rising for Some

THURSDAY, May 12, 2016 (HealthDay News) -- While Americans suffered fewer acute ischemic strokes overall from 2000 to 2010, stroke rates climbed substantially among younger adults and blacks, according to study findings published online May 11 in the Journal of the American Heart Association.

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Zika May Present With Mucocutaneous Features

THURSDAY, May 12, 2016 (HealthDay News) -- In one recent case of Zika virus infection, a diffuse papular descending eruption, petechiae on the palate, and hyperemic sclerae were key symptoms of infection with the mosquito-borne virus, according to a case report published online May 11 in JAMA Dermatology.

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Marijuana-Linked Fatal MVAs Up in WA State After Legalization

TUESDAY, May 10, 2016 (HealthDay News) -- The number of fatal motor vehicle crashes involving marijuana more than doubled after Washington state legalized the sale of the drug, according to a study from the AAA Foundation for Traffic Safety.

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CDC Updates Zika Testing Guidance for Urine Samples

TUESDAY, May 10, 2016 (HealthDay News) -- The interim diagnostic testing guidance for Zika virus in public health laboratories has been updated, according to a report published in the May 10 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Case: Exertional Compartment Syndrome in Motorcycle Racer

TUESDAY, May 10, 2016 (HealthDay News) -- In a case study published online April 14 in BMJ Case Reports, chronic exertional compartment syndrome of both flexor and extensor compartments of the forearm is described in a motorcycle racer, which resolved after fasciotomies.

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Cutting Brand-Name Drug Use Could Save U.S. $73 Billion

TUESDAY, May 10, 2016 (HealthDay News) -- Americans could save tens of billions of dollars with more efficient drug use, replacing brand-name drugs with their generic equivalents whenever possible, according to a study published online May 9 in JAMA Internal Medicine.

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Drug Allergy Passport Advised for Patients With Hypersensitivity

TUESDAY, May 10, 2016 (HealthDay News) -- A drug allergy passport, providing information on culprit drugs, clinical manifestations, and alternate drugs to prescribe, should be provided to patients with drug hypersensitivity, according to a position paper published online May 4 in Allergy.

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E-Cigarette Poisonings Rising Quickly Among Young Children

MONDAY, May 9, 2016 (HealthDay News) -- Calls to poison control centers about young children's exposure to e-cigarettes have increased significantly in recent years, and those children who are exposed seem to suffer worse health effects than those exposed to traditional cigarettes, according to research published online May 9 in Pediatrics.

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CDC Establishes New 'Clean Hands Count' Campaign

MONDAY, May 9, 2016 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has introduced a new campaign, "Clean Hands Count," to encourage health care professionals, patients, and patients' families to keep their hands clean in order to prevent health care-associated infections.

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Venlafaxine-Induced Rise in Intraocular Pressure Described

MONDAY, May 9, 2016 (HealthDay News) -- In a case report published online April 30 in Clinical & Experimental Ophthalmology, venlafaxine-induced increase in intraocular pressure (IOP) is described in a patient with open angle glaucoma.

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First Case of Paintball-Linked Liver Injury Described

FRIDAY, May 6, 2016 (HealthDay News) -- A first case of paintball-related blunt liver injury has been described in an article published online April 27 in BMJ Case Reports.

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United States Still Has Shortages of Acute, Non-Acute Drugs

FRIDAY, May 6, 2016 (HealthDay News) -- Drug shortages remain a problem in the United States despite government legislation meant to increase availability, according to a study published in the May issue of Health Affairs.

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Case of Palytoxin-Related Keratitis Described

FRIDAY, May 6, 2016 (HealthDay News) -- In a letter to the editor published online April 30 in Clinical and Experimental Ophthalmology, unilateral palytoxin-induced chemical keratitis is described after a coral expressed its toxin into the patient's eye.

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Fluconazole Use May Raise Risk of Certain Birth Defects

THURSDAY, May 5, 2016 (HealthDay News) -- Prenatal use of low-dose fluconazole is associated with cleft lip with cleft palate and d-transposition of the great arteries, according to a study published in the May issue of the American Journal of Obstetrics & Gynecology.

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Guideline-Based Phone Program Ups Provision, Timeliness of CPR

THURSDAY, May 5, 2016 (HealthDay News) -- Cardiopulmonary resuscitation (CPR) instruction may be just a cellphone call away, according to a study published online May 4 in JAMA Cardiology.

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Increase in Low-Risk AMI Survivors From 2001 to 2011

WEDNESDAY, May 4, 2016 (HealthDay News) -- The proportion of low-risk survivors of acute myocardial infarction (AMI) increased from 2001 to 2011, and characteristics include younger age, male gender, and being married, according to a study published in the May 15 issue of The American Journal of Cardiology.

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Physician Leadership Training May Help Counteract Burnout

WEDNESDAY, May 4, 2016 (HealthDay News) -- Physician leaders with good leadership qualities are more likely to have employees who are satisfied and do not show signs of burnout, according to a study published in the April issue of the Mayo Clinic Proceedings and a report published by the American Medical Association.

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Emergency PCI Linked to Better Outcomes

WEDNESDAY, May 4, 2016 (HealthDay News) -- Almost one-third of out-of-hospital cardiac arrest (OHCA) patients without ST-segment elevation (STE) require percutaneous coronary intervention (PCI), which is tied to a nearly twofold increase in the rate of favorable outcomes, according to a study published in the April issue of JACC: Cardiovascular Interventions.

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Price Transparency Tool Doesn't Cut Health Care Spending

WEDNESDAY, May 4, 2016 (HealthDay News) -- Employee use of a price transparency tool does not cut health care spending, according to a study published in the May 3 issue of the Journal of the American Medical Association.

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Still Too Many Antibiotic Prescriptions Being Written

TUESDAY, May 3, 2016 (HealthDay News) -- Nearly one-third of the antibiotics prescribed in the United States aren't appropriate for the conditions being treated, according to research published in the May 3 issue of the Journal of the American Medical Association.

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High School Football Players Have Most Post-Concussion Symptoms

TUESDAY, May 3, 2016 (HealthDay News) -- High school football players are more likely to suffer more symptoms after a concussion, and to need more recovery time than their college counterparts; however, those who play in youth football leagues are the most likely to get back on the field less than 24 hours after a concussion, according to research published online May 2 in JAMA Pediatrics.

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Report: Why Health Care Costs Are Lower in Europe Than U.S.

TUESDAY, May 3, 2016 (HealthDay News) -- European residents have access to the same health care services as U.S. residents but pay much less, and this is related to several specific factors, according to a report published by INDIGOMED on April 25.

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2017 May Offer Fewer Choices for Affordable Care Act Enrollees

MONDAY, May 2, 2016 (HealthDay News) -- With the nation's largest health insurer exiting all but a few Affordable Care Act exchanges next year, some Americans may be left with fewer choices and some might see higher monthly premiums.

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Distraction Methods During Blood Draws Have Similar Effectiveness

MONDAY, May 2, 2016 (HealthDay News) -- Three different distraction methods are not significantly different in terms of pain and anxiety reduction in children having their blood drawn, according to a study published online April 26 in the Journal of Clinical Nursing.

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