October 2015 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 October 2015. 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.

Middle Finger Length Good Guide for Intubation Depth in Children

FRIDAY, Oct. 30, 2015 (HealthDay News) -- Using middle finger length to guide tracheal intubation depth improves the rate of appropriate tube placement in children, according to a study published in the November issue of Pediatric Anesthesia.

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Stewardship Could Improve Appropriate Medical Imaging Use

FRIDAY, Oct. 30, 2015 (HealthDay News) -- Stewardship may be a promising approach for improving appropriate use of medical imaging technology, according to a perspective piece published in the Oct. 29 issue of the New England Journal of Medicine.

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Increasing Numbers of Med School Applicants, Enrollees

FRIDAY, Oct. 30, 2015 (HealthDay News) -- There has been a 25 percent increase in the number of medical school enrollees since 2002, with the number reaching an all-time high of 20,630 this year, according to a report published online Oct. 22 by the Association of American Medical Colleges (AAMC).

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AAFP Encourages Family Doctors to Consider Prescribing Naloxone

FRIDAY, Oct. 30, 2015 (HealthDay News) -- A resource has been produced to encourage family physicians to consider prescribing naloxone to patients, their family members, or close friends when there is a risk of opioid overdose, according to a report published by the American Academy of Family Physicians (AAFP).

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Sanofi Recalls Auvi-Q Injectors Used to Treat Anaphylaxis

THURSDAY, Oct. 29, 2015 (HealthDay News) -- All packs of Auvi-Q injectors are being recalled in the United States as some may not deliver the correct dose of epinephrine, according to a news release issued by Sanofi on Wednesday.

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More Prescription Opioid Addicts Are Turning to Heroin

THURSDAY, Oct. 29, 2015 (HealthDay News) -- Concurrent use of heroin and prescription opioids is increasing, according to a research letter published in the Oct. 29 issue of the New England Journal of Medicine.

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Early CT Scan Impacts Management of Suspected CAP

THURSDAY, Oct. 29, 2015 (HealthDay News) -- Computed tomography (CT) findings affect the diagnosis and management of suspected community-acquired pneumonia (CAP), according to a study published in the Oct. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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State Abusive Head Trauma Program Didn't Reduce Injuries

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- A program designed to prevent abusive head trauma in North Carolina didn't reduce rates of infant head injuries related to the abuse, according to a study published online Oct. 26 in JAMA Pediatrics.

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Nearly 15 Percent of Plans Lack In-Network Specialists

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- A considerable proportion of federal marketplace plans lack at least one in-network specialist, according to a research letter published in the Oct. 27 issue of the Journal of the American Medical Association.

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Treatment of Post-Thrombolysis sICH Doesn't Lower Mortality

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- Treatment of thrombolysis-related symptomatic intracerebral hemorrhage (sICH) does not reduce in-hospital mortality, according to a study published online Oct. 26 in JAMA Neurology.

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Case of Lactic Acidosis With Metformin, Normal Renal Function

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- In a case report published in the October issue of Clinical Diabetes, lactic acidosis is described in a patient with normal renal function receiving metformin for type 2 diabetes.

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LABAs No Better Than Tiotropium in Black Adults With Asthma

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- For black patients with asthma treated with inhaled corticosteroids (ICS), outcomes are similar with addition of tiotropium and long-acting β-agonists (LABAs), according to a study published in the Oct. 27 issue of the Journal of the American Medical Association.

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Physician Emphasizes Importance of Saying Thank You

TUESDAY, Oct. 27, 2015 (HealthDay News) -- The importance of thanking patients for coming to see you, the physician, is described in an essay published online in Medical Economics.

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Gender Gap Appears to Continue in Cardiovascular Care

TUESDAY, Oct. 27, 2015 (HealthDay News) -- New research suggests that doctors don't warn younger women when they're at risk for cardiovascular disease as often as they warn men. And once younger women suffer an ST-segment elevation myocardial infarction (STEMI), they are less likely to receive revascularization and more likely to die in the hospital. The findings were reported in two separate studies published in the Nov. 3 issue of the Journal of the American College of Cardiology.

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Wrist Fracture Linked to Higher Subsequent Fracture Risk

MONDAY, Oct. 26, 2015 (HealthDay News) -- For postmenopausal women, wrist fracture is associated with increased risk of subsequent non-wrist fracture, according to a study published in the November issue of the Journal of Bone and Mineral Research.

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AMA: Eight Reasons for Nonadherence to Medications

FRIDAY, Oct. 23, 2015 (HealthDay News) -- Eight reasons associated with patient's intentional nonadherence to medications have been identified in a report published by the American Medical Association (AMA).

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Patients' Reasons for Returning to ER Differ From Predicted

FRIDAY, Oct. 23, 2015 (HealthDay News) -- Patients' reasons for returning to the emergency department after discharge from an internal medicine unit include being discharged too soon and feeling weak, and these reasons differ from those predicted by the liaison nurse clinician's evaluation, according to a study published online Oct. 14 in the Journal of Clinical Nursing.

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AC Joint Dislocation Heals Well Without Surgery

THURSDAY, Oct. 22, 2015 (HealthDay News) -- There is no clear evidence that operative treatment improves short-term outcome for complete acromioclavicular (AC) joint dislocation, according to research published in the November issue of the Journal of Orthopaedic Trauma.

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Ultrasound Highly Accurate for Diagnosing Groin Hernia

THURSDAY, Oct. 22, 2015 (HealthDay News) -- Ultrasound (US) is highly accurate for diagnosing the presence and type of groin hernia, according to a study published in the November/December issue of the Journal of Clinical Ultrasound.

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Knee, Hip Arthroplasty Tied to Increased Short-Term MI Risk

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- For patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) for osteoarthritis, the risk of myocardial infarction (MI) is increased in the first postoperative month, according to a study published in the October issue of Arthritis & Rheumatology.

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Marijuana Use Doubles Among Americans in Past Decade

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- As laws and attitudes about marijuana have relaxed in the past decade, the number of Americans who say they smoke marijuana has more than doubled, and nearly three of 10 users had a marijuana use disorder in 2012 to 2013, according to a report published online Oct. 21 in JAMA Psychiatry.

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Opioid Added to Rx Naproxen No Help in Low Back Pain

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- Naproxen alone appears to provide as much relief for low back pain as naproxen plus oxycodone/acetaminophen or cyclobenzaprine, according to research published in the Oct. 20 issue of the Journal of the American Medical Association.

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Longer QRS Duration Predicts Cardiac Death, Heart Attack

MONDAY, Oct. 19, 2015 (HealthDay News) -- Longer QRS duration predicts cardiac death and nonfatal myocardial infarction (MI) in patients with coronary artery disease, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

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CDC: Prescribing Practices Key to Curbing Rx Abuse

FRIDAY, Oct. 16, 2015 (HealthDay News) -- Improved prescribing practices could help reduce opioid abuse and overdose deaths from those drugs, according to research published in the Oct. 16 issue of the CDC's Morbidity and Mortality Weekly Report.

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Patterns of Pediatric Mandible Fx Vary With Age, Sex

FRIDAY, Oct. 16, 2015 (HealthDay News) -- The patterns of pediatric mandible fracture vary with age and sex, according to a study published online Oct. 15 in JAMA Facial Plastic Surgery.

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Stroke Risk Higher for People With High-Strain Jobs

THURSDAY, Oct. 15, 2015 (HealthDay News) -- Exposure to high-strain jobs is associated with an increased risk of stroke, especially in women, according to a meta-analysis published online Oct. 14 in Neurology.

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About 23,000 ER Visits/Year for Supplement-Linked Side Effects

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Every year about 23,000 U.S. emergency department visits involve adverse events related to dietary supplements, according to a special article published online Oct. 14 in the New England Journal of Medicine.

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Metronome Can Improve Rate of Compressions in Pediatric CPR

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- The rate of chest compressions during CPR can be optimized by the use of a metronome, according to a study published online Oct. 12 in Pediatrics.

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Enterovirus D68 Doesn't Raise Mortality Risk in Children

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Enterovirus D68 (EV-D68) seems to be a more virulent pulmonary pathogen in children than rhinovirus or non-EV-D68 enterovirus, but it does not increase the risk of death, according to a study published Oct. 13 in CMAJ, the journal of the Canadian Medical Association.

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Early Physical Therapy Shows Limited Value in Low Back Pain

TUESDAY, Oct. 13, 2015 (HealthDay News) -- For adults with low back pain (LBP) fitting a decision rule, early physical therapy is associated with modest improvement in disability compared with usual care, but the improvement is not seen at one-year follow-up, according to a study published online Oct. 13 in the Journal of the American Medical Association.

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Some Changes Seen in Line With 'Choosing Wisely' Initiative

TUESDAY, Oct. 13, 2015 (HealthDay News) -- Significant decreases in low-value services were seen in accordance with two of seven early "Choosing Wisely" recommendations, according to a study published online Oct. 12 in JAMA Internal Medicine.

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Intervention Cuts Contamination in Protective Gear Removal

TUESDAY, Oct. 13, 2015 (HealthDay News) -- An educational intervention can reduce contamination of the skin and clothing of health care personnel during removal of contaminated personal protective equipment (PPE), according to a study published online Oct. 12 in JAMA Internal Medicine.

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Immediate Hypersensitivity to Raw Garlic Described

MONDAY, Oct. 12, 2015 (HealthDay News) -- Raw garlic can induce immediate hypersensitivity reactions, according to a letter to the editor published in the October issue of the Journal of Dermatology.

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Americans Spend More on Health Care, but Fare Worse

MONDAY, Oct. 12, 2015 (HealthDay News) -- When compared to 12 other industrialized nations, Americans spend more on health care services, but they fare worst in terms of life expectancy, according to recent findings from The Commonwealth Fund.

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High Rate of Concussion Linked to Isolated Mandible Fractures

FRIDAY, Oct. 9, 2015 (HealthDay News) -- The rate of concussions associated with isolated mandible fractures is high, according to a study published online Oct. 8 in JAMA Facial Plastic Surgery.

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Two Decision Instruments ID Major Injuries in Blunt Trauma

FRIDAY, Oct. 9, 2015 (HealthDay News) -- Two decision instruments (DIs) have high sensitivity for identifying blunt trauma patients with clinically significant thoracic injuries, according to a study published online Oct. 6 in PLOS Medicine.

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Troponin Cut-Off Could Help Reduce Admissions, Costs

THURSDAY, Oct. 8, 2015 (HealthDay News) -- A cardiac troponin concentration of <5 ng/L identifies patients at very low risk of myocardial infarction (MI) either during admission or within the following 30 days, researchers report online Oct. 7 in The Lancet.

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Substantial Proportion of Revisits Post Ambulatory Sx Occur in ER

THURSDAY, Oct. 8, 2015 (HealthDay News) -- Acute care revisits occur with considerable frequency among low-risk patients undergoing ambulatory operations, with a substantial proportion of revisits occurring in emergency departments, according to a research letter published in the Oct. 6 issue of the Journal of the American Medical Association.

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CDC: Four Deaths Linked to Latest Salmonella Outbreak

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- A Salmonella outbreak that has been linked to contaminated cucumbers imported from Mexico has now caused 732 illnesses in 35 states, U.S. health officials said Tuesday.

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Rehab Not Necessary for Uncomplicated Ankle Fracture

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- A supervised exercise program does not confer additional benefits in activity limitation or quality of life compared with advice alone for patients with isolated and uncomplicated ankle fracture, according to research published in the Oct. 6 issue of the Journal of the American Medical Association.

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Older Adults May Take Longer to Recover From Concussion

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- Older adults recover more slowly from concussion than younger patients, according to a small new study published online Oct. 6 in Radiology.

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Guidelines Developed for Managing Conflicts of Interest

TUESDAY, Oct. 6, 2015 (HealthDay News) -- The Guidelines International Network has developed principles for disclosure and management of conflicts of interest (COIs) during the clinical practice guideline development process, according to a report published in the Oct. 6 issue of the Annals of Internal Medicine.

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Zip Line Injuries Up Significantly in the United States

TUESDAY, Oct. 6, 2015 (HealthDay News) -- An estimated 16,850 nonfatal zip line injuries were treated in U.S. emergency departments between 1997 and 2012, and nearly 70 percent of those injuries occurred during the last four years of that span, according to research published recently in the American Journal of Emergency Medicine.

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Researchers Urge Routine Screening for Child Abuse

TUESDAY, Oct. 6, 2015 (HealthDay News) -- The early signs of child abuse among infants and toddlers -- head trauma, rib fractures, or abdominal injuries -- are often missed, and that may be due in part to a lack of standardized screening, researchers report. The findings were published online Oct. 5 in Pediatrics.

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Type of Provider Impacts Health Care Utilization in LBP

MONDAY, Oct. 5, 2015 (HealthDay News) -- For new entries into health care with low back pain (LBP), the provider chosen for entry is associated with future health care utilization, according to research published online Sept. 29 in the Journal of Evaluation in Clinical Practice.

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Modified SOAP Ups Student Awareness of Health Care Costs

MONDAY, Oct. 5, 2015 (HealthDay News) -- Modification of the traditional Subjective-Objective-Assessment-Plan (SOAP) presentation to consider value (SOAP-V) can help medical students learn to practice high-value, cost-conscious care, according to a study published online Sept. 28 in the Journal of Hospital Medicine.

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Providers Must Understand Legal Limits of Telemedicine

FRIDAY, Oct. 2, 2015 (HealthDay News) -- In order to minimize risk when practicing telemedicine, providers should ensure they hold the proper medical licenses, have medical liability insurance coverage, and communicate with patients regarding the potential risks of telemedicine, according to a report published in Medical Economics.

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No Benefit Seen With Physical Tx in Acute Lateral Epicondylitis

FRIDAY, Oct. 2, 2015 (HealthDay News) -- Most patients with acute lateral epicondylitis recover without physical therapy and steroid injections, according to a study published recently in BMC Musculoskeletal Disorders.

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Strategies Provided for Improving EHR Efficiency

THURSDAY, Oct. 1, 2015 (HealthDay News) -- Several strategies can be implemented in order to better use electronic health records (EHRs) for patient care and efficiency, according to an article published in Medical Economics.

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Colds, Flu Up Odds for Stroke in Children, Though Risk Is Low

THURSDAY, Oct. 1, 2015 (HealthDay News) -- Having a cold or the flu may sometimes trigger a stroke in children -- particularly those with underlying health conditions -- though the overall risk remains low, according to a new study, published online Sept. 30 in Neurology.

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