April 2018 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 2018. 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.

Flu Vaccines Have High Impact, Even With Relatively Low Efficacy

MONDAY, April 30, 2018 (HealthDay News) -- Even relatively low-efficacy influenza vaccines can have a high impact, especially with optimal distribution across age groups, according to a study published online April 30 in the Proceedings of the National Academy of Sciences.

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ALS by Physician May Improve Traumatic Arrest Outcomes

FRIDAY, April 27, 2018 (HealthDay News) -- For patients with traumatic out-of-hospital cardiac arrest (OHCA), pre-hospital advanced life support (ALS) provided by a physician is associated with increased likelihood of one-month survival, according to a study published online April 25 in JAMA Surgery.

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High Risk of Death After Major Diabetes-Related Amputations

FRIDAY, April 27, 2018 (HealthDay News) -- There is a high risk of postoperative mortality among patients undergoing lower-limb amputation, according to a study published online April 5 in Diabetes Care.

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Tenecteplase Appears Superior to Alteplase After Ischemic Stroke

THURSDAY, April 26, 2018 (HealthDay News) -- For patients with ischemic stroke, treatment with tenecteplase within 4.5 hours of symptom onset and before thrombectomy is associated with better outcomes than treatment with alteplase during the same timeframe, according to a study published in the April 26 issue the New England Journal of Medicine.

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Saturday Is National Prescription Drug Take Back Day

THURSDAY, April 26, 2017 (HealthDay News) -- The U.S. Drug Enforcement Administration and local agencies are holding the 15th National Prescription Drug Take Back Day across the country this Saturday, April 28.

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People With Opioid Use Disorder Have High Suicide Rate

WEDNESDAY, April 25, 2018 (HealthDay News) -- Patients with opioid use disorder (OUD) seem to have a high rate of suicide, according to a perspective piece published in the April 26 issue of the New England Journal of Medicine.

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Medicare Requiring Hospitals to Post Prices Online

WEDNESDAY, April 25, 2018 (HealthDay News) -- U.S. hospitals will have to post their standard prices online and make it easier for patients to access their electronic medical records, Medicare officials said Tuesday.

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Black Men More Likely to Die From Firearm Homicide

TUESDAY, April 24, 2018 (HealthDay News) -- Firearm homicides are much more common among black men compared to white men, particularly in rust belt states, according to a study published online April 24 in the Annals of Internal Medicine.

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Patients Prefer Doctors Who Engage in Face-to-Face Visits

MONDAY, April 23, 2018 (HealthDay News) -- Patients prefer physicians who engage in face-to-face (F2F) clinic visits, rather than those using an examination room computer (ERC), according to a research letter published online April 19 in JAMA Oncology.

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Pediatric Exposures to Liquid Nicotine Down From 2015 to 2016

MONDAY, April 23, 2018 (HealthDay News) -- Pediatric exposures to liquid nicotine decreased from 2015 to 2016, but exposure still poses serious risks to children, according to a study published online April 23 in Pediatrics.

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Opioids Tied to Adverse Outcomes in Hemodialysis Patients

THURSDAY, April 19, 2018 (HealthDay News) -- For patients on hemodialysis, opioids are associated with adverse outcomes, according to a study published online April 19 in the Clinical Journal of the American Society of Nephrology.

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Triple Therapy Tied to Reduced Rate of COPD Exacerbations

WEDNESDAY, April 18, 2018 (HealthDay News) -- For patients with chronic obstructive pulmonary disease (COPD), triple therapy is associated with a reduced rate of exacerbations, according to a study published online April 18 in the New England Journal of Medicine.

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USPSTF: Exercise Interventions Prevent Falls in Seniors

TUESDAY, April 17, 2018 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) concludes that exercise interventions may be beneficial for preventing falls in older adults; however, the evidence is insufficient to weigh the benefits and harms of vitamin D, calcium, and combined supplementation. These findings form the basis of two recommendation statements published April 17 in the Journal of the American Medical Association.

Evidence Report - Falls
Final Recommendation Statement - Falls
Editorial - Falls
Evidence Report - Vitamin D
Final Recommendation Statement - Vitamin D
Editorial - Vitamin D

Caffeine Does Not Appear to Be Linked to Risk of Arrhythmia

TUESDAY, April 17, 2018 (HealthDay News) -- Regular intake of coffee and tea does not appear to be associated with the risk of arrhythmia, according to a review published in the April 1 issue of JACC: Clinical Electrophysiology.

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UTI Calculator Predicts Risk of Infant Urinary Tract Infection

TUESDAY, April 17, 2018 (HealthDay News) -- The newly developed UTICalc calculator can be used to guide testing and treatment in children with suspected urinary tract infection (UTI), according to a study published online April 16 in JAMA Pediatrics.

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Recommendations Developed on Gender Equity in Medicine

MONDAY, April 16, 2018 (HealthDay News) -- In a position paper published online April 17 in the Annals of Internal Medicine, recommendations are provided aimed at addressing gender equity in physician compensation and career advancement opportunities.

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Increased Pollution Exposure Ups Health Care Visits for Acute URI

MONDAY, April 16, 2018 (HealthDay News) -- Short-term exposure to fine particulate matter (PM2.5) is associated with increased health care utilization for acute lower respiratory infection (ALRI), according to a study published online April 13 in the American Journal of Respiratory and Critical Care Medicine.

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Youth With Gender Nonconformity Vulnerable to Adversity

MONDAY, April 16, 2018 (HealthDay News) -- Youth with gender nonconformity are vulnerable to experiencing adversity, and transgender and/or gender nonconforming (TGNC) youth have higher prevalence of mental health conditions, according to two studies published online April 16 in Pediatrics.

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Number of Drinks Predicts Teens' Other Risky Behaviors

MONDAY, April 16, 2018 (HealthDay News) -- The number of drinks consumed in high school students' binge drinking episodes predicts other health risk behaviors, according to a study published online April 10 in Alcoholism: Clinical & Experimental Research.

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Nonoptimized Drug Therapy Costs More Than $500 Billion Annually

MONDAY, April 16, 2018 (HealthDay News) -- The estimated annual cost of drug-related morbidity and mortality resulting from nonoptimized medication therapy is more than half a trillion dollars in the United States, according to a study published online March 26 in the Annals of Pharmacotherapy.

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FDA Cracks Down on Caffeine-Loaded Dietary Supplements

FRIDAY, April 13, 2018 (HealthDay News) -- The U.S. Food and Drug Administration announced Friday that it has issued tough new restrictions on the sale of dietary supplements that contain dangerously high amounts of caffeine.

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Recent Years Saw Increase in Burden of Prior Authorization

THURSDAY, April 12, 2018 (HealthDay News) -- The burden of prior authorization (PA) has increased over the past five years, and 92 percent of physicians report associated delays in access to care, according to the results of a survey published by the American Medical Association (AMA).

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CVD Burden Decreased From 1990 to 2016 Across U.S.

THURSDAY, April 12, 2018 (HealthDay News) -- From 1990 to 2016 there were decreases in cardiovascular disease (CVD) disability-adjusted life years (DALYs) in all states across the United States, according to a study published online April 11 in JAMA Cardiology.

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Sleep Deficiency Leads to Higher Number of Motor Vehicle Crashes

WEDNESDAY, April 11, 2018 (HealthDay News) -- Sleep deficiency due to sleep apnea or sleep duration less than seven hours is associated with motor vehicle crashes independent of self-reported excessive sleepiness, according to a study published online March 20 in BMC Medicine.

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Smoke Exposure Tied to Higher CV, Cerebrovascular ER Visits

WEDNESDAY, April 11, 2018 (HealthDay News) -- For all adults, and especially for those older than 65 years, smoke exposure is associated with cardiovascular and cerebrovascular emergency department visits, according to a study published online April 11 in the Journal of the American Heart Association.

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TBI Associated With Increased Risk of Subsequent Dementia

WEDNESDAY, April 11, 2018 (HealthDay News) -- Traumatic brain injury (TBI) is associated with increased risk of dementia, according to a study published online April 10 in The Lancet Psychiatry.

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Civilian Prehospital Tourniquets Linked to Reduction in Mortality

WEDNESDAY, April 11, 2018 (HealthDay News) -- Civilian prehospital tourniquet application is associated with a six-fold mortality reduction in patients with peripheral vascular injuries, according to a study published in the Journal of the American College of Surgeons.

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Considerable Differences in Burden of Disease at State Level

TUESDAY, April 10, 2018 (HealthDay News) -- There are considerable differences in the burden of disease at the state level, according to a study published in the April 10 issue of the Journal of the American Medical Association.

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Suggestions Offered to Reduce Physician Frustration With EHRs

TUESDAY, April 10, 2018 (HealthDay News) -- Changes can be implemented to help reduce physician frustration with electronic health records (EHRs), according to an article published in Medical Economics.

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Whole Body CT Doesn't Cut Mortality in Peds Blunt Trauma

TUESDAY, April 10, 2018 (HealthDay News) -- Whole body computed tomography (WBCT) is not associated with reduced mortality compared with a selective CT approach among children with blunt trauma, according to a study published online April 9 in JAMA Pediatrics.

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Interns' Schedule Takes Toll on Sleep, Physical Activity, Mood

FRIDAY, April 6, 2018 (HealthDay News) -- New interns' intense and changing schedules take a toll on sleep, activity, and mood, according to a study published online March 14 in the Journal of General Internal Medicine.

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U.S. Providers Fix Complications From Medical Tourism Procedures

FRIDAY, April 6, 2018 (HealthDay News) -- Cosmetic surgery procedures done in developing countries can carry substantial risks of complications that U.S. providers and payers must handle, according to a study published in the April issue of Plastic and Reconstructive Surgery.

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Child Opportunity Index Linked to Pediatric Acute Care Use

FRIDAY, April 6, 2018 (HealthDay News) -- The Child Opportunity Index measure of neighborhood context is associated with pediatric acute care visit frequency and diagnoses, according to a study published online April 6 in Pediatrics.

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Online Doc Reviews Don't Reflect Patient Satisfaction Surveys

THURSDAY, April 5, 2018 (HealthDay News) -- Online physician reviews do not reflect patient satisfaction surveys (PSSs), according to a study published in the April issue of the Mayo Clinic Proceedings.

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ACA Marketplaces Expand Coverage for Chronically Ill

THURSDAY, April 5, 2018 (HealthDay News) -- The Affordable Care Act's Marketplaces covered a disproportionate share of non-elderly adults with high health care risks in the 2014 to 2015 time period, according to a study published in the April issue of Health Affairs.

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New Map Improves Emergency, Trauma Care Referrals

THURSDAY, April 5, 2018 (HealthDay News) -- The Pittsburgh Atlas provides a new framework for emergency and trauma care regional referrals in the United States, according to a study published online March 28 in the Annals of Emergency Medicine.

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Medicare Program Narrows Racial Disparities in Readmissions

WEDNESDAY, April 4, 2018 (HealthDay News) -- Medicare's Hospital Readmissions Reduction Program is associated with a narrowing of racial disparities in hospital readmissions, according to a study published in the April issue of Health Affairs.

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Marijuana Legalization May Reduce Opioid Use

WEDNESDAY, April 4, 2018 (HealthDay News) -- State implementation of medical marijuana laws is associated with a reduction in the rate of opioid prescribing, according to a study published online April 2 in JAMA Internal Medicine.

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Variations Identified in Free-Text Directions in E-Prescriptions

WEDNESDAY, April 4, 2018 (HealthDay News) -- There is considerable variation in the quality of free-text patient directions (Sig) in electronic prescriptions (e-prescriptions), according to a study published online April 2 in the Journal of Managed Care & Specialty Pharmacy.

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CDC: Overdose Deaths Up Across Drug Categories in 2015 to 2016

TUESDAY, April 3, 2018 (HealthDay News) -- From 2015 to 2016, there were increases in deaths across all drug categories examined, with 63,632 drug overdose deaths in 2016, according to research published in the March 30 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Grief Symptoms Similar in Donor vs Non-Donor Decision Families

MONDAY, April 2, 2018 (HealthDay News) -- Perceptions of the organ donation experience vary between relatives who decide to donate their relative's organs and those who do not, but the decision does not appear to be associated with subsequent grief symptoms, according to a study published online March 19 in the American Journal of Respiratory and Critical Care Medicine.

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Pre-Op Chronic Opioid Use Ups Poor Outcomes Post Spinal Fusion

MONDAY, April 2, 2018 (HealthDay News) -- Preoperative chronic opioid use is associated with poor outcomes and continued dependence after posterior lumbar fusion, according to a study published online March 20 in Spine.

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