March 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 March 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.

After Hockey Win, Fans' Heart Attack Risk Rises

FRIDAY, March 30, 2018 (HealthDay News) -- Following a professional hockey game victory, there is an increase in heart attack-related hospital admissions among male fans, according to a study published online March 29 in the Canadian Journal of Cardiology.

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Scale of Online Marketplace for Marijuana Increasing

THURSDAY, March 29, 2018 (HealthDay News) -- The scale of the online marketplace for marijuana increased from 2005 to 2017, according to a study published online March 22 in the American Journal of Preventive Medicine.

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Non-Targeted HIV Testing in ER Acceptable to Patients

THURSDAY, March 29, 2018 (HealthDay News) -- A non-targeted HIV testing approach in a South African emergency department is acceptable to patients and reveals a high HIV prevalence, including undiagnosed cases, according to a study published online March 13 in PLOS ONE.

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Novel Interstitium Has Been Identified in Human Tissues

THURSDAY, March 29, 2018 (HealthDay News) -- A previously unrecognized interstitium has been identified in human tissues, according to a study published online March 27 in Scientific Reports.

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Traumatic Brain Injury Rare for Children With Isolated Vomiting

THURSDAY, March 29, 2018 (HealthDay News) -- Children presenting with head injury with isolated vomiting rarely have clinically important traumatic brain injury (ci-TBI) or traumatic brain injury on computed tomography (TBI-CT), according to a study published online March 29 in Pediatrics.

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Condition Readmission Measures Don't Reflect Overall Quality

TUESDAY, March 27, 2018 (HealthDay News) -- Current publicly reported measures may not be good surrogates for overall hospital quality related to 30-day readmissions, according to a study published online March 27 in the Annals of Internal Medicine.

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EHR Usability Contributes to Possible Patient Harm Events

TUESDAY, March 27, 2018 (HealthDay News) -- Electronic health record (EHR) usability may contribute to possible patient harm events, according to a research letter published in the March 27 issue of the Journal of the American Medical Association.

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Children's Hoverboard, Skateboard Injuries Are Similar

TUESDAY, March 27, 2018 (HealthDay News) -- Injury characteristics among hoverboard riders and skateboarders are similar, according to a study published online March 26 in Pediatrics.

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Geographic, Social Variances Tied to Higher Drug-Related Mortality

TUESDAY, March 27, 2018 (HealthDay News) -- County-level economic and other social conditions explain the geographic disparities in overdose rates across the country, according to a study published online March 26 in the American Journal of Preventive Medicine.

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Ethical Duties ID'd for Short-Term Global Health Experiences

MONDAY, March 26, 2018 (HealthDay News) -- In a position paper published online March 27 in the Annals of Internal Medicine, ethical obligations have been detailed for physicians participating in short-term global health experiences (STEGHs).

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Lean Approach May Help Tackle Burnout in Health Care Providers

FRIDAY, March 23, 2018 (HealthDay News) -- The Lean approach, which emphasizes reducing waste and improving customer value by focusing on the big picture, can be used to address physician burnout, according to a report published in Medical Economics.

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Unique Risks Associated With Texting Medical Orders

THURSDAY, March 22, 2018 (HealthDay News) -- Despite the popularity, convenience, and speed of texting medical orders, there are unique and alarming risks associated with the practice, according to a report published in Drug Topics.

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Time to Epinephrine Tied to Survival in Non-Shockable OHCA

THURSDAY, March 22, 2018 (HealthDay News) -- For patients with out-of-hospital cardiac arrest (OHCA) with non-shockable initial rhythm, each minute delay in epinephrine administration is associated with reduced survival and unfavorable neurologic outcomes, according to a study published online March 6 in Circulation.

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Higher Myocardial Infarction Care Payments Improve Mortality

THURSDAY, March 22, 2018 (HealthDay News) -- Higher 30-day payments for acute myocardial infarction (AMI) care for both inpatient care and in multiple settings after discharge are associated with lower 30-day mortality among Medicare beneficiaries, according to a study published online March 12 in Circulation: Cardiovascular Quality and Outcomes.

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Home-Based Primary Care Ups Access in Rural Areas

THURSDAY, March 22, 2018 (HealthDay News) -- Expanding home-based primary care (HBPC) to American Indian reservations and other rural communities increases access to long-term care and enrollment for health care benefits within the Veterans Affairs (VA) system, according to a study published online March 12 in the Journal of the American Geriatrics Society.

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High-Flow O2 Therapy Feasible for Infants With Bronchiolitis

WEDNESDAY, March 21, 2018 (HealthDay News) -- High-flow oxygen therapy may be more effective than standard oxygen therapy in preventing care escalation among infants with bronchiolitis treated outside an intensive care unit, according to a study published in the March 22 issue of the New England Journal of Medicine.

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Adjuvant Long-Acting Muscarinic Antagonist Improves Asthma

WEDNESDAY, March 21, 2018 (HealthDay News) -- For patients with persistent asthma, the use of long-acting muscarinic antagonists (LAMAs) versus placebo as an adjunct to inhaled corticosteroids, and combined use of inhaled corticosteroids and long-acting β-agonists (LABAs), termed single maintenance and reliever therapy (SMART), are associated with a reduced risk of exacerbations, according to two reviews published online March 19 in the Journal of the American Medical Association.

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HIV Incidence Down in All Except Men Who Have Sex With Men

WEDNESDAY, March 21, 2018 (HealthDay News) -- From 2008 to 2015, there was a decrease in modeled HIV incidence in all transmission risk groups except men who have sex with men (MSM), according to research published online March 20 in the Annals of Internal Medicine.

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Blueprint Being Developed to Address Physician Burnout

WEDNESDAY, March 21, 2018 (HealthDay News) -- A new, three-pronged approach is being applied to develop a blueprint for addressing physician burnout, according to a report published in Medical Economics.

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Personal Health Info Found in Recycling at Five Hospitals

TUESDAY, March 20, 2018 (HealthDay News) -- A considerable amount of personal health information (PHI) and personally identifiable information (PII) was found in the recycling at five Canadian teaching hospitals, according to a research letter published in the March 20 issue of the Journal of the American Medical Association.

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In 2015, Each U.S. Binge Drinker Consumed About 470 Drinks

TUESDAY, March 20, 2018 (HealthDay News) -- U.S. binge drinkers consumed about 470 binge drinks per binge drinker in 2015, according to a study published in the April issue of the American Journal of Preventive Medicine.

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In-Flight Transmission of Respiratory Diseases Low

TUESDAY, March 20, 2018 (HealthDay News) -- The probability of direct transmission of respiratory diseases is low for passengers on transcontinental U.S. flights not seated in close proximity to an infectious passenger, according to a study published online March 19 in the Proceedings of the National Academy of Sciences.

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Prior Authorization Negatively Impacts Clinical Outcomes

MONDAY, March 19, 2018 (HealthDay News) -- The burdens associated with prior authorization (PA) are high and include a negative impact on clinical outcomes, reported by 92 percent of physicians, according to the results of a survey conducted for the American Medical Association (AMA).

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Risk of Suicide Up for Teens, Young Adults After Self-Harm

MONDAY, March 19, 2018 (HealthDay News) -- Adolescents and young adults have increased risk of suicide after nonfatal self-harm, according to a study published online March 19 in Pediatrics.

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2013 to 2016 Saw No Change in Antibiotic Prescribing Practices

FRIDAY, March 16, 2018 (HealthDay News) -- From 2013 to 2016, annual national outpatient antibiotic prescribing practices remained unchanged, according to a study published online Feb. 27 in Infection Control & Hospital Epidemiology.

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No Benefit for MRI After Normal Cervical CT in Blunt Trauma

FRIDAY, March 16, 2018 (HealthDay News) -- For patients with obtunded blunt trauma to the cervical spine, magnetic resonance imaging (MRI) follow-up appears not to be beneficial after normal cervical computed tomography (CT) findings, according to a study published online March 14 in JAMA Surgery.

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Burn Deaths Down From 1989 to 2017 in the United States

THURSDAY, March 15, 2018 (HealthDay News) -- Burn injury survival has dramatically increased over the past 30 years, according to a study published online March 9 in the Journal of the American College of Surgeons.

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VTE Risk Up in Most Emergency General Surgery Patients

THURSDAY, March 15, 2018 (HealthDay News) -- Almost all emergency general surgery (EGS) patients treated operatively and nonoperatively have increased risk of venous thromboembolism (VTE) and should receive prophylactic treatment, according to a review published online March 14 in JAMA Surgery.

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Novel Pediatric Appendicitis Risk Calculator Accurately IDs Risk

WEDNESDAY, March 14, 2018 (HealthDay News) -- The pediatric appendicitis risk calculator (pARC) accurately quantifies the risk for appendicitis in a validation cohort of patients with acute abdominal pain, according to a study published online March 13 in Pediatrics.

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Possible Effect of Australia Gun Ban on Rate of Mass Shootings

WEDNESDAY, March 14, 2018 (HealthDay News) -- Evidence suggests rejecting the hypothesis that the rate of mass shootings remained unchanged after implementation of the 1996 National Firearms Agreement in Australia, according to a research letter published online March 13 in the Annals of Internal Medicine.

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Lower Hospital Mortality for Acute MI During Heart Meeting

WEDNESDAY, March 14, 2018 (HealthDay News) -- Thirty-day mortality is lower for hospitalization with acute myocardial infarction during Transcatheter Cardiovascular Therapeutics meeting dates, according to a study published online March 9 in the Journal of the American Heart Association.

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Drug Copayments Often Exceed Prescription Drug Costs

WEDNESDAY, March 14, 2018 (HealthDay News) -- Drug copayments frequently exceed prescription drug costs, with overpayments affecting 23 percent of all prescriptions, according to a research letter published in the March 13 issue of the Journal of the American Medical Association.

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U.S. Spends Twice As Much for Similar Health Care Utilization

TUESDAY, March 13, 2018 (HealthDay News) -- Spending on health care is much higher in the United States than other high-income countries, but utilization rates are similar, according to a study published in the March 13 issue of the Journal of the American Medical Association.

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Substance Use Mortality Varies Widely Across U.S. Counties

TUESDAY, March 13, 2018 (HealthDay News) -- Across U.S. counties there is considerable variation in mortality due to alcohol use disorders, drug use disorders, self-harm, and interpersonal violence, according to a study published in the March 13 issue of the Journal of the American Medical Association.

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Head Injury Outcomes Better With Trauma Center Care

TUESDAY, March 13, 2018 (HealthDay News) -- Patients with isolated, severe head injury have better outcomes if they are initially treated in designated trauma centers, according to a study published online March 1 in the Journal of the American College of Surgeons.

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Three-Pronged Approach Can Improve Physician Engagement

MONDAY, March 12, 2018 (HealthDay News) -- The three-pronged approach implemented by one practice successfully improved physician engagement, according to an article published in Medical Economics.

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Considerable Resource Use, Costs for Cardiovascular Care

MONDAY, March 12, 2018 (HealthDay News) -- The 10-year costs associated with cardiovascular disease (CVD) are considerable, according to a study published in the March 13 issue of the Journal of the American College of Cardiology.

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Doctors Present Recs For and Against Acupuncture for Pain

MONDAY, March 12, 2018 (HealthDay News) -- The reasons for and against recommending acupuncture for treating pain are discussed in a head-to-head article published online March 7 in The BMJ.

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No Safety Concerns Noted in Study of Intranasal Insulin Use

MONDAY, March 12, 2018 (HealthDay News) -- Intranasal insulin application appears to be safe, according to a review published online March 6 in Diabetes, Obesity and Metabolism.

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Over 5,100 Noncongenital Zika Cases Reported in U.S. in 2016

MONDAY, March 12, 2018 (HealthDay News) -- A total of 5,168 noncongenital Zika virus disease cases were reported from U.S. states and the District of Columbia in 2016, with 95 percent of cases identified in travelers returning from Zika virus-affected areas, according to research published in the March 9 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Severity of Nonfatal Firearm Injuries Increased, 1993 to 2014

FRIDAY, March 9, 2018 (HealthDay News) -- The severity of hospitalized firearm injuries increased significantly from 1993 to 2014, according to a study published online Feb. 13 in Trauma Surgery & Acute Care Open.

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Falls in Elderly Patients Cost $50 Billion Annually

FRIDAY, March 9, 2018 (HealthDay News) -- Older adult falls result in substantial medical costs, according to a study published online March 7 in the Journal of the American Geriatrics Society.

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30-Day ER Revisit Predicts Poor Outcomes in Elderly

THURSDAY, March 8, 2018 (HealthDay News) -- A revisit to the emergency department within 30 days of a previous visit predicts poor outcomes in elderly adults, according to a study published online Feb. 28 in the Journal of the American Geriatrics Society.

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Vaccine Exposure in First 23 Months Has No Adverse Impact

WEDNESDAY, March 7, 2018 (HealthDay News) -- The estimated cumulative vaccine antigen exposure through age 23 months does not differ significantly for children with versus those without hospital visits for infectious diseases not targeted by vaccines from age 24 to 47 months, according to a study published in the March 6 issue of the Journal of the American Medical Association.

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CDC: Opioid-Involved Overdoses Up July 2016 to Sept. 2017

WEDNESDAY, March 7, 2018 (HealthDay News) -- Opioid-involved overdoses are continuing to increase, according to research published in the March 6 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Coronary Risk Scores Accurate When Used With Low cTnI

TUESDAY, March 6, 2018 (HealthDay News) -- Coronary risk scores for predicting major adverse cardiac events (MACE) in patients with possible acute coronary syndrome (ACS) perform well when using a cardiac troponin I (cTnI) cut-off below the 99th percentile, according to a study published in the Feb. 13 issue of the Journal of the American College of Cardiology.

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Pediatric Opioid-Related Hospital, ICU Admissions on the Rise

MONDAY, March 5, 2018 (HealthDay News) -- Nationally, the rate of hospitalization and pediatric intensive care unit (PICU) admission for opioid ingestions increased from 2004 to 2015, according to a study published online March 5 in Pediatrics.

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Gender Minorities Have Greater Mental Illness, Disability

MONDAY, March 5, 2018 (HealthDay News) -- Gender minority Medicare beneficiaries have larger disability and mental health burdens than the general Medicare population, according to a study published online March 4 in Health Affairs.

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Strong State Firearm Policies, Lower Firearm Suicide Rate Tied

MONDAY, March 5, 2018 (HealthDay News) -- Strong state firearm policies are associated with lower firearm suicide rates and lower homicide rates, according to a study published online March 5 in JAMA Internal Medicine.

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Risk of Mental Health Visits Up in Childhood Cancer Survivors

FRIDAY, March 2, 2018 (HealthDay News) -- Survivors of adolescent cancer have higher rates of adverse mental health outcomes than the general population, according to a study published online Feb. 22 in Cancer.

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Bystander Defibrillation Improves Outcome for Public Cardiac Arrest

THURSDAY, March 1, 2018 (HealthDay News) -- Bystander automated external defibrillator use in shockable observed public out-of-hospital cardiac arrest (OHCA) is associated with improved survival and functional outcomes, according to a study published online Feb. 26 in Circulation.

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