February 2019 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for February 2019. 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.

HEART Care Pathway Reduces Admission, Stress Testing in ACS

THURSDAY, Feb. 28, 2019 (HealthDay News) -- Implementing a history, electrocardiogram, age, risk factors, and troponin (HEART) care pathway can reduce use of hospital care and noninvasive stress testing among patients with suspected acute coronary syndrome (ACS), according to a study published online Feb. 20 in the Annals of Emergency Medicine.

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Stewardship Programs Decrease Inpatient Fluoroquinolone Rx

WEDNESDAY, Feb. 27, 2019 (HealthDay News) -- Fluoroquinolone stewardship interventions at hospitals are associated with less fluoroquinolone prescribing during hospitalization but not at discharge, according to a study published online Feb. 13 in Clinical Infectious Diseases.

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Converting Naloxone to OTC Expected to Increase Sales

TUESDAY, Feb. 26, 2019 (HealthDay News) -- The demand for naloxone is relatively inelastic with respect to changes in its out-of-pocket price, and conversion to an over-the-counter medication is expected to increase naloxone pharmacy sales, according to a study published online Feb. 20 in Health Services Research.

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Prediction Rule IDs Febrile Infants 0 to 2 Months Old at Low Risk for SBIs

TUESDAY, Feb. 26, 2019 (HealthDay News) -- A new prediction rule can accurately identify febrile infants aged ≤60 days at low risk for serious bacterial infections (SBIs) using urinalysis, absolute neutrophil count (ANC), and procalcitonin levels, according to a study published online Feb. 18 in JAMA Pediatrics.

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MRI Cardiac Stress Test Predicts Death From Heart Disease

TUESDAY, Feb. 26, 2019 (HealthDay News) -- Stress cardiac magnetic resonance imaging (CMR) can predict mortality in patients with known or suspected coronary artery disease (CAD), according to a study published online Feb. 8 in JAMA Cardiology.

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2014 to 2017 Saw Improvement in Burnout for U.S. Physicians

MONDAY, Feb. 25, 2019 (HealthDay News) -- From 2014 to 2017, there was an improvement in burnout and satisfaction with work-life integration among U.S. physicians, according to a study published online Feb. 22 in the Mayo Clinic Proceedings.

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Incidence of Acute Myocardial Infarctions Up Among Young Women

MONDAY, Feb. 25, 2019 (HealthDay News) -- The incidence of acute myocardial infarctions (AMI) has increased among younger women, and sedentary time is associated with an increased risk for cardiovascular disease (CVD) among women, according to two studies published in the Feb. 19 issue of Circulation, a "Go Red for Women" theme issue on cardiovascular disease in women.

Abstract/Full Text - Arora
Editorial
Abstract/Full Text - Bellettiere

Opioid-Related Mortality Up From 1999 to 2016 in Eastern U.S.

MONDAY, Feb. 25, 2019 (HealthDay News) -- In the eastern United States, opioid-related mortality, particularly mortality associated with synthetic opioids, has increased, according to a study published online Feb. 22 in JAMA Network Open.

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Serious Medical Outcomes Reported With Kratom Exposure

MONDAY, Feb. 25, 2019 (HealthDay News) -- Kratom, or Mitragyna speciosa, exposure is associated with serious medical outcomes, especially as part of multiple-substance exposure, according to a study published online Feb. 20 in Clinical Toxicology.

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National Health Spending Set to Increase 5.5 Percent Annually

FRIDAY, Feb. 22, 2019 (HealthDay News) -- National health spending is projected to increase at an annual rate of 5.5. percent from 2018 to 2027, with fundamental economic and demographic factors the main drivers, according to a report published online Feb. 20 in Health Affairs.

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Most Patients Do Not Disclose Complementary Medicine Use

FRIDAY, Feb. 22, 2019 (HealthDay News) -- Just one-third of users of biologically based complementary medicine (CM) disclose their use to traditional health care providers, according to a review published online Feb. 7 in Scientific Reports.

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Intervention Can Reduce Orders for Inpatient Urine Cultures

FRIDAY, Feb. 22, 2019 (HealthDay News) -- An intervention that makes changes to urine testing orderables can reduce the urine culturing rate, according to a study published online Feb. 21 in Infection Control & Hospital Epidemiology.

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Vertical Integration Has Little Impact on Quality Measures

THURSDAY, Feb. 21, 2019 (HealthDay News) -- Vertical integration between hospitals and physicians has little impact on quality measures, while increased hospital market concentration is strongly associated with reduced quality in measures of patient satisfaction, according to a study published online Feb. 9 in Medical Care Research and Review.

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Experimental Test May Quickly Diagnose Sepsis

WEDNESDAY, Feb. 20, 2019 (HealthDay News) -- A blood test that can quickly diagnose dangerous sepsis infections has been developed, according to research published in the Feb. 1 issue of Biosensors and Bioelectronics.

CNN Article
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New Kaiser Permanente Medical School Plans to Waive Tuition

WEDNESDAY, Feb. 20, 2019 (HealthDay News) -- A new medical school to be opened by California-based health system Kaiser Permanente will waive tuition for all students in its first five graduating classes.

The New York Times Article
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CDC: Salmonella Cases Tied to Raw Turkey Products Now at 279

TUESDAY, Feb. 19, 2019 (HealthDay News) -- Sixty-three more cases of illness in a Salmonella outbreak linked to raw turkey products have been reported since Dec. 21, 2018, bringing the total number to 279, the U.S. Centers for Disease Control and Prevention says in an update.

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Hospital Prices Growing Faster Than Physician Prices

FRIDAY, Feb. 15, 2019 (HealthDay News) -- Growth in hospital prices and payments outpaced growth in physician prices and payments from 2007 through 2014, according to a report published in the February issue of Health Affairs.

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Sports Medicine Society Updates Concussion Guidelines

FRIDAY, Feb. 15, 2019 (HealthDay News) -- The American Medical Society for Sports Medicine (AMSSM) has released an updated position statement on concussion in sports. The statement was published in the February issue of the British Journal of Sports Medicine.

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CDC: Severity of Influenza Season Low Through Feb. 2, 2019

THURSDAY, Feb. 14, 2019 (HealthDay News) -- The 2018 to 2019 influenza season has been low in severity so far, and overall vaccine effectiveness is about 47 percent, according to two reports published in the Feb. 15 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Abstract/Full Text - Blanton
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FDA Panel Backs Ketamine-Like Drug for Depression

WEDNESDAY, Feb. 13, 2019 (HealthDay News) -- An expert panel for the U.S. Food and Drug Administration has endorsed a drug for major depressive disorder that is a close relative to ketamine.

CNN Article

Health Care Spending Per Person Increased to $5,641 in 2017

TUESDAY, Feb. 12, 2019 (HealthDay News) -- In 2017, health care spending per person reached $5,641, according to the Health Care Cost Institute (HCCI) annual Health Care Cost and Utilization Report.

Health Care Cost and Utilization Report

Many Systematic Reviews Do Not Fully Report Adverse Events

TUESDAY, Feb. 12, 2019 (HealthDay News) -- Many systematic review protocols in the International Prospective Register of Systematic Reviews (PROSPERO) do not include adverse event reporting, according to a study published in the April issue of the Journal of Clinical Epidemiology.

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Racial/Ethnic, Income Variation ID'd in the Opioid Epidemic

MONDAY, Feb. 11, 2019 (HealthDay News) -- There is considerable race/ethnicity and income-level variation in the opioid epidemic, according to research published online Feb. 11 in JAMA Internal Medicine.

Abstract/Full Text - Friedman Study
Abstract/Full Text - Research Letter 1 (subscription or payment may be required)
Abstract/Full Text - Research Letter 2 (subscription or payment may be required)
Editorial (subscription or payment may be required)

Predictors of Kidney Stone Recurrence Identified

FRIDAY, Feb. 8, 2019 (HealthDay News) -- A model has been developed for predicting recurrence among kidney stone formers, according to a study published in the February issue of the Mayo Clinic Proceedings.

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Measles Outbreak Triggers Sharp Rise in Demand for Vaccine

FRIDAY, Feb. 8, 2019 (HealthDay News) -- Health clinics in Clark County, Washington, are scrambling to meet the sharply increased demand for measles vaccination as people seek protection during an outbreak of the highly contagious virus.

Kaiser Health News Article

Delayed EMS Response Time Tied to Mortality After Car Accident

FRIDAY, Feb. 8, 2019 (HealthDay News) -- Longer emergency medical service (EMS) response times are associated with higher rates of motor vehicle crash (MVC) mortality, according to a study published online Feb. 6 in JAMA Surgery.

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CDC: Heart Attack Awareness Improved Since 2008

FRIDAY, Feb. 8, 2019 (HealthDay News) -- Since 2008, there has been an increase in the number of U.S. adults with awareness of heart attack symptoms and knowledge of the appropriate response to a heart attack, according to research published in the Feb. 8 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Dialysis Staff-Initiated CPR Ups Outcomes in Cardiac Arrest

THURSDAY, Feb. 7, 2019 (HealthDay News) -- For patients with out-of-hospital cardiac arrest (OHCA) occurring in outpatient dialysis clinics, dialysis staff-initiated cardiopulmonary resuscitation (CPR) is associated with improved outcomes, according to a study published online Feb. 7 in the Journal of the American Society of Nephrology.

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Editorial (subscription or payment may be required)

FDA: Number of U.S. Women With Breast Implant-Caused Cancer Has Increased

THURSDAY, Feb. 7, 2019 (HealthDay News) -- There has been an increase in the number of U.S. women diagnosed with a cancer caused by breast implants, the U.S. Food and Drug Administration said Wednesday.

NBC News Article
More Information: FDA
Letter to Health Care Providers

Radiologists Can Help ID Intimate Partner Violence

TUESDAY, Feb. 5, 2019 (HealthDay News) -- Victims of intimate partner violence (IPV) undergo more imaging procedures than age- and sex-matched control patients and are more likely to have obstetric-gynecologic findings and acute fractures, according to a study published online Feb. 5 in Radiology.

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Burden of Sudden Cardiac Death Higher in Black Men, Women

TUESDAY, Feb. 5, 2019 (HealthDay News) -- African-Americans have a higher burden of sudden cardiac death (SCD) than whites, especially among women, according to a study published online Feb. 4 in Circulation.

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Washington State Measles Cases Now at 48 Since Jan. 1

MONDAY, Feb. 4, 2019 (HealthDay News) -- There have been 48 confirmed cases of measles in Washington state since the start of the year as health officials struggle to stop the spread of the infectious disease.

CNN Article

Unrestrained Driver Predicts Unrestrained Child Passenger

MONDAY, Feb. 4, 2019 (HealthDay News) -- An unrestrained driver is a strong predictor for having an unrestrained child passenger in both fatal and nonfatal crashes, according to a study published online Feb. 4 in Pediatrics.

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Direct-to-Doctor Payments May Increase Opioid Prescribing

FRIDAY, Feb. 1, 2019 (HealthDay News) -- Physicians who receive direct pharmaceutical payments for opioid prescribing prescribe more opioids, especially hydrocodone and oxycodone, according to a study published online Jan. 22 in Addiction.

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