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May 2019 Briefing – Emergency Medicine

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

Noncompliance Common in Teens Prescribed STI Treatment in ED

FRIDAY, May 31, 2019 (HealthDay News) — Less than 60 percent of prescriptions for the treatment of sexually transmitted infections (STIs) among teens seeking care in the emergency department are filled, according to a research letter published online May 28 in JAMA Pediatrics.

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More Opioids Given Than Prescribed in Emergency Department

FRIDAY, May 31, 2019 (HealthDay News) — The rate of emergency department visits with opioids only given during the visit is higher than the rate for visits with opioids only prescribed at discharge and for visits with opioids given and prescribed, according to a May data brief published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

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Excess Cause-Specific Mortality Tied to Chronic Proton Pump Inhibitor Use

FRIDAY, May 31, 2019 (HealthDay News) — Taking proton pump inhibitors (PPIs) is associated with an excess of cause-specific mortality, according to a study published online May 30 in The BMJ.

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High Costs Associated With Physician Burnout in U.S.

THURSDAY, May 30, 2019 (HealthDay News) — High costs are associated with physician turnover and reduced clinical hours attributed to burnout, according to a study published online May 28 in the Annals of Internal Medicine.

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Reading Visit Notes May Improve Medication Management

WEDNESDAY, May 29, 2019 (HealthDay News) — Reading clinical notes can help patients to understand why medications are prescribed and improves medication adherence for some patients, according to a brief research report published online May 28 in the Annals of Internal Medicine.

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Rate of Opioid Prescribing High for Teens, Young Adults in ED

TUESDAY, May 28, 2019 (HealthDay News) — For adolescents and young adults, the rate of opioid prescribing in emergency departments is high, according to a study published online May 28 in Pediatrics.

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Postdischarge Fall-Related Injury a Top Readmission Diagnosis

FRIDAY, May 24, 2019 (HealthDay News) — Postdischarge fall-related injury (FRI) is a leading readmission diagnosis for seniors, according to a study published online May 24 in JAMA Network Open.

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U.S. Lawmakers Say WHO Opioid Guidelines Too Lax

THURSDAY, May 23, 2019 (HealthDay News) — The World Health Organization’s pain care guidelines contain false claims about the safety of prescription opioid painkillers and should be withdrawn, two U.S. lawmakers say.

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Most Patients at High Risk of Opiate Overdose Do Not Receive Naloxone Rx

THURSDAY, May 23, 2019 (HealthDay News) — Patients at high risk of opioid overdose rarely receive prescriptions for naloxone, despite many interactions with the health care system, according to a study published online May 3 in JAMA Network Open.

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Classification System Developed for Cardiogenic Shock

THURSDAY, May 23, 2019 (HealthDay News) — A classification system has been developed for categorizing cardiogenic shock; the consensus statement, endorsed by the American College of Cardiology, American Heart Association, Society of Critical Care Medicine, and Society of Thoracic Surgeons, was published online May 19 in Catheterization & Cardiovascular Interventions.

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Firearms Leading Cause of Death Among Young Adult Men

THURSDAY, May 23, 2019 (HealthDay News) — Firearm mortality in the United States, Mexico, Brazil, and Colombia is highest among young adult men, and is strongly associated with race, ethnicity, and low education levels, according to a study published online May 21 in The Lancet Public Health.

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Bystander Resuscitation Attempted Less Often for Women in Cardiac Arrest

WEDNESDAY, May 22, 2019 (HealthDay News) — In out-of-hospital cardiac arrest (OHCA), women are less often resuscitated than men, and they have lower survival rates with resuscitation, according to a study published online May 21 in the European Heart Journal.

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Non-Rx Fentanyl Up in Urine Tests Positive for Other Drugs

TUESDAY, May 21, 2019 (HealthDay News) — An increasing number of urine drug test (UDT) results positive for cocaine or methamphetamine are also positive for nonprescribed fentanyl, according to a study recently published in JAMA Network Open.

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Clinical Drug Diversion Costly to Health Care Organizations

TUESDAY, May 21, 2019 (HealthDay News) — U.S. health care organizations lost nearly $454 million due to clinical drug diversion in 2018, according to the 2019 Drug Diversion Digest, released by Protenus Inc.

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Millennial Parents Found More Likely to Drive Distracted

MONDAY, May 20, 2019 (HealthDay News) — Millennial parents are more likely to text while driving than older parents, according to a research letter published online May 13 in JAMA Pediatrics.

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Pool Chemical Injuries Led to ~13,500 ED Visits in 2015-2017

FRIDAY, May 17, 2019 (HealthDay News) — Pool chemical injuries led to an estimated 13,508 U.S. emergency department visits during 2015 to 2017, and about one-third of these injuries occurred in children, according to research published in the May 17 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Many Lives Could Be Saved if All Hospitals Had Grade A Rating

FRIDAY, May 17, 2019 (HealthDay News) — More than 50,000 lives could be saved if all hospitals had an avoidable death rate equivalent to “A” grade hospitals, according to an updated report prepared for The Leapfrog Institute.

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Private Insurers Pay 241 Percent of What Medicare Would Pay

FRIDAY, May 17, 2019 (HealthDay News) — Prices paid to hospitals for privately insured patients in 2017 averaged 241 percent of what Medicare would have paid, with wide variation in prices among states, according to a report published by the RAND Corporation.

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CDC: Salmonella Outbreaks Linked to Backyard Poultry

FRIDAY, May 17, 2019 (HealthDay News) — Backyard flocks of live poultry have been linked with Salmonella outbreaks that have sickened 52 people in 21 states, the U.S. Centers for Disease Control and Prevention said Thursday.

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Heroin Overdose ED Visits Decreased From 2017 to 2018

FRIDAY, May 17, 2019 (HealthDay News) — From 2017 to 2018, there was a decrease in heroin overdose emergency department visits, although the declines were not consistent among states, according to a study published online May 16 in the American Journal of Public Health.

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Recs Updated for TB Screening, Treatment in Health Care Workers

THURSDAY, May 16, 2019 (HealthDay News) — Guidelines have been updated for screening and treatment for tuberculosis (TB) infection among health care personnel, according to research published in the May 17 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Cannabis Legalization Not Tied to Higher Health Care Utilization

THURSDAY, May 16, 2019 (HealthDay News) — Legalization of recreational cannabis is not associated with changes in health care utilization, as measured by length of stay or health care costs, according to a study published in the May issue of BMJ Open.

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FDA: Tattoo Inks Recalled Due to Bacterial Contamination

WEDNESDAY, May 15, 2019 (HealthDay News) — Six tattoo inks have been recalled because they are contaminated with bacteria and could lead to infection that poses a serious health risk, the U.S. Food and Drug Administration says.

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Risk for Repeat Concussion Quantified for Pediatric Patients

WEDNESDAY, May 15, 2019 (HealthDay News) — A total of 16.2 percent of children with an index concussion experience at least one repeat concussion within two years, according to a study published online May 14 in The Journal of Pediatrics.

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CDC: U.S. Measles Cases in 2019 Reach 839

MONDAY, May 13, 2019 (HealthDay News) — The number of reported measles cases in the United States climbed to 839 as of last week, the highest yearly total in 25 years, the U.S. Centers for Disease Control and Prevention said Monday.

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Fournier Gangrene Is Safety Concern With SGLT2 Inhibitors

MONDAY, May 13, 2019 (HealthDay News) — Fournier gangrene (FG) is a safety concern for adults with diabetes receiving treatment with sodium-glucose cotransporter-2 (SGLT2) inhibitors, according to a study published online May 7 in the Annals of Internal Medicine.

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Health Professionals Supportive of Medicinal Cannabis

FRIDAY, May 10, 2019 (HealthDay News) — Health professionals are generally supportive of medicinal cannabis use but report a lack of knowledge about its use, according to a review published online May 6 in PLOS ONE.

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Fatal Overdoses Reduced With Pharmacist Dispensation of Naloxone

FRIDAY, May 10, 2019 (HealthDay News) — Only state naloxone access laws (NALs) allowing direct dispensing of naloxone by pharmacists appear to be useful in cutting fatal overdose rates, according to a study published online May 6 in JAMA Internal Medicine.

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Doctors Aware of Patient Difficulties Affording Medical Care

FRIDAY, May 10, 2019 (HealthDay News) — Physicians are aware of patients’ difficulty with affording medical care and consider out-of-pocket costs in their decision making, according to an article published in a supplement to the May 7 issue of the Annals of Internal Medicine.

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Suicide Attempts by Self-Poisoning Have Increased in Teens

FRIDAY, May 10, 2019 (HealthDay News) — In children aged younger than 19 years, the incidence and rate of suicide attempts using self-poisoning have increased since 2011, according to research published online May 1 in The Journal of Pediatrics.

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Prehospital Tx Guidelines May Improve Outcomes in Severe TBI

FRIDAY, May 10, 2019 (HealthDay News) — Implementation of prehospital traumatic brain injury (TBI) guidelines is associated with improvement in survival to hospital discharge for patients with severe TBI, according to a study published online May 8 in JAMA Surgery.

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Model Predicts Counties at Risk for Measles Outbreak

FRIDAY, May 10, 2019 (HealthDay News) — In a commentary published online May 9 in The Lancet Infectious Diseases, an analysis is proposed that can predict counties at risk for a measles outbreak.

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2018 Saw More Employed Physicians Than Self-Employed

THURSDAY, May 9, 2019 (HealthDay News) — In 2018, employed physicians outnumbered self-employed physicians, according to a report from the American Medical Association (AMA).

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CDC: Uninsurance Levels Did Not Change Significantly in 2018

THURSDAY, May 9, 2019 (HealthDay News) — In 2018, the percentage of U.S. individuals who were uninsured was not significantly different from the numbers in 2017, although uninsurance increased among adults aged 45 to 64 years, according to a report published online May 9 by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

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Alteplase Seems Beneficial at 4.5 to 9.0 Hours After Stroke

THURSDAY, May 9, 2019 (HealthDay News) — The use of alteplase between 4.5 and 9.0 hours after stroke onset results in a higher number of patients with no or minor neurological deficits, according to a study published in the May 9 issue of the New England Journal of Medicine.

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Scientology Cruise Ship Passengers, Crew Still Under Quarantine

WEDNESDAY, May 8, 2019 (HealthDay News) — Hundreds of passengers and crew members of a Church of Scientology cruise ship remain under quarantine in its home port of Curacao while awaiting measles test results.

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In 2015 to 2016, 45.8 Percent of U.S. Population Used Rx Drugs

WEDNESDAY, May 8, 2019 (HealthDay News) — In 2015 to 2016, 45.8 percent of the U.S. population used prescription drugs within the past 30 days, according to a May data brief published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics (NCHS).

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Alcohol Consumption Per Capita Increasing Among Adults

WEDNESDAY, May 8, 2019 (HealthDay News) — Global goals for reducing alcohol use are unlikely to be achieved, with the global adult per-capita consumption projected to continue increasing to 2030, according to a study published online May 7 in The Lancet.

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Radiology Residents Often Miss Child Abuse

TUESDAY, May 7, 2019 (HealthDay News) — Many radiology residents do not accurately recognize child abuse, according to a study presented at the annual meeting of the American Roentgen Ray Society, held from May 5 to 10 in Honolulu.

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External Reference Pricing Could Cut Drug Costs in U.S.

TUESDAY, May 7, 2019 (HealthDay News) — The average price for single-source brand-name drugs is higher in the United States than in other countries, indicating that external reference pricing could reduce costs, according to a study published in the May issue of Health Affairs.

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Efforts Needed to Ensure Publication of All Trials

TUESDAY, May 7, 2019 (HealthDay News) — Efforts are needed to ensure all completed large trials are reported, according to a research letter published online May 7 in the Annals of Internal Medicine.

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Gentamicin Appropriate Second-Line Therapy to Ceftriaxone for Gonorrhea

TUESDAY, May 7, 2019 (HealthDay News) — A single dose of gentamicin is an appropriate second-line therapy for gonorrhea resistant to a single dose of ceftriaxone, according to a study published online May 2 in The Lancet.

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Combat Application Tourniquet Suitable for Use in Children

TUESDAY, May 7, 2019 (HealthDay News) — The Combat Application Tourniquet (CAT) is suitable for use in the upper and lower extremities of school-age children, according to a study published online May 7 in Pediatrics.

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FDA: French Soft Ripened Cheese Possibly Contaminated

MONDAY, May 6, 2019 (HealthDay News) — Consumers should not eat and retailers should not sell or serve l’Explorateur soft ripened cheese due to possible Listeria monocytogenes contamination, the U.S. Food and Drug Administration says.

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CDC: Number of Measles Cases in the United States Reaches 764

MONDAY, May 6, 2019 (HealthDay News) — At least 60 more measles cases have been reported in the United States, bringing the total so far this year to 764, health officials said Monday.

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U.S. Energy Drink Consumption Rose From 2003 to 2016

MONDAY, May 6, 2019 (HealthDay News) — Consumption of caffeinated energy drinks is on the rise in the United States among adolescents, young adults, and middle-aged adults, according to a study published April 18 in the American Journal of Preventive Medicine.

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Vascular Surgery for Gun Injuries Carries Higher Mortality Risk

FRIDAY, May 3, 2019 (HealthDay News) — Vascular surgery after a firearm injury is associated with an increased risk for complications and mortality, according to a study published in the May issue of the Journal of Vascular Surgery.

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More Than Half of U.S. Adults Have Medical Financial Hardship

FRIDAY, May 3, 2019 (HealthDay News) — Medical financial hardship affects more than half of adults in the United States, according to a study published online May 1 in the Journal of General Internal Medicine.

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CDC: Foodborne Infections Increased From 2015 to 2018

FRIDAY, May 3, 2019 (HealthDay News) — From 2015 to 2018, the incidence of most foodborne infections increased, according to research published in the April 26 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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FDA Approves Dengue Vaccine for Endemic Regions

THURSDAY, May 2, 2019 (HealthDay News) — The dengue vaccine Dengvaxia has been approved by the U.S. Food and Drug Administration for use in the U.S. territories of American Samoa, Guam, Puerto Rico, and the U.S. Virgin Islands, but its use is limited to people aged 9 to 16 years. The vaccine has already been approved in 19 countries and the European Union.

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Measles Case Leads to Quarantine of Cruise Ship in St. Lucia

THURSDAY, May 2, 2019 (HealthDay News) — A case of measles has led to the quarantine of a cruise ship with nearly 300 passengers and crew on the Caribbean island of St. Lucia, health officials reported Wednesday. They said that one female crew member has a confirmed case of measles and that the ship has been under quarantine since Monday morning. The ship is scheduled to leave late Thursday, NBC News reported.

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Cocaine-, Psychostimulant-Involved Death Rates Increasing

THURSDAY, May 2, 2019 (HealthDay News) — Drug overdose deaths involving cocaine and psychostimulants accounted for 19.8 and 14.7 percent, respectively, of all 2017 drug overdose deaths, and the death rates are continuing to increase, according to research published in the May 3 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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FDA Puts Tough Warning Label on Ambien, Lunesta, Other Sleep Aids

WEDNESDAY, May 1, 2019 (HealthDay News) — The U.S. Food and Drug Administration is requiring a new boxed warning on sleep medications such as Ambien, Lunesta, and Sonata due to dangers from daytime drowsiness the day after their use.

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