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October 2019 Briefing – Emergency Medicine

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

Early Infectious Diseases Consult May Lower Sepsis Mortality

THURSDAY, Oct. 31, 2019 (HealthDay News) — Early infectious diseases (ID) consultation is associated with a reduction in in-hospital mortality for patients receiving a severe sepsis and septic shock (SS/SS) treatment bundle, according to a study published online Oct. 31 in Open Forum Infectious Diseases.

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Close to 1,900 Cases of Vaping-Linked Lung Illness Reported, CDC Says

THURSDAY, Oct. 31, 2019 (HealthDay News) — The number of Americans stricken with a severe, sometimes fatal lung illness tied to vaping has now reached 1,888, the U.S. Centers for Disease Control and Prevention reported Thursday. That is a rise from the 1,604 case total from a week ago.

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White House Launches Website to Help Those Battling Substance Abuse

WEDNESDAY, Oct. 30, 2019 (HealthDay News) — A new website to help Americans with substance abuse problems find treatment was activated Wednesday by the Trump administration.

FindTreatment.gov

AP News Article

CDC: U.S. Life Expectancy Up Slightly, Mortality Lower in 2017

WEDNESDAY, Oct. 30, 2019 (HealthDay News) — Life expectancy has increased slightly in the United States, and mortality is lower than in 2007, according to a report published Oct. 30 by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

Health, United States, 2018

Facebook Launches Preventive Health Tool

TUESDAY, Oct. 29, 2019 (HealthDay News) — A new tool designed to help guide preventive care for heart disease, cancer, and seasonal flu was launched in the United States Monday by Facebook.

CNN Article

CDC: Most Patients With Vaping-Related Lung Injury Report THC Use

TUESDAY, Oct. 29, 2019 (HealthDay News) — Most patients with electronic cigarette, or vaping, product use-associated lung injury (EVALI) reported use of tetrahydrocannabinol (THC)-containing products in the three months preceding symptom onset, according to research published in the Oct. 28 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Racial Inequity Seen for Admission to Cardiology for Heart Failure

TUESDAY, Oct. 29, 2019 (HealthDay News) — Black and Latinx patients are less likely than white patients to be admitted to cardiology for heart failure care, according to a study published online Oct. 29 in Circulation: Heart Failure.

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Outcomes Poor With Medical Care From Fraud, Abuse Perpetrators

MONDAY, Oct. 28, 2019 (HealthDay News) — Receiving medical care from fraud and abuse perpetrators (FAPs), subsequently excluded from Medicare, is associated with higher rates of all-cause mortality and emergency hospitalization, according to a study published online Oct. 28 in JAMA Internal Medicine.

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Editorial (subscription or payment may be required)

Doctors Mostly Dissatisfied With Electronic Health Record Systems

MONDAY, Oct. 28, 2019 (HealthDay News) — The majority of physicians are dissatisfied with their current electronic health record (EHR) systems, according to survey results released Oct. 16 by Medical Economics.

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Antibiotics Not Recommended for Most Toothaches

FRIDAY, Oct. 25, 2019 (HealthDay News) — Antibiotics are not recommended for urgent management of symptomatic irreversible pulpitis with or without symptomatic apical periodontitis, pulp necrosis, and symptomatic apical periodontitis or for pulp necrosis and localized acute apical abscess in immunocompetent adults, according to an evidence-based clinical practice guideline published in the November issue of the Journal of the American Dental Association.

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CDC: Drugs Involved in Overdose Deaths Varied Regionally in 2017

FRIDAY, Oct. 25, 2019 (HealthDay News) — The drugs most frequently involved in drug overdose deaths in 2017 varied regionally in the United States, according to a study published online Oct. 25 in the National Health Statistics Reports, a publication from the U.S. Centers for Disease Control and Prevention.

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Disneyland Visitors May Have Been Exposed to Measles

THURSDAY, Oct. 24, 2019 (HealthDay News) — People who were at Disneyland in Anaheim, California, and a Starbucks in Los Angeles on Oct. 16 may have been exposed to measles, the Los Angeles County Department of Public Health says.

NBC News Article

CDC: Cases of Vaping-Linked Lung Illness Now Top 1,600

THURSDAY, Oct. 24, 2019 (HealthDay News) — More than 1,600 Americans have now been struck by a severe, sometimes fatal, lung illness tied to vaping, the U.S. Centers for Disease Control and Prevention reported Thursday.

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Risk for Life-Threatening Infections Greater With Stress-Related Disorders

THURSDAY, Oct. 24, 2019 (HealthDay News) — Stress-related disorders are associated with an increased risk for life-threatening infections, according to a study published online Oct. 23 in The BMJ.

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Limited English Proficiency May Worsen Chronic Disease Outcome

WEDNESDAY, Oct. 23, 2019 (HealthDay News) — In predominantly English-speaking settings, patients with limited English proficiency (LEP) and chronic conditions have higher rates of emergency department revisits and hospital readmissions than patients with English proficiency (EP), according to a research letter published in the Oct. 22/29 issue of the Journal of the American Medical Association.

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More Choices, Lower Premiums for ACA Consumers Next Year

TUESDAY, Oct. 22, 2019 (HealthDay News) — There will be more health insurance choices and a slight decrease in premiums for many consumers next year under the Affordable Care Act, according to the Trump administration.

AP News Article

Antiviral Antibodies ID’d in CSF of Acute Flaccid Myelitis Cases

MONDAY, Oct. 21, 2019 (HealthDay News) — Enterovirus (EV)-specific antibodies have been identified in the cerebrospinal fluid (CSF) of pediatric cases of acute flaccid myelitis (AFM) versus controls, according to a study published online Oct. 21 in Nature Medicine.

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Recommendations Updated for Nonvariceal Upper GI Bleeding

MONDAY, Oct. 21, 2019 (HealthDay News) — In clinical guidelines published online Oct. 22 in the Annals of Internal Medicine, updated recommendations are presented for the management of nonvariceal upper gastrointestinal bleeding.

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Editorial (subscription or payment may be required)

Tranexamic Acid Within Three Hours Cuts Some TBI Deaths

MONDAY, Oct. 21, 2019 (HealthDay News) — Among patients with mild-to-moderate acute traumatic brain injury (TBI), the risk for head injury-related death is reduced in those receiving tranexamic acid within three hours compared with placebo, according to a study published online Oct. 14 in The Lancet.

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NATA: Single-Sport Focus Not Good for Children

FRIDAY, Oct. 18, 2019 (HealthDay News) — Parents should try to keep their children from focusing on a single sport for as long as possible to reduce their risk for injuries and other problems, the National Athletic Trainers’ Association (NATA) says.

The New York Times Article

More Information: NATA

Study Looks at Pediatric Firearm-Related Eye Injuries in the U.S.

THURSDAY, Oct. 17, 2019 (HealthDay News) — A quarter of all U.S. ocular firearm injuries occur within the pediatric population, according to a study published online Oct. 10 in JAMA Ophthalmology.

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Suicide, Homicide Rates Up Among Youth Aged 10 to 24

THURSDAY, Oct. 17, 2019 (HealthDay News) — Suicide rates increased from 2007 to 2017 among youth aged 10 to 24 years, according to an October data brief published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

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PTSD Linked to Early Incident TIA, Stroke in Young Veterans

THURSDAY, Oct. 17, 2019 (HealthDay News) — For young and middle-aged veterans, posttraumatic stress disorder (PTSD) is associated with an increased risk for early incident transient ischemic attack (TIA) and ischemic stroke, according to a study published online Oct. 17 in Stroke.

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Opioid Crisis Cost United States $631 Billion Over Four Years

WEDNESDAY, Oct. 16, 2019 (HealthDay News) — The U.S. opioid epidemic cost the nation’s economy $631 billion from 2015 through 2018, a new study says.

AP News Article

Society of Actuaries

Decrease Seen in Football Practice-Related Concussions

TUESDAY, Oct. 15, 2019 (HealthDay News) — Rates of concussion during football practice and recurrent concussion rates across all high school sports decreased from the 2013-2014 to 2017-2018 school years, according to a study published online Oct. 15 in Pediatrics.

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CDC Releases Clinical Guidance on E-Cigarette Lung Injury

TUESDAY, Oct. 15, 2019 (HealthDay News) — In an early-release Oct. 11 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, the CDC presents interim guidance to help clinicians assess, evaluate, manage, and follow patients with electronic cigarette, or vaping, product use-associated lung injury (EVALI).

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Increase in Suicide Attempts Seen for Black Adolescents

TUESDAY, Oct. 15, 2019 (HealthDay News) — From 1991 to 2017, black high school students experienced an increase in suicide attempts, according to a study published online Oct. 14 in Pediatrics.

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Editorial

Black Patients With Diabetes Have Higher 30-Day Readmission Rates

TUESDAY, Oct. 15, 2019 (HealthDay News) — Black patients with diabetes have a significantly higher risk for 30-day readmission compared with other racial/ethnic groups, according to a study published online Oct. 11 in JAMA Network Open.

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CDC: Seasonal Influenza Viruses Circulating in Southern Hemisphere

THURSDAY, Oct. 10, 2019 (HealthDay News) — Seasonal influenza viruses are circulating widely in the Southern Hemisphere, but influenza activity is currently low in the United States, according to research published in the Oct. 11 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Close to 1,300 Cases of Vaping-Linked Illness Now Identified

THURSDAY, Oct. 10, 2019 (HealthDay News) — The number of Americans sickened with a severe lung injury tied to vaping just keeps rising, U.S. health officials said Thursday.

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Anaphylactic Reactions Tied to PICC Insertion With Magnetic Tip

THURSDAY, Oct. 10, 2019 (HealthDay News) — Potential anaphylactic or anaphylactoid reactions have been associated with insertion of peripherally inserted central catheters (PICCs) using the Sherlock tip locating system (TLS), which features a magnetized stylet wire, according to a study published online Oct. 8 in Infection Control & Hospital Epidemiology.

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Medicare Fraud-Prevention Rules to Be Revised

WEDNESDAY, Oct. 9, 2019 (HealthDay News) — Revision of decades-old Medicare rules meant to prevent fraud has been proposed by the Trump administration.

AP News Article

2000 to 2015 Saw Increase in Medicare GME Payments

WEDNESDAY, Oct. 9, 2019 (HealthDay News) — Medicare graduate medical education (GME) payments increased significantly from 2000 to 2015, according to a study published online Oct. 7 in JAMA Internal Medicine.

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Cost of Waste in U.S. Health System Estimated

TUESDAY, Oct. 8, 2019 (HealthDay News) — The estimated cost of waste in the U.S. health care system varies from $760 to $935 billion, according to a special communication published online Oct. 7 in the Journal of the American Medical Association.

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Burnout Linked to Poor Quality Care in Published Literature

TUESDAY, Oct. 8, 2019 (HealthDay News) — In the published literature, burnout in health care professionals is frequently associated with poor-quality care, but the effect size may be smaller than reported, according to data from a systematic review published online Oct. 8 in the Annals of Internal Medicine.

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Testosterone, Estradiol Levels May Play Role in Sex Differences in Asthma

TUESDAY, Oct. 8, 2019 (HealthDay News) — Sex hormones seem to play a role in known sex differences in asthma in adults, with the effects modified by obesity, according to a study published online Sept. 16 in the American Journal of Respiratory and Critical Care Medicine.

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Pediatric Firearm Injury Prevention Research Underfunded

TUESDAY, Oct. 8, 2019 (HealthDay News) — Funding for pediatric firearm injury prevention research is only 3.3 percent of that predicted according to the mortality burden, say the authors of a report published in the October issue of Health Affairs.

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OTC Meds Often Used in Drug-Related Suicide Attempts in Youth

MONDAY, Oct. 7, 2019 (HealthDay News) — Over-the-counter medications are commonly used in suicide attempts by self-poisoning among young people, according to a study published online Oct. 7 in Clinical Toxicology.

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Data Suggest Viral Etiology for Pediatric Acute Flaccid Myelitis

MONDAY, Oct. 7, 2019 (HealthDay News) — Surveillance data for acute flaccid myelitis (AFM) suggests a viral etiology, according to a study published online Oct. 7 in Pediatrics.

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Guideline for Community-Acquired Pneumonia Updated

MONDAY, Oct. 7, 2019 (HealthDay News) — In an updated official clinical practice guideline from the American Thoracic Society and Infectious Diseases Society of America, published in the Oct. 1 issue of the American Journal of Respiratory and Critical Care Medicine, recommendations are presented for the diagnosis and management of community-acquired pneumonia (CAP).

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North Carolina Outbreak of Legionnaires’ Traced to Hot Tub Display

FRIDAY, Oct. 4, 2019 (HealthDay News) — An outbreak of Legionnaires’ disease that has sickened 116 and killed one at the state fair may have started at a hot tub display, the North Carolina Department of Health and Human Services reported Wednesday.

AP News Article

NCDHHS Press Release

Survey: Many U.S. Adults Not Planning to Get Flu Vaccine

FRIDAY, Oct. 4, 2019 (HealthDay News) — Many U.S. adults, including some at the highest risk for the flu and pneumonia, do not plan to get preventive vaccines, according to a survey conducted by NORC at the University of Chicago on behalf of the National Foundation for Infectious Diseases.

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United States Will Keep Measles Elimination Status

THURSDAY, Oct. 3, 2019 (HealthDay News) — Despite recent outbreaks among unvaccinated people, the U.S. Centers for Disease Control and Prevention expects the United States will maintain its measles elimination status.

CNN Article

Cases of Serious Vaping-Linked Lung Injury Now Top 1,000

THURSDAY, Oct. 3, 2019 (HealthDay News) — The number of Americans sickened with a severe lung illness tied to vaping continues to climb, U.S. health officials said Thursday.

Press Release: CDC

NEJM Research Letter

Three-Drug Single Inhaler Treats Uncontrolled Asthma in Adults

THURSDAY, Oct. 3, 2019 (HealthDay News) — A three-in-one inhaler therapy can improve lung function and reduce asthma attacks in adults with uncontrolled disease, according to a study published online Sept. 30 in The Lancet.

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Ligelizumab Safely, Effectively Treats Hives

THURSDAY, Oct. 3, 2019 (HealthDay News) — Ligelizumab appears to be a safe and effective treatment option for chronic spontaneous urticaria, according to a study published in the Oct. 3 issue of the New England Journal of Medicine.

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Editorial (subscription or payment may be required)

Only Half of Ear, Nose, Throat Infections Receive Recommended Antibiotics

WEDNESDAY, Oct. 2, 2019 (HealthDay News) — In outpatient settings, only 50 percent of visits for pharyngitis, sinusitis, and acute otitis media (AOM) receive recommended first-line antibiotics, according to a study published online Sept. 23 in Antimicrobial Agents and Chemotherapy.

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Gradual ACS Symptom Onset Linked to Delay in Presentation for Acute Care

WEDNESDAY, Oct. 2, 2019 (HealthDay News) — For patients with acute coronary syndrome (ACS), having a gradual onset of symptoms is associated with longer prehospital delay, according to a study published online Sept. 11 in the European Journal of Cardiovascular Nursing.

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Medicare Spends More Than $6 Billion on Secondary Fractures

WEDNESDAY, Oct. 2, 2019 (HealthDay News) — Medicare could save billions of dollars if secondary fractures could be prevented with improved osteoporosis screening, according to a new National Osteoporosis Foundation report conducted by Milliman.

Research Report: Medicare Cost of Osteoporotic Fractures

Juul Halts Funding for San Francisco Vaping Ballot Initiative

TUESDAY, Oct. 1, 2019 (HealthDay News) — On Monday, San Francisco-based Juul Labs Inc. said it will no longer fund an effort to quash an antivaping law in the city, effectively ending the campaign.

AP News Article

NBC News Article

Food Insecurity Prevalent Among Medicare Enrollees

TUESDAY, Oct. 1, 2019 (HealthDay News) — Food insecurity is prevalent among Medicare enrollees, affecting 38.3 percent of those aged younger than 65 years, according to a research letter published online Sept. 30 in JAMA Internal Medicine.

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Asthma-Related ED Use Up for Children With Anxiety, Depression

TUESDAY, Oct. 1, 2019 (HealthDay News) — Children with asthma and with anxiety, depression, or both have increased rates of asthma-related emergency department use, according to a study published online Sept. 25 in Pediatrics.

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North Carolina Legionnaires’ Case Count Climbs to 79

TUESDAY, Oct. 1, 2019 (HealthDay News) — The number of confirmed cases of Legionnaires’ disease linked to a North Carolina state fair now stands at 79, including 55 people hospitalized and one death.

CNN Article

More Information: CDC

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