November 2015 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for November 2015. 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.

Neurotoxicity Seen With Acyclovir at Recommended Dose in Dialysis

MONDAY, Nov. 30, 2015 (HealthDay News) -- Acyclovir-induced neurotoxicity should be considered for patients with herpes zoster on hemodialysis, according to a case report published online Nov. 21 in the Journal of Dermatology.

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Nonalcoholic Fatty Liver Disease Predicts MACE in STEMI

MONDAY, Nov. 30, 2015 (HealthDay News) -- For patients without diabetes with ST-segment myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), nonalcoholic fatty liver disease (FLD) independently predicts impaired myocardial perfusion and adverse in-hospital outcomes, according to a study published in the Dec. 15 issue of The American Journal of Cardiology.

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Trimethoprim-Induced Aseptic Meningitis Described

MONDAY, Nov. 30, 2015 (HealthDay News) -- Drug-induced aseptic meningitis following trimethoprim use has been described in a research letter published online Nov. 20 in the International Journal of Rheumatic Diseases.

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Mortality Rate Increases With Age in Emergency Abdominal Surgery

MONDAY, Nov. 30, 2015 (HealthDay News) -- Emergency major abdominal surgical procedures are associated with high mortality in older adults, with the odds of death increasing with age, according to a review published online Nov. 23 in the Journal of the American Geriatrics Society.

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Crib Bumpers Tied to Increasing Number of Infant Fatalities

TUESDAY, Nov. 24, 2015 (HealthDay News) -- Infant deaths linked to crib bumpers have spiked in recent years in the United States, leading researchers to urge a ban on the padded bedding accessories. These findings appear online Nov. 24 in The Journal of Pediatrics.

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FDA Expands Anthrax Vaccine Approval

TUESDAY, Nov. 24, 2015 (HealthDay News) -- U.S. Food and Drug Administration approval for the BioThrax anthrax vaccine has been expanded to include adults aged 18 to 65 with known or suspected exposure, the agency said in a media release. The vaccine was first approved in 1970 for people at high risk of anthrax contact.

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Music Can Help Doctors Develop Relationships With Patients

TUESDAY, Nov. 24 2015 (HealthDay News) -- For one physician, writing songs has improved her self-awareness and strengthened her relationships with patients, according to an article published by the American Medical Association.

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ACP: Physicians Should Prescribe Generic Meds If Possible

TUESDAY, Nov. 24, 2015 (HealthDay News) -- Physicians should prescribe generic medications whenever possible, keeping in mind that generics have comparable effectiveness to brand name medications and are associated with reduced costs and increased adherence, according to new guidelines published online Nov. 24 in the Annals of Internal Medicine.

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Drug Overdose Rates Up Substantially Among U.S. Youth

MONDAY, Nov. 23, 2015 (HealthDay News) -- Nationwide, the drug overdose mortality rate has more than doubled during the past decade among people aged 12 to 25 -- rising from 3.1 deaths per 100,000 in 1999-2001 to 7.3 deaths in 2011-2013, according to the Trust for America's Health's new Reducing Teen Substance Misuse: What Really Works report.

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Team Unveils Neck Collar That Could Protect Athletes From mTBI

MONDAY, Nov. 23, 2015 (HealthDay News) -- A new type of lightweight and pressurized neck collar may help prevent mild traumatic brain injury during sports, according to the developers of the device.

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Terlipressin Therapy Can Induce Hyponatremia

FRIDAY, Nov. 20, 2015 (HealthDay News) -- Terlipressin therapy can induce hyponatremia, according to a case report published online Nov. 17 in the Journal of Clinical Pharmacy and Therapeutics.

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FDA Approves Narcan Nasal Spray to Counter Opioid Overdose

THURSDAY, Nov. 19, 2015 (HealthDay News) -- Narcan (naloxone hydrochloride) nasal spray has been approved by the U.S. Food and Drug Administration to stop or reverse an overdose of opioids.

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E-Portfolio Developed to Assess Millennial Med Students

THURSDAY, Nov. 19, 2015 (HealthDay News) -- Electronic portfolios are being used to transform medical students' assessments and track progress as students advance through medical training, according to a report published by the American Medical Association (AMA).

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Most IV HTN Meds Ordered for Patients With SBP <180 mm Hg

THURSDAY, Nov. 19, 2015 (HealthDay News) -- Intravenous (IV) antihypertensives are often ordered and administered for patients with asymptomatic uncontrolled blood pressure (BP) levels that are not associated with immediate cardiovascular risk, according to a study published online Nov. 12 in the Journal of Hospital Medicine.

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Factors ID'd That Predict Antibiotic Rx in Pediatric URI

THURSDAY, Nov. 19, 2015 (HealthDay News) -- Factors that relate to appropriate management of upper respiratory tract infections (URIs) in children include clinician specialty and patient race/ethnicity and age, according to a study published in the November/December issue of the Annals of Family Medicine.

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AAFP: Expected 0.5 Percent Pay Increase Reduced to Zero

WEDNESDAY, Nov. 18, 2015 (HealthDay News) -- A small but promised Medicare pay increase has effectively been reduced to zero for all physician specialties, according to the final 2016 Medicare physician fee schedule and a report published by the American Academy of Family Physicians.

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Burnout Reduces Readiness to Change Teaching Approaches

WEDNESDAY, Nov. 18, 2015 (HealthDay News) -- Occupational burnout appears to reduce clinical faculty members' readiness to change teaching approaches, according to a study published online Nov. 13 in the Journal of Evaluation in Clinical Practice.

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Hypertension-Linked ER Visits Common and Increasing

WEDNESDAY, Nov. 18, 2015 (HealthDay News) -- Hypertension-related emergency department visits are relatively common and increased from 2006 to 2012, according to a study published in the Dec. 1 issue of The American Journal of Cardiology.

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Therapeutic Hypothermia May Help Cardiac Arrest Patients

TUESDAY, Nov. 17, 2015 (HealthDay News) -- Patients who receive therapeutic hypothermia may be nearly three times more likely to survive cardiac arrest, according to a study published online Nov. 16 in Circulation.

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Continuation of Antibiotics for UTI Often Inappropriate

TUESDAY, Nov. 17, 2015 (HealthDay News) -- For patients with urinary tract infections (UTIs), initiation of antibiotics in the emergency department is frequently inappropriate, as is continuation of antibiotics after admission, according to a study published online Nov. 12 in the Journal of Hospital Medicine.

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Head Lice infestation Could Cause Iron Deficiency Anemia

TUESDAY, Nov. 17, 2015 (HealthDay News) -- Head lice infestation could cause iron deficiency anemia in the absence of any other cause, according to a case report published online Nov. 5 in BMJ Case Reports.

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Transitional Care Interventions Cut Risk of Readmission in CHF

MONDAY, Nov. 16, 2015 (HealthDay News) -- For patients with congestive heart failure, transitional care interventions (TCIs), especially high-intensity TCIs, are effective for reducing the risks of readmission and emergency department visits, according to a review published in the November/December issue of the Annals of Family Medicine.

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Radial Artery Access Reduces Mortality, Major Bleeds in ACS

FRIDAY, Nov. 13, 2015 (HealthDay News) -- For patients with acute coronary syndrome managed with invasive procedures, radial artery access reduces mortality, major coronary adverse events, and major bleeding compared to femoral artery access, according to a meta-analysis published online Nov. 10 in the Annals of Internal Medicine.

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Facilitating Shared Decision-Making Can Cut Antibiotic Use

FRIDAY, Nov. 13, 2015 (HealthDay News) -- For patients with acute respiratory infections (ARIs), interventions that aim to facilitate shared decision-making reduce antibiotic use in primary care, according to a review published online Nov. 12 in The Cochrane Library.

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Case of Bobby Pin Piercing Kidney Reported in 4-Year-Old

FRIDAY, Nov. 13, 2015 (HealthDay News) -- A swallowed bobby pin can be cause for concern, capable of piercing through the kidney, according to a case report published online Nov. 5 in BMJ Case Reports.

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Swiss Report Highlights Danger of Drug-Resistant Tuberculosis

THURSDAY, Nov. 12, 2015 (HealthDay News) -- Although antibiotics have largely eradicated tuberculosis (TB) in the United States in recent decades, researchers say evidence is mounting that the bacteria is becoming increasingly resistant to these medications. Details of a recent Swiss case are reported in the Nov. 12 issue of the New England Journal of Medicine.

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Emergency Sx Patients Often Readmitted to Different Hospital

THURSDAY, Nov. 12, 2015 (HealthDay News) -- Nearly 17 percent of patients are readmitted to a hospital after having emergency surgery, with one in five of these patients admitted to a hospital other than where the surgery was done, according to a study published online Nov. 11 in JAMA Surgery.

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Substantial Increase in Costs for Uncontrolled Asthma

THURSDAY, Nov. 12, 2015 (HealthDay News) -- A considerable proportion of patients with mild to moderate asthma are symptomatically uncontrolled, and uncontrolled asthma is associated with significantly increased costs, according to a study published online Nov. 3 in Allergy.

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Loss of Consciousness at SAH Onset Indicates Early Brain Injury

WEDNESDAY, Nov. 11, 2015 (HealthDay News) -- Loss of consciousness (LOC) at subarachnoid hemorrhage (SAH) onset is associated with worse prognosis, according to a study published online Nov. 9 in JAMA Neurology.

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ACP Issues Guidance on 'Concierge' Practices

TUESDAY, Nov. 10, 2015 (HealthDay News) -- Direct patient contracting practices (DPCPs), in which patients pay out of pocket for some or all services provided by the practice, are growing in popularity, according to a position paper published online Nov. 10 in the Annals of Internal Medicine.

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Blood Test Has Potential for Detecting Concussion in Children

WEDNESDAY, Nov. 11, 2015 (HealthDay News) -- A simple blood test may one day be able to detect concussions in children, according to a study published in the November issue of Academic Emergency Medicine.

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Macrolides May Raise Cardiovascular Risks

TUESDAY, Nov. 10, 2015 (HealthDay News) -- Macrolides are associated with a small but measurable increased risk of sudden cardiac death, according to research published in the Nov. 17 issue of the Journal of the American College of Cardiology.

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Case Report Highlights Dangers of Natural Remedies

TUESDAY, Nov. 10, 2015 (HealthDay News) -- A case of accidental overdose of an Atropa belladonna preparation highlights the dangers of the use of herbal remedies, according to a case report published online Nov. 5 in BMJ Case Reports.

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D-Dimer Levels Predict DVT in Cervical Spinal Cord Injury

TUESDAY, Nov. 10, 2015 (HealthDay News) -- For patients with acute traumatic cervical spinal cord injury (SCI), D-dimer levels can predict the likelihood of developing deep vein thrombosis (DVT), according to a study published in the Nov. 1 issue of The Spine Journal.

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Web-Based CBT Program Cuts Suicidal Ideation in Interns

MONDAY, Nov. 9, 2015 (HealthDay News) -- A web-based cognitive behavioral therapy (wCBT) program is effective for preventing suicidal ideation among medical interns, according to a study published online Nov. 4 in JAMA Psychiatry.

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Doctors Can Often Miss Achilles Tendon Diagnosis

MONDAY, Nov. 9, 2015 (HealthDay News) -- About one-quarter of Achilles tendon ruptures are missed during doctors' initial examinations, according to a clinical review published in the November issue of the Journal of the American Osteopathic Association.

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Scarlet Fever Incidence Rising in Some Parts of the World

FRIDAY, Nov. 6, 2015 (HealthDay News) -- Genome sequencing techniques can shed light on the rise in incidence of scarlet fever-causing bacteria and their increasing resistance to antibiotics, according to research published online Nov. 2 in Scientific Reports.

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Updated Checklist for Reporting Diagnostic Accuracy Studies

FRIDAY, Nov. 6, 2015 (HealthDay News) -- An updated list of 30 essential items should be included in every report of a diagnostic accuracy study, according to the Standards for Reporting Diagnostic Accuracy Studies (STARD) 2015. These new guidelines have been published in several journals, including Radiology, Clinical Chemistry, and The BMJ.

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Poll: Americans Want Health Care Costs Kept in Check

THURSDAY, Nov. 5, 2015 (HealthDay News) -- Most Americans now support aggressive regulation to keep health care costs in check -- including price caps on drugs, medical devices, and payments to doctors and hospitals, a new HealthDay/Harris Poll has found.

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Doctors Who Order More Tests Have Fewer Malpractice Claims

THURSDAY, Nov. 5, 2015 (HealthDay News) --The more tests and treatments U.S. doctors order for patients, the less likely they are to be sued for malpractice, according to a study published online Nov. 4 in The BMJ.

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ACP Joins Amicus Curiae Brief to Supreme Court

THURSDAY, Nov. 5, 2015 (HealthDay News) -- The American College of Physicians (ACP) has joined other organizations in an amicus curiae brief to the Supreme Court, urging the court to uphold considerations of race and ethnicity in the medical school admissions process.

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AMA: 6 Steps to Help Ensure Patients Get Preventive Care

WEDNESDAY, Nov. 4, 2015 (HealthDay News) -- Panel management, or population health management, can help physicians provide necessary preventive and chronic care to all patients regardless of their visit frequency, according to a report published by the American Medical Association (AMA).

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Doctors Should Consider Financial Factors Before Career Change

WEDNESDAY, Nov. 4, 2015 (HealthDay News) -- Financial and other factors should be considered before physicians change career direction, according to a report published in Medical Economics.

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Endovascular Tx Beats tPA Alone for Stroke Patients

WEDNESDAY, Nov. 4, 2015 (HealthDay News) -- Endovascular therapy with mechanical thrombectomy in ischemic stroke is superior to standard treatment with tissue plasminogen activator (tPA) for preserving brain function, according to research published in the Nov. 3 issue of the Journal of the American Medical Association.

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Prescription Medication Use on the Rise in the United States

WEDNESDAY, Nov. 4, 2015 (HealthDay News) -- More Americans than ever are taking prescription drugs, as well as using more of them, according to research published in the Nov. 3 issue of the Journal of the American Medical Association.

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New Electronic Health Record Regulations Released

TUESDAY, Nov. 3, 2015 (HealthDay News) -- New electronic health record (EHR) regulations modify Stage 2 of the meaningful use program and finalize requirements for Stage 3, according to a report published by the American Medical Association (AMA).

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H. pylori Triple Therapy Linked to Erythema Multiforme

TUESDAY, Nov. 3, 2015 (HealthDay News) -- Triple therapy for Helicobacter pylori can cause erythema multiforme, according to a case study published online Oct. 28 in The Journal of Dermatology.

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Competition for Fellowships Broke Records in 2015

MONDAY, Nov. 2, 2015 (HealthDay News) -- According to the American Medical Association (AMA), 2015 was a record-breaking year for fellowship applications.

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Prescribing Drugs 'Off-Label' Can Pose Serious Safety Risks

MONDAY, Nov. 2, 2015 (HealthDay News) -- Off-label drug use puts patients at risk for serious side effects, especially when scientific evidence is lacking, according to a study published online Nov. 2 in JAMA Internal Medicine.

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Aripiprazole Can Cause False-Positive Amphetamine Screens

MONDAY, Nov. 2, 2015 (HealthDay News) -- Urine drug screens (UDSs) can be false-positive for amphetamines after ingestion of aripiprazole, according to two case reports published online Nov. 2 in Pediatrics.

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Displaying Prices to Providers Seems to Reduce Order Costs

MONDAY, Nov. 2, 2015 (HealthDay News) -- Displaying order prices to physicians seems to reduce order costs, according to a review published online Oct. 23 in the Journal of Hospital Medicine.

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Ranolazine Bests Old School Antianginal Medications

MONDAY, Nov. 2, 2015 (HealthDay News) -- Newer antianginal (AA) medications such as ranolazine show substantial outcome improvements in chronic stable angina pectoris (CSA) compared to traditional medications, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

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Case Study: Bisphosphonate-Linked Osteonecrosis in Diabetes

MONDAY, Nov. 2, 2015 (HealthDay News) -- A case of bisphosphonate-related osteonecrosis of the jaw is described in an elderly patient with diabetes mellitus. The report is published in the October issue of the Journal of the American Geriatrics Society.

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