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September 2014 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for September 2014. 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.

Low Professional Liability for No Esophageal Cancer Screening

TUESDAY, Sept. 30, 2014 (HealthDay News) -- The risk of medical professional liability claims alleging failure to screen for esophageal cancer is not a reason to screen for esophageal cancer, according to a research letter published in the Oct. 1 issue of the Journal of the American Medical Association.

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AHA: Consider Radiation Risks of Heart Imaging Procedures

TUESDAY, Sept. 30, 2014 (HealthDay News) -- Doctors need to make sure patients understand the radiation-related risks of heart imaging tests before sending them for such procedures, a new American Heart Association scientific statement says. The statement was published online Sept. 29 in Circulation.

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40 States, District of Columbia Reporting Enterovirus D68

TUESDAY, Sept. 30, 2014 (HealthDay News) -- Forty states and the District of Columbia now have a total of 277 confirmed cases of Enterovirus D68, the severe respiratory illness that typically targets children, U.S. health officials are reporting.

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American Academy of Neurology Issues Opioid Guidelines

TUESDAY, Sept. 30, 2014 (HealthDay News) -- The risks of opioids outweigh their benefits for treating chronic noncancer pain such as chronic headaches, low back pain, and fibromyalgia, according to a new statement from the American Academy of Neurology (AAN).

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'Just-in-Time' Methodology Can Reduce Patient Waiting Times

MONDAY, Sept. 29, 2014 (HealthDay News) -- Having trainee physicians review cases prior to clinic hours can reduce patient waiting times, flow times, and clinic session times, according to a study published online Sept. 16 in Pain Medicine. The management process studied was first popularized by Toyota in Japan.

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Daytime Cholecystectomy May Be Better for Acute Cholecystitis

MONDAY, Sept. 29, 2014 (HealthDay News) -- Patients who require cholecystectomy for acute cholecystitis are more likely to have a minimally invasive procedure if they have the surgery during daytime rather than at night, according to a study published online Sept. 20 in the American Journal of Surgery.

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AMA Launches Three Programs for Physician Wellness

MONDAY, Sept. 29, 2014 (HealthDay News) -- Physicians' personal health is a global concern and three initiatives are being developed to encourage positive change, according to a report from the American Medical Association (AMA).

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ACC Withdraws One Choosing Wisely Recommendation

MONDAY, Sept. 29, 2014 (HealthDay News) -- Researchers have withdrawn one of the previous Choosing Wisely recommendations from April 2012, according to a report from the American College of Cardiology (ACC).

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NIH Funds Study of Malpractice Risk, Cardiac Testing Incentives

FRIDAY, Sept. 26, 2014 (HealthDay News) -- The National Institutes of Health has granted $2 million to study the effect of malpractice risk and financial incentives on cardiac testing.

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Experiences Trump Things, Even Before Purchase

FRIDAY, Sept. 26, 2014 (HealthDay News) -- People derive value from the anticipation of purchasing something, and this anticipation tends to be greater for an experiential purchase than for a material purchase, according to a study published online Aug. 21 in Psychological Science.

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Can Media Multitasking Alter Your Brain?

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Multitasking with smartphones, laptop computers, and other media devices could change the structure of your brain, according to a study published online Sept. 24 in PLOS ONE.

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NSAIDs Tied to Risk of Venous Thromboembolism

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Use of nonsteroidal anti-inflammatory drugs (NSAIDs) may increase risk of venous thromboembolism (VTE), according to new research published online Sept. 24 in Rheumatology.

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Kidney Disease Doesn't Bar Thrombolytic Therapy in Stroke

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Intravenous (IV) thrombolytic therapy for acute ischemic stroke (IS) is not contraindicated in patients with chronic kidney disease (CKD), according to research published online Sept. 23 in Circulation: Cardiovascular Quality and Outcomes.

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ACP Launches Program for Nonvalvular A-Fib Management

THURSDAY, Sept. 25, 2014 (HealthDay News) -- A new program is being developed to help patients recognize the signs and symptoms of nonvalvular atrial fibrillation (NVAF), according to a report from the American College of Physicians (ACP).

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New Clinical Guidelines Developed for NSTE-ACS

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- New guidelines for management of patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) have been developed and published online Sept. 23 in Circulation.

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CDC: Enterovirus D68 in 29 States, District of Columbia

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- Twenty-nine states and the District of Columbia now have a total of 213 confirmed cases of Enterovirus D68, the severe respiratory illness that typically targets children, U.S. health officials are reporting.

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Report Identifies Game Changers for U.S. Health Care

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- Imagine if doctors and hospitals got paid for providing better care, not more care, and patients had better data for making informed health choices. A new report suggests that's the direction the U.S. health system is headed.

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Most Doctors Are Over-Extended or at Full Capacity

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- Most physicians report being over-extended or at full capacity, according to a survey conducted by Merritt Hawkins for The Physicians Foundation.

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CDC: Ebola Cases Could Reach 1.4 Million in Months

TUESDAY, Sept. 23, 2014 (HealthDay News) -- Infections from the Ebola epidemic in Liberia and Sierra Leone could soar to 1.4 million cases by mid-January unless the global community mounts a rapid response to the West African crisis. This prediction is part of a new report published in the Sept. 23 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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FDA Warns Doctors of Danger From 'Fake' Drugs

TUESDAY, Sept. 23, 2014 (HealthDay News) -- The number of "rogue" wholesale distributors selling fake or unapproved prescription drugs is growing, so doctors need to be vigilant when purchasing medicines, the U.S. Food and Drug Administration warned Tuesday.

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Healthy Behaviors May Prevent ~80 Percent of Heart Attacks

TUESDAY, Sept. 23, 2014 (HealthDay News) -- Five recommended health behaviors may prevent four out of five heart attacks in men, according to a study published in the Sept. 30 issue of the Journal of the American College of Cardiology.

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Ebola Cases Predicted to Continue Increasing

TUESDAY, Sept. 23, 2014 (HealthDay News) -- Based on data from the first nine months of the Ebola virus disease (EVD) epidemic, the numbers of cases are predicted to continue increasing, according to a study published online Sept. 23 in the New England Journal of Medicine.

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Chikungunya Fever Identified in the United States

TUESDAY, Sept. 23, 2014 (HealthDay News) -- Chikungunya fever is being seen in travelers returning to the United States from affected regions and should be considered as a diagnosis for febrile travelers, according to an ideas and opinions piece published online Sept. 23 in the Annals of Internal Medicine.

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Health Conditions Expected to Worsen Due to Climate Change

MONDAY, Sept. 22, 2014 (HealthDay News) -- A new study warns that rising temperatures and altered weather patterns in the United States may soon exacerbate many existing health risks. The study was published online Sept. 22 in the Journal of the American Medical Association, ahead of the United Nations' summit on climate change, which kicks off Tuesday in New York City.

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One in 15 Family Docs Focus Time on Emergency/Urgent Care

MONDAY, Sept. 22, 2014 (HealthDay News) -- Approximately one in 15 family physicians spend at least 80 percent of their time in emergency or urgent care, with higher percentages seen for doctors in rural areas, according to a report published by the American Academy of Family Physicians. The findings were published in the July-August issue of the Journal of the American Board of Family Medicine.

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Redundant Antimicrobial Therapy Is Pervasive, Costly

MONDAY, Sept. 22, 2014 (HealthDay News) -- Redundant use of antimicrobial therapy is pervasive in U.S. hospitals and is associated with considerable, potentially avoidable, health care costs, according to a study published in the October issue of Infection Control and Hospital Epidemiology.

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Doctor Describes Importance of Interpretation in Patient Care

MONDAY, Sept. 22, 2014 (HealthDay News) -- Understanding patients is important for all doctors, including those working with patients with limited English proficiency, according to an article published in the September/October issue of the Annals of Family Medicine.

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Systemwide Changes Needed to Restrain Health Care Spending

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Systemwide changes are necessary to prevent excessive health care spending, and so are tools to help consumers make better, more informed medical choices, according to a white paper published in June by Vitals.

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Electronic Health Records Tied to Shorter Time in ER

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Length of emergency room stay for trauma patients is shorter with the use of electronic health records, according to a study published in the September issue of the Journal of Emergency Nursing.

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Recent Increase in Liver Injury From Herbs, Supplements

FRIDAY, Sept. 19, 2014 (HealthDay News) -- The proportion of liver injury cases resulting from herbals and dietary supplements (HDS) has increased significantly in the last decade, according to a study published online Aug. 25 in Hepatology.

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Presence of Peers Ups Health Workers' Hand Hygiene

FRIDAY, Sept. 19, 2014 (HealthDay News) -- The presence of other health care workers improves hand hygiene adherence, according to a study published in the October issue of Infection Control and Hospital Epidemiology.

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Obama Calls for National Plan to Fight Antibiotic Resistance

FRIDAY, Sept. 19, 2014 (HealthDay News) -- President Barack Obama escalated the fight against antibiotic-resistant bacteria on Thursday, ordering key federal agencies to pursue a national strategy to deal with the threat.

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CDC: Almost Everyone Needs a Flu Shot

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Less than half of all Americans got a flu shot last year, so U.S. health officials on Thursday urged that everyone 6 months and older get vaccinated for the coming flu season. "It's really unfortunate that half of Americans are not getting the protection from flu they could get," said Thomas Frieden, M.D., director of the U.S. Centers for Disease Control and Prevention, during a morning news conference.

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Strategies Can Help Docs Lower Their Tax Burden

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Strategies are presented to help physicians lower their tax burden in an article published Sept. 2 in Medical Economics.

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Initial Sonography OK for Diagnosing Nephrolithiasis

THURSDAY, Sept. 18, 2014 (HealthDay News) -- No significant difference in outcomes is observed between the use of ultrasonography or computed tomography (CT) for suspected nephrolithiasis, according to research published in the Sept. 18 issue of the New England Journal of Medicine.

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Insulin Rx Tied to Increased Major Adverse CV Events in DM

THURSDAY, Sept. 18, 2014 (HealthDay News) -- The rate of major adverse cardiovascular events is higher in patients with diabetes mellitus (DM) and multivessel coronary artery disease treated with insulin (ITDM) versus those not treated with insulin (non-ITDM), according to a study published in the Sept. 23 issue of the Journal of the American College of Cardiology.

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ER Timeliness to Be Improved but Some Measures May Backfire

THURSDAY, Sept. 18, 2014 (HealthDay News) -- While there is room for improvement in the timeliness of emergency department care, pressure to comply with length of stay (LOS) measures may have unintended consequences, according to two research letters published online Sept. 15 in JAMA Internal Medicine.

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Internists Report Considerable EMR-Linked Time Loss

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Use of electronic medical record (EMR) systems is associated with considerable loss of free time per clinic day, according to a research letter published online Sept. 8 in JAMA Internal Medicine.

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Researchers ID Factor in Hospital Bacterial Resistance

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Scientists have uncovered a key factor to explain why antibiotic-resistant bacteria can thrive in a hospital setting. These findings have published in the Sept. 17 issue of Science Translational Medicine.

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12 States Now Reporting Severe Respiratory Illness Affecting Kids

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Twelve states now have confirmed cases of Enterovirus D68, the severe respiratory illnesses that may have sickened hundreds of children, U.S. health officials report.

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Doctors Promoting Transparency With Patients

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Efforts to increase transparency among doctors are underway, according to an article published in The Boston Globe.

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One in Five U.S. Men Admit to Violence Against Partner

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- One in five American men admit to using violence against his spouse or partner, a new survey shows. The research was published in the September-October issue of the Journal of the American Board of Family Medicine.

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Most Treatments for Acute VTE Appear Safe, Effective

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Almost all the various treatment options for acute venous thromboembolism are equally safe and effective, according to research published in the Sept. 17 issue of the Journal of the American Medical Association.

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Obama to Step Up Aid to Fight Ebola in West Africa

TUESDAY, Sept. 16, 2014 (HealthDay News) -- On the same day that President Barack Obama was to announce a significant increase in U.S. aid to help combat West Africa's Ebola crisis, the World Health Organization warned Tuesday that the window to contain the virus was closing and infections could start doubling every three weeks.

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CDC: Opioid-Related Deaths Quadrupled in Past Decade

TUESDAY, Sept. 16, 2014 (HealthDay News) -- The number of Americans dying from accidental overdoses of opioid analgesics jumped significantly from 1999 to 2011, according to a September data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Fewer U.S. Teens Using Illegal Drugs and Alcohol

TUESDAY, Sept. 16, 2014 (HealthDay News) -- Illegal drug use among teens in the United States is on the decline, according to a new federal report. Alcohol use, binge drinking, and the use of tobacco products among young people between the ages of 12 and 17 also dropped between 2002 and 2013, according to the report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

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Over a Quarter of Hospital Orders Classified As Defensive

TUESDAY, Sept. 16, 2014 (HealthDay News) -- More than one-quarter of hospital medicine services were rated by ordering physicians as at least a partially defensive order, according to a research letter published online Sept. 15 in JAMA Internal Medicine.

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Eight Percent of Children Account for 24 Percent of ER Visits

TUESDAY, Sept. 16, 2014 (HealthDay News) -- Eight percent of children account for nearly one-quarter of emergency department visits and 31 percent of costs, according to a study published online Sept. 15 in Pediatrics.

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Children's Severe Respiratory Virus Confirmed in Northeast

MONDAY, Sept. 15, 2014 (HealthDay News) -- The severe respiratory virus believed to have sickened hundreds of U.S. children in Midwestern and Western states has now spread to the Northeast, health officials report.

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Unsupervised Prescription Drug Intake Sends Many Children to ER

MONDAY, Sept. 15, 2014 (HealthDay News) -- From 2007 to 2011, there were nearly 10,000 emergency hospitalizations per year for unsupervised prescription medication ingestion by young children, according to a study published online Sept. 15 in Pediatrics.

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Antimicrobial Prescriptions for Children Higher Than Expected

MONDAY, Sept. 15, 2014 (HealthDay News) -- Just over one-quarter of U.S. children with acute respiratory tract infections (ARTI) have bacterial illness, yet antimicrobials are prescribed twice as frequently as expected during ARTI outpatient visits, according to a study published online Sept. 15 in Pediatrics.

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INR Variability Predicts Warfarin Adverse Effects

MONDAY, Sept. 15, 2014 (HealthDay News) -- Unstable anticoagulation predicts warfarin adverse effects regardless of time in therapeutic range, according to a study published online Sept. 2 in Circulation: Cardiovascular Quality and Outcomes.

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Errata Frequently Seen in Medical Literature

MONDAY, Sept. 15, 2014 (HealthDay News) -- Errata, including those that may materially change the interpretation of data, are frequent in medical publications, according to a study published in the August issue of The American Journal of Medicine.

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New Role of Patient As Consumer Requires Market Changes

FRIDAY, Sept. 12, 2014 (HealthDay News) -- The new consumer retail market in U.S. health care is necessary and will benefit consumers, and as consumers take on more costs of care, access to information to help them make informed decisions is crucial, according to a recent white paper published by Vitals.

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Poverty Tied to Increased Respiratory Hospitalization Rate

FRIDAY, Sept. 12, 2014 (HealthDay News) -- Household income is tied to significant differences in hospitalizations for ambulatory-care-sensitive respiratory conditions, according to a study published in the September/October issue of the Annals of Family Medicine.

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Highly Sensitive Troponin Test IDs Asymptomatic Heart Damage

FRIDAY, Sept. 12, 2014 (HealthDay News) -- A high-sensitivity cardiac troponin T (hs-cTnT) test may be helpful in identifying early heart damage, eventually standing alongside cholesterol tests as a standard screening tool for heart disease risk, according to researchers who presented their study findings online Aug. 22 in Circulation.

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U.S. Ebola Survivor Gives Blood to Infected Health Care Colleague

FRIDAY, Sept. 12, 2014 (HealthDay News) -- An American medical missionary who survived infection with Ebola has donated blood to a colleague who's struggling to fight his own infection with the virus.

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Opioid Overdose Prevention Needed in Young Adult Users

FRIDAY, Sept. 12, 2014 (HealthDay News) -- Many young adult nonmedical prescription opioid (PO) users are relatively uninformed about overdose awareness, avoidance, and response strategies, according to a study published online Aug. 22 in The International Journal of Drug Policy.

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Physician Describes Impact of Malpractice Suit

THURSDAY, Sept. 11, 2014 (HealthDay News) -- A family doctor who was involved in a malpractice suit describes the impact on her practice of medicine in an article published online in the September/October issue of the Annals of Family Medicine.

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Ebola-Infected Doctor Showing Improvement in Nebraska

THURSDAY, Sept. 11, 2014 (HealthDay News) -- An American medical missionary being treated at a Nebraska medical center for Ebola infection is showing signs of improvement, according to the hospital.

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Gates Foundation Gives $50M to Fight Ebola Outbreak in Africa

THURSDAY, Sept. 11, 2014 (HealthDay News) -- Acting in response to the devastating Ebola outbreak in four West African nations, the Bill and Melinda Gates Foundation announced Wednesday that it has pledged $50 million to help combat the epidemic.

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White Matter Measure Predicts Longer Concussion Recovery

THURSDAY, Sept. 11, 2014 (HealthDay News) -- A measure of white matter in the brain, particularly in males, is an independent predictor of longer time to symptom resolution (TSR) after mild traumatic brain injury (mTBI), according to a study published in the September issue of Radiology.

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Case Highlights Anaphylaxis Risk With Antibiotics in Foods

THURSDAY, Sept. 11, 2014 (HealthDay News) -- Anaphylactic reactions to antibiotics may occur after exposure via fruit consumption, according to a case study published in the September issue of the Annals of Asthma, Allergy & Immunology.

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Fear About Disease Progression Prompts ER Returns

THURSDAY, Sept. 11, 2014 (HealthDay News) -- Perceived inability to access timely follow-up care and uncertainty and fear about disease progression are the main reasons for return visits to the emergency department, according to a study published online Sept. 2 in the Annals of Emergency Medicine.

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Review: Rapid Antigen Tests Accurate for Strep Diagnosis

WEDNESDAY, Sept. 10, 2014 (HealthDay News) -- Rapid antigen diagnostic tests (RADTs) can be used for accurate diagnosis of group A streptococcal (GAS) pharyngitis for management of sore throat in primary care settings, according to a study published online Sept. 8 in Pediatrics.

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Reanalyses of RCTs Can Lead to Different Conclusions

WEDNESDAY, Sept. 10, 2014 (HealthDay News) -- More than one-third of the small number of reanalyses of randomized clinical trials (RCTs) have implied conclusions different from those of the original articles, according to a study published online Sept. 9 in the Journal of the American Medical Association.

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Fourth U.S. Ebola Patient Airlifted to Atlanta Hospital

TUESDAY, Sept. 9, 2014 (HealthDay News) -- A fourth American medical worker infected with the deadly Ebola virus in West Africa was brought back to the United States Tuesday morning for treatment at Emory University Hospital in Atlanta.

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For Some, Health Insurance More Costly Than Uninsured Penalty

TUESDAY, Sept. 9, 2014 (HealthDay News) -- For some young people in the United States, the cost of paying a penalty for not buying health insurance will be lower than the lowest-cost insurance, according to a study published online Sept. 9 in the Annals of Internal Medicine.

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CDC: Respiratory Virus Affecting Children in Multiple States

TUESDAY, Sept. 9, 2014 (HealthDay News) -- A respiratory virus has stricken more than 1,000 children across several states, requiring hospitalization in some and prompting concerns of a wider outbreak, health officials reported Monday.

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MI, CHD Incidence for Adults With Diabetes Decreases

TUESDAY, Sept. 9, 2014 (HealthDay News) -- From 1998 to 2010 there was a decrease in the incidence rates of hospitalized myocardial infarction (MI) and coronary heart disease (CHD) among adults with diabetes mellitus in Western Australia, according to a study published online Aug. 26 in Circulation: Cardiovascular Quality and Outcomes.

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Single-Dose, Injected Flu Treatment Shows Promise

MONDAY, Sept. 8, 2014 (HealthDay News) -- A new single-dose, injected drug appears safe and effective at helping ease flu symptoms, according to an analysis of Phase II and Phase III clinical trials. The research, funded by the U.S. National Institutes of Health and drugmaker BioCryst Pharmaceuticals, was presented Saturday at the American Society for Microbiology meeting in Washington, D.C.

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Sepsis Survival Up at High-Volume Hospitals

MONDAY, Sept. 8, 2014 (HealthDay News) -- Patients with sepsis are more likely to survive this life-threatening bloodstream infection if they're treated in a hospital that handles a large number of sepsis cases, according to research published online Aug. 12 in the American Journal of Respiratory and Critical Care Medicine.

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Health Care Spending Expected to Rise in 2014 Through 2023

MONDAY, Sept. 8, 2014 (HealthDay News) -- While health spending growth was slow in 2013, health spending is expected to increase in 2014 and remain higher through 2023, according to a study published online Sept. 3 in Health Affairs.

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FDA: NephroCheck Test Approved to Predict Kidney Injury Risk

FRIDAY, Sept. 5, 2014 (HealthDay News) -- The NephroCheck test, designed to predict the risk of sudden kidney injury within 12 hours, has been approved by the U.S. Food and Drug Administration.

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Serious Childhood Burns Tied to Long-Term Mental Health Risks

FRIDAY, Sept. 5, 2014 (HealthDay News) -- Adult survivors of childhood burns are at increased risk for depression and suicidal thoughts, according to a new study published in the September issue of Burns.

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Excessive Precautions Unnecessary for Ebola Virus

FRIDAY, Sept. 5, 2014 (HealthDay News) -- Given that Ebola virus is mainly transmitted via contact, excessive precautions, including complete respiratory protection are unnecessary, according to a letter published online Aug. 29 in The Lancet.

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Nearly 10 Percent of Americans Admit to Illicit Drug Use

FRIDAY, Sept. 5, 2014 (HealthDay News) -- Nearly 10 percent of Americans aged 12 and older were illicit drug users in 2013, and almost 20 million said they used marijuana, making it the most widely used drug, U.S. health officials reported Thursday. Two states, Colorado and Washington, permit the recreational use of marijuana.

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British Ebola Patient Released From the Hospital

WEDNESDAY, Sept. 3, 2014 (HealthDay News) -- A British man infected with Ebola during the outbreak in West Africa has fully recovered and been released from the hospital.

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Another American Physician Infected With Ebola

TUESDAY, Sept. 2, 2014 (HealthDay News) -- Another American doctor working in West Africa for a missionary group has become infected with the Ebola virus.

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More Global Help Needed to Fight Ebola Outbreak

TUESDAY, Sept. 2, 2014 (HealthDay News) -- As the Ebola outbreak continues to overwhelm health care workers in three West African nations, medical experts from the United States and the United Nations called on Tuesday for a concerted international response to stem history's biggest outbreak of the often-fatal virus.

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