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June 2015 Briefing – Emergency Medicine

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

Three Issues to Consider Before Selecting EHR

TUESDAY, June 30, 2015 (HealthDay News) — Work flow, features and functionality, and technical infrastructure should all be considered in advance of selecting an electronic heath record (EHR) system, according to an article published in Medical Economics.

Almost One in Three American Adults Own a Firearm

TUESDAY, June 30, 2015 (HealthDay News) — Guns are owned by nearly one in three Americans, and most gun owners are white men who are married and over 55, according to survey results published online June 29 in Injury Prevention.

AHA/ASA: Guidelines Support Endovascular Tx in Stroke

TUESDAY, June 30, 2015 (HealthDay News) — Endovascular treatment should be used to treat certain stroke victims, according to new guidelines issued by the American Heart Association and American Stroke Association. The guidelines were published online June 29 in Stroke.

Increased Morbidity, Mortality in Food System Industries

TUESDAY, June 30, 2015 (HealthDay News) — Occupational morbidity and mortality are elevated across food system industries compared with nonfood system industries, according to a study published online May 12 in the Journal of Occupational and Environmental Medicine.

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U.S. Children Experience High Rates of Assault, Abuse

MONDAY, June 29, 2015 (HealthDay News) — More than one-third of U.S. children and adolescents have been physically assaulted — mostly by siblings and peers — in the past year, and one in 20 children have been physically abused by a parent or another caregiver in the same time period. These findings were published online June 29 in JAMA Pediatrics.

AMA Discusses Pre-Retirement Evaluation for Aging Doctors

MONDAY, June 29, 2015 (HealthDay News) — Issues relating to physician retirement and evaluation of aging physicians before retirement are discussed in a Council on Medical Education report published by the American Medical Association (AMA).

H3N2 Mutation to Blame for Low Efficacy of 2014-15 Flu Vaccine

MONDAY, June 29, 2015 (HealthDay News) — A mutation in the H3N2 virus led to a mismatch between it and the H3N2 strain used to create the 2014-2015 vaccine, according to research published June 25 in Cell Reports.

New Rapid Ebola Test Shows Promise in African Clinics

FRIDAY, June 26, 2015 (HealthDay News) — A new rapid-detection test that diagnoses Ebola within minutes could improve treatment of the virus and help health care workers contain outbreaks, according to research published online June 25 in The Lancet.

Older Adults Often Use Electronic Devices While Driving

FRIDAY, June 26, 2015 (HealthDay News) — Older adults frequently engage in potentially distracting uses of electronic devices while driving, according to a study published in the June issue of the Journal of the American Geriatrics Society.

SCOTUS Upholds Subsidies for Affordable Care Act

FRIDAY, June 26, 2015 (HealthDay News) — The U.S. Supreme Court upheld on Thursday the legality of tax subsidies for millions of Americans who signed up for health insurance under the Affordable Care Act.

Pharmacist-Managed Warfarin Therapy Beats Usual Care

THURSDAY, June 25, 2015 (HealthDay News) — Pharmacist-managed warfarin therapy (PMWT) is superior to a usual medical care (UMC) model for management of warfarin therapy, according to a systematic review published online June 22 in the Journal of Clinical Pharmacology.

Lack of Consistent Supplement Use Documentation for Inpatients

THURSDAY, June 25, 2015 (HealthDay News) — Upon hospital admission, most patients are not asked if they take dietary supplements, according to a study published recently in Patient Education and Counseling.

Atraumatic Needles Prevent Postdural Puncture Headache

THURSDAY, June 25, 2015 (HealthDay News) — Atraumatic needles appear to be effective for preventing postdural puncture headache (PDPH), according to a study published in the July 1 issue of The Spine Journal.

Variable Symptoms for Acid-Hydrolyzed Wheat Protein Allergy

THURSDAY, June 25, 2015 (HealthDay News) — Patients with allergy to Glupearl 19S, an acid-hydrolyzed wheat protein (HWP), often manifest symptoms of HWP-wheat-dependent exercise-induced anaphylaxis and contact urticaria, according to a report published online June 20 in the International Journal of Dermatology.

Global Public Awareness of Venous Thromboembolism Is Low

THURSDAY, June 25, 2015 (HealthDay News) — Global public awareness about thrombosis, venous thromboembolism in particular, is low, according to a study published online June 18 in the Journal of Thrombosis and Haemostasis.

Edible Cannabis Products Often Mislabeled

WEDNESDAY, June 24, 2015 (HealthDay News) — Most edible cannabis products sampled in three major U.S. cities are mislabeled, often containing more or less active ingredient than indicated on the packaging, according to a report published in the June 23/30 issue of the Journal of the American Medical Association.

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CDC: Costly Epidemic of Rocky Mountain Spotted Fever in AZ

TUESDAY, June 23, 2015 (HealthDay News) — An epidemic of Rocky Mountain spotted fever among several American Indian tribes on two reservations in Arizona has led to more than $13.2 million in societal costs in nine years, according to research published online June 1 in the American Journal of Tropical Medicine and Hygiene.

Medical Identity Theft Incidents Increasing

MONDAY, June 22, 2015 (HealthDay News) — Medical identity theft is on the rise, costly to consumers, and challenging to resolve, according to the fifth annual report published by the Ponemon Institute.

Extreme Exercising Without Training May Trigger Sepsis

MONDAY, June 22, 2015 (HealthDay News) — Extreme exercise may trigger sepsis in people who haven’t trained properly, new research suggests. The findings were published recently in two journals. One study was in the International Journal of Sports Medicine. The other was in the Exercise Immunology Review.

Minimal Yield Seen for Routine Noninvasive Testing for CAD

MONDAY, June 22, 2015 (HealthDay News) — For patients presenting with acute chest pain and low clinical risk evaluated in a chest pain evaluation center (CPEC), the yield of routine noninvasive testing is low for coronary artery disease (CAD), according to a study published in the July 15 issue of The American Journal of Cardiology.

Caution in Social Media Age: Self-Promotion Can Backfire

FRIDAY, June 19, 2015 (HealthDay News) — In a series of experiments, researchers found that people who self-promote often offend others. The study was published in the June issue of Psychological Science.

Summer Spurs Calls to Poison Centers

FRIDAY, June 19, 2015 (HealthDay News) — The wet spring in many parts of the United States has led to mold and mildew in some homes and, as a result, an increase in the use of bleach. As a result, calls about bleach exposure are on the rise this summer, the Nebraska Regional Poison Center says.

Medications Can Increase Risk of Heat-Related Illness

FRIDAY, June 19, 2015 (HealthDay News) — Commonly used medications may increase the risk of dehydration and heat-related illness during hot weather, according to an article published online June 13 in the Journal of Clinical Pharmacy and Therapeutics.

CDC: Narcon Overdose-Reversal Kits Are Saving Addicts’ Lives

FRIDAY, June 19, 2015 (HealthDay News) — Friends and family members have saved the lives of tens of thousands of opioid users from overdoses by using emergency injection kits containing naloxone (Narcan), according to a new federal report. The findings were published in the June 19 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

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FDA Cracks Down on Online Sale of Illegal Medical Products

FRIDAY, June 19, 2015 (HealthDay News) — The U.S. Food and Drug Administration, along with international partners, moved this week against more than 1,050 websites that sell potentially dangerous counterfeit medicines and medical devices, the agency said Thursday.

Hundreds Arrested Nationwide for Medicare/Medicaid Fraud

FRIDAY, June 19, 2015 (HealthDay News) — Hundreds of people have been charged after health care fraud sweeps were made across the United States, the federal government said Thursday.

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Readmitted Surgery Patients Fare Better at Same Hospital

THURSDAY, June 18, 2015 (HealthDay News) — Surgery patients who suffer complications after discharge from a hospital are more likely to die if they’re readmitted to a different hospital than where they had their original operation, according to a new study published online June 17 in The Lancet.

Virtual Credit Card Fees Amount to 3 to 5 Percent of Payments

THURSDAY, June 18, 2015 (HealthDay News) — Payment with virtual credit cards (VCCs) is associated with considerable fees, although physicians are often unaware of these charges, according to the American Medical Association (AMA).

Case Report: Pregnancy Could Mask Symptoms of Ebola

THURSDAY, June 18, 2015 (HealthDay News) — The unique immunologic status of pregnant women might alter the presentation and progression of Ebola virus disease (EVD), according to a letter published in the June 18 issue of the New England Journal of Medicine.

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Fluoroquinolone Preventive Therapy Deemed Beneficial in TB

WEDNESDAY, June 17, 2015 (HealthDay News) — Fluoroquinolone therapy for contacts of individuals with multi-drug resistant tuberculosis is associated with cost savings and reduced incidence of multi-drug resistant tuberculosis, according to a study published online April 27 in the American Journal of Respiratory and Critical Care Medicine.

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Antibiotics May Be Enough for Some Appendicitis Patients

WEDNESDAY, June 17, 2015 (HealthDay News) — Although surgical removal of the appendix has long been a standard treatment, new research suggests that almost three-quarters of people treated with antibiotics could be spared appendectomy. The findings were published in the June 16 issue of the Journal of the American Medical Association.

Direct Messaging Not Yet Widely Adopted by Physicians

TUESDAY, June 16, 2015 (HealthDay News) — Direct secure messaging (Direct), which is a standardized protocol for exchanging clinical messages and attachments, has not been widely adopted by physicians, despite its potential for improving care coordination, according to an article published in Medical Economics.

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GI Antispasmodic, Anticholinergic Rx Use May Raise Injury Risk

TUESDAY, June 16, 2015 (HealthDay News) — Gastrointestinal (GI) antispasmodic and anticholinergic medication use is associated with increased risk of injury in older adults, according to a study published online June 11 in the Journal of the American Geriatrics Society.

Review Examines Inappropriate Prescribing of IV Fluids

TUESDAY, June 16, 2015 (HealthDay News) — Inappropriate prescribing of intravenous (IV) fluids most often involves incorrect volumes and types of IV fluids prescribed, according to a review published online June 11 in the Journal of Clinical Pharmacy and Therapeutics.

Article Weighs Paying Off Student Loans Versus Investment

MONDAY, June 15, 2015 (HealthDay News) — Newly-minted physicians should consider the issues relating to paying off their loans versus investing for retirement, according to an article published in Medical Economics.

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ER Visits for Self-Harm Rising for U.S. Teens

MONDAY, June 15, 2015 (HealthDay News) — Between 2009 and 2012, self-injuries accounted for a rising percentage of children’s emergency department trips — increasing from 1.1 to 1.6 percent of all visits, according to a study published online June 15 in Pediatrics.

Asthma Rx Deemed Less Likely to Work in Patients Aged 30 and Up

MONDAY, June 15, 2015 (HealthDay News) — Asthma treatments, especially inhaled corticosteroids, are less likely to work for older patients, according to a study published online June 11 in the American Journal of Respiratory and Critical Care Medicine.

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Risky Pot ‘Dabbing’ Method Growing in Popularity

MONDAY, June 15, 2015 (HealthDay News) — A potentially hazardous form of marijuana use called “dabbing” is growing in popularity across the United States, according to an article published online June 15 in Pediatrics.

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Aerobic Fitness Measures Predict Post-AAA Complications

FRIDAY, June 12, 2015 (HealthDay News) — Cardiopulmonary exercise testing variables can predict postoperative complications after abdominal aortic aneurysm repair, according to a study published in the June issue of Anaesthesia.

Car Crash Risk Up for New Users of Sedating Sleep Meds

FRIDAY, June 12, 2015 (HealthDay News) — Sedating sleep medications increase the risk for car accidents among new users compared with nonusers, with risk continued for up to a year among regular users, according to a new report published online June 11 in the American Journal of Public Health.

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CDC Advises U.S. Health Professionals to Be Alert for MERS

FRIDAY, June 12, 2015 (HealthDay News) — Government officials are advising U.S. health professionals to be alert for signs and symptoms of Middle East respiratory syndrome (MERS) following an outbreak in South Korea.

Poison Control Calls Up Steeply Due to Synthetic Cannabinoid

FRIDAY, June 12, 2015 (HealthDay News) — Calls to poison centers for issues related to synthetic marijuana have risen more than 220 percent since last year, according to research published in the June 12 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

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Macrolide Resistance Doesn’t Impact Pneumonia Outcomes

FRIDAY, June 12, 2015 (HealthDay News) — Patients hospitalized with macrolide-resistant Streptococcus pneumoniae pneumonia are not more severely ill and do not have worse outcomes, according to a study published in the June 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Some Graduating Seniors Not Matching to Residency Positions

THURSDAY, June 11, 2015 (HealthDay News) — More than 250 of this year’s graduating seniors from U.S. medical schools did not match to a residency position, according to the American Medical Association.

CDC: Men With Anxiety, Depression Not Getting Treated

THURSDAY, June 11, 2015 (HealthDay News) — Close to one in 10 American men suffer from depression or anxiety, but fewer than half get treatment, according to a June data brief published by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS).

Report Offers Guidance on Medical Ethics Education

WEDNESDAY, June 10, 2015 (HealthDay News) — An analysis of the current state of medical ethics education in the United States has been published in the June issue of Academic Medicine. The article, the Romanell Report, also offers guidance to assist medial ethics educators in meeting expectations.

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Geographic Location Most Important for Residents

WEDNESDAY, June 10, 2015 (HealthDay News) — For residents, the most important element in a future practice is geographic location, with lifestyle, adequate call hours and personal time, and a good financial package also cited as being important, according to the American Medical Association (AMA).

Extra Time During MCAT Linked to Less Success in Med School

WEDNESDAY, June 10, 2015 (HealthDay News) — Medical school applicants with Medical College Admission Test (MCAT) scores obtained with extra test administration time have lower rates of success in medical schools, according to a study published in the June 9 issue of the Journal of the American Medical Association.

Spinal Cord Injuries Up Among the Elderly in U.S.

WEDNESDAY, June 10, 2015 (HealthDay News) — While the overall rate of traumatic spinal cord injuries was stable from 1993 to 2012, an increasing number of older Americans have experienced this injury, according to research published in the June 9 issue of the Journal of the American Medical Association.

CDC: Seeking Those Exposed to Drug-Resistant Tuberculosis

WEDNESDAY, June 10, 2015 (HealthDay News) — U.S. health authorities are trying to find anyone who may have had contact with a woman who has been diagnosed with a highly drug-resistant form of tuberculosis.

CDC: Drug-Resistant Foodborne Bacteria on Rise

WEDNESDAY, June 10, 2015 (HealthDay News) — Antibiotic-resistant infections from foodborne germs still cause about 440,000 illnesses in the United States each year, the U.S. Centers for Disease Control and Prevention reported Tuesday.

Another Tick-Borne Disease Documented in Northeast

TUESDAY, June 9, 2015 (HealthDay News) — The same ticks that spread Lyme disease may also carry a rarer bacteria, Borrelia miyamotoi, that’s causing serious illness in the northeastern United States, according to a new report published online June 9 in the Annals of Internal Medicine.

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Analysis Targets U.S. Hospitals With Highest Markups

TUESDAY, June 9, 2015 (HealthDay News) — The 50 U.S. hospitals with the highest charge-to-cost ratio have markups approximately 10 times the Medicare-allowable costs, and most of these hospitals are for profit, according to a study published in the June issue of Health Affairs.

AMA Offers Guidance for Physician-Hospital Relationships

MONDAY, June 8, 2015 (HealthDay News) — New guidelines can enable successful physician hospital relationships and integrated leadership, according to a report published by the American Medical Association (AMA).

Scoring System Helps Predict Post-Hospital Mortality

MONDAY, June 8, 2015 (HealthDay News) — A fairly simple scoring system appears to accurately estimate patients’ risk of dying within a year of hospitalization, according to research results reported online June 8 in CMAJ, the journal of the Canadian Medical Association.

Most ER Patients With Low-Risk PE Eligible for Outpatient Tx

FRIDAY, June 5, 2015 (HealthDay News) — The majority of adults presenting to the emergency department with low-risk pulmonary embolism (PE) are eligible for outpatient treatment, but relative contraindications to outpatient management are associated with increased frequency of adverse events at 30 days, according to a study published in the May issue of the Annals of the American Thoracic Society.

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Statin + Ezetimibe May Benefit After Acute Coronary Syndrome

THURSDAY, June 4, 2015 (HealthDay News) — In treatment following acute coronary syndrome, ezetimibe added to statin therapy appears beneficial, according to a study published online June 3 in the New England Journal of Medicine.

Interstate Medical Licensure Compact Formed

THURSDAY, June 4, 2015 (HealthDay News) — Nine states have enacted the Interstate Medical Licensure Compact law, with the seventh state’s enactment triggering formation of a commission to administer a process for physicians seeking licensure in multiple states, according to a report published by the American Academy of Family Physicians.

CMS: Hospital Charges for Common Procedures Up

WEDNESDAY, June 3, 2015 (HealthDay News) — The prices hospitals charge patients for a number of common procedures rose more than 10 percent between 2011 and 2013, more than twice the rate of inflation, according to data released by the federal government Monday.

Resident Education Intervention Ups Patient Satisfaction

WEDNESDAY, June 3, 2015 (HealthDay News) — A patient satisfaction education, feedback, and incentive intervention provided to internal medicine residents can improve patient satisfaction, according to a study published online May 27 in the Journal of Hospital Medicine.

TBI Linked to Parkinson’s Risk in Patients Aged ≥55 Years

TUESDAY, June 2, 2015 (HealthDay News) — Patients aged 55 years and older presenting to an inpatient/emergency department setting with traumatic brain injury (TBI) have an increased risk of developing Parkinson’s disease (PD), according to a study published in the June issue of the Annals of Neurology.

Revisits for 8.3 Percent of Patients With Index ER Visit

TUESDAY, June 2, 2015 (HealthDay News) — Overall, 8.3 percent of patients with an index emergency department visit have a revisit within three days, according to a study published in the June 2 issue of the Annals of Internal Medicine.

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ICD-10-CM Challenges ID’d for Emergency Medicine Physicians

TUESDAY, June 2, 2015 (HealthDay News) — The transition to the expanded International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) system is likely to be associated with considerable challenges for emergency medicine physicians, according to a study published in the May issue of the American Journal of Emergency Medicine.

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