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

CDC: Cases of Flu Continue to Mount Across America

MONDAY, Dec. 30, 2019 (HealthDay News) — Flu continues to spread throughout the United States and has reached elevated levels in nearly every state, according to the U.S. Centers for Disease Control and Prevention.

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Samoa Ends State of Emergency Over Measles

MONDAY, Dec. 30, 2019 (HealthDay News) — Slowing infection rates and a surge in vaccinations have prompted the South Pacific island of Samoa to end a six-week state of emergency over a measles outbreak, the BBC reported Sunday.

BBC Article

Number of Children With Opioid Poisonings Increasing

MONDAY, Dec. 30, 2019 (HealthDay News) — The severity of pediatric admissions for acute opioid ingestions, especially following attempted suicide, increased from 2005 to 2018, according to a study published online Dec. 19 in Clinical Toxicology.

Abstract/Full Text

Many With Peanut Allergies Unnecessarily Avoid Tree Nuts

MONDAY, Dec. 30, 2019 (HealthDay News) — Individual tree nuts have unique characteristics in the context of peanut allergy, so dietary recommendations should reflect these differences, according to a study published online Dec. 2 in the Annals of Allergy, Asthma & Immunology.

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Changes Needed to Address Out-of-Network Billing at Hospitals

FRIDAY, Dec. 27, 2019 (HealthDay News) — Requiring hospitals to sell a package of facility and physician services would protect patients from out-of-network bills at in-network hospitals, according to a report published online Dec. 16 in Health Affairs.

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Case Study: Methylmercury Toxicity Found From Skin-Lightening Cream

FRIDAY, Dec. 27, 2019 (HealthDay News) — In a Notes from the Field report, published in the Dec. 20 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, doctors present the case of a California woman with significant central nervous system damage after using a skin-lightening cream from Mexico that contained toxic mercury.

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Prescribing Practices Can Mitigate Opioid Overdose Risk for Teens

FRIDAY, Dec. 27, 2019 (HealthDay News) — Older teens may have similar risk factors for prescription opioid overdose as adults, according to a study published online Dec. 16 in JAMA Pediatrics.

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Marginal Increase in PCP Access After ACA Medicaid Expansion

THURSDAY, Dec. 26, 2019 (HealthDay News) — The Affordable Care Act (ACA) Medicaid expansions correlated with a slight increase in access to primary care providers (PCPs), but no change in emergency department use, according to a study published online Dec. 11 in the Journal of General Internal Medicine.

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Mortality Due to Fire, Heat, Hot Substances Declined Globally

THURSDAY, Dec. 26, 2019 (HealthDay News) — From 1990 to 2017, there was a general decline in global mortality due to fire, heat, and hot substances, although considerable regional variation was observed in incidence, according to a study published online Dec. 18 in Injury Prevention.

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Most Children Do Not Have Positive Results to Antibiotic Challenge

THURSDAY, Dec. 26, 2019 (HealthDay News) — Most children with non-β-lactam antibiotic (NBLA) allergy can be delabeled, with positive results on allergy testing for only 18 percent, according to a study published online Dec. 3 in Pediatrics.

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Overdose, Relapse After Buprenorphine Discontinuation High

THURSDAY, Dec. 26, 2019 (HealthDay News) — Buprenorphine treatment may be needed for several years after an opioid overdose to reduce the risk of overdose and other adverse events, according to a study published online Dec. 2 in The American Journal of Psychiatry.

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Patient Share of Out-of-Network Costs Rising

TUESDAY, Dec. 24, 2019 (HealthDay News) — The out-of-pocket costs for out-of-network (OON) care grew rapidly for privately insured Americans from 2012 to 2017, according to a study published in the December issue of the American Journal of Managed Care.

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Endocrine Society Releases Hypoglycemia Performance Measures

TUESDAY, Dec. 24, 2019 (HealthDay News) — A new set of quality measures can help health care providers identify older adults with type 2 diabetes who are at increased risk for hypoglycemia, according to an article published online Dec. 11 in the Journal of Clinical Endocrinology & Metabolism.

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Vitamin E Acetate ID’d in Lungs of Most Vaping Illness Patients

TUESDAY, Dec. 24, 2019 (HealthDay News) — Vitamin E acetate was identified in almost all patients with electronic cigarette, or vaping, product use-associated lung injury (EVALI), and there has been a decrease in EVALI cases since a peak in September 2019, according to a study and a report published online Dec. 20 in the New England Journal of Medicine.

Abstract/Full Text – Blount
Abstract/Full Text – Hartnett

12 Million U.S. Residents Drove Under Influence of Marijuana in 2018

TUESDAY, Dec. 24, 2019 (HealthDay News) — In 2018, 12 million U.S. residents reported driving under the influence of marijuana in the previous 12 months, according to research published in the Dec. 20 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Report Estimates Readmission, Death After Vaping Illness Discharge

MONDAY, Dec. 23, 2019 (HealthDay News) — The prevalence of rehospitalization and death after electronic cigarette, or vaping, product use-associated lung injury (EVALI) has been determined, and guidelines have been developed based on these findings. Both reports were published in the Dec. 20 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Abstract/Full Text – Mikosz
Abstract/Full Text – Evans

Enrollment in Affordable Care Act Holds Steady for Third Straight Year

MONDAY, Dec. 23, 2019 (HealthDay News) — Enrollment in Affordable Care Act coverage for next year has surpassed 8 million, a sign that many Americans still turn to the government health insurance program to help pay for their medical care.

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Opioid-Related Suicides Down, Rate of Unintentional Deaths Up

FRIDAY, Dec. 20, 2019 (HealthDay News) — The rate of opioid-related suicides as well as unintentional deaths significantly increased from 2000 to 2017, according to a research letter published in the Dec. 17 issue of the Journal of the American Medical Association.

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Concussions More Common Among College Students Than Thought

FRIDAY, Dec. 20, 2019 (HealthDay News) — Concussions are common among the U.S. collegiate population, with rates higher for non-sport-related concussion versus sport-related concussion, according to a study published online Dec. 18 in JAMA Network Open.

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Gabapentinoids, Opioids Combo Carries Risk for Breathing Problems

FRIDAY, Dec. 20, 2019 (HealthDay News) — New warnings about the risk for dangerous breathing difficulties when gabapentinoids are used with opioids or by certain patients must now appear on product labels, the U.S. Food and Drug Administration announced Thursday.

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Some U.S. Adults Unaware of Any Myocardial Infarction Symptoms

FRIDAY, Dec. 20, 2019 (HealthDay News) — A considerable proportion of U.S. adults are unaware of some or all of the symptoms of myocardial infarction (MI), according to a study published online Dec. 18 in JAMA Network Open.

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Private Care Program for U.S. Vets Gets $8.9 Billion in Budget Deal

THURSDAY, Dec. 19, 2019 (HealthDay News) — A controversial program meant to get more U.S. veterans to use private health care received $8.9 billion as part of a government spending bill approved by the House.

AP News Article

Misuse of Nonopioid Medications Appears to Be on the Rise in U.S.

THURSDAY, Dec. 19, 2019 (HealthDay News) — Misuse/abuse, use in suicide attempts, and hospital admissions associated with gabapentin and baclofen have significantly increased among U.S. adults since 2013, according to a study published online Dec. 1 in Clinical Toxicology.

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FDA to Allow States to Import Prescription Drugs From Other Countries

WEDNESDAY, Dec. 18, 2019 (HealthDay News) — Federal health officials have unveiled plans to allow prescription drug imports from Canada and other foreign nations.

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Possible Measles Exposures Occurred at LA International Airport

TUESDAY, Dec. 17, 2019 (HealthDay News) — People who were at Los Angeles International Airport on Dec. 11 may have been exposed to the measles virus, the Los Angeles County Department of Public Health warned Monday.

CNN Article

Suicide 30 to 50 Times Higher After ED Visit for Self-Harm, Suicidal Ideation

TUESDAY, Dec. 17, 2019 (HealthDay News) — Emergency department patients presenting with deliberate self-harm or suicidal ideation are at substantially increased risk for suicide in the year following discharge, according to a study published online Dec. 13 in JAMA Network Open.

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Early Regional Anesthesia Effective for Extremity Injury Pain

TUESDAY, Dec. 17, 2019 (HealthDay News) — Regional anesthesia may aid pain management if used soon after traumatic injury of the extremities, according to a study published in the December issue of Regional Anesthesia & Pain Medicine.

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Hospital-Level Home Acute Care Can Cut Costs, Health Care Use

TUESDAY, Dec. 17, 2019 (HealthDay News) — For acutely ill adults, hospital-level care at home is associated with reduced costs, health care use, and readmissions compared with usual hospital care, according to a study published online Dec. 17 in the Annals of Internal Medicine.

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Frailty May Worsen Outcomes in Traumatic Spinal Cord Injury

TUESDAY, Dec. 17, 2019 (HealthDay News) — Frailty is an important predictor of worse outcome after traumatic spinal cord injury (tSCI) in patients <75 years of age, according to a study recently published in the Journal of Neurotrauma.

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Outcomes Worse for Rural Residents With Chronic Conditions

MONDAY, Dec. 16, 2019 (HealthDay News) — Rural Medicare beneficiaries with complex chronic conditions have higher preventable hospitalization and mortality rates than their urban peers, which is partially explained by reduced access to specialists, according to a report published in the December issue of Health Affairs, a theme issue on rural health.

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Five-Year Mortality Up in Older Adults With Unplanned Admission

MONDAY, Dec. 16, 2019 (HealthDay News) — Death within five years of first unplanned hospital admission is common among older adults, according to a study published in the Dec. 16 issue of CMAJ, the journal of the Canadian Medical Association.

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Hahn Confirmed as New FDA Chief

FRIDAY, Dec. 13, 2019 (HealthDay News) — Stephen Hahn, M.D., was confirmed as commissioner of the U.S. Food and Drug Administration in a 72-18 Senate vote on Thursday.

The New York Times Article

U.S. Will Have Three-Digit Number for Suicide Prevention Hotline

FRIDAY, Dec. 13, 2019 (HealthDay News) — A new three-digit number in the United States to contact a suicide prevention hotline is being created by federal officials.

AP News Article

One in Three Parents Report Skipping Doctor, Dentist Appointment

THURSDAY, Dec. 12, 2019 (HealthDay News) — One in three parents have skipped a doctor or dentist appointment in the past year because they could not afford to pay for visits or find transportation, according to the results of a survey released Nov. 18 by Nemours Children’s Health System.

Redefining Health for the Well-Being of Children

Trampoline-Related Pediatric Fractures Increased 2008 Through 2017

WEDNESDAY, Dec. 11, 2019 (HealthDay News) — From 2008 to 2017, there was an increase in the incidence of trampoline-related pediatric fractures, with a significant increase in the odds of a fracture occurring at a place of recreation or sport, according to a study published online Dec. 11 in Pediatrics.

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Household Cleaning Product-Linked Ocular Exposure Declining

WEDNESDAY, Dec. 11, 2019 (HealthDay News) — From 2000 to 2016, there was a decrease in the annual frequency of ocular exposures associated with household cleaning products among children, according to a study published online Dec. 9 in Eye.

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U.S. Primary Care Doctors Face Challenges in Coordinating Care

TUESDAY, Dec. 10, 2019 (HealthDay News) — Physicians from the United States and other high-income countries report difficulties with care coordination, with a substantial proportion of U.S. physicians not receiving timely notification or the information needed from specialists or other sites of care, according to a study published online Dec. 10 in Health Affairs.

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U.S. Health Care Spending Up 4.6 Percent in 2018

TUESDAY, Dec. 10, 2019 (HealthDay News) — In 2018, U.S. health care spending increased 4.6 percent, a faster rate than that seen in 2017, according to a report published online Dec. 5 in Health Affairs.

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2016 to 2019 Saw Increase in Medical Students With Disabilities

MONDAY, Dec. 9, 2019 (HealthDay News) — From 2016 to 2019, there was an increase in the proportion of medical students reporting disabilities, according to a research letter published in the Nov. 26 issue of the Journal of the American Medical Association.

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Distinct Populations of Sudden Unexpected Infant Death ID’d

MONDAY, Dec. 9, 2019 (HealthDay News) — Sudden unexpected infant death (SUID) can be classified into two groups based on the age of death, with distinct risk factors for sudden unexpected early neonatal deaths (SUENDs) and postperinatal SUIDs, according to a study published online Dec. 9 in Pediatrics.

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Receipt of Anticoagulant Rx in ED Linked to Use at Six Months

MONDAY, Dec. 9, 2019 (HealthDay News) — For patients aged 65 years or older with atrial fibrillation, receipt of a prescription for an oral anticoagulant in the emergency department is associated with increased use of oral anticoagulants at six months, according to a study published online Dec. 9 in CMAJ, the journal of the Canadian Medical Association.

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Rural Population Underrepresented Among Medical Students

FRIDAY, Dec. 6, 2019 (HealthDay News) — In 2017, less than 5 percent of all incoming medical students were rural students, according to a study published in the December issue of Health Affairs, a theme issue on rural health.

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CDC: All 50 States Now Reporting Cases of Severe Vaping-Linked Lung Injury

FRIDAY, Dec. 6, 2019 (HealthDay News) — Cases of a serious, sometimes fatal, form of lung injury tied to vaping have now been reported in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. In total, case numbers have risen to 2,291, according to the latest update from the U.S. Centers for Disease Control and Prevention, issued Thursday.

More Information: CDC
CMAJ Report
European Respiratory Journal Report

Cellphone-Related Injuries to Head, Neck on the Rise

FRIDAY, Dec. 6, 2019 (HealthDay News) — The number of head and neck injuries related to cellphone use that require emergency department attention has increased during a 20-year period, according to a study published online Dec. 5 in JAMA Otolaryngology-Head & Neck Surgery.

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Seven Deaths in California From Infections Tied to Black Tar Heroin

THURSDAY, Dec. 5, 2019 (HealthDay News) — Infections linked to injections of black tar heroin have killed seven people in San Diego County in the past two months, health officials said Wednesday.

NBC News Article
County of San Diego Press Release

More Than 100 E. Coli Illnesses Now Linked to Romaine Lettuce

THURSDAY, Dec. 5, 2019 (HealthDay News) — Federal health officials are currently investigating a multistate outbreak of Escherichia coli infection linked to romaine lettuce thought to be grown in Salinas, California.

More Information: CDC
More Information: FDA

Annual Reported Measles Incidence Dropped From 2000 to 2018

THURSDAY, Dec. 5, 2019 (HealthDay News) — The annual reported measles incidence decreased from 2000 to 2018, but the number of cases increased from 2016 to 2018, according to research published in the Dec. 6 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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6.5 Percent of Adults Report Prescription Opioid Analgesic Use

THURSDAY, Dec. 5, 2019 (HealthDay News) — Overall, 6.5 percent of adults aged 20 years and older reported using a prescription opioid analgesic in the previous 30 days during 2013 to 2016, according to a report published in the December Health E-Stats, a publication of the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

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Services Affected by Rural Hospitals Joining Health Systems

WEDNESDAY, Dec. 4, 2019 (HealthDay News) — While affiliating with health systems may boost a rural hospital’s financial viability, the affiliation is often associated with reductions in critical services, according to a study published in the December issue of Health Affairs, a theme issue on rural health.

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Adults Not Living in Metro Areas Have Reduced Access to Care

WEDNESDAY, Dec. 4, 2019 (HealthDay News) — Adults not living in metropolitan statistical areas (MSAs) are more likely to have reduced access to or use of health care services, according to a study published online Dec. 4 in the National Health Statistics Reports, a publication from the U.S. Centers for Disease Control and Prevention.

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About One in Three in ED for Low Back Pain Receive Imaging

WEDNESDAY, Dec. 4, 2019 (HealthDay News) — Imaging is obtained for about one in three patients with emergency department visits for low back pain, according to a study published online Nov. 19 in the American Journal of Roentgenology.

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Mobile Stroke Unit Care May Reduce Time to Thrombolysis

WEDNESDAY, Dec. 4, 2019 (HealthDay News) — Mobile stroke unit (MSU) care is associated with quicker time to thrombolysis in acute ischemic stroke compared with conventional ambulance care in a densely populated urban area, according to a study published online Dec. 4 in the Journal of the American Heart Association.

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Physician Depressive Symptoms Tied to Higher Risk for Medical Errors

WEDNESDAY, Dec. 4, 2019 (HealthDay News) — Physicians showing depressive symptoms are at higher risk for medical errors, according to a review published Nov. 27 in JAMA Network Open.

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Digital Sepsis Monitoring May Improve Inpatient Outcomes

TUESDAY, Dec. 3, 2019 (HealthDay News) — A digital sepsis alert is associated with improved outcomes, according to a study published online Nov. 20 in the Journal of the American Medical Informatics Association.

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eBay Bans Infant Inclined Sleepers, Other Companies Urged to Do Same

TUESDAY, Dec. 3, 2019 (HealthDay News) — eBay’s decision to ban infant inclined sleepers from its platform, including nonrecalled sleepers, was welcomed by Consumer Reports, which urged other companies to do the same.

Consumer Reports Article

Concussion May Up Risk for Suicide in High School Students

TUESDAY, Dec. 3, 2019 (HealthDay News) — High school students with a history of sports-related concussions might be at an increased risk for suicide, according to a study published online Nov. 11 in the Journal of Affective Disorders.

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ᴅ-dimer Test Adjusted to Clinical Probability IDs Low Risk for PE

TUESDAY, Dec. 3, 2019 (HealthDay News) — Low clinical pretest probability (C-PTP) and a ᴅ-dimer of less than 1,000 ng/mL identify patients with a low risk for pulmonary embolism, according to a study published in the Nov. 28 issue of the New England Journal of Medicine.

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Government Shut Down as Samoa Battles Measles Outbreak

MONDAY, Dec. 2, 2019 (HealthDay News) — The government of Samoa will close on Thursday and Friday as civil servants join the fight against a measles outbreak in the South Pacific Island nation that has killed 53 people, the country’s prime minister said Monday.

CNN Article

Overall, 8.5 Percent of Suicide Acts in U.S. Are Fatal

MONDAY, Dec. 2, 2019 (HealthDay News) — Overall, 8.5 percent of suicidal acts are fatal, with higher rates for males and older adults, according to a study published online Dec. 3 in the Annals of Internal Medicine.

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Federal, State Background Check Laws Together Cut Teen Gun Carrying

MONDAY, Dec. 2, 2019 (HealthDay News) — The National Instant Criminal Background Check System (NICS) together with the universal background check (U/BC) significantly reduces gun carrying among adolescents, according to a study published online Dec. 2 in Pediatrics.

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Editorial

Risk for Hospital Admission Up With Short-Term PM2.5 Exposure

MONDAY, Dec. 2, 2019 (HealthDay News) — Short-term exposure to fine particulate matter with diameter less than 2.5 µm (PM2.5) is associated with increased hospital admission risks and costs, according to a study published online Nov. 27 in The BMJ.

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