Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for November 2018. 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.

Case Description Can Reliably Define Acute Flaccid Myelitis

FRIDAY, Nov. 30, 2018 (HealthDay News) — A case description can reliably define patients with acute flaccid myelitis (AFM), according to a study published online Nov. 30 in JAMA Pediatrics.

Abstract/Full Text
Editorial 1
Editorial 2

Climate Change Ups Heat Deaths, Especially Among Elderly

THURSDAY, Nov. 29, 2018 (HealthDay News) — Risk for heat-related disease and death is rising worldwide due to climate change, according to a report published online Nov. 28 in The Lancet.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Lower Mortality Seen for Cardiac Care at Top-Ranked Hospitals

WEDNESDAY, Nov. 28, 2018 (HealthDay News) — Compared with nonranked hospitals, top-ranked hospitals have lower 30-day mortality but similar or higher readmission rates for cardiovascular conditions, according to a study published online Nov. 28 in JAMA Cardiology.

Abstract/Full Text (subscription or payment may be required)

FDA: Kratom Products Have High Levels of Heavy Metals

WEDNESDAY, Nov. 28, 2018 (HealthDay News) — In addition to many other health risks, kratom products can have high levels of heavy metals, according to Scott Gottlieb, M.D., commissioner of the U.S. Food and Drug Administration.

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FDA: Safe to Eat Romaine Lettuce Again, but Check Labels

TUESDAY, Nov. 27, 2018 (HealthDay News) — In a statement released late yesterday, the U.S. Food and Drug Administration Commissioner Scott Gottlieb, M.D., announced that the agency was lifting its advisory against eating romaine lettuce, first put in place last Tuesday. At that point, the agency had not been able to narrow down the source of the tainted lettuce. But now the source seems to be “end-of-season” lettuce harvested somewhere in the Central Coast regions of central and northern California. And “harvesting of romaine lettuce from this region has [already] ended for the year,” Gottlieb noted.

More Information: FDA
More Information: CDC

FDA to Update Medical Device Approvals Process

TUESDAY, Nov. 27, 2018 (HealthDay News) — A major update of the United States’ system for approving medical devices was announced yesterday by the Food and Drug Administration.

CBS/AP News Article
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Four Principles Underlie Patient and Family Partnership in Care

TUESDAY, Nov. 27, 2018 (HealthDay News) — Patient and family partnership in care should include treatment of patients and families with dignity and respect, their active engagement in all aspects of care, and their contribution to the improvement of health care systems and education of health care professionals, according to a position paper published online Nov. 27 in the Annals of Internal Medicine.

Position Paper
Editorial (subscription or payment may be required)

ACA Coverage Substantial, but Did Not Impact Labor Markets

MONDAY, Nov. 26, 2018 (HealthDay News) — Millions of workers gained insurance coverage under the Affordable Care Act (ACA) without adverse effects on labor markets, according to a report published by the Robert Wood Johnson Foundation and the Urban Institute.

Report: How Have Workers Fared Under the ACA?

Clinical Decision Support System Ups Outpatient PE Management

MONDAY, Nov. 26, 2018 (HealthDay News) — The use of a clinical decision support system (CDSS) in the emergency department can improve outpatient management for patients with acute pulmonary embolism (PE), according to a study published online Nov. 13 in the Annals of Internal Medicine.

Abstract/Full Text (subscription or payment may be required)

Probiotics Show No Benefits for Pediatric Acute Gastroenteritis

MONDAY, Nov. 26, 2018 (HealthDay News) — For children with acute gastroenteritis, probiotics show no significant benefit versus placebo, according to two studies published in the Nov. 22 issue of the New England Journal of Medicine.

Abstract/Full Text – Schnadower (subscription or payment may be required)
Abstract/Full Text – Freedman (subscription or payment may be required)
Editorial (subscription or payment may be required)

FDA Approves Drug for Treatment of Travelers’ Diarrhea

WEDNESDAY, Nov. 21, 2018 (HealthDay News) — The U.S. Food and Drug Administration on Friday announced it has approved Aemcolo (rifamycin), an antibacterial drug indicated for treating adult patients with travelers’ diarrhea caused by noninvasive strains of Escherichia coli (E. coli) without fever or blood in the stool.

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ED Utilization Up for Pediatric mTBI After TBI Legislation

WEDNESDAY, Nov. 21, 2018 (HealthDay News) — Implementation of state youth traumatic brain injury (TBI) legislation correlated with an increase in pediatric emergency department utilization for youth sports- and recreation-related mild TBI (mTBI) evaluation, according to a study published in the November/December issue of the Journal of Head Trauma Rehabilitation.

Abstract/Full Text (subscription or payment may be required)

CDC Announces Acute Flaccid Myelitis Task Force

TUESDAY, Nov. 20, 2018 (HealthDay News) — A task force to investigate a rising number of cases of a rare polio-like disease among children in the United States has been created by the U.S. Centers for Disease Control and Prevention.

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FDA: Another E. coli Outbreak Linked to Romaine Lettuce

TUESDAY, Nov. 20, 2018 (HealthDay News) — The U.S. Food and Drug Administration and U.S. Centers for Disease Control and Prevention along with health officials from various states are asking American consumers to avoid romaine lettuce due to an outbreak of Escherichia coli illness.

FDA Fast Facts
CDC Food Safety Alert

Major Bleeding Up With Frailty in Acute MI Patients

TUESDAY, Nov. 20, 2018 (HealthDay News) — Frail acute myocardial infarction (AMI) patients are less likely to undergo cardiac catheterization and have an increased risk for bleeding, according to a study published in the Nov. 26 issue of JACC: Cardiovascular Interventions.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Better Work Environment Tied to Better Patient Safety

TUESDAY, Nov. 20, 2018 (HealthDay News) — The results of a recent survey of thousands of nurses and patients show that hospital patient safety remains a serious concern, according to a study published in the November issue of Health Affairs.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Cap’n Crunch Cereal Recalled Due to Salmonella Scare

MONDAY, Nov. 19, 2018 (HealthDay News) — A small number of boxes of Cap’n Crunch’s Peanut Butter Crunch are being recalled due to potential Salmonella contamination, Quaker Oats says.

FDA Recall Notice
More Information: CDC

Even With Standing Orders, Naloxone Access Varies

MONDAY, Nov. 19, 2018 (HealthDay News) — There are great differences in access to naloxone even among states that have passed legislation to allow pharmacists to dispense the medication without a physician’s prescription, according to two research letters published in the Nov. 13 issue of the Journal of the American Medical Association.

Abstract/Full Text – Puzantian (subscription or payment may be required)
Abstract/Full Text – Evoy (subscription or payment may be required)
Editorial (subscription or payment may be required)

Prevalence of Food Allergy 7.6 Percent in U.S. Children

MONDAY, Nov. 19, 2018 (HealthDay News) — The prevalence of food allergy (FA) is 7.6 percent among children in the United States, according to a study published online Nov. 19 in Pediatrics.

Abstract/Full Text

Opioid Misuse Varies With Sexual Orientation

MONDAY, Nov. 19, 2018 (HealthDay News) — Opioid misuse varies with sexual orientation, with increased misuse among female bisexuals, according to a study published online Nov. 19 in the American Journal of Preventive Medicine.

Abstract/Full Text (subscription or payment may be required)

HIV Transmission Risk Small With Antiretroviral Compliance

MONDAY, Nov. 19, 2018 (HealthDay News) — The risk for sexual transmission of HIV is negligible when an HIV-positive sex partner adheres to antiretroviral therapy and maintains viral suppression, according to research published in the November issue of CMAJ, the journal of the Canadian Medical Association.

Abstract/Full Text

AAP Updates Management of Sport-Related Concussion

FRIDAY, Nov. 14, 2018 (HealthDay News) — Recommendations have been developed for the diagnosis and management of pediatric sport-related concussion (SRC), according to a clinical report published online Nov. 12 in Pediatrics.

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Epinephrine Personal Autoinjectors Cost-Effective at $24

FRIDAY, Nov. 16, 2018 (HealthDay News) — In a simulation of children with peanut allergy, epinephrine personal autoinjectors are cost-effective at $24, according to a study published online Nov. 16 in JAMA Network Open.

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CDC: Increase Seen in Salmonella Illnesses From Ground Beef

FRIDAY, Nov. 16, 2018 (HealthDay News) — There have been 126 more cases of illness added to an investigation into a Salmonella outbreak linked to recalled ground beef products from JBS Tolleson Inc., bringing the total to 246 cases in 25 states, the U.S. Centers for Disease Control and Prevention says.

CDC Food Safety Alert

CDC: 8.8 Percent Uninsured in U.S. in First Half of 2018

FRIDAY, Nov. 16, 2018 (HealthDay News) — In the first six months of 2018, 8.8 percent of U.S. individuals of all ages were uninsured, which was not significantly different from 2017, according to a report published Nov. 15 by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

Abstract/Full Text

Drug Overdose Mortality Rates Highest in United States

FRIDAY, Nov. 16, 2018 (HealthDay News) — In 2015, the United States had higher drug overdose mortality rates than those of many other Organisation for Economic Co-operation and Development member countries, according to a research letter published online Nov. 13 in the Annals of Internal Medicine.

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Treatments Appear No Better Than Placebo for Tennis Elbow

FRIDAY, Nov. 16, 2018 (HealthDay News) — At best, all treatments provide only small pain relief for tennis elbow, according to a review published online Oct. 31 in the American Journal of Sports Medicine.

Abstract/Full Text (subscription or payment may be required)

Harms ID’d With Nonoperative Management of Appendicitis

THURSDAY, Nov. 15, 2018 (HealthDay News) — Patients with uncomplicated appendicitis undergoing nonoperative management are more likely to have an appendicitis-associated readmission and to develop an abscess, although index hospitalization costs are lower compared with appendectomy, according to a study published online Nov. 14 in JAMA Surgery.

Abstract/Full Text
Editorial

Name-Brand Medications Driving Spike in U.S. Drug Spending

THURSDAY, Nov. 15, 2018 (HealthDay News) — Rising drug spending in the United States is being fueled by expensive name-brand prescription medicines, a new study shows.

NBC News Article
Blue Cross Blue Shield Report

Patient Experiences Shed Light on Diagnostic Errors

THURSDAY, Nov. 15, 2018 (HealthDay News) — Data from patient- and family-reported error narratives indicate that problems related to patient-physician interactions are major contributors to diagnostic errors, according to a study published in the November issue of Health Affairs.

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AMA to Collect Data on Suicide Among Doctors-in-Training

WEDNESDAY, Nov. 14, 2018 (HealthDay News) — By collecting data on suicides by medical students, residents, and fellows, the American Medical Association hopes to identify ways to reduce suicides among doctors-in-training. The data collection policy was approved at a meeting yesterday.

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Red Cross Issues Urgent Call for Blood Ahead of the Holidays

WEDNESDAY, Nov. 14, 2018 (HealthDay News) — There is an urgent need for blood and platelet donations in the United States because donations during September and October fell 21,000 units short of hospital needs, the American Red Cross says.

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CDC Probe Continues as Cases of Acute Flaccid Myelitis Rise

WEDNESDAY, Nov. 14, 2018 (HealthDay News) — Cases of a mysterious polio-like illness continue to mount in the United States, and health officials are scrambling to figure out the cause.

HealthDay Article
Abstract/Full Text

No Efficacy Signal for Fluoxetine in EV-D68 Acute Flaccid Myelitis

TUESDAY, Nov. 13, 2018 (HealthDay News) — The antiviral agent fluoxetine is well tolerated but is not effective for patients with proven or presumptive enterovirus D68-associated acute flaccid myelitis (AFM), according to a study published online Nov. 9 in Neurology.

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One-Third of Peds Medication Errors Due to Usability Issues

TUESDAY, Nov. 13, 2018 (HealthDay News) — More than one-third of pediatric patient safety reports in 2012 to 2017 that were related to electronic health record (EHR) use were attributed to usability issues, according to a study published in the November issue of Health Affairs.

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Repetitive Hits May Predispose Athletes to Concussion

TUESDAY, Nov. 13, 2018 (HealthDay News) — Repetitive head impact exposure appears to be a predisposing factor for the onset of concussion, according to a study published online Oct. 22 in the Annals of Biomedical Engineering.

Abstract/Full Text

CDC: Gun Deaths on the Rise in the United States

FRIDAY, Nov. 9, 2018 (HealthDay News) — Homicides and suicides involving guns are on the rise in the United States, according to a federal government study.

CNN Article
MMWR Article

CDC Warns of Salmonella Illnesses Linked to Raw Turkey

THURSDAY, Nov. 8, 2018 (HealthDay News) — The total number of illnesses in a Salmonella outbreak linked with raw turkey products now stands at 164 people across 35 states, according to the U.S. Centers for Disease Control and Prevention.

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FDA Approves New Version of OTC Primatene Mist

THURSDAY, Nov. 8, 2018 (HealthDay News) — A new version of an over-the-counter asthma inhaler that was taken off the market in 2011 has been approved by the U.S. Food and Drug Administration.

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Concussion-Related Biomarkers Vary Based on Sex, Race

THURSDAY, Nov. 8, 2018 (HealthDay News) — Concussion-related serum biomarkers vary by sex and race, which may complicate their interpretation, according to three studies published online Nov. 7 in Neurology.

Abstract/Full Text 1 (subscription or payment may be required)
Abstract/Full Text 2 (subscription or payment may be required)
Abstract/Full Text 3 (subscription or payment may be required)
Editorial (subscription or payment may be required)

Possible Salmonella Prompts Duncan Hines Cake Mix Recall

WEDNESDAY, Nov. 7, 2018 (HealthDay News) — Four varieties of Duncan Hines cake mix have been recalled due to possible Salmonella contamination.

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Medicaid Expansion Approved in Three Republican-Leaning States

WEDNESDAY, Nov. 7, 2018 (HealthDay News) — Hundreds of thousands more low-income Americans could get health insurance after voters in three Republican-leaning states approved Medicaid expansion in the midterm elections.

CNBC Article

Peds Firearm-Related Injuries Lead to Clinical, Financial Burden

WEDNESDAY, Nov. 7, 2018 (HealthDay News) — For pediatric patients, the clinical and financial burdens associated with firearm-related injuries are considerable, according to a research letter published online Oct. 29 in JAMA Pediatrics.

Abstract/Full Text (subscription or payment may be required)

CDC: Cases of Polio-Like Illness Still Increasing in the U.S.

TUESDAY, Nov. 6, 2018 (HealthDay News) — Cases of a polio-like condition that mainly affects children continue to rise this year in the United States, health officials say.

More Information: CDC

New Guidelines Issued for Patellofemoral Pain Management

TUESDAY, Nov. 6, 2018 (HealthDay News) — The National Athletic Trainers’ Association has issued recommendations for identifying and managing patients with patellofemoral pain (PFP); these recommendations form the basis of a position statement published in the September issue of the Journal of Athletic Training.

Abstract/Full Text

Blood Donations Exceeded Demand After Las Vegas Shooting

TUESDAY, Nov. 6, 2018 (HealthDay News) — Nearly 500 blood components were transfused in the first 24 hours following the Las Vegas shooting on Oct. 1, 2017, while more than 800 units of blood were donated in the immediate aftermath, according to a study published online Nov. 2 in the Journal of Trauma and Acute Care Surgery.

Abstract/Full Text (subscription or payment may be required)

Characteristics of Black AMI Patients Impact Mortality Rate

MONDAY, Nov. 5, 2018 (HealthDay News) — For patients with acute myocardial infarction (AMI), mortality rates differ based on characteristics associated with race, according to a study published online Nov. 2 in JAMA Network Open.

Abstract/Full Text

Surgery Restores Boy’s Ability to Walk Post-Acute Flaccid Myelitis

MONDAY, Nov. 5, 2018 (HealthDay News) — A first-of-its-kind surgery has restored the ability to walk in a boy paralyzed by acute flaccid myelitis (AFM).

CBS News Article
More Information: CDC

U.S. Opioid Overdose Deaths Reach Record Number

FRIDAY, Nov. 2, 2018 (HealthDay News) — The number of opioid overdose deaths in the United States reached a new record last year with 72,000 deaths, which works out to about 200 a day, according to a Drug Enforcement Administration report released today. The report comes just over a week after U.S. health secretary Alex Azar said overdose deaths have started to level off.

AP News Article
2018 National Drug Threat Assessment

Sign-Up Season Begins on HealthCare.gov

FRIDAY, Nov. 2, 2018 (HealthDay News) — The federal government website where Americans can sign up for health insurance under the Affordable Care Act is up and running, officials said yesterday.

AP News Article
HealthCare.gov

Age, Racial Disparities Seen in Hospitalization for Heart Failure

FRIDAY, Nov. 2, 2018 (HealthDay News) — For emergency department patients with heart failure, data reveal age and racial disparities in hospitalization rates, according to a study published in the November issue of the American Journal of Preventive Medicine.

Abstract/Full Text

Financial Conflicts of Interest Prevalent Among CPG Authors

THURSDAY, Nov. 1, 2018 (HealthDay News) — There is a high prevalence of financial conflicts of interest among authors of clinical practice guidelines (CPGs) related to high-revenue medications and in gastroenterology, according to two research letters published online Oct. 29 in JAMA Internal Medicine.

Abstract/Full Text – Khan (subscription or payment may be required)
Abstract/Full Text – Combs (subscription or payment may be required)
Editorial (subscription or payment may be required)

Updated Guidelines Released for Emergency Care of Children

THURSDAY, Nov. 1, 2018 (HealthDay News) — The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have released updated guidelines for emergency care of injured and critically ill children. The guidelines were published in a policy statement in the November issue of Pediatrics.

Abstract/Full Text

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