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Category: Emergency Medicine | Monthly Briefing

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September 2011 Briefing - Emergency Medicine

Last Updated: October 03, 2011.

 

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Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for September 2011. 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.

Surfactants Feasible for Self-Breathing Preterm Infants

FRIDAY, Sept. 30 (HealthDay News) -- Application of surfactant to spontaneously breathing preterm infants stabilized with continuous positive airway pressure (CPAP) is feasible, and reduces the need for mechanical ventilation, according to a study published online Sept. 30 in The Lancet.

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Doctors, Patients Identify Tacit Clues in Their Interactions

FRIDAY, Sept. 30 (HealthDay News) -- Both doctors and patients identify tacit clues as well as judgments based on these clues during video elicitation interviews of health maintenance examinations, according to a study published in the October issue of the Journal of Evaluation in Clinical Practice.

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Spinal MRI Reviewer Accuracy Equal Across Training Levels

FRIDAY, Sept. 30 (HealthDay News) -- Doctors at multiple levels of training can accurately and efficiently interpret the integrity of the posterior ligamentous complex (PLC) on spinal magnetic resonance imaging (MRI), according to a study published in the August issue of The Spine Journal.

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Illness Associated With HEV68 Seen in Clusters Globally

THURSDAY, Sept. 29 (HealthDay News) -- Human enterovirus 68 (HEV68), rarely reported since it was first identified in the early 1960s, has recently been seen in disease clusters around the world, according to research published in the Sept. 30 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Surveillance Info Sheds Light on Utah's Influenza Patterns

THURSDAY, Sept. 29 (HealthDay News) -- The United States was hard hit by the 2009 pandemic influenza A (H1N1) virus, and Utah experienced a particularly high proportion of severe illness compared with previous influenza seasons, particularly among certain subsets of the population, according to research published in the Sept. 30 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Prehypertension Tied to Higher Risk of Incident Stroke

THURSDAY, Sept. 29 (HealthDay News) -- Individuals with prehypertension are at significant risk of incident stroke, with the risk increasing substantially among those with higher prehypertensive values, according to a meta-analysis published online Sept. 28 in Neurology.

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SSRI With Antiplatelet Therapy Ups Post-MI Bleeding Risk

THURSDAY, Sept. 29 (HealthDay News) -- Combined use of selective serotonin reuptake inhibitors (SSRIs) with antiplatelet agents, including acetylsalicylic acid (ASA), clopidogrel, or both, is associated with an increased risk of bleeding following acute myocardial infarction (MI), according to a study published online Sept. 26 in CMAJ, the journal of the Canadian Medical Association.

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Burdensome Transitions Impact End-of-Life Care Quality

WEDNESDAY, Sept. 28 (HealthDay News) -- Burdensome health care transitions in the last months of life are common and are associated with poor quality end-of-life care, according to a study published in the Sept. 29 issue of the New England Journal of Medicine.

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Child Face Mask Approved to Help Prevent Spread of Germs

WEDNESDAY, Sept. 28 (HealthDay News) -- A child-size, single-use face mask to help prevent the spread of germs in hospitals and other health care settings has been approved by the U.S. Food and Drug Administration.

FDA

Immune Globulin Therapy Has No Benefit for Neonatal Sepsis

WEDNESDAY, Sept. 28 (HealthDay News) -- Infants with suspected or proven sepsis treated with intravenous immune globulin have no significant difference in outcomes compared to those receiving a placebo, according to a study published in the Sept. 29 issue of the New England Journal of Medicine.

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Fear of Childbirth Tied to Higher Odds of Cesarean Section

WEDNESDAY, Sept. 28 (HealthDay News) -- Emergency and elective cesarean sections (CS) are more common in women with a fear of childbirth, even after psychological counseling, according to a study published online July 24 in Acta Obstetricia et Gynecologica Scandinavica.

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Cognition Similar for Standard, Intensive Glycemic Control

WEDNESDAY, Sept. 28 (HealthDay News) -- Intensive glycemic lowering is not better than standard glycemic control for preventing cognitive decline in patients with type 2 diabetes, despite a higher total brain volume, according to a study published online Sept. 28 in The Lancet Neurology.

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U.S. Docs Feel They Give More Patient Care Than Required

TUESDAY, Sept. 27 (HealthDay News) -- Many primary care physicians in the United States believe that their patients are receiving too much medical care, and that the pressure to do more than is necessary could be reduced by malpractice reform, adjusting financial incentives, and spending more time with patients, according to a study published in the Sept. 26 issue of the Archives of Internal Medicine.

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Asthma Prevalence Elevated in Youth With Diabetes

TUESDAY, Sept. 27 (HealthDay News) -- Asthma is more prevalent in youth with diabetes compared to the general U.S. population, and is associated with poor glycemic control in youth with type 1 diabetes, especially if untreated, according to a study published online Sept. 26 in Pediatrics.

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Tdap Safe After Tetanus-, Diphtheria-Containing Products

MONDAY, Sept. 26 (HealthDay News) -- The use of tetanus toxoid, reduced-content diphtheria toxoid, and acellular pertussis vaccine (Tdap) is safe, with no excess reactogenecity and no need for caution regarding Tdap use within any interval of a tetanus- or diphtheria-containing toxoid product, according to a policy statement published online Sept. 26 in Pediatrics.

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Evidence for Nondrug Childhood Constipation Therapies Limited

MONDAY, Sept. 26 (HealthDay News) -- Although there is a lack of high-quality evidence for nonpharmacologic treatments for childhood constipation, there is some evidence of effectiveness of fiber supplements, but not for effectiveness of fluid supplements, prebiotics, probiotics, or behavioral interventions, according to a review published online Sept. 26 in Pediatrics.

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Bed Bug Treatment Can Cause Illness

THURSDAY, Sept. 22 (HealthDay News) -- Illnesses related to the pesticides used to treat bed bug infestations -- an increasingly prevalent problem in the United States and worldwide -- are few and far between; still, inappropriate use of the insecticides can and does cause harm, according to research published in the Sept. 23 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Stroke Outcomes Similar With CT-Perfusion, Time Criteria

THURSDAY, Sept. 22 (HealthDay News) -- For patients with ischemic stroke, use of computed tomography perfusion (CTP)-based criteria for selecting patients for endovascular treatment has similar rates of functional outcome and intracranial hemorrhage compared to time-guided selection, according to a study published online Sept. 19 in the Journal of Neurointerventional Surgery.

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Risk Up for Patients During Long Interdialytic Interval

WEDNESDAY, Sept. 21 (HealthDay News) -- For patients receiving hemodialysis, mortality and adverse cardiovascular-related events occur mainly on the day after the long interdialytic interval, rather than on other days, according to a study published in the Sept. 22 issue of the New England Journal of Medicine.

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Exposure to Air Pollution Found to Up Transient Risk of MI

WEDNESDAY, Sept. 21 (HealthDay News) -- Short-term exposure to particles with a diameter <10 µm (PM10) and nitrogen dioxide (NO2) in the air is associated with a short-term increased risk of myocardial infarction (MI) one to six hours later, according to a study published online Sept. 20 in BMJ.

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2006/2007 U.S. Flu Vaccination Policy Lowers Morbidity

WEDNESDAY, Sept. 21 (HealthDay News) -- The 2006/2007 influenza vaccination policy change in the United States to include healthy children aged 24 to 59 months has reduced influenza morbidity in the United States, as evident by reduction in the emergency department visits in the United States versus Canada, according to a study published in the Sept. 20 issue of the CMAJ, the journal of the Canadian Medical Association.

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Mortality Up in Hospitals With More Minority Trauma Patients

WEDNESDAY, Sept. 21 (HealthDay News) -- The odds of in-hospital mortality for trauma patients are associated with the proportion of minority patients in the hospital, according to a study published online Sept. 19 in the Archives of Surgery.

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Lower Sudden Death Risk With Add-On Antiepileptic Therapy

TUESDAY, Sept. 20 (HealthDay News) -- Patients with refractory epilepsy who are treated with adjunctive antiepileptic drugs (AEDs) at efficacious doses may have lower incidence of sudden unexpected death in epilepsy (SUDEP) compared with those receiving a placebo, according to a meta-analysis published online Sept. 20 in The Lancet Neurology.

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Treatment Delays Identified in Regional STEMI Systems

TUESDAY, Sept. 20 (HealthDay News) -- Treatment delays occur in standardized regional systems for transfer of patients with ST-segment-elevation myocardial infarction (STEMI) to receive primary percutaneous coronary intervention (PCI), with delays most frequently occurring at the referral hospital, PCI center, and during the transport process, according to a study published online Sept. 19 in Circulation.

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Payer Status Affects Health Care Quality and Outcomes

TUESDAY, Sept. 20 (HealthDay News) -- Patients with heart failure who have no insurance, or have Medicaid or Medicare, have lower quality of care and worse outcomes than those with private/health maintenance organization (HMO) insurance, according to a study published in the Sept. 27 issue of the Journal of the American College of Cardiology.

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Cold Ischemia Time Tied to Delayed Kidney Graft Function

MONDAY, Sept. 19 (HealthDay News) -- Increasing cold ischemia time (CIT) in expanded-criteria donor (ECD) kidney pairs is a risk factor for delayed graft function (DGF), but has no effect on graft survival, according to a study published online Sept. 11 in the American Journal of Transplantation.

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Work Intensity Similar Across Physician Specialties

MONDAY, Sept. 19 (HealthDay News) -- The level of physician work intensity appears to be similar among specialties, with variations in the specific dimensions of stress, physical demands, performance, and temporal demand, according to a study published online Sept. 3 in Medical Care.

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Posterior Shoulder Dislocation Has Low Prevalence

MONDAY, Sept. 19 (HealthDay News) -- Prevalence of posterior dislocation is low, with recurrent instability the most common complication after injury, and functional deficit persisting at two years after injury, according to a study published in the Sept. 7 issue of The Journal of Bone & Joint Surgery.

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Child Abuse Head Trauma Rates Increase During Recession

MONDAY, Sept. 19 (HealthDay News) -- The rate of abusive head trauma (AHT) in children increased significantly in three U.S. geographic regions during the recent economic recession, according to a study published online Sept. 19 in Pediatrics.

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White Coat Adherence Seen in Children With Type 1 Diabetes

THURSDAY, Sept. 15 (HealthDay News) -- For children with type 1 diabetes, those with low levels of hemoglobin A1c (A1C) may be more likely to increase the frequency of blood glucose monitoring (BGM) prior to a scheduled visit to the clinic, according to a study published online Aug. 18 in Diabetes Care.

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CDC: MRSA USA300 Strain Resistant to Topical Antibiotics

FRIDAY, Sept. 16 (HealthDay News) -- Most methicillin-resistant Staphylococcus aureus (MRSA) isolates are susceptible to bacitracin, but MRSA USA300 isolates show resistance to bacitracin and neomycin, according to a study published online Sept. 14 in the U.S. Centers for Disease Control and Prevention's Emerging Infectious Diseases.

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Optimal CRC Screening Varies With Age, Family History

FRIDAY, Sept. 16 (HealthDay News) -- The optimal colonoscopy screening strategy for individuals with colorectal cancer (CRC) varies considerably with the number of affected first-degree relatives and their age at diagnosis, according to a study published in the Sept. 15 issue of Cancer.

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Statins After Ischemic Stroke Not Tied to Brain Hemorrhage

FRIDAY, Sept. 16 (HealthDay News) -- Exposure to statins after acute ischemic stroke is not associated with intracerebral hemorrhage (ICH), according to a study published online Sept. 12 in the Archives of Neurology.

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Child Self-Exposure to Meds Explains Most Drug Poisoning

FRIDAY, Sept. 16 (HealthDay News) -- Child self-exposure to prescription medications was responsible for 95 percent of the cases of pediatric pharmaceutical poisonings between 2001 and 2008, with the greatest resource use and morbidity due to self-ingestion of prescription products, including opioids, sedative-hypnotics, and cardiovascular agents, according to a study published online Sept. 16 in The Journal of Pediatrics.

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Anti-Nausea Drug May Lead to Dangerous Heart Rhythms

THURSDAY, Sept. 15 (HealthDay News) -- Zofran (ondansetron), used to prevent nausea in patients receiving cancer treatment, is undergoing an ongoing safety review and labeling change by the U.S. Food and Drug Administration because it may cause potentially fatal changes in heart rhythm, according to a Sept. 15 FDA safety alert.

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CDC: Recent Influenza Activity Relatively Low

THURSDAY, Sept. 15 (HealthDay News) -- Influenza activity was relatively low worldwide over the summer of 2011, but vaccination remains an important criteria for keeping influenza under control and preventing potentially serious, even fatal, complications, according to two articles published in the Sept. 16 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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New Tiered Sharing Policy Suggested for Liver Transplants

THURSDAY, Sept. 15 (HealthDay News) -- An algorithm incorporating a national sharing policy with a tiered policy, such as the model for end-stage liver disease (MELD), may reduce the number of wait-list deaths and organ travel distances, according to a study published in the September issue of Liver Transplantation.

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Surgery Effective for Subaxial Cervical Synovial Cysts

THURSDAY, Sept. 15 (HealthDay News) -- Surgical resection can be an effective treatment for patients presenting with cervical radiculopathy or myelopathy who have a subaxial cervical synovial cyst with minimal postoperative complications, according to a study published in the Sept. 15 issue of Spine.

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Long-Term Nonaspirin NSAID Use Ups Renal Cell Cancer Risk

WEDNESDAY, Sept. 14 (HealthDay News) -- Use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs), but not aspirin and acetaminophen, is associated with an increased risk of renal cell cancer (RCC), with increased duration of use correlated with an elevated risk, according to a study published in the Sept. 12 issue of the Archives of Internal Medicine.

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Malaria Vaccine Does Not Protect Against Clinical Malaria

WEDNESDAY, Sept. 14 (HealthDay News) -- The malaria vaccine, FMP 2.1/AS02A, based on apical membrane antigen 1 (AMA1) from the 3D7 strain of Plasmodium falciparum does not provide significant protection against clinical malaria, but may have strain-specific efficacy against parasites with AMA1 corresponding to that of the vaccine strain, according to a study published in the Sept. 15 issue of the New England Journal of Medicine.

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Mortality Gap Widening for Schizophrenia, Bipolar Disorder

WEDNESDAY, Sept. 14 (HealthDay News) -- By 2006, the standardized mortality ratios for individuals with schizophrenia or bipolar disorder was approximately double the population average, with the mortality gap increasing over time, according to a study published online Sept. 13 in BMJ.

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Sorafenib Plus DEB-TACE Safe, Tolerated in Unresectable HCC

WEDNESDAY, Sept. 14 (HealthDay News) -- In patients with unresectable hepatocellular carcinoma (HCC), combined treatment with transarterial chemoembolization (TACE) with doxorubicin-eluting beads (DEB) and sorafenib is well tolerated and safe, according to a study published online Sept. 12 in the Journal of Clinical Oncology.

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Prehypertension-Hypertension Conversion Rate Tied to Race

WEDNESDAY, Sept. 14 (HealthDay News) -- Conversion from prehypertension to hypertension is more accelerated in blacks than in whites, according to a study published online Sept. 12 in Hypertension.

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Aortic Dissection Incidence Higher in Individuals With BAV

TUESDAY, Sept. 13 (HealthDay News) -- Aortic dissection incidence is higher in individuals with bicuspid aortic valves (BAVs) than in the general population, according to a study published in the Sept. 14 issue of the Journal of the American Medical Association.

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Febrile Seizures Tied to Systemic Respiratory Alkalosis

TUESDAY, Sept. 13 (HealthDay News) -- Febrile seizures (FS) in children are associated with systemic respiratory alkalosis, and the lack of FS in children with gastroenteritis (GE) may be attributable to the low pH in GE, according to a study published online Sept. 13 in Epilepsia.

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Climate Change Model Predicts Increase in Childhood Asthma

MONDAY, Sept. 12 (HealthDay News) -- Global-to-regional climate and atmospheric chemistry models predict an increase of 7.3 percent in emergency department presentations for regional summer ozone-related asthma in children aged 0 to 17 years across the New York City metropolitan region by the 2020s, according to a study published in the September issue of the American Journal of Preventive Medicine.

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~13 Percent of Trauma Patients Re-Present Post Discharge

FRIDAY, Sept. 9 (HealthDay News) -- A substantial percentage of trauma patients, particularly those who are uninsured, publicly insured, or who belong to low-income neighborhoods, re-present to the emergency department within 30 days of discharge from the hospital, but only a small percentage of these need readmission, according to a study published online June 20 in the Annals of Emergency Medicine.

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64-MDCT Improves Radiologic Workflow in Mass Casualties

FRIDAY, Sept. 9 (HealthDay News) -- The implementation of an emergency radiology protocol using a modern 64-multidetector computed tomography (MDCT) scanner coupled with volume image reading during a mass casualty incident improves radiologic workflow, according to a study published in the September issue of the American Journal of Roentgenology.

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SAMHSA Assesses Recent Trends in Illicit Drug Use

THURSDAY, Sept. 8 (HealthDay News) -- The use of illicit drugs and alcohol remained similar between 2009 and 2010, but was higher than in 2008, according to the 2010 National Survey on Drug Use and Health, published Sept. 8 by the Substance Abuse and Mental Health Services Administration (SAMHSA) at the start of the 22nd annual National Recovery Month held in September in United States.

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Trends in Respiratory Syncytial Virus Seasonality Reported

THURSDAY, Sept. 8 (HealthDay News) -- In most of the United States, the respiratory syncytial virus (RSV) season starts in the fall and continues through early spring, but more specific timing varies regionally; an understanding of seasonal trends can help guide decision making around diagnostic testing and the administration of prophylaxis, according to a report published in the Sept. 9 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Gastroesophageal Reflux Symptoms Tied to 9/11 Exposure

THURSDAY, Sept. 8 (HealthDay News) -- For individuals who were exposed to the September 11, 2001 (9/11) attacks on the World Trade Center (WTC), the incidence of gastroesophageal reflux symptoms (GERS) is higher in those with asthma or posttraumatic stress disorder (PTSD) and highest in those in whom both comorbidities are present, according to a study published online Sept. 6 in The American Journal of Gastroenterology.

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Comparative Efficacy Proposed for European Drug Approval

WEDNESDAY, Sept. 7 (HealthDay News) -- New drugs should be compared with existing treatments instead of placebo before their approval in Europe, according to a report published online Sept. 6 in the BMJ.

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Many Hospital Staff Uniforms Contaminated With Bacteria

WEDNESDAY, Sept. 7 (HealthDay News) -- More than 60 percent of hospital staff uniforms are contaminated with potentially pathogenic bacteria, including drug-resistant species, according to a study published in the September issue of the American Journal of Infection Control.

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Odds of Board Certification Vary in New Doctors

WEDNESDAY, Sept. 7 (HealthDay News) -- Certification of recent U.S. medical school graduates by the American Board of Medical Specialties (ABMS) varies across specialties by educational and demographic factors, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Gestational NSAID Intake Tied to Spontaneous Abortion Risk

WEDNESDAY, Sept. 7 (HealthDay News) -- Exposure to any type or dosage of nonaspirin nonsteroidal anti-inflammatory drug (NSAID) in early pregnancy increases the risk of spontaneous abortion, according to a study published online Sept. 6 in CMAJ, the journal of the Canadian Medical Association.

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Psychogenic Seizure Diagnosis Often Delayed in U.S. Veterans

WEDNESDAY, Sept. 7 (HealthDay News) -- Compared to civilians, U.S. veterans suffer a substantial delay in the diagnosis of psychogenic nonepileptic seizures (PNES), which is associated with greater cumulative antiepileptic drug (AED) treatment, according to a study published in the Sept. 6 issue of Neurology.

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Medical Students Show Racial, Cultural Patient Preference

WEDNESDAY, Sept. 7 (HealthDay News) -- Medical students may have a preferential bias toward whites and wealthier patients, but this does not appear to influence their clinical decision making or physician-patient interactions, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Training Protocols Do Not Affect Ventilation Knowledge

TUESDAY, Sept. 6 (HealthDay News) -- For first-time examinees of the American Board of Internal Medicine (ABIM), training in a high-intensity ventilator protocol environment does not correlate with worse knowledge about mechanical ventilation management compared to training in a low-intensity environment, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Hospitalized Children Exposed to Considerable Polypharmacy

TUESDAY, Sept. 6 (HealthDay News) -- A considerable proportion of hospitalized children are exposed to polypharmacy, with exposure to more drugs significantly more likely among those with rare conditions, according to a study published online Sept. 5 in the Archives of Pediatrics & Adolescent Medicine.

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More Than 50 Air, Paintball Gun Injuries Present Daily to ER

TUESDAY, Sept. 6 (HealthDay News) -- In 2008, an average of 56 emergency department visits per day were due to air and paintball gun injuries, with more visits for males, children, and adolescents, according to an August statistical brief based on Healthcare Cost and Utilization Project data published by the Agency for Healthcare Research and Quality (AHRQ).

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Immunoadsorption Therapy Effective in E. coli-Induced HUS

TUESDAY, Sept. 6 (HealthDay News) -- Immunoadsorption of immunoglobulin G (IgG) antibodies can safely be used to treat neurological complications in patients with Escherichia coli (E. coli) O104:H4-induced hemolytic uremic syndrome (HUS), according to a study published online Sept. 5 in The Lancet.

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Cases of Transfusion-Linked Babesiosis in U.S. Described

TUESDAY, Sept. 6 (HealthDay News) -- From 1979 to 2009, 159 Babesia microti (B. microti) transfusion-associated cases of Babesiosis were identified in the United States, and occurrence was not limited by season or region, according to a study published online Sept. 5 in the Annals of Internal Medicine.

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Increase in Child/Young Adult Stroke Hospitalization Rate

TUESDAY, Sept. 6 (HealthDay News) -- The rates of hospitalization due to acute ischemic stroke increased in children and young adults of all age and gender groups from 1995 to 2008, except females aged 5 to 14 years, according to a study published online Sept. 2 in the Annals of Neurology.

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Temp Staff Errors More Harmful Than Those of Permanent Staff

MONDAY, Sept. 5 (HealthDay News) -- Emergency department medication errors associated with temporary staff are more likely to reach the patient and result in harm compared with errors associated with permanent staff, according to a study published in the July/August issue of the Journal for Healthcare Quality.

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FDA: New Contraindication, Updated Warning for Reclast

FRIDAY, Sept. 2 (HealthDay News) -- The drug label for Reclast (zoledronic acid) has been updated to reflect the risk of kidney failure, according to a safety alert issued Sept. 1 by the U.S. Food and Drug Administration.

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FDA: Antipsychotic Drug May Cause Severe Allergic Reaction

FRIDAY, Sept. 2 (HealthDay News) -- The drug label for Saphris (asenapine maleate), an antipsychotic medication, has been revised to warn of the risk of serious allergic reaction in patients with hypersensitivity to the drug, according to a safety alert issued Sept. 1 by the U.S. Food and Drug Administration.

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Traumatic Brain Injury Deaths Tied to Life Support Removal

THURSDAY, Sept. 1 (HealthDay News) -- For patients with traumatic brain injury, most deaths are associated with withdrawal of life-sustaining therapy, according to a study published online Aug. 29 in CMAJ, the journal of the Canadian Medical Association.

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