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Category: Critical Care | Monthly Briefing

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October 2011 Briefing - Critical Care

Last Updated: November 01, 2011.

 

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Here are what the editors at HealthDay consider to be the most important developments in Critical Care for October 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.

Preexisting Dementia in Stroke Patients Ups Disability

MONDAY, Oct. 31 (HealthDay News) -- For patients with stroke, preexisting dementia is associated with increased disability at discharge and lower likelihood of being discharged to prestroke domicile, according to a study published in the Nov. 1 issue of Neurology.

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Switching From IV to Oral Meds Cuts Health Care Costs

MONDAY, Oct. 31 (HealthDay News) -- For patients who are clinically eligible for oral (PO) medication intake, switching from intravenous (IV) to oral medication can substantially reduce the annual cost of health care, according to a study published online Oct. 17 in Clinical Therapeutics.

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Pre-Op Erythropoietin Reduces Need for Peri-Op Transfusion

MONDAY, Oct. 31 (HealthDay News) -- Preoperative administration of erythropoietin and an iron supplement significantly reduces the requirement for perioperative transfusion in anemic patients undergoing valvular heart surgery, according to a study published in the November issue of Anesthesiology.

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Low Income, Less Health Care Spending Ups Stroke Incidence

THURSDAY, Oct. 27 (HealthDay News) -- Lower per-capita gross domestic product and lower total health expenditure per capita are associated with increased stroke incidence, according to a study published online Oct. 27 in Stroke.

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Obesity Tied to Impaired Immunity After Flu Vaccine

THURSDAY, Oct. 27 (HealthDay News) -- Obese individuals have reduced levels of influenza antibody titers and decreased CD8+ T-cell responses 12 months after influenza vaccination, according to a study published online Oct. 25 in the International Journal of Obesity.

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Bedtime Medications Offer Better BP Control in CKD

WEDNESDAY, Oct. 26 (HealthDay News) -- For patients with chronic kidney disease (CKD), taking at least one hypertension medication at bedtime results in better blood pressure (BP) control compared to morning medication, according to a study published online Oct. 24 in the Journal of the American Society of Nephrology.

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Small Airway Obstruction Heralds Emphysema in COPD

WEDNESDAY, Oct. 26 (HealthDay News) -- The number of airways with a diameter of 2 to 2.5 mm is significantly reduced in patients with chronic obstructive pulmonary disease (COPD), and the narrowing and disappearance of small-airways precedes emphysematous destruction, according to a study published in the Oct. 27 issue of the New England Journal of Medicine.

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Smoking Rarely Cited As Cause of Death on Death Certificates

WEDNESDAY, Oct. 26 (HealthDay News) -- Doctors rarely cite smoking as the cause of death (COD) on death certificates, even in cases where there is a strong causal link to smoking, according to a study published online Oct. 24 in the Journal of Clinical Pathology.

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Ghost Authorship Prevalent in About One-Fifth of Articles

WEDNESDAY, Oct. 26 (HealthDay News) -- The prevalence of articles with honorary authorship, ghost authorship, or both is 21 percent, which marks a significant decrease since 1996, according to a study published online Oct. 25 in BMJ.

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Clinical, Genetic Factors Linked to Early Stent Thrombosis

TUESDAY, Oct. 25 (HealthDay News) -- Both genetic and clinical factors are independently associated with early stent thrombosis, according to a study published in the Oct. 26 issue of the Journal of the American Medical Association.

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FDA: Xigris Pulled From Global Market

TUESDAY, Oct. 25 (HealthDay News) -- Xigris (drotrecogin alfa [activated]), used in the treatment of patients with severe sepsis, is being voluntarily pulled from the market by its manufacturer, Eli Lilly and Company, after failing to show a survival benefit in these patients, according to a drug safety notification issued Oct. 25 by the U.S. Food and Drug Administration.

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Traumatic Brain Injury Lowers Children's Quality of Life

TUESDAY, Oct. 25 (HealthDay News) -- Children with moderate or severe traumatic brain injury (TBI) and children with mild TBI with an intracranial hemorrhage have a considerable reduction in their quality of life, according to a study published online Oct. 24 in Pediatrics.

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Cardiac Troponin Predicts Mortality in Acute Heart Failure

FRIDAY, Oct. 21 (HealthDay News) -- A sensitive cardiac troponin I (s-cTnI) assay can predict mortality risk for patients with acute heart failure, according to a study published online Oct. 11 in the Journal of Internal Medicine.

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Readmission Risk Models Display Poor Predictive Ability

TUESDAY, Oct. 18 (HealthDay News) -- Most hospital readmission risk models have poor predictive ability, according to a review published in the Oct. 19 issue of the Journal of the American Medical Association.

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E-Beam Sterilized Dialyzers Up Risk of Thrombocytopenia

TUESDAY, Oct. 18 (HealthDay News) -- Use of electron-beam (e-beam) sterilized hemodialysis membranes increases the risk of significant thrombocytopenia, according to a study published in the Oct. 19 issue of the Journal of the American Medical Association.

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Heart Failure Hospitalizations Down From 1998 to 2008

TUESDAY, Oct. 18 (HealthDay News) -- Overall heart failure hospitalization rates in the United States declined significantly from 1998 to 2008, with black men showing the lowest rate of decline, according to a study published in the Oct. 19 issue of the Journal of the American Medical Association.

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Marker IDs Injury in Hypoxic-Ischemic Encephalopathy

MONDAY, Oct. 17 (HealthDay News) -- Neonates with hypoxic-ischemic encephalopathy (HIE) treated with whole-body cooling have increased serum glial fibrillary acidic protein (GFAP) during the first week of life, which may be predictive of brain injury on magnetic resonance imaging (MRI), according to a study published in the September issue of the American Journal of Obstetrics & Gynecology.

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No Effect of Prophylaxis Type on Pulmonary Embolism Rate

FRIDAY, Oct. 14 (HealthDay News) -- The rate of pulmonary embolism after total hip arthroplasty does not differ by the type of prophylaxis or anesthesia used, according to a study published in the Oct. 5 issue of The Journal of Bone & Joint Surgery.

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Rare Disorders ID'd by NIH Undiagnosed Diseases Program

THURSDAY, Oct. 13 (HealthDay News) -- The extensive application of genomic technology under the U.S. National Institutes of Health Undiagnosed Diseases Program (NIH-UDP) helps diagnose complex and rare multisystem disorders, according to a report published online Sept. 26 in Genetics in Medicine.

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Increased Travel Time to Trauma Centers in 2007

THURSDAY, Oct. 13 (HealthDay News) -- Geographic access to trauma centers in the United States declined from 2001 to 2007, especially in communities with higher numbers of poor, uninsured, African-American residents, and individuals living in rural areas, according to a study published in the October issue of Health Affairs.

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Multidisciplinary Intervention Ups Outcomes in Acute Stroke

WEDNESDAY, Oct. 12 (HealthDay News) -- Stroke patients who receive a multidisciplinary intervention targeting management of fever, hyperglycemia, and swallowing dysfunction are less likely to be dead or dependent at 90 days and more likely to have better physical functioning, according to a study published online Oct. 12 in The Lancet.

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Financial Conflicts of Interest Prevalent, Under-Reported

WEDNESDAY, Oct. 12 (HealthDay News) -- Conflicts of interest (COI) are prevalent among members and chairs of guideline panels, and are under-reported, according to a study published online Oct. 11 in BMJ.

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Leukemia Drug May Cause Pulmonary Arterial Hypertension

TUESDAY, Oct. 11 (HealthDay News) -- Sprycel (dasatinib), a drug administered to certain leukemia patients, may increase the rare but serious risk of pulmonary arterial hypertension (PAH), according to an Oct. 11 safety announcement from the U.S. Food and Drug Administration.

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ICD Deactivation Knowledge Lacking in End-of-Life Care

TUESDAY, Oct. 11 (HealthDay News) -- Patients and providers require more knowledge about the functions of implantable cardioverter-defibrillators (ICDs) and end-of-life options in order to facilitate timely ICD deactivation discussions, according to a review published in the October issue of the American Journal of Nursing.

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High Yield of Viral Diagnoses for RT-PCR in Respiratory Infection

TUESDAY, Oct. 11 (HealthDay News) -- Real-time polymerase chain reaction (RT-PCR) testing has a high yield of viral diagnoses, but rapid communication of results to clinicians has no positive impact on hospital admissions, length of hospital stay, or duration of antibiotic use for children with acute respiratory infections (ARI), according to a study published online Oct. 10 in Pediatrics.

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Septicemia Most Costly Reason for Hospitalization in 2009

MONDAY, Oct. 10 (HealthDay News) -- Septicemia was the single most expensive condition treated in U.S. hospitals in 2009, with expenditure totaling nearly $15.4 billion, according to an October statistical brief based on Healthcare Cost and Utilization Project (HCUP) data published by the Agency for Healthcare Research and Quality (AHRQ).

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Use of Oral Steroids Linked to Vitamin D Deficiency

THURSDAY, Oct. 6 (HealthDay News) -- The use of oral steroids is associated with serum 25-hydroxyvitamin D (25[OH]D) deficiency, according to a study published online Sept. 28 in the Journal of Clinical Endocrinology & Metabolism.

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Many Elderly in U.S. Undergo Surgery in Last Year of Life

THURSDAY, Oct. 6 (HealthDay News) -- A considerable proportion of elderly people in the United States undergo surgery in the year before their death, with the rate varying with age and geographical region, according to a study published online Oct. 6 in The Lancet.

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Early ID of Morbidly Obese Improves Surgical Care

THURSDAY, Oct. 6 (HealthDay News) -- Early identification of patients with a body mass index (BMI) of 35 kg/m² or more improves perioperative care and outcomes, according to a study published in the October issue of the AORN Journal.

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Pre-Op Anemia Ups Mortality After Non-Cardiac Surgery

THURSDAY, Oct. 6 (HealthDay News) -- For patients undergoing non-cardiac surgery, even a mild degree of preoperative anemia is independently associated with an increased risk of 30-day morbidity and mortality, according to a study published online Oct. 6 in The Lancet.

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Oral Acyclovir Improves Outcomes in Neonatal Herpes

THURSDAY, Oct. 6 (HealthDay News) -- The neurodevelopmental outcomes in neonates with herpes simplex virus (HSV) infection and central nervous system (CNS) involvement improve with six months of acyclovir suppressive therapy, according to a study published in the Oct. 6 issue of the New England Journal of Medicine.

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More Minority Patients in Low-Quality, High-Cost Hospitals

THURSDAY, Oct. 6 (HealthDay News) -- Hospitals where the quality is low and costs high (worst hospitals) in the United States care for a higher proportion of elderly black, Hispanic, and Medicaid patients than high-quality, low-cost institutions (best hospitals), according to a study published in the October issue of Health Affairs.

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Neonatal ICU Stressors Alter Brain Structure, Function

WEDNESDAY, Oct. 5 (HealthDay News) -- Exposure to stressors in the neonatal intensive care unit (NICU) is associated with alterations in regional brain structure and function in preterm infants, according to a study published online Oct. 4 in the Annals of Neurology.

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Eating Disorders in Children Tied to Serious Health Consequences

WEDNESDAY, Oct. 5 (HealthDay News) -- The incidence of early-onset restrictive eating disorders is 2.6 cases per 100,000 person-years in children, is increased in girls, and can result in serious medical consequences, according to a study published in the October issue of the Archives of Pediatrics & Adolescent Medicine.

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Membrane Oxygenation Reduces Mortality in H1N1-Related ARDS

WEDNESDAY, Oct. 5 (HealthDay News) -- For patients with H1N1-related acute respiratory distress syndrome (ARDS), referral and transfer to an extracorporeal membrane oxygenation (ECMO) center is associated with lower hospital mortality, according to a study published online Oct. 5 in the Journal of the American Medical Association.

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Omega-3 Supplements May Be Harmful in Acute Lung Injury

WEDNESDAY, Oct. 5 (HealthDay News) -- Twice-daily enteral supplementation with omega-3 (n-3) fatty acids, γ-linolenic acid, and antioxidants does not decrease ventilator-free days or improve other clinical outcomes, and may be harmful for patients with acute lung injury, according to a study published online Oct. 5 in the Journal of the American Medical Association.

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Early Identification of Ischemic Stroke With DWI-FLAIR Mismatch

WEDNESDAY, Oct. 5 (HealthDay News) -- The mismatch between acute ischemic lesion visibility on diffusion-weighted magnetic resonance imaging (MRI) (DWI), and fluid-attenuated inversion recovery (FLAIR) MRI (DWI-FLAIR mismatch) can identify patients with acute ischemic lesions within 4.5 hours of symptom onset, according to a study published online Oct. 5 in The Lancet Neurology.

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Alcohol-Impaired Driving Down by 30 Percent in U.S.

TUESDAY, Oct. 4 (HealthDay News) -- U.S. adults drive after drinking "a bit too much" about a third less often than they did in 2006; still, about 1.8 percent of adults (four million people) reported alcohol-impaired driving in 2010, according to a report in the Oct. 4 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Advance Directives Linked to Regional Medical Expenditures

TUESDAY, Oct. 4 (HealthDay News) -- Advance directives (living wills) specifying limitations in end-of-life care are associated with significantly lower levels of Medicare spending, lower likelihood of in-hospital death, and higher use of hospice care during the last six months of life for patients living in regions with high medical expenditures but not in other regions, according to a study published in the Oct. 5 issue of the Journal of the American Medical Association.

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Computer-Generated Markers Predict Death Risk Post ACS

TUESDAY, Oct. 4 (HealthDay News) -- Computationally generated cardiac biomarkers -- morphologic variability (MV), symbolic mismatch (SM), and heart rate motifs (HRMs) -- can accurately stratify the risk of cardiovascular death after acute coronary syndrome (ACS), according to a study published in the Sept. 28 issue of Science Translational Medicine.

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No Increased MI Risk in Ulcerative Colitis, Crohn's

TUESDAY, Oct. 4 (HealthDay News) -- Patients with ulcerative colitis (UC) or Crohn's disease (CD) do not have an increased risk of first-time acute myocardial infarction (MI) compared with general practice patients, according to a study published in the October issue of Clinical Gastroenterology and Hepatology.

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Pericardial Fat Volume Tied to Coronary Artery Plaque Burden

TUESDAY, Oct. 4 (HealthDay News) -- Pericardial fat volume is positively associated with coronary atherosclerotic plaque burden, as measured by plaque eccentricity, in asymptomatic individuals, and this relationship is stronger in men than women, according to a study published in the October issue of Radiology.

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Early Anesthesia Exposures Tied to Learning Disabilities

MONDAY, Oct. 3 (HealthDay News) -- Exposure to multiple anesthesia/surgery before the age of 2 years is a significant risk factor for the development of learning disabilities (LDs) later in life, but not for the receipt of an individualized education program for an emotional/behavior disorder (IEP-EBD), according to a study published online Oct. 3 in Pediatrics.

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