Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine 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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Nonclinical Factors Impact Back Pain Treatment Decisions
FRIDAY, Oct. 28 (HealthDay News) -- Nonclinical factors, including gender, socioeconomic status, and patient presentation, influence physicians' treatment recommendations for acute nonspecific low back pain, with patient presentation the most influential factor, according to a study published in the Nov. 1 issue of Spine.
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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.
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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Evidence Suggests Variable Effectiveness for Flu Vaccine
WEDNESDAY, Oct. 26 (HealthDay News) -- Influenza vaccines provide variable effectiveness and efficacy in young children and adults, according to a study published online Oct. 26 in The Lancet Infectious Diseases.
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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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Drinking Non-Diet Soda Tied to Violent Behavior Among Teens
WEDNESDAY, Oct. 26 (HealthDay News) -- Soft drink consumption among adolescents is significantly associated with weapon possession and with perpetration of violence against peers, family members, and dates, according to a study published online Oct. 24 in Injury Prevention.
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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.
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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New Estimates of Rotavirus-Attributable Diarrhea Mortality
TUESDAY, Oct. 25 (HealthDay News) -- Worldwide in 2008, 453,000 deaths in children younger than 5 years old resulted from diarrhea attributable to rotavirus, according to a meta-analysis published online Oct. 25 in The Lancet Infectious Diseases.
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HPV Infection, Cardiovascular Disease in Women Linked
MONDAY, Oct. 24 (HealthDay News) -- Human papillomavirus (HPV) infection in women, especially tumor-associated oncogenic HPV, is correlated with an increased risk of cardiovascular disease (CVD), according to a study published in the Nov. 1 issue of the Journal of the American College of Cardiology.
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Insomnia Moderately Raises Risk of Myocardial Infarction
MONDAY, Oct. 24 (HealthDay News) -- Insomnia symptoms are associated with a moderate increase in the risk of acute myocardial infarction (AMI), according to a study published online Oct. 24 in Circulation.
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LABA Use Ups Risk of Serious Asthma Events in Children
MONDAY, Oct. 24 (HealthDay News) -- The use of long acting β²-adrenergic receptor agonists (LABAs) in children increases the risk for an excess of serious asthma-related events, 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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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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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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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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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.
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.
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).
Cocaine Use Associated With Open-Angle Glaucoma
FRIDAY, Oct. 7 (HealthDay News) -- Use of cocaine is significantly associated with open-angle glaucoma, and the association remains significant in men after multivariable adjustment, according to a study published in the September issue of the Journal of Glaucoma.
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Adults With Mental Distress More Likely to Be Uninsured
FRIDAY, Oct. 7 (HealthDay News) -- Lack of insurance is more likely among nonelderly adults in the United States with frequent mental distress only or with both frequent mental and physical distress than in those with frequent physical distress only, according to a study published in the October issue of Psychiatric Services.
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Sports-Related Brain Injury Rates Climbing in Youths
THURSDAY, Oct. 6 (HealthDay News) -- The number of sports- and recreation-related, nonfatal traumatic brain injuries (TBIs) in children and adolescents has increased significantly in recent years, according to research published in the Oct. 7 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
Chemicals That Keep Pools Clean Can Cause Harm
THURSDAY, Oct. 6 (HealthDay News) -- An estimated 4,010 illnesses or injuries caused by exposure to pool chemicals happen every year; some or many of these could be avoided by adhering to established recommendations, according to research published in the Oct. 7 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
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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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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Psychotherapy Service Cuts Health Care Use, Sick Leave
THURSDAY, Oct. 6 (HealthDay News) -- Individuals with common mental health problems (CMHP) use more health care resources, and referral to the Improving Access to Psychological Therapies (IAPT) program reduces their number of emergency department visits and sick days, according to a study published online Oct. 3 in the Journal of Epidemiology & Community Health.
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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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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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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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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.
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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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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Same-Day Discharge Feasible in Select Cases of Elective PCI
TUESDAY, Oct. 4 (HealthDay News) -- For select low-risk older patients undergoing elective percutaneous coronary intervention (PCI), same-day discharge is not correlated with an increase in death or rehospitalization rates at two and 30 days, compared with overnight observation, according to a study published in the Oct. 5 issue of the Journal of the American Medical Association.
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High Children's Asthma Care Compliance in Peds Hospitals
TUESDAY, Oct. 4 (HealthDay News) -- For children admitted with asthma to pediatric hospitals, there are high levels of hospital compliance with Children's Asthma Care (CAC) quality measures for receiving asthma relievers (CAC-1) and systemic corticosteroids (CAC-2), and moderate compliance for discharge with a home-management care plan (CAC-3), according to a study published in the Oct. 5 issue of the Journal of the American Medical Association.
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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.
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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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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MRI Safe, Feasible in Some With Implanted Cardiac Devices
TUESDAY, Oct. 4 (HealthDay News) -- Magnetic resonance imaging (MRI) can be performed safely in certain patients with implanted cardiac devices by using a protocol based on device selection and programming, along with proper electrophysiologic back-up support, according to a study published in the Oct. 4 issue of the Annals of Internal Medicine.
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Poor Footwear Ups Impairment, Disability in Chronic Gout
MONDAY, Oct. 3 (HealthDay News) -- Use of poor footwear is common among patients with chronic gout, and is associated with foot-related disability and impairment, according to a study published online Oct. 3 in Arthritis Care & Research.
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