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Category: Emergency Medicine | Monthly Briefing

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December 2011 Briefing - Emergency Medicine

Last Updated: January 02, 2012.

 

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

Use of Propofol Saves Time Compared to Midazolam/Ketamine

FRIDAY, Dec. 30 (HealthDay News) -- Procedural sedation with propofol accelerates patient management in emergency departments, and saves time in comparison with midazolam/ketamine sedation, according to a study published in the Dec. 21 issue of The Journal of Bone & Joint Surgery.

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Oseltamivir-Resistant H1N1 Identified in Australia

THURSDAY, Dec. 29 (HealthDay News) -- Oseltamivir-resistant prepandemic seasonal influenza 1 (H1N1) viruses with a neuraminidase substitution (H275Y) (A[H1N1]pdm09) have been identified in Australia, according to a letter published in the Dec. 29 issue of the New England Journal of Medicine.

Letter

Irradiation of Left Breast Linked to Coronary Stenosis Risk

WEDNESDAY, Dec. 28 (HealthDay News) -- Women with irradiated left sided breast cancer (BC) have an increased risk of high-grade coronary artery stenosis in the mid and distal left anterior descending artery and distal diagonal (mdLAD + dD), according to a study published online Dec. 27 in the Journal of Clinical Oncology.

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Editorial

Serial Change in hsTnI or cTnI Accurately Rule In/Out AMI

TUESDAY, Dec. 27 (HealthDay News) -- For patients admitted with suspected acute coronary syndrome (ACS), use of highly sensitive troponin I (hsTnI) or contemporary troponin I (cTnI) assays on admission, and changes in their levels within three hours, can confirm the diagnosis of acute myocardial infarction (AMI), according to a study published in the Dec. 28 issue of the Journal of the American Medical Association.

Abstract
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Perceptions of Inappropriate Care Prevalent Among ICU Staff

TUESDAY, Dec. 27 (HealthDay News) -- Perceptions of inappropriate care are prevalent among intensive care unit (ICU) clinicians in Europe and Israel, according to a study published in the Dec. 28 issue of the Journal of the American Medical Association.

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Norway Shows Rise in Gastro-Oesophageal Reflux Symptoms

TUESDAY, Dec. 27 (HealthDay News) -- The prevalence of gastro-oesophageal reflux symptoms (GORS) in a Norwegian county increased substantially between 1995-7 and 2006-9, according to a study published online Dec. 21 in Gut.

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Coronary MRI Good Alternative to SPECT for CHD Diagnosis

MONDAY, Dec. 26 (HealthDay News) -- For patients with suspected coronary heart disease, a multiparametric cardiovascular magnetic resonance (CMR) protocol has better sensitivity and negative predictive value, and similar specificity as single-photon emission computed tomography (SPECT), according to a study published online Dec. 23 in The Lancet.

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No Complications From MRSA Otorrhea After Tube Placement

WEDNESDAY, Dec. 21 (HealthDay News) -- Ear infections caused by methicillin-resistant Staphylococcus aureus (MRSA) following ear tube placement in children are not associated with the need for additional surgical procedures or other complications, according to a study published in the December issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Majority of Practitioners in U.K. Advise Time Off for Back Pain

WEDNESDAY, Dec. 21 (HealthDay News) -- Despite guidelines for the clinical management of patients with low back pain (LBP) that encourage patients to stay active and return to work, the majority of practitioners advise patients to take a break from work to recover, according to a study published in the December issue of Pain.

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ADA Updates Standards of Care for Driving With Diabetes

WEDNESDAY, Dec. 21 (HealthDay News) -- For people with diabetes, the eligibility to receive a driver's license should be an individual decision, based on clinical evidence and appropriate consideration of potential safety risks, according to a position statement from the American Diabetes Association published in a supplement to the January issue of Diabetes Care.

Diabetes and Driving Position Statement
Standard of Care Position Statement

Trauma Quality Indicators Linked to Clinical Outcomes

WEDNESDAY, Dec. 21 (HealthDay News) -- Several of the American College of Surgeons Committee on Trauma (ACSCOT) quality indicators have significant associations with in-hospital mortality and the composite outcome of death or major complications, according to a study published online Dec. 19 in the Archives of Surgery.

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NCHS: Poisonings Are Leading Cause of Injury Deaths

WEDNESDAY, Dec. 21 (HealthDay News) -- From 1980 to 2008, the number of poisoning deaths increased almost six-fold, and became the leading cause of injury deaths (death attributable to a force external to the body), according to research published online Dec. 20 by the National Center for Health Statistics.

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Physician Opinions on Benefits of Open Visit Notes Vary

MONDAY, Dec. 19 (HealthDay News) -- Primary care physicians (PCPs) have varied opinions about open access to doctors' notes; and most users of a personal health record (PHR) system are interested in sharing access to their information, according to two studies published in the Dec. 20 issue of the Annals of Internal Medicine.

Abstract - Walker
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Abstract - Zulman
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Nearly One-Half of Short-Term PCI Deaths Occur Post-Discharge

MONDAY, Dec. 19 (HealthDay News) -- Nearly 40 percent of all post-percutaneous coronary intervention (PCI) short-term deaths occur after discharge and within 30 days of the procedure, according to a study published in the Jan. 1 issue of The American Journal of Cardiology.

Abstract
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Rule of 7's Sensitive in ID'ing Low Risk of Lyme Meningitis

MONDAY, Dec. 19 (HealthDay News) -- The "Rule of 7's," a Lyme meningitis clinical prediction rule based on clinical and laboratory parameters, identifies children with cerebrospinal fluid (CSF) pleocytosis who are at low risk for Lyme meningitis with high sensitivity, according to a study published online Dec. 19 in Pediatrics.

Abstract
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Suboptimal Intensive Statin Therapy Use After ACS

MONDAY, Dec. 19 (HealthDay News) -- Intensive statin therapy (IST) use during hospitalization is suboptimal following acute coronary syndrome (ACS), and there is poor persistence after discharge, according to a study published in the Jan. 1 issue of The American Journal of Cardiology.

Abstract
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Cumulative Prevalence of Arrest Up in U.S. Youth

MONDAY, Dec. 19 (HealthDay News) -- Since the 1960s, there has been a substantial increase in the cumulative prevalence of arrest among U.S. youth aged 8 to 23 years, according to a study published online Dec. 19 in Pediatrics.

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Laws Impact School Support for Anaphylaxis Management

MONDAY, Dec. 19 (HealthDay News) -- School boards in jurisdictions that legislate anaphylaxis policy make greater efforts to support students at risk for anaphylaxis compared with schools in nonlegislated environments, although significant gaps exist in both environments with respect to awareness of school anaphylaxis procedures and EpiPen administration technique, according to a study published in the January issue of Allergy.

Abstract
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AHA: U.S. Cardiovascular Disease Burden Still High

THURSDAY, Dec. 15 (HealthDay News) -- Despite a decrease in the rate of death attributable to cardiovascular disease and stroke, the burden of disease is still high, according to the American Heart Association's (AHA's) Heart Disease and Stroke Statistical Update 2012, published online Dec. 15 in Circulation.

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Statins Lower Death Risk in Adults Hospitalized With Flu

THURSDAY, Dec. 15 (HealthDay News) -- In adults hospitalized for influenza virus infections, administration of statins before or during the hospitalization is associated with a reduced risk of mortality, according to a study published online Dec. 13 in the Journal of Infectious Diseases.

Abstract
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Regional Rehospitalization Rate Tied to Overall Admissions

WEDNESDAY, Dec. 14 (HealthDay News) -- For patients with congestive heart failure or pneumonia, regional rates of rehospitalizations are substantially associated with overall admission rates at 30, 60, and 90 days, according to a study published in the Dec. 15 issue of the New England Journal of Medicine.

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Pediatric Football-Linked Risk Factors for Stroke Explored

WEDNESDAY, Dec. 14 (HealthDay News) -- Several factors, including repeated head or neurological injury and obesity, may contribute to the risk of stroke among young football players, according to a study published in the December issue of the Journal of Child Neurology.

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PCI Outcomes No Worse in Centers Without On-Site Surgery

TUESDAY, Dec. 13 (HealthDay News) -- Similar rates of in-hospital mortality and emergency coronary artery bypass grafting (CABG) surgery for percutaneous coronary intervention (PCI) are seen at centers with and without on-site surgery, according to a review published in the Dec. 14 issue of the Journal of the American Medical Association.

Abstract
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Editorial (subscription or payment may be required)

Infection Prevention Up in VA, Non-Federal Hospitals

TUESDAY, Dec. 13 (HealthDay News) -- From 2005 to 2009, there was a significant increase in the use of hospital-acquired infection (HAI) prevention practices in non-federal and Veterans Affairs (VA) hospitals, according to a study published online Dec. 6 in the Journal of General Internal Medicine.

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Khat Ups Adverse Outcomes in Acute Coronary Syndrome

MONDAY, Dec. 12 (HealthDay News) -- For patients with acute coronary syndrome, chewing khat is associated with an increased risk of recurrent ischemia, heart failure, stroke, and death, according to a study published in the Dec. 13 issue of Circulation.

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Intravenous Salbutamol Ups Mortality in Early ARDS

MONDAY, Dec. 12 (HealthDay News) -- For patients with acute respiratory distress syndrome (ARDS), treatment with intravenous salbutamol in the early course of disease is associated with a significant increase in 28-day mortality, according to a study published online Dec. 12 in The Lancet.

Abstract
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Dysfunctional Dynamics Seen in Pain Pathways in Migraine

MONDAY, Dec. 12 (HealthDay News) -- Patients with migraines have an interictal increase in resting state intrinsic connectivity between the periaqueductal gray matter (PAG) and both nociceptive and sensory processing pathways, according to a study published online Dec. 7 in the Annals of Neurology.

Abstract
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Meds Reduce Stroke Risk in Patients With Prehypertension

FRIDAY, Dec. 9 (HealthDay News) -- The administration of blood pressure-lowering medication to people in a prehypertensive range appears to significantly reduce their risk of stroke, according to research published online Dec. 8 in Stroke.

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Factors Affecting Micro-RNA Detection Accuracy Identified

FRIDAY, Dec. 9 (HealthDay News) -- Accurate detection and quantitation of circulating microRNAs (miRNAs) is affected by inherent differences in plasma samples, methods used for their collection and analysis, and the presence of specific inhibitors in plasma, according to a study published online Dec. 9 in the Journal of Molecular Diagnostics.

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Acute Kidney Injury Prevalent in Military Burn Casualties

FRIDAY, Dec. 9 (HealthDay News) -- Acute kidney injury (AKI) is prevalent among military casualties with a burn injury, and is independently associated with increased morbidity and mortality after multivariate adjustments, according to a study published online Dec. 8 in the Clinical Journal of the American Society of Nephrology.

Abstract
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Nephrology Referral Low Following Acute Kidney Injury

FRIDAY, Dec. 9 (HealthDay News) -- Following an acute kidney injury (AKI), most patients at risk for subsequent decline in kidney function are not referred to a kidney specialist, according to a study published online Dec. 8 in the Journal of the American Society of Nephrology.

Abstract
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Seasonal Flu Activity Low in the United States So Far

THURSDAY, Dec. 8 (HealthDay News) -- Reports of influenza virus in the Unites States have been low for the first part of the influenza season, according to a summary published in the Dec. 9 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Endurance Exercises Tied to Right Ventricular Dysfunction

THURSDAY, Dec. 8 (HealthDay News) -- Myocardial dysfunction following endurance exercises predominantly affects the right ventricle (RV), according to a study published online Dec. 6 in the European Heart Journal.

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Hong Kong Dust Storms Up Emergency COPD Admissions

THURSDAY, Dec. 8 (HealthDay News) -- There is a significant correlation between dust storms and chronic obstructive pulmonary disease (COPD)-related emergency hospital admissions two days later, according to a study published online Aug. 24 in Respirology.

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Pediatric Traumatic Brain Injury Linked to Headaches

WEDNESDAY, Dec. 7 (HealthDay News) -- Pediatric traumatic brain injury (TBI) is associated with increased prevalence of headaches three months after injury, which, in turn, are related to patient's age, gender, and severity of injury, according to a study published online Dec. 5 in Pediatrics.

Abstract
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Androgen Deprivation in Prostate Cancer Not Tied to CVD Death

TUESDAY, Dec. 6 (HealthDay News) -- Use of androgen deprivation therapy (ADT) is not associated with cardiovascular death, but is correlated with significantly lower prostate cancer-specific mortality (PCSM) and all-cause mortality, according to a review and meta-analysis published in the Dec. 7 issue of the Journal of the American Medical Association.

Abstract
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LV Dyssynchrony Has Prognostic Value After Acute MI

TUESDAY, Dec. 6 (HealthDay News) -- In patients admitted with ST-segment elevation acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI), left ventricular (LV) dyssynchrony is a strong predictor of long-term mortality and hospitalization for heart failure, over known clinical and echocardiographic risk factors, according to research published in the Dec. 15 issue of The American Journal of Cardiology.

Abstract
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Elevated BPs in Pediatric ERs Go Unrecognized

TUESDAY, Dec. 6 (HealthDay News) -- More than half of the patients under 18 years of age triaged in the emergency department may have elevated blood pressure (BP), with very few of these patients being recognized as having elevated BP, according to research published in the October issue of Pediatric Emergency Care.

Abstract
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1 in 5 Limb Fractures in Children Receive Delayed Care

TUESDAY, Dec. 6 (HealthDay News) -- Approximately one in five children with an accidental extremity fracture receive their first medical evaluation more than eight hours after the injury, according to a study published online Dec. 5 in Pediatrics.

Abstract
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Gender Impacts Chronic Pain Adjustment in Couples

TUESDAY, Dec. 6 (HealthDay News) -- Men, as patients with chronic pain or spouses of someone with chronic pain, appear to be more sensitive to their partner's validation or invalidation responses, and the context and timing of these responses have an impact, according to a study published in the November issue of The Journal of Pain.

Abstract
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Preventive Asthma Medication Use Increasing in Children

TUESDAY, Dec. 6 (HealthDay News) -- Use of preventive asthma medications (PAMs) among children with current asthma increased significantly from 1988 to 2008, but disparities persisted, with lower PAM usage reported among minority children, adolescents, and the uninsured, according to a study published online Dec. 5 in Pediatrics .

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Eating Little or No Fish Ups Young Women's CVD Risk

MONDAY, Dec. 5 (HealthDay News) -- Young and initially healthy women who consume little or no fish and long-chain n-3 polyunsaturated fatty acids (LCn3FAs) have an increased risk of cardiovascular disease, according to a study published online Dec. 5 in Hypertension.

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Medical Students Fail to ID Hand Hygiene Indications

MONDAY, Dec. 5 (HealthDay News) -- Medical students who are about to start the clinical phase of their education have a lack of knowledge regarding the correct indications for hand disinfection, according to a study published in the December issue of the American Journal of Infection Control.

Abstract
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C. difficile Infection Ups Duration of Hospital Stay

MONDAY, Dec. 5 (HealthDay News) -- Hospital-acquired infection with Clostridium difficile (C. difficile) significantly and independently lengthens the duration of stay in the hospital, according to a study published online Dec. 5 in CMAJ, the journal of the Canadian Medical Association.

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High Incidence of Adverse Upper GI Events in MI Patients

MONDAY, Dec. 5 (HealthDay News) -- Patients with ST-segment elevation myocardial infarction, who undergo primary percutaneous coronary intervention and receive routine dual-antiplatelet therapy, have a high incidence of short- and long-term major adverse upper gastrointestinal events (MAUGIEs), according to a study published in the Dec. 15 issue of The American Journal of Cardiology.

Abstract
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Youth Often Get Hypertension Rx From PCPs Who Treat Adults

MONDAY, Dec. 5 (HealthDay News) -- Nearly two-thirds of adolescents with primary hypertension who receive antihypertensive medication prescriptions get them from adult primary care physicians (PCPs), according to a study published online Dec. 5 in Pediatrics.

Abstract
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Quality of Life Up in Obese A-Fib Patients Post-Ablation

FRIDAY, Dec. 2 (HealthDay News) -- For obese patients with atrial fibrillation (AF), but not for their non-obese counterparts, quality of life (QoL) scores improve significantly following catheter ablation, according to a study published in the December issue of Heart Rhythm.

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Risk Factors Identified for Pregnancy-Associated Suicide

FRIDAY, Dec. 2 (HealthDay News) -- The presence of an existing mental health diagnosis, current depressed mood, substance use, and intimate partner problems are risk factors which influence pregnancy-associated suicide, according to a study published online Nov. 3 in General Hospital Psychiatry.

Abstract
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Time of Operation Not Linked to Postoperative Mortality

FRIDAY, Dec. 2 (HealthDay News) -- The timing of general surgery and the moon phase are not associated with 30-day mortality after surgery, according to a study published in the December issue of Anesthesia & Analgesia.

Abstract
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Diet High in Antioxidants Cuts Stroke Risk for Women

THURSDAY, Dec. 1 (HealthDay News) -- Following a diet with high total antioxidant capacity (TAC) is associated with reduced incidence of total stroke among women with no history of cardiovascular disease (CVD) and hemorrhagic stroke in those with a CVD history, according to a study published online Dec. 1 in Stroke.

Abstract
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Anticoagulant Self-Monitoring Safe Option for Suitable Patients

THURSDAY, Dec. 1 (HealthDay News) -- Self-monitoring and self-management of oral coagulation is associated with a significant reduction in thromboembolic events and is a safe option for suitable patients of all ages, according to a review published online Dec. 1 in The Lancet.

Abstract
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