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Category: Emergency Medicine | Monthly Briefing

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April 2012 Briefing - Emergency Medicine

Last Updated: May 01, 2012.

 

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Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for April 2012. 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.

About Half of Teens Who Self-Harm Were Frequently Bullied

FRIDAY, April 27 (HealthDay News) -- About half of young adolescents who have self-harmed were frequently bullied, and self-harm among the bullied is more likely in those with mental health problems, a family history of suicide, or a history of being physically abused by an adult, according to a study published online April 26 in BMJ.

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Sleep of Short Duration Common in U.S. Workers

THURSDAY, April 26 (HealthDay News) -- A substantial proportion of workers in the United States get less sleep than recommended by the National Sleep Foundation, according to a report published in the April 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Hyperalgesia Similar With Drug Therapies for Heroin Addiction

THURSDAY, April 26 (HealthDay News) -- Heroin-addicted patients treated with methadone or buprenorphine have a heightened sensitivity to pain, and the hyperalgesia does not change over the course of treatment, according to a study published in the April issue of The Journal of Pain.

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Accelerated Aging Evident in Cocaine-Dependent Individuals

THURSDAY, April 26 (HealthDay News) -- The brains of individuals addicted to cocaine show accelerated loss of gray matter over and above the loss due to normal aging, according to a letter published online April 24 in Molecular Psychiatry.

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Early Menopause Ups Risk of Osteoporosis, Fractures, Death

THURSDAY, April 26 (HealthDay News) -- The occurrence of menopause before age 47 correlates with increased osteoporosis at age 77, increased incidence of fragility fractures, and increased mortality, according to a study published online April 25 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Warfarin Keeps Stroke Risk Low in Patients With A-Fib

WEDNESDAY, April 25 (HealthDay News) -- Use of warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (AF) is associated with a low risk of stroke or systemic embolism, according to a meta-analysis published in the April 23 issue of the Archives of Internal Medicine.

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Primary Enforcement Leads to Higher Teen Seat Belt Use

WEDNESDAY, April 25 (HealthDay News) -- Teen drivers and passengers in states with secondary safety belt enforcement laws are less likely to wear seat belts compared with teens in states with primary enforcement, according to a study published in the American Journal of Public Health.

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Low-Dose CT Noninferior for Diagnosing Appendicitis

WEDNESDAY, April 25 (HealthDay News) -- For young adults with suspected appendicitis, low-dose computed tomography (CT) is noninferior to standard-dose CT with respect to negative appendectomy rates, according to a study published in the April 26 issue of the New England Journal of Medicine.

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Ultrasound May Safely Rule Out DVT in Pregnancy

WEDNESDAY, April 25 (HealthDay News) -- For pregnant and postpartum women, a single complete compression ultrasonography may safely exclude a diagnosis of deep vein thrombosis, according to a study published online April 24 in BMJ.

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Mortality High for Cardiac Device Infective Endocarditis

TUESDAY, April 24 (HealthDay News) -- Patients with infective endocarditis involving implanted cardiac devices experience high in-hospital and one-year mortality rates, particularly if there is valve involvement, according to a study published in the April 25 issue of the Journal of the American Medical Association.

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Pathway Involved in Kidney Stone Formation Identified

TUESDAY, April 24 (HealthDay News) -- A gene previously linked to an increased risk of developing kidney stones is part of a calcium-sensitive pathway that regulates calcium absorption in the kidney, according to a study in the April 18 issue of The EMBO Journal.

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Gritti-Stokes Amputations Beneficial for Trauma Patients

MONDAY, April 23 (HealthDay News) -- The Gritti-Stokes amputation procedure is beneficial and appears to be safe for patients in a trauma setting, according to a study published in the April 4 issue of The Journal of Bone & Joint Surgery.

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S. Aureus, Enterotoxins ID'd in Atopic Keratoconjunctivitis

MONDAY, April 23 (HealthDay News) -- Staphylococcus aureus (S. aureus) and S. aureus-secreted enterotoxins (SE) are frequently found in patients with atopic keratoconjunctivitis (AKC), particularly in those with corneal ulceration, according to a study published online April 10 in Allergy.

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Reliability, Validity of Clinical Dehydration Scale Questioned

MONDAY, April 23 (HealthDay News) -- A previously derived clinical dehydration scale (CDS) is characterized by moderate interobserver reliability and weak links with objective measures of disease severity for children administered intravenous rehydration, according to a study published online April 23 in Pediatrics.

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Pulmonary HTN Predicts Heart Failure After Acute MI

THURSDAY, April 19 (HealthDay News) -- Pulmonary hypertension (PH) is a strong independent predictor of heart failure in patients with acute myocardial infarction (AMI), according to a study published in the May 1 issue of The American Journal of Cardiology.

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Use of PICU Beds for Non-Critical Care Found to Be Significant

THURSDAY, April 19 (HealthDay News) -- Pediatric intensive care unit (PICU) beds are used for critical care services the majority of the time, but even when new patients are waiting for floor beds, at least one PICU bed is usually in use for non-critical care services, according to a study published in the April issue of the Journal of Hospital Medicine.

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FDA: Clinicians Urged to Stop Using Certain Ultrasound Gel

WEDNESDAY, April 18 (HealthDay News) -- Hospitals, clinics, and health care professionals should immediately discontinue using Other-Sonic Generic Ultrasound Transmission Gel due to risk of bacterial contamination in certain batches, according to a safety communication issued April 18 by the U.S. Food & Drug Administration.

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Medicare Coverage Gap Leads to Drug Discontinuation

WEDNESDAY, April 18 (HealthDay News) -- Part D Medicare beneficiaries who do not have financial assistance during the coverage gap are at increased risk for cardiovascular drug discontinuation, according to research published online April 17 in Circulation: Cardiovascular Quality and Outcomes.

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For Major Trauma, Survival Up With Helicopter Transport

TUESDAY, April 17 (HealthDay News) -- For patients with major trauma who are admitted to level I or II trauma centers, those who are transported by helicopter have improved survival compared to those transported by ground emergency medical services, according to a study published in the April 18 issue of the Journal of the American Medical Association, a theme issue on comparative effectiveness research.

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Rate Down But Unintentional Injury Still Top Cause of Death

TUESDAY, April 17 (HealthDay News) -- Although the unintentional injury death rate has declined over the last decade, it is still the leading cause of death among children and adolescents in the United States, according to a study published in the April 16 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Alcohol Use With Opioids Common Even Without Abuse Past

MONDAY, April 16 (HealthDay News) -- Alcohol or sedative use during chronic opioid therapy (COT) for non-cancer pain puts patients at risk for adverse events such as respiratory depression or sedation, and the risk of concurrent use of central nervous system (CNS) depressants is not limited to patients with a history of substance abuse, according to a study published in the March issue of The Journal of Pain.

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'Choking Game' Linked to Other Risk Behaviors in Young Teens

MONDAY, April 16 (HealthDay News) -- About 6 percent of Oregon male and female eighth-graders participate in the "choking game," an activity in which children apply pressure to the neck to limit oxygen and blood flow in the hopes of experiencing a euphoric feeling once the pressure is released and blood and oxygen rush back to the brain; and participation in this activity is linked to other risk behaviors, according to research published online April 16 in Pediatrics.

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Mentholated Cigarettes Linked to Increased Stroke Risk

THURSDAY, April 12 (HealthDay News) -- Mentholated cigarettes are associated with a significantly increased risk of stroke, particularly among women and non-African-American smokers, according to a letter published in the April 9 issue of the Archives of Internal Medicine.

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For Obese, Deep Organs Receive Lower Doses of Radiation

WEDNESDAY, April 11 (HealthDay News) -- For obese individuals, organs deep within the abdomen may receive lower doses of radiation than the organs of normal-weight individuals, with the same scanner operating parameters, according to a study published online April 5 in Physics in Medicine and Biology.

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Mobile Stroke Units Halve Time to Treatment

WEDNESDAY, April 11 (HealthDay News) -- Diagnosis and treatment of stroke in patients at the scene of the emergency rather than at the hospital about halves the time to treatment, according to a study published online April 11 in The Lancet Neurology.

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Stroke Risk Much Higher If Sibling Has Had a Stroke

WEDNESDAY, April 11 (HealthDay News) -- Having a sibling who has had a stroke significantly increases the familial stroke risk by at least 60 percent, according to a study published online April 10 in Circulation: Cardiovascular Genetics.

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Decision Aid for Chest Pain in ER Engages Patients

TUESDAY, April 10 (HealthDay News) -- Use of a decision aid, a visual patient education tool, helps chest pain patients become more engaged in their care and results in fewer admissions for observation and stress testing, without negatively impacting care outcomes, according to a study published online April 10 in Circulation: Cardiovascular Quality and Outcomes.

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Increased Risk of Fatal Road Crashes on Tax Day in the U.S.

TUESDAY, April 10 (HealthDay News) -- There is a small, but significant, increase in fatal road crashes on tax day in the United States, according to a letter published in the April 11 issue of the Journal of the American Medical Association.

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Death Risk Similar With High-Dose Losartan, Candesartan

TUESDAY, April 10 (HealthDay News) -- For patients with heart failure, the use of high-dose losartan is not associated with an increased mortality risk compared with high-dose candesartan, according to a study published in the April 11 issue of the Journal of the American Medical Association.

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ECG Abnormalities Add to Accuracy of CHD Risk Prediction

TUESDAY, April 10 (HealthDay News) -- Major and minor electrocardiographic (ECG) abnormalities are associated with an increased risk of coronary heart disease (CHD) events, particularly in elderly individuals, according to a study published in the April 11 issue of the Journal of the American Medical Association.

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Radiation Exposure High for Patients With GI Disorders

TUESDAY, April 10 (HealthDay News) -- Patients with inflammatory bowel disorders and other organic and functional gastrointestinal (GI) disorders are exposed to high levels of annual and cumulative diagnostic radiation, according to a study published in the March issue of Clinical Gastroenterology and Hepatology.

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Infection May Be Trigger for Venous Thromboembolism

MONDAY, April 9 (HealthDay News) -- Older adults recovering from an infection are at increased risk of being hospitalized for a venous thromboembolism (VTE), according to a study published online April 3 in Circulation.

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Report Highlights Child Deaths From Post-Surgery Codeine Use

MONDAY, April 9 (HealthDay News) -- Researchers have identified three previously unreported instances of severe opioid-induced toxicity in children following adenotonsillectomy for obstructive sleep apnea syndrome, according to a case report published online April 9 in Pediatrics.

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Wire Grill Brush Bristles Pose Unexpected Danger

FRIDAY, April 6 (HealthDay News) -- For patients presenting with odynophagia or abdominal pain, physicians should consider the possibility of inadvertent wire brush bristle ingestion after eating grilled meat, according to a report published in the April issue of the American Journal of Roentgenology.

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Treating Hepatic Encephalopathy Reduces Costs Due to MVAs

FRIDAY, April 6 (HealthDay News) -- For patients with minimal hepatic encephalopathy (MHE), diagnosis and treatment with lactulose reduces costs associated with motor vehicle accidents (MVAs), according to a study published in the April issue of Hepatology.

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Early Exposure to Interpersonal Trauma Harms Cognition

FRIDAY, April 6 (HealthDay News) -- Exposure to interpersonal trauma (IPT) in the first years of life is associated with decreased cognitive functioning in childhood, with exposure in the first two years particularly harmful, according to a study published online April 4 in the Journal of Epidemiology & Community Health.

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Antibiotics Safe and Effective to Treat Appendicitis

FRIDAY, April 6 (HealthDay News) -- Although surgery is standard practice for treating appendicitis, uncomplicated acute appendicitis can be safely and effectively treated with antibiotics, according to a meta-analysis published online April 5 in BMJ.

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Medical Malpractice Claims Incur Substantial Defense Costs

WEDNESDAY, April 4 (HealthDay News) -- Defense costs for medical malpractice claims vary among specialties and are higher for claims that result in indemnity payments, according to a letter published in the April 5 issue of the New England Journal of Medicine.

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Alcohol, Drug Use Prevalent Among U.S. Adolescents

WEDNESDAY, April 4 (HealthDay News) -- Alcohol and drug use is prevalent among teens, with the median age of alcohol and drug abuse occurring during adolescence, according to a study published in the April issue of the Archives of General Psychiatry.

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Antibiotic-Resistant S. aureus Found in Many Ambulances

WEDNESDAY, April 4 (HealthDay News) -- Antibiotic-resistant strains of Staphylococcus aureus (S. aureus) are found in the majority of advanced life support (ALS) ambulances in the Chicago area, according to a study published in the April issue of the American Journal of Infection Control.

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Fluoroquinolone Use Linked to Retinal Detachment

TUESDAY, April 3 (HealthDay News) -- The use of the oral fluoroquinolone antibiotics is associated with an increased risk of retinal detachment, although the absolute risk is small, according to a study published in the April 4 issue of the Journal of the American Medical Association.

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Guidelines Improve Outcomes in Nonshockable Cardiac Arrest

MONDAY, April 2 (HealthDay News) -- Implementation of the latest American Heart Association (AHA) resuscitation guidelines, which eliminate "stacked" shocks and emphasize chest compressions, results in significantly improved outcomes for patients experiencing nonshockable out-of-hospital cardiac arrest (OHCA), according to a study published online April 2 in Circulation.

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Serious Eye Disease Linked to Bisphosphonate Use

MONDAY, April 2 (HealthDay News) -- First-time users of oral bisphosphonates have an increased risk of both uveitis and scleritis compared with nonusers, according to a study published online April 2 in CMAJ, the journal of the Canadian Medical Association.

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Operator Sleep Deprivation Does Not Adversely Affect PCI

MONDAY, April 2 (HealthDay News) -- Percutaneous coronary intervention (PCI) performed in the middle of the night does not impact the same operator's ability to perform PCI the next day, according to a study published online March 30 in Catheterization and Cardiovascular Interventions.

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Malodorous Urine Often Reported for Infants With UTI

MONDAY, April 2 (HealthDay News) -- Parental reports of malodorous urine increase the likelihood of a diagnosis of a urinary tract infection (UTI) in young children being evaluated for a suspected infection, according to a study published online April 2 in Pediatrics.

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