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Category: Emergency Medicine | Monthly Briefing

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January 2010 Briefing - Emergency Medicine

Last Updated: February 01, 2010.

 

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Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for January 2010. 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.

Imaging for Coronary Artery Disease Diagnosis Examined

FRIDAY, Jan. 29 (HealthDay News) -- Computed tomographic (CT) angiography and first-pass magnetic resonance (MR) myocardial perfusion imaging provide complementary capabilities; the first to detect or rule out coronary artery disease (CAD), and the second to detect any resulting myocardial ischemia, according to a study in the February issue of Radiology.

Abstract
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Rural and Urban Care Quality Compared for CAD

FRIDAY, Jan. 29 (HealthDay News) -- After adjustment for variables, hospital quality of care for coronary artery disease (CAD) in rural areas is on a par with care in urban areas, according to a study in the Jan. 15 issue of the American Journal of Cardiology.

Abstract
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More Patient Surveillance Needed to Reduce Nurse Errors

THURSDAY, Jan. 28 (HealthDay News) -- It is common for nurses to commit errors in the course of their work, and nurse educators are urged to improve training in strategies to improve patient surveillance, according to a study in the February issue of Applied Nursing Research.

Abstract
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Electrocardiogram Test for Long QT Syndrome Assessed

THURSDAY, Jan. 28 (HealthDay News) -- The response of the QT interval to a sudden heart rate acceleration as seen on an electrocardiogram (ECG) offers diagnostic information helpful in the challenging diagnosis of long QT syndrome (LQTS), according to a study published online Jan. 27 in the Journal of the American College of Cardiology.

Abstract
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Increased Medicare Copayments Affect Care Usage

WEDNESDAY, Jan. 27 (HealthDay News) -- In elderly patients, increasing copayments for ambulatory care may result in adverse health consequences and increased health care spending, according to a study in the Jan. 28 issue of the New England Journal of Medicine.

Abstract
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FDA Issues Recall of Nipro Medical's Infusion Needles

TUESDAY, Jan. 26 (HealthDay News) -- The U.S. Food and Drug Administration has issued a Class I recall of Exel/Exelint Huber needles, Exel/Exelint Huber Infusion Sets, and Exel/Exelint "Securetouch+" Safety Huber Infusion Sets, manufactured by Nipro Medical Corporation for Exelint International Corporation.

Press Release
FDA MedWatch Adverse Event Reporting

Insulin Syringe Recalled Because of Defective Needle

MONDAY, Jan. 25 (HealthDay News) -- According to a Jan. 21 press release issued by the U.S. Food and Drug Administration, the Nipro Medical Corporation has voluntarily recalled all of its GlucoPro Insulin Syringes because of a defect that may cause the needle to detach from the syringe, resulting in its being stuck in the insulin vial, pushed back into the syringe, or lodged in the patient's skin.

Safety Alert
Press Release
FDA MedWatch Adverse Event Reporting

Car Crash Trauma Often Under-Detected in Elderly

MONDAY, Jan. 25 (HealthDay News) -- Elderly people involved in motor vehicle crashes (MVCs) are often under-triaged and inappropriately treated for injuries that go undetected, according to a study in the January issue of the Journal of Emergency Nursing.

Abstract
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New Protocol Cuts Radiation Dose to Embolism Patients

MONDAY, Jan. 25 (HealthDay News) -- Implementing a new protocol for the judicious use of ventilation-perfusion (V/Q) scanning and computed tomography pulmonary angiography (CTPA) in patients with suspected pulmonary embolism reduced patient radiation exposure by 20 percent without increasing the false-negative rate, according to a study in the February issue of the American Journal of Roentgenology.

Abstract
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Risk of Youth Soccer Injuries Higher Than for Other Sports

MONDAY, Jan. 25 (HealthDay News) -- Youth soccer carries a higher risk of injury than many other contact sports, with injuries such as concussion and musculoskeletal trauma occurring fairly commonly, according to a report published online Jan. 25 in Pediatrics.

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Most Combat Zone Soldier Evacuations Not Battle Related

FRIDAY, Jan. 22 (HealthDay News) -- In Operation Iraqi Freedom and Operation Enduring Freedom, non-battle-related injuries and disease account for more medical evacuations of military personnel than combat injuries, according to a study in the Jan. 23 issue of The Lancet.

Abstract
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Comment (subscription or payment may be required)

Electrocardiogram in Field Can Benefit Heart Attack Response

FRIDAY, Jan. 22 (HealthDay News) -- Patients suspected of having a heart attack have a shorter door-to-balloon (D2B) time and are able to start reperfusion therapy faster if they have an electrocardiogram (ECG) taken in the field by emergency response personnel rather than in the hospital, according to a study in the Feb. 1 issue of Catheterization and Cardiovascular Interventions.

Abstract
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Palestinian Turmoil Linked to Domestic Abuse

FRIDAY, Jan. 22 (HealthDay News) -- In the occupied Palestinian territory, intimate-partner violence is strongly associated with exposure to political violence, according to a study in the Jan. 23 issue of The Lancet.

Abstract
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Disease Now Main Cause of Death in Darfur Conflict

FRIDAY, Jan. 22 (HealthDay News) -- Since 2005, disease has replaced violence as the leading cause of death in Darfur, especially among displaced populations, according to a study in the Jan. 23 issue of The Lancet.

Abstract
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Nurse Education Can Improve Elderly Pain Monitoring

THURSDAY, Jan. 21 (HealthDay News) -- Barriers to timely documentation must be addressed and specific training given if nurses are to adhere to best practice in reporting patients' pain levels before and after analgesic treatment, according to a study in the January issue of the Journal of Emergency Nursing.

Abstract
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Factors Help Predict Continued Opioid Use for Back Pain

THURSDAY, Jan. 21 (HealthDay News) -- Patients with chronic back pain are more likely to use opioid analgesics long term if they smoke and had non-surgical treatment, according to a study in the January issue of the Journal of Pain.

Abstract
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Nurses Often Deeply Affected by Workplace Errors

THURSDAY, Jan. 21 (HealthDay News) -- Nurses are deeply affected by errors they make in the intraoperative environment and need more guidance on what constitutes an error in order to encourage more open reporting, according to a study in the Jan. 10 issue of the AORN Journal.

Abstract
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Reducing Dietary Salt Could Substantially Impact Health

WEDNESDAY, Jan. 20 (HealthDay News) -- Even modest reductions in Americans' dietary salt could substantially reduce cardiovascular events, including death, myocardial infarction and stroke, and should be a public health goal, according to a study published online Jan. 20 in the New England Journal of Medicine.

Abstract
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Editorial

Tylenol Recall in Effect Includes Several Other Drugs

WEDNESDAY, Jan. 20 (HealthDay News) -- McNeil Consumer Healthcare has recently expanded its voluntary recall of some over-the-counter drugs to include about 500 lots of products, according to officials from the Office of Compliance in the Center for Drug Evaluation and Research at the U.S. Food and Drug Administration.

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Toddlers With Burns Should Also Be Checked for Fractures

WEDNESDAY, Jan. 20 (HealthDay News) -- Young children with burns suspected to have been caused by abuse should also be routinely evaluated for fractures, according to an analysis published online Jan. 18 in Pediatrics.

Abstract
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Researchers Call for Reform of Opioid Prescription Practices

TUESDAY, Jan. 19 (HealthDay News) -- In patients receiving higher doses of prescribed opioids for chronic pain, overdoses are common, suggesting a need to reform prescribing practices, according to a study in the Jan. 19 issue of the Annals of Internal Medicine.

Abstract
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Editorial (subscription or payment may be required)

Specialization Can Improve Outcomes After Surgery

MONDAY, Jan. 18 (HealthDay News) -- Patients who undergo emergency colorectal surgery have better outcomes if the surgeon is specialized in colorectal surgery, according to a study in the January issue of the Archives of Surgery.

Abstract
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Number of People Infected by H1N1 Reaches 55 Million

MONDAY, Jan. 18 (HealthDay News) -- On Jan. 15, federal officials reported that, from mid-April through mid-December, an estimated 55 million people in the United States were infected with H1N1 influenza, including approximately 11,200 who died.

CDC MMWR
H1N1 Estimates

MDCT Findings Linked to Outcomes Following Stenting

FRIDAY, Jan. 15 (HealthDay News) -- The use of multidetector computed tomography (MDCT) angiography to assess plaque in coronary lesions may help predict outcomes following stent implantation, according to research published in the January issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

Abstract
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Editorial

Antipsychotic Use in Elderly, Prescribing Rates Examined

FRIDAY, Jan. 15 (HealthDay News) -- Elderly patients newly admitted to nursing homes are more likely to be prescribed antipsychotics if the nursing home has a high prescribing rate for antipsychotics, according to a study in the Jan. 11 Archives of Internal Medicine. A related study determined that an FDA advisory on the use of atypical antipsychotics in elderly dementia patients resulted in decreased use.

Abstract - Chen
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Abstract - Dorsey
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Commentary (subscription or payment may be required)

Many Stroke Survivors Stop Taking Meds Within Two Years

FRIDAY, Jan. 15 (HealthDay News) -- Many Swedish stroke survivors stop taking preventive medications in the first two years after their stroke, pointing out the need for interventions to improve patient persistence and prevent future strokes, according to a study published online Jan. 14 in Stroke.

Abstract
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Study Links Caregiving Strains to Increased Stroke Risk

FRIDAY, Jan. 15 (HealthDay News) -- The strain of caring for a disabled spouse probably increases the risk of stroke, particularly among African-American men, according to a study published online Jan. 14 in Stroke.

Abstract
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Stroke Care on Weekends, Weekdays Compared

FRIDAY, Jan. 15 (HealthDay News) -- Despite the notion that hospital emergency care on weekends is less aggressive than weekday care, the use of tissue plasminogen activator for acute ischemic stroke (AIS) is higher on weekends than weekdays, according to a retrospective study of AIS care in Virginia published in the January issue of the Archives of Neurology.

Abstract
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Regional Systems Proposed for Emergency Cardiac Arrest Care

FRIDAY, Jan. 15 (HealthDay News) -- Regional systems incorporating emergency medical services and hospitals should be created to standardize care and improve outcomes for patients resuscitated after out-of-hospital cardiac arrest, according to a policy statement by the American Heart Association published online Jan. 14 in Circulation.

Abstract
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Ionizing Radiation May Increase Cardiovascular Risk

FRIDAY, Jan. 15 (HealthDay News) -- Exposure to ionizing radiation may be associated with an increased risk of cardiovascular disease, according to a study published online Jan. 14 in BMJ.

Abstract
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Editorial (subscription or payment may be required)

Spine Immobilization May Do More Harm Than Good

THURSDAY, Jan. 14 (HealthDay News) -- The odds of mortality for patients with penetrating trauma are doubled by the use of spine immobilization before transportation to hospital, according to a study in the January issue of the Journal of Trauma: Injury, Infection, and Critical Care.

Abstract
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Lengthy Army Deployments Affect Spouses' Mental Health

WEDNESDAY, Jan. 13 (HealthDay News) -- Wives of U.S. Army soldiers who have prolonged deployments to combat zones may have a higher risk of receiving a mental health diagnosis. In addition, injured soldiers who receive morphine during trauma care may have a lower risk of subsequently developing post-traumatic stress disorder (PTSD), according to two studies in the Jan. 14 issue of the New England Journal of Medicine.

Abstract - Mansfield
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Abstract - Holbrook
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Editorial

Study Confirms Steroid Efficacy for Sore Throat Pain

WEDNESDAY, Jan. 13 (HealthDay News) -- Steroids are an effective adjuvant treatment for relieving sore throat pain, according to a study in the January/February issue of the Annals of Family Medicine.

Abstract
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Platelet-Rich Plasma Injections May Not Help Tendinopathy

TUESDAY, Jan. 12 (HealthDay News) -- Compared to placebo, platelet-rich plasma (PRP) injections do not significantly improve pain and activity level in patients with chronic tendinopathy of the Achilles tendon, according to a study in the Jan. 13 issue of the Journal of the American Medical Association.

Abstract
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Biomedical Research Funding Shows Decline in 2008

TUESDAY, Jan. 12 (HealthDay News) -- After increasing since 1994, annual funding for biomedical research topped out at $90.2 billion in 2007 and began to decline in 2008, according to a study in the Jan. 13 issue of the Journal of the American Medical Association.

Abstract
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Editorial

Models Assess Effect of School Closures in Flu Pandemic

TUESDAY, Jan. 12 (HealthDay News) -- As an isolated approach, closing schools would have a limited effect on an influenza pandemic, but lengthy closures could forestall the peak of the epidemic and allow for other strategies such as vaccinations to be implemented, according to research published online Dec. 23 in the Journal of Public Health Management and Practice.

Abstract
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Right Restraint Use Key for Children's Car Safety

MONDAY, Jan. 11 (HealthDay News) -- There is a population-level benefit to interventions aimed at improving the rate of children's restraint use in cars, with promotion of age-appropriate restraints yielding the greatest benefits, according to a study published online Jan. 11 in Pediatrics.

Abstract
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Study Assesses Thrombi in Plaque Erosions, Ruptures

FRIDAY, Jan. 8 (HealthDay News) -- In victims of sudden coronary death, more thrombi in erosions showed later stages of healing than thrombi in ruptures, according to research published in the Jan. 12 issue of the Journal of the American College of Cardiology.

Abstract
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Editorial (subscription or payment may be required)

Drug-Eluting Stents Compared in Dutch Study

FRIDAY, Jan. 8 (HealthDay News) -- The everolimus-eluting stent performed better than the second-generation paclitaxel-eluting stent for safety and efficacy in patients undergoing percutaneous coronary intervention (PCI) in the COMPARE study, published online Jan. 8 in The Lancet.

Abstract
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Predictors of Middle-Age Lung Function Evaluated

FRIDAY, Jan. 8 (HealthDay News) -- Lung function in middle age is impacted by lifestyle factors, such as smoking, but also early childhood factors, such as low birth weight and respiratory infection, according to a study in the January issue of Chest.

Abstract
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Ipratropium Bromide for COPD May Up Cardiovascular Risks

FRIDAY, Jan. 8 (HealthDay News) -- The use of the short-acting anticholinergic ipratropium bromide for chronic obstructive pulmonary disease (COPD) within the past six months increases the risk of a cardiovascular event (CVE), while the long-acting anticholinergic bronchodilator tiotropium reduces mortality and cardiovascular events among patients with COPD, according to two studies in the January Chest.

Abstract - Ogale
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Abstract - Celli
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Editorial (subscription or payment may be required)

Readmissions After Cesarean Higher Than Vaginal Delivery

THURSDAY, Jan. 7 (HealthDay News) -- Hospital readmissions for women in the postpartum period are often due to infections, and women have a higher risk of readmission after cesarean than vaginal deliveries, according to research published in the January issue of the American Journal of Obstetrics & Gynecology.

Abstract
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Misoprostol Found Effective in Treating Post-Birth Bleeding

THURSDAY, Jan. 7 (HealthDay News) -- In women who develop excess bleeding after childbirth, treatment with sublingual misoprostol may be a viable alternative to treatment with intravenous oxytocin, according to two studies published online Jan. 7 in The Lancet.

Abstract - Winikoff
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Abstract - Blum
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Mouse Study Evaluates Role of Gdf5 Following Heart Damage

THURSDAY, Jan. 7 (HealthDay News) -- Growth differentiation factor 5 (Gdf5) -- also known as bone morphogenetic protein 14 -- appears to play a role in cardiac repair following myocardial infarction, according to research published in the Jan. 12 issue of the Journal of the American College of Cardiology.

Abstract
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Editorial (subscription or payment may be required)

Skin Preparations Decrease Risk of Surgical-Site Infections

WEDNESDAY, Jan. 6 (HealthDay News) -- Simple preoperative skin preparations may significantly reduce the risk of surgical-site infections, according to two studies in the Jan. 7 issue of the New England Journal of Medicine.

Abstract - Bode
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Abstract - Darouiche
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Editorial (subscription or payment may be required)

Cardiac Events Seen With β-Blockers, Surgical Anemia

TUESDAY, Jan. 5 (HealthDay News) -- Patients undergoing non-cardiac surgery who develop acute surgical anemia are more likely to have major cardiac complications and mortality if they receive perioperative β-blockers, according to research published in the January issue of Anesthesiology.

Full Text

Beside Exams May Trump CT Scanning After Brain Surgery

TUESDAY, Jan. 5 (HealthDay News) -- After patients undergo open brain surgery, a simple bedside examination may be more effective at identifying serious complications than routine computed tomography (CT) scanning, according to a study published online Dec. 18 in the Journal of Neurosurgery.

Full Text (subscription or payment may be required)

Early and Selective Invasive Heart Strategies Compared

MONDAY, Jan. 4 (HealthDay News) -- An early invasive revascularization strategy for patients who present with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) and elevated troponin T does not have any benefit over a selective invasive strategy that starts with medical stabilization in reducing death or myocardial infarction, according to a study published online Dec. 30 in the Journal of the American College of Cardiology.

Abstract
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Editorial (subscription or payment may be required)

Scans Identify Common Injuries After Earthquake

FRIDAY, Jan. 1 (HealthDay News) -- Multiple fractures and lung injuries were common in victims of a major earthquake in China who suffered crush thoracic trauma, according to research published in the January issue of Radiology.

Abstract
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