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February 2012 Briefing - Critical Care

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

Care Protocol for Comatose Patients May Need Revision

WEDNESDAY, Feb. 29 (HealthDay News) -- Although neurological tests are highly reliable predictors of death in patients who remain in a coma following cardiopulmonary resuscitation (CPR), withdrawal-of-treatment decisions may need to be delayed for those who undergo mild hypothermia therapy, according to a Dutch study published in the February issue of the Annals of Neurology.

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Poor Asthma Control Prevalent in the United States

MONDAY, Feb. 27 (HealthDay News) -- Many patients with asthma who do not use controller medications have persistent disease, and among those patients who do use controller medications, few have well-controlled disease, according to a study published in the March issue of the Annals of Allergy, Asthma & Immunology.

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Combo of Diabetes, Depression Increases Post-MI Mortality

MONDAY, Feb. 27 (HealthDay News) -- Having both diabetes and depression significantly increases the risk of dying in the years following a heart attack, beyond the increased risk from either condition alone, according to a study published in the March issue of Diabetes Care.

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Body Clock Linked to Sudden Cardiac Death

FRIDAY, Feb. 24 (HealthDay News) -- A body clock-dependent protein is associated with variations in electrical stability in the heart, which may explain why people are at higher risk of sudden cardiac death in the morning, according to research published online Feb. 22 in Nature.

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Highest Diabetes Death Rates Seen in Trials Selecting for CKD

WEDNESDAY, Feb. 22 (HealthDay News) -- In type 2 diabetes patients selected for randomized controlled trials (RCTs), chronic kidney disease (CKD) is associated with the highest overall risk of mortality, according to a review published online Feb. 21 in the Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease.

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Skin Cancer Frequency in Chronic Leg Ulcers >10 Percent

WEDNESDAY, Feb. 22 (HealthDay News) -- Chronic leg ulcers (CLUs) that don't heal after three months of appropriate treatment have an overall skin cancer frequency of 10.4 percent, according to a study published online Feb. 20 in the Archives of Dermatology.

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External Cooling Improves Outcomes in Septic Shock

TUESDAY, Feb. 21 (HealthDay News) -- Use of external cooling to achieve fever control is safe for sedated patients in septic shock, and decreases vasopressor requirements and early mortality, according to a study published online Feb. 17 in the American Journal of Respiratory and Critical Care Medicine.

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Alcohol Dependence Significant Problem for U.S. Surgeons

TUESDAY, Feb. 21 (HealthDay News) -- A considerable number of U.S. surgeons have alcohol abuse and dependence, which is more likely in those who have recently reported major errors, are burned out, and are depressed, according to a study published in the February issue of the Archives of Surgery.

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CT Myelography More Accurately Detects CSF Leakage

MONDAY, Feb. 20 (HealthDay News) -- Cerebrospinal fluid (CSF) leakage may be detected more accurately in patients with spontaneous intracranial hypotension (SIH) using epidural collection on computed tomography myelography (CTM) rather than paraspinal radioisotope (RI) accumulation on radioisotope cisternography (RIC), according to a study published in the Feb. 15 issue of Spine.

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High Uric Acid Level Predictive of Adverse Cardiac Events

FRIDAY, Feb. 17 (HealthDay News) -- A high serum uric acid level is an independent predictor of in-hospital and long-term adverse cardiac events in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), according to research published in the Feb. 15 issue of The American Journal of Cardiology.

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MRI Alone Not Ideal in Pulmonary Embolism Diagnosis

FRIDAY, Feb. 17 (HealthDay News) -- Magnetic resonance imaging (MRI) should not be used as a stand-alone test to diagnose pulmonary embolism (PE), according to a study published online Feb. 9 in the Journal of Thrombosis and Haemostasis.

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Study Evaluates Clinical Value of Stroke Biomarkers

FRIDAY, Feb. 17 (HealthDay News) -- While 136 different stroke biomarkers have been identified, the clinical value of these biomarkers remains unclear, according to a study published online Feb. 9 in the British Journal of Clinical Pharmacology.

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Aphasia Increases Cost of Care After Ischemic Stroke

FRIDAY, Feb. 17 (HealthDay News) -- In ischemic stroke patients, aphasia is associated with greater morbidity, higher mortality, and increased length of stay, and adds $1,703 per patient to the cost of stroke-related care, according to research published online Feb. 16 in Stroke.

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Cardiac Stem Cell Infusion After Myocardial Infarction Safe

TUESDAY, Feb. 14 (HealthDay News) -- Intracoronary infusion of cardiosphere-derived cells (CDCs) after myocardial infarction (MI) is safe and improves cardiac function, according to a phase 1 study published online Feb. 14 in The Lancet.

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New Staging System IDs cSCC Risk in Transplant Patients

TUESDAY, Feb. 14 (HealthDay News) -- The newly updated seventh edition American Joint Committee on Cancer (AJCC) staging system accurately predicts the risk of recurrence of cutaneous squamous cell carcinoma (cSCC) in high-risk heart and lung transplant recipients, according to a study published online Jan. 30 in the Journal of the American Academy of Dermatology.

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Guidelines for VTE Prophylaxis in Nonsurgical Patients Issued

THURSDAY, Feb. 9 (HealthDay News) -- New evidence-based clinical practice guidelines have been issued for the prophylaxis of venous thromboembolism (VTE) in nonsurgical patients; the guidelines have been published in a supplement to the February issue of CHEST.

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Risk Factors Identified for Post NICU-Discharge Mortality

THURSDAY, Feb. 9 (HealthDay News) -- Premature babies with extremely low birth weight (ELBW) are at increased risk of dying following discharge from the neonatal intensive care unit (NICU) if they are African-American, lack health insurance, or had a long stay in the NICU, according to a study published online Feb. 9 in The Journal of Pediatrics.

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Reduced Caloric Nourishment Doesn't Reduce Ventilator Use

TUESDAY, Feb. 7 (HealthDay News) -- Providing lower amounts of nutritional support does not reduce ventilator-free days, risk of death at 60 days, or infectious complications for critically ill patients with acute lung injury compared to providing full caloric nourishment, according to a study published online Feb. 5 in the Journal of the American Medical Association.

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Noroviruses Are Leading Cause of Hospital Infections

MONDAY, Feb. 6 (HealthDay News) -- Norovirus outbreaks are the leading cause of infection outbreaks in hospitals, particularly in the non-acute care setting, and often lead to unit closure, according to an article published in the February issue of the American Journal of Infection Control.

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Live Liver Donation Doesn't Impact Long-Term Mortality

WEDNESDAY, Feb. 1 (HealthDay News) -- The risk of early death for live liver donors is 1.7 per 1,000 donors, and long-term mortality is similar to that of healthy individuals, according to a study published in the February issue of Gastroenterology.

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