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January 2011 Briefing - Critical Care

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

Heart Failure Patients in General Wards Have Worse Prognosis

THURSDAY, Jan. 27 (HealthDay News) -- Patients with heart failure who are admitted to general hospital wards are at an increased risk of mortality compared to those admitted to cardiology wards, according to a study published online Dec. 20 in Heart.

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Immune-Mediated Diseases May Up Thromboembolism Risk

THURSDAY, Jan. 27 (HealthDay News) -- People admitted to the hospital with immune-mediated diseases may have a higher risk of getting venous thromboembolism (VTE), according to research published online Jan. 10 in BMC Medicine.

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Electronic Health Records May Not Improve Care Quality

WEDNESDAY, Jan. 26 (HealthDay News) -- Electronic health records (EHRs) and clinical decision support (CDS) do not appear to improve the quality of clinical care, according to a study published online Jan. 24 in the Archives of Internal Medicine.

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Contrast-Stress Echocardiography Predicts Coronary Syndromes

WEDNESDAY, Jan. 26 (HealthDay News) -- Exercise-electrocardiogram testing may not accurately predict the risk of a cardiovascular event in patients with nondiagnostic electrocardiographic findings and normal 12-hour cardiac troponin levels, as compared to contrast-stress echocardiograms, according to a study published in the Jan. 15 issue of The American Journal of Cardiology.

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Stroke Center Admission Likely Improves Patient Outcomes

TUESDAY, Jan. 25 (HealthDay News) -- Admission of patients with acute ischemic stroke to a designated stroke center may lower mortality and improve use of thrombolytic therapy, and the occurrence of stroke among patients undergoing coronary artery bypass graft (CABG) surgery appears to be declining despite increases in patient risk profiles, according to two studies published online Jan. 25 in the Journal of the American Medical Association.

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Extra Implanted Defibrillator Shocks Raise Mortality

TUESDAY, Jan. 25 (HealthDay News) -- Inappropriate shocks by implantable cardioverter-defibrillators (ICDs) are associated with a higher mortality risk, according to a study published in the Feb. 1 issue of the Journal of the American College of Cardiology.

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Deep Brain Stimulation Lowers Blood Pressure

TUESDAY, Jan. 25 (HealthDay News) -- Deep brain stimulation (DBS) may offer a new strategy for treating refractory hypertension, according to findings described in a case report published in the Jan. 25 issue of Neurology.

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Vulnerable Populations Have Poor Access to Trauma Care

THURSDAY, Jan. 20 (HealthDay News) -- Difficult access to trauma care is not uncommon among specific segments of the U.S. population, and warfarin use in trauma patients has increased and is associated with a higher mortality risk, according to two articles published in the January issue of the Archives of Surgery.

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Pneumonia Guidelines May Need Adjustment

THURSDAY, Jan. 20 (HealthDay News) -- Mortality rates appear to be higher in intensive care patients at risk for multidrug-resistant (MDR) pneumonia who are treated by a protocol in compliance with current American Thoracic Society and Infectious Diseases Society of America guidelines, according to research published online Jan. 20 in The Lancet Infectious Diseases.

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Rise in Stroke Patients With Comorbid HIV

THURSDAY, Jan. 20 (HealthDay News) -- U.S. hospitals are treating significantly more stroke patients who have co-existing HIV infections, according to a study published online Jan. 19 in Neurology.

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Repeated Acetaminophen Can Cause Infant Liver Failure

TUESDAY, Jan. 18 (HealthDay News) -- Acetaminophen is generally considered child-safe, but repeated doses in infants can result in acute liver failure, according to a case report published online Jan. 17 in Pediatrics.

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FDA: Severe Liver Injury Tied to Dronedarone (Multaq)

MONDAY, Jan. 17 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care professionals and patients of the risk of acute liver failure associated with the heart medication dronedarone (Multaq).

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Metrics Proposed to Monitor Care at Stroke Centers

FRIDAY, Jan. 14 (HealthDay News) -- The American Heart Association has proposed a set of metrics intended to provide a framework for standard data collection at comprehensive stroke centers (CSCs). These metrics, published online Jan. 13 in Stroke, will help monitor quality of care in these centers and may lead to the development of national performance standards.

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CDC Report Highlights Important Health Disparities

THURSDAY, Jan. 13 (HealthDay News) -- Among Americans, disparities in income, race and ethnicity, gender, and other social attributes have an impact on whether an individual is healthy or ill or will die prematurely, according to a report by the U.S. Centers for Disease Control and Prevention, released as a supplement to the Jan. 14 issue of the Morbidity and Mortality Weekly Report.

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Organ Donors From Mortalities in Neonatal ICUs Identified

THURSDAY, Jan. 13 (HealthDay News) -- The identification of theoretically eligible infant donors in neonatal intensive care units (NICUs) is described in a study published in the January issue of The Journal of Pediatrics.

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Private Room ICU May Reduce Infection Acquisition

WEDNESDAY, Jan. 12 (HealthDay News) -- Patients in single-room intensive care units (ICUs) acquire fewer infectious organisms than those treated in multibed ICUs, according to research published in the Jan. 10 issue of the Archives of Internal Medicine.

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Corticosteroid Use May Shorten Children's Hospital Stays

TUESDAY, Jan. 11 (HealthDay News) -- The use of adjunct corticosteroids in children hospitalized with community-acquired pneumonia (CAP) is associated with shortened lengths of stay (LOS) in the hospital, especially those patients who receive concomitant β-agonist therapy, according to a study published online Jan. 10 in Pediatrics.

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Obesity Prevalent Among 2009 H1N1-Infected Californians

TUESDAY, Jan. 11 (HealthDay News) -- One-half of Californians ≥20 years of age hospitalized with 2009 H1N1 infection were obese, with extreme obesity associated with increased odds of death, according to a study published online Jan. 4 in Clinical Infectious Diseases.

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Statins May Be Inadvisable After Hemorrhagic Stroke

TUESDAY, Jan. 11 (HealthDay News) -- Statin use for primary or secondary prevention of cardiovascular events may be inadvisable in patients with a high risk of recurrent intracerebral hemorrhage (ICH), according to a study published online Jan. 10 in the Archives of Neurology.

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Latent Tuberculosis Therapy May Be Risky in the Elderly

MONDAY, Jan. 10 (HealthDay News) -- People over the age of 65 appear to be at significantly increased risk for serious adverse events requiring admittance to a hospital when receiving therapy for latent tuberculosis, according to research published online Jan. 10 in CMAJ, the journal of the Canadian Medical Association.

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Burnout Levels Particularly High in Residents

MONDAY, Jan. 10 (HealthDay News) -- The incidence of burnout and risk for burnout are high in physicians, particularly residents, and more than a quarter of anesthesiology chairs meet criteria for high burnout, according to two articles published in the January issue of Anesthesiology.

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New Guidelines for Treatment of Pulmonary Fungal Infections

MONDAY, Jan. 10 (HealthDay News) -- The American Thoracic Society has issued a new official clinical policy statement introducing new guidelines for treating fungal infections in adult pulmonary and critical care patients; the statement has been published in the Jan. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Prehospital Intravenous Fluids May Harm Trauma Patients

MONDAY, Jan. 10 (HealthDay News) -- Trauma patients receiving prehospital intravenous fluid have a higher mortality rate than those who do not, according to a study published online Dec. 20 in the Annals of Surgery.

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Fluoxetine May Improve Post-Stroke Motor Function

MONDAY, Jan. 10 (HealthDay News) -- Patients with moderate to severe motor deficit who are given the antidepressant fluoxetine shortly after suffering an ischemic stroke may experience improved motor function, according to research published online Jan. 10 in The Lancet Neurology.

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Fish-Oil Lipid Emulsion Lowers Retinopathy Risk

FRIDAY, Jan. 7 (HealthDay News) -- Administration of a fish-oil-based lipid emulsion in very-low-birth-weight infants may be useful for prophylaxis of severe retinopathy, according to a study published online Jan. 3 in Pediatrics.

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Invasive Strategy Can Reduce Mortality in Elderly With MI

THURSDAY, Jan. 6 (HealthDay News) -- Applying the invasive strategy of coronary angiography to older patients with acute myocardial infarctions (AMIs) complicated by cardiogenic shock reduces in-hospital and six-month mortality rates, according to research published in the January issue of The American Journal of Cardiology.

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