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July 2010 Briefing - Critical Care

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

Specialties See Modest Compensation Increases in '09

FRIDAY, July 30 (HealthDay News) -- Most medical specialties saw modest compensation increases in 2009, but many provider organizations are still operating at a substantial loss, according to the findings of the American Medical Group Association's (AMGA) 2010 Medical Group Compensation and Financial Survey.

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FDA: Daptomycin May Increase Eosinophilic Pneumonia Risk

FRIDAY, July 30 (HealthDay News) -- The U.S. Food and Drug Administration has requested that the manufacturer of daptomycin (Cubicin) add information to its drug label regarding a possible increased risk of eosinophilic pneumonia in patients receiving the drug.

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Two Studies Offer Support for Compression-Only CPR

WEDNESDAY, July 28 (HealthDay News) -- Instructions from emergency dispatchers to give cardiopulmonary resuscitation (CPR) with chest compressions only or compressions with rescue breathing are associated with similar survival rates, according to two studies published in the July 29 New England Journal of Medicine.

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Late Preterm Babies Still at Risk for Respiratory Morbidity

TUESDAY, July 27 (HealthDay News) -- Late preterm babies -- those born at 34 to 37 weeks' gestation -- are more likely than full-term babies to suffer respiratory distress syndrome and other respiratory morbidity, though the risk decreases with each additional week of gestation, according to research in the July 28 issue of the Journal of the American Medical Association.

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Alteplase Remains Safe Up to 4.5 Hours After Acute Stroke

TUESDAY, July 27 (HealthDay News) -- Extending the treatment window for administration of alteplase from three hours to 4.5 hours in patients who experience an acute ischemic stroke is safe and does not result in delayed treatment of patients, according to a study published online July 27 in The Lancet Neurology.

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Direct Trip to Intervention Center Improves STEMI Outcomes

FRIDAY, July 23 (HealthDay News) -- Pre-hospital triage of ST-segment elevation myocardial infarction (STEMI) with direct transport to an intervention center is associated with decreased symptom-to-balloon time and a lower mortality rate, according to research published in the July issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

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Heart Failure Emergency Care, Physician Skill Sets Explored

FRIDAY, July 23 (HealthDay News) -- The competencies required for physicians caring for heart failure and transplant patients and the need for research to better manage heart failure in emergency departments are explored in a pair of reports published in the July 27 issue of the Journal of the American College of Cardiology.

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Heart Failure Mortality Down Significantly in Veterans

FRIDAY, July 23 (HealthDay News) -- Although veterans with heart failure have presented with more comorbidities and have been rehospitalized more frequently in recent years, their 30-day mortality rates have decreased significantly, according to a study in the July 27 issue of the Journal of the American College of Cardiology.

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Patient-Centered Care Linked to Improved AMI Survival

THURSDAY, July 22 (HealthDay News) -- Patient-centered care (PCC) of patients hospitalized for an initial acute myocardial infarction (AMI) is associated with modestly improved survival over a one-year period, according to a study published online July 20 in Health Services Research.

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Study Examines Activity in Goodpasture's Disease

WEDNESDAY, July 21 (HealthDay News) -- New findings suggest that Goodpasture's disease -- which is marked by progressive glomerulonephritis and pulmonary hemorrhage -- may involve a so-called autoimmune "conformeropathy," according to research published in the July 22 issue of the New England Journal of Medicine.

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Birth Timing Not Tied to Low Birth Weight Infants' Outcomes

WEDNESDAY, July 21 (HealthDay News) -- Timing of birth in very low birth weight infants appears to have very little effect on the incidence of morbidity and mortality, according to a study published online July 19 in Pediatrics.

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Study Looks at Pediatric Pneumonia Complication Rates

TUESDAY, July 20 (HealthDay News) -- Rates of systemic complications associated with community-acquired pneumonia (CAP) fell only in children under the age of 1 following the introduction of heptavalent pneumococcal conjugate vaccine (PCV7) in 2000, but local complications related to CAP have increased among all pediatric age groups, according to research published online July 19 in Pediatrics.

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Post-Op, Sepsis More Common Than MI, Pulmonary Embolism

TUESDAY, July 20 (HealthDay News) -- The incidence of post-surgical sepsis is higher than the incidence of post-surgical myocardial infarction or pulmonary embolism, and risk factors for sepsis include older age, need for emergency surgery, and comorbidities, according to research published in the July issue of the Archives of Surgery.

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Post-Traumatic Epilepsy Can Occur Years After Brain Injury

MONDAY, July 19 (HealthDay News) -- Some soldiers who suffered penetrating head injuries (PHIs) in the Vietnam War developed post-traumatic epilepsy (PTE) more than 14 years after receiving their injuries, and the location, size, and type of lesion all predict PTE, according to the latest phase of the decades-long Vietnam Head Injury Study (VHIS) reported in the July 20 issue of Neurology.

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Stroke Risk Doubled One Hour After Drinking Alcohol

THURSDAY, July 15 (HealthDay News) -- The risk of stroke is more than doubled in the hour after ingestion of alcohol, according to the results of a study published online July 15 in Stroke.

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FDA Issues Requirements for Baxter Infusion Pump Recall

THURSDAY, July 15 (HealthDay News) -- The U.S. Food and Drug Administration has issued conditions for Baxter Healthcare Corporation to follow in performing its April 2010 recall of Colleague Volumetric Infusion Pumps (CVIPs), and the agency is requiring the company to provide refunds or replacement pumps for customers or terminate their leases.

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BMIPP Data Improve Acute Coronary Syndrome Diagnosis

THURSDAY, July 15 (HealthDay News) -- Use of β-methyl-p-[123I]-iodophenyl-pentadecanoic acid (BMIPP) data in addition to initially available information can help with the early diagnosis of acute coronary syndromes (ACS), according to research published in the July 20 issue of the Journal of the American College of Cardiology.

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Home, Hospital Antibiotics Offer Similar Results in Cystic Fibrosis

WEDNESDAY, July 14 (HealthDay News) -- Cystic fibrosis (CF) patients treated with intravenous antibiotics for respiratory exacerbations have similar lung function outcomes whether their therapy is administered at home or in the hospital, according to research published online June 25 in the American Journal of Respiratory and Critical Care Medicine.

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Pneumonia, Raised CRP Level Tied to Severe H1N1 Outcomes

TUESDAY, July 13 (HealthDay News) -- Pandemic H1N1 influenza infection often leads to hospitalization in previously healthy individuals, as well as people with underlying conditions, and an abnormal chest X-ray or an elevated C-reactive protein (CRP) level -- particularly in obese individuals or those with pulmonary conditions other than asthma or chronic obstructive pulmonary disease (COPD) -- is associated with a potentially serious outcome, according to research published in the July issue of Thorax.

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Hospital Care of Heart Attack Patients Has Improved

TUESDAY, July 13 (HealthDay News) -- Hospitals nationwide have improved their care of heart attack patients and are increasingly administering therapies -- such as percutaneous coronary intervention (PCI) -- in a timely manner, safely, and according to clinical guidelines, according to a new analysis of data from the American College of Cardiology's National Cardiovascular Data Registry published in the July 20 issue of the Journal of the American College of Cardiology.

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Diffusion-Weighted Imaging Superior for Stroke Diagnosis

MONDAY, July 12 (HealthDay News) -- Diffusion-weighted imaging (DWI) is accurate and appears to be more useful than noncontrast computed tomography (CT) for diagnosing acute ischemic stroke within 12 hours after symptoms appear; however, there is not enough evidence to support or refute the efficacy of perfusion-weighted imaging (PWI) in diagnosing acute ischemic stroke, according to an analysis published in the July 13 issue of Neurology.

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H1N1 Tied to Death, Serious Illness in Transplant Patients

FRIDAY, July 9 (HealthDay News) -- Influenza A H1N1 can cause substantial morbidity and mortality in solid organ transplant recipients; however, initiation of antiviral therapy within 48 hours of symptom development may decrease intensive care unit (ICU) admissions, according to a study published online July 9 in the The Lancet: Infectious Diseases.

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Heart Rate Measures May Predict Kidney Disease Risk

FRIDAY, July 9 (HealthDay News) -- High resting heart rate and low heart rate variability appear to be associated with increased risk of end-stage renal disease (ESRD) and hospitalization related to chronic kidney disease (CKD), according to a study published online July 8 in the Journal of the American Society of Nephrology.

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Sudden Cardiac Death May Affect Women's Mortality Less

FRIDAY, July 9 (HealthDay News) -- Women with dilated cardiomyopathy enrolled in primary prevention implantable cardioverter-defibrillator (ICD) trials have the same overall mortality as men but undergo significantly fewer appropriate ICD interventions, implying a smaller impact of sudden cardiac death on overall mortality in women, according to a systematic review and meta-analysis published in the July issue of Heart Rhythm.

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Improper Anesthesia Practice Causes Hepatitis Outbreak

FRIDAY, July 9 (HealthDay News) -- An anesthesiologist who reused a contaminated single-use propofol vial on multiple endoscopy patients caused an outbreak of hepatitis infection affecting 13 patients at two clinics, according to a report published in the July issue of Gastroenterology.

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Self-Identified Race May Lead to Misestimated Lung Function

WEDNESDAY, July 7 (HealthDay News) -- The use of predictive equations that depend on self-identified race alone may not correctly assess lung function in individuals who identify themselves as African-American, and including ancestry may improve lung-function estimates, according to research published online July 7 in the New England Journal of Medicine.

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Many Doctors in Specialties Other Than Their Early Choices

WEDNESDAY, July 7 (HealthDay News) -- Ten years after graduation, approximately one-fourth of doctors work in a specialty other than the one they chose in their third year post-graduation, according to research published online July 6 in BMJ.

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Weekend ICU Admission Linked to Higher Mortality Risk

WEDNESDAY, July 7 (HealthDay News) -- Patients admitted to hospital intensive care units (ICUs) on the weekends may have an increased mortality risk, but those admitted at night do not appear to have a higher mortality risk, according to research published in the July issue of Chest.

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Lung Transplantation Survival Varies Among Centers

TUESDAY, July 6 (HealthDay News) -- Survival following lung transplantation varies between transplantation centers, and the variation is only partially associated with volume of procedures, according to research published in the July 7 issue of the Journal of the American Medical Association.

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Biomass Smoke Is a Risk Factor for COPD

TUESDAY, July 6 (HealthDay News) -- Exposure to biomass smoke -- from wood and other forms of biomass, such as animal dung and crop residues -- is associated with an increased risk of developing chronic obstructive pulmonary disease (COPD), according to research published in the July issue of Chest.

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Out-of-Hospital CHD Mortality Higher in Young Men

FRIDAY, July 2 (HealthDay News) -- Young men have a higher rate of out-of-hospital coronary heart disease (CHD) mortality than young women, which could partly explain the fact that young women are more likely than young men to die when hospitalized for myocardial infarction (MI), according to research published in the July 1 issue of the American Journal of Cardiology.

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Early Stroke Complications Rob Patients of Healthy Years

THURSDAY, July 1 (HealthDay News) -- Early complications following ischemic stroke cost patients about two years' worth of optimal health, in addition to the loss of optimal health due to the stroke itself, and a higher number of complications is linked to a larger loss of healthy life-years, according to research published online July 1 in Stroke.

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Report Addresses Physician Financial Conflicts in Care

THURSDAY, July 1 (HealthDay News) -- In a new report, the Association of American Medical Colleges (AAMC) urges U.S. teaching hospitals to establish policies that ensure financial relationships between physicians and industry do not result in conflicts of interest that influence patient care.

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Half of Cirrhosis Patients With Ascites Have Renal Failure

THURSDAY, July 1 (HealthDay News) -- About half of all patients with cirrhosis will develop functional renal failure after the development of ascites, and renal failure in these patients is linked to worse prognosis, according to research published in the July issue of Clinical Gastroenterology and Hepatology.

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Continuous Flow Device Associated With Bleeding

THURSDAY, July 1 (HealthDay News) -- Patients who receive a commonly used axial flow pump, the HeartMate II (HM II), are at high risk for major bleeding during both long-term support and heart transplantation, possibly due to acquired von Willebrand syndrome, according to research published online June 30 in the Journal of the American College of Cardiology.

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