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June 2008 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for June 2008. 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.

Pain Measurement Tools May Be Too Blunt for Infants

THURSDAY, June 26 (HealthDay News) -- Behavioral assessment may not give an accurate picture of pain in infants because they may process pain at the cortical level and not exhibit any behavioral changes, according to research published in the June issue of PLoS Medicine.

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Organ Transplants in Need of Up-Front Consent Policy

WEDNESDAY, June 25 (HealthDay News) -- The United Network for Organ Sharing (UNOS) should create a policy requiring potential organ transplant recipients to go through a comprehensive consent process that allows them to specify whether they'll accept or decline all non-standard organs, according to a Sounding Board feature in the June 26 issue of the New England Journal of Medicine.

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Cannabinoids Don't Alleviate Acute Nociceptive Pain

WEDNESDAY, June 25 (HealthDay News) -- Orally administered cannabis extract did not produce significant analgesic or anti-hyperalgesic effects in two well-established human pain models -- sunburn and intradermal capsaicin -- according to study findings published in the July issue of Anesthesiology.

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Anesthesia Types Used in Combat Injuries Compared

WEDNESDAY, June 25 (HealthDay News) -- Total intravenous anesthesia, often including ketamine, did not produce better outcomes than volatile gas anesthesia in patients who underwent neurosurgery for combat-related traumatic brain injury, according to a report in the July issue of Anesthesiology.

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Radio Frequency Identification May Be Hazardous

TUESDAY, June 24 (HealthDay News) -- Radio frequency identification can induce potentially hazardous electromagnetic interference in critical care medical equipment, according to research published in the June 25 issue of the Journal of the American Medical Association.

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Outcomes of Drug-Eluting Versus Bare-Metal Stent Analyzed

TUESDAY, June 24 (HealthDay News) -- The widespread use of drug-eluting stents has decreased the incidence of repeat revascularization but has not increased the risk of death or ST-elevation myocardial infarction compared to the use of bare-metal stents, according to a report published in the June 25 issue of the Journal of the American Medical Association.

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Mechanism Explains Toxicity of Late tPA After Stroke

MONDAY, June 23 (HealthDay News) -- A protein activated by tissue plasminogen activator (tPA) may explain why administering tPA more than three hours after a stroke can lead to hemorrhagic complications, according to the results of a study published online June 22 in Nature Medicine.

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Article Examines Use of 'Key Opinion Leaders' in Drug Sales

FRIDAY, June 20 (HealthDay News) -- Influential doctors known as "key opinion leaders" are paid generous fees to influence their peers to prescribe a company's drugs and may in fact be considered salespeople by the industry, according to an article in the June 21 issue of BMJ.

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Editorial - Buckwell
Editorial - Fava

Combination Asthma Therapy Compared with Steroids Alone

FRIDAY, June 20 (HealthDay News) -- Salmeterol plus inhaled corticosteroids may decrease the risk for severe exacerbations, but does not appear to lower the risk of hospitalization, asthma-related deaths or intubations compared with inhaled corticosteroids alone, according to a new meta-analysis published in the July issue of the Annals of Internal Medicine.

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Bosentan Beneficial in Pulmonary Arterial Hypertension

FRIDAY, June 20 (HealthDay News) -- Bosentan, a dual endothelin receptor antagonist, was associated with improvements in pulmonary vascular resistance in patients with mildly symptomatic pulmonary arterial hypertension, according to research published in the June 21 issue of The Lancet.

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Non-Adherence Raises Mortality Risk for Epilepsy Patients

THURSDAY, June 19 (HealthDay News) -- Epilepsy patients who regularly fail to take their anti-epileptic drugs have increased risks of mortality and serious clinical events, according to a study published online June 18 in Neurology.

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Blood Substitute Can Be Alternative to Transfusion

MONDAY, June 16 (HealthDay News) -- In the largest randomized controlled study to date of hemoglobin-based oxygen carrier (HBOC) use in elective orthopedic surgical patients, the majority of patients treated with HBOC-201 were able to safely avoid red blood cell transfusions, researchers report in the June issue of the Journal of Trauma: Injury, Infection, and Critical Care.

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Carbocisteine Linked to Fewer COPD Exacerbations

FRIDAY, June 13 (HealthDay News) -- The use of carbocisteine reduced the number of exacerbations in patients with chronic obstructive pulmonary disease (COPD) and improved their quality of life, according to research published in the June 14 issue of The Lancet.

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CT Lung Cancer Screenings Show Mixed Results

FRIDAY, June 13 (HealthDay News) -- In patients at high risk for lung cancer, regular helical computed tomographic screening may reduce long-term lung cancer-specific mortality. Because of other mortality risks associated with smoking, however, it may have a less significant effect on reducing overall mortality, according to research published in the July issue of Radiology.

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Aspergillosis Is Potentially Serious Hazard for Gardeners

FRIDAY, June 13 (HealthDay News) -- A 47-year-old U.K. man died of aspergillosis after exposure to aspergillis spores in decaying plant matter, which he inhaled during the course of working on his garden, according to a case report published in the June 14 issue of The Lancet.

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'Transplant Tourism' May Be Inappropriate Term

FRIDAY, June 13 (HealthDay News) -- When patients cross borders to receive organ transplants, there may be serious ethical, clinical, social and economic problems, which the term "transplant tourism" does not suggest, according to an article in the June 14 issue of BMJ.

Abstract - Turner
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Abstract - Noorani
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Smoking Needs Recognition as a Chronic Disorder

FRIDAY, June 13 (HealthDay News) -- Tobacco addiction must be recognized as a chronic disorder that may require long-term treatment, which will have more success when treatments are better matched with patients, according to an article published in the June 14 issue of The Lancet.

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Cardiac Device Implantation Overused in Very Ill Patients

THURSDAY, June 12 (HealthDay News) -- Advanced heart failure patients may be undergoing cardiac device implantation that does not help them and increases their risk of in-hospital mortality because they are too ill to benefit from the treatment, according to research published online June 3 in the American Heart Journal.

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Oxypurinol May Not Improve Heart Failure

THURSDAY, June 12 (HealthDay News) -- Treatment with oxypurinol didn't result in improvements in individuals with moderate to severe heart failure, although the underlying mechanism of oxypurinol may benefit patients with elevated serum uric acid, according to the results of a study published in the June 17 issue of the Journal of the American College of Cardiology.

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Once Daily Leukemia Drug Dose Effective, Less Toxic

THURSDAY, June 12 (HealthDay News) -- Dasatinib, a BCR-ABL inhibitor considerably more potent than imatinib, has similar efficacy but less toxicity at a dose of 100 mg once a day compared with the approved 70 mg twice a day in patients with chronic-phase chronic myelogenous leukemia who have failed imatinib treatment, according to study findings published online June 9 in the Journal of Clinical Oncology.

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Middle-Aged Smokers at Risk of Memory Loss

WEDNESDAY, June 11 (HealthDay News) -- Middle-aged smokers are at greater risk of poor memory, but studying the impact of smoking on cognition is hampered by the greater rate of loss to follow-up by death and non-participation in tests compared to non-smokers, according to study findings published in the June 9 issue of the Archives of Internal Medicine.

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CRP Has Poor Predictive Value for Later Heart Events

WEDNESDAY, June 11 (HealthDay News) -- C-reactive protein (CRP) measurement at three time points in patients with acute coronary syndromes was unable to predict a composite of death, non-fatal myocardial infarction and unstable angina at one year, according to research published in the June 17 issue of the Journal of the American College of Cardiology.

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A Third of In-Hospital Deaths After CABG Were Preventable

WEDNESDAY, June 11 (HealthDay News) -- Approximately one-third of in-hospital deaths following coronary artery bypass graft surgery (CABG) were preventable and occurred regardless of hospitals' low all-cause mortality rates, according to a report in the June 10 issue of Circulation: Journal of the American Heart Association.

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Cancer Costs Increasing Due to More Treatment

WEDNESDAY, June 11 (HealthDay News) -- The costs associated with treating cancer in the elderly have largely increased due to more patients receiving surgery and adjuvant treatment, and rising prices for these therapies, researchers report in the June 18 issue of the Journal of the National Cancer Institute.

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Electrical Dyssynchrony Studied in Heart Failure Patients

TUESDAY, June 10 (HealthDay News) -- Patients with reduced left ventricular ejection fraction who are hospitalized for worsening heart failure are likely to have a prolonged QRS duration, which is an independent risk factor for high rates of post-discharge morbidity and mortality, researchers report in the June 11 issue of the Journal of the American Medical Association.

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Peptide Level Points to Future Decompensated Heart Failure

TUESDAY, June 10 (HealthDay News) -- B-type natriuretic peptide (BNP) assessment six months after hospital discharge for decompensated heart failure identifies a long-term risk of future decompensation even in low-risk individuals with non-ischemic dilated cardiomyopathy, according to research published in the June 17 issue of the Journal of the American College of Cardiology.

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Infant Pertussis Outbreak Traced to Hospital Worker

TUESDAY, June 10 (HealthDay News) -- An outbreak of pertussis in the summer of 2004 in 11 infants born in a Texas hospital was linked to a health care worker at the hospital's newborn nursery with the illness, according to a report in the U.S. Centers for Disease Control and Prevention's June 6 issue of the Morbidity and Mortality Weekly Report.

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Hispanic Work-Related Deaths Higher Than U.S. Average

TUESDAY, June 10 (HealthDay News) -- The death rate due to work-related injuries was consistently higher for Hispanic workers than the general U.S. workforce from 1992 to 2006, according to a report in the U.S. Centers for Disease Control and Prevention's June 6 issue of the Morbidity and Mortality Weekly Report.

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Many Nurses Not Trained for Potential Bioterrorist Attack

MONDAY, June 9 (HealthDay News) -- Many perioperative nurses may feel unprepared for the challenges of a bioterrorism event, but a relatively brief self-study guide can help improve their sense of preparedness, according to research published in the May AORN Journal.

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Mild Hypothermia Can Reduce Post-Ischemic Injury

FRIDAY, June 6 (HealthDay News) -- Use of mild hypothermia following an ischemic injury appears to reduce permanent damage to tissue function if treatment is administered within hours of the event and, following treatment, the body is re-warmed slowly, researchers report in the June 7 issue of The Lancet.

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Fewer U.S. Physicians Training in Pediatric Neurosurgery

FRIDAY, June 6 (HealthDay News) -- Very few physicians are training and becoming certified in pediatric neurosurgery, suggesting an upcoming crisis in the workforce of this subspecialty that may put children at risk, according to a report in the June issue of the Journal of Neurosurgery: Pediatrics.

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Study Says ICU Patients' Death Risk Higher with Certain Doctors

THURSDAY, June 5 (HealthDay News) -- Critically ill patients in intensive care units (ICUs) in the United States are more likely to die if they receive care entirely from physicians trained in critical care medicine, even after taking illness severity into account, according to an article in the June 3 issue of Annals of Internal Medicine.

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Tuberculosis False Positive Rate High in U.S. Army

MONDAY, June 2 (HealthDay News) -- Outbreaks of tuberculin skin test conversions among U.S. Army personnel are likely to be false positives, and the personnel have a low risk of tuberculosis infection due to limited exposure to locals, researchers report in the June 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Prenatal Cigarette Smoke May Affect SIDS Risk

MONDAY, June 2 (HealthDay News) -- Rats prenatally exposed to cigarette smoke are more likely to have gasping breathing patterns after hypoxia and take longer to recover normal breathing after hypoxia at higher temperatures, investigators have found. The research suggests that prenatal exposure to cigarette smoke may affect the risk of sudden infant death syndrome (SIDS), according to a report in the June 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Adverse Events Lengthen Stays at Pediatric Hospitals

MONDAY, June 2 (HealthDay News) -- Adverse events experienced by hospitalized children may increase length of stay and costs, and pediatric-specific quality indicators are useful in calculating these effects, according to research published in the journal Pediatrics in June.

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Following Quake, China Responds to Medical Challenges

MONDAY, June 2 (HealthDay News) -- The massive earthquake in southwestern China on May 12 left more than 62,000 people dead, over 23,000 missing and an estimated 360,000 injured survivors, creating a multitude of medical challenges, according to an article in the May 31 issue of The Lancet.

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Physician's Briefing
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