Here are what the editors at HealthDay consider to be the most important developments in Critical Care for June 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.
Biomarker Aids in Heart Attack Risk Stratification
WEDNESDAY, June 30 (HealthDay News) -- Mid-regional pro-adrenomedullin (sAM) levels can predict mortality or heart failure in non-ST-elevation myocardial infarction (NSTEMI) patients, complementing other risk stratification tools, according to a study published in the July 6 issue of the Journal of the American College of Cardiology.
Abstract
Full Text (subscription or payment may be required)
Lower CYP2C19 Function Plus Clopidogrel May Cause Harm
TUESDAY, June 29 (HealthDay News) -- Patients treated with clopidogrel who are carriers of the loss-of-function CYP2C19*2 allele may be at increased risk for cardiovascular events and death, according to research published in the July 6 issue of the Journal of the American College of Cardiology.
Abstract
Full Text (subscription or payment may be required)
Diagnostic Adverse Events Usually Due to Human Failure
TUESDAY, June 29 (HealthDay News) -- Diagnostic adverse events (DAEs) are most often caused by human error, and their consequences are more severe than those of other types of adverse events, according to research published in the June 28 issue of the Archives of Internal Medicine.
Abstract
Full Text (subscription or payment may be required)
Invited Commentary (subscription or payment may be required)
End-of-Life Hospital Care Has Room for Improvement
TUESDAY, June 29 (HealthDay News) -- In U.S. hospitals, the care of patients at end of life nearly always includes close attention to pain management and efforts to ease breathing, but there are other areas of care that need improvement, according to research published in the June 28 issue of the Archives of Internal Medicine.
Abstract
Full Text (subscription or payment may be required)
Doctors Agree Malpractice Fears Drive Overuse of Tests
MONDAY, June 28 (HealthDay News) -- A large majority of physicians agree that the practice of defensive medicine -- stemming from malpractice concerns -- is responsible for an overuse of medical tests and procedures, according to a research letter in the June 28 issue of the Archives of Internal Medicine.
Abstract
Full Text (subscription or payment may be required)
Venous Thromboembolism Risk Factors Vary by Race
MONDAY, June 28 (HealthDay News) -- Black Americans with venous thromboembolism (VTE) are less likely to have commonly recognized transient risk factors for the condition, are more likely to have cardiovascular disease risk factors, and are more likely to progress to pulmonary embolism than are white Americans, according to research published in the July issue of the American Journal of Hematology.
Abstract
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Moldy Homes Linked to Higher Risk of Severe Asthma Attacks
FRIDAY, June 25 (HealthDay News) -- High mold exposure in the home may lead to an increased risk of severe asthma attacks among children with variants in the chitinase gene CHIT1, according to research published online June 10 in the American Journal of Respiratory and Critical Care Medicine.
Abstract
Full Text (subscription or payment may be required)
Diabetes May Complicate COPD Hospital Admissions
THURSDAY, June 24 (HealthDay News) -- Patients admitted to the hospital with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who have comorbid diabetes mellitus (DM) have trends toward longer hospital length of stay and an increased risk of death compared with those without DM, according to research published online June 4 in Respirology.
Abstract
Full Text (subscription or payment may be required)
Early Shunting Controls Bleeding in Cirrhotic Patients
WEDNESDAY, June 23 (HealthDay News) -- Typically reserved as a rescue therapy, the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) soon after hospital admittance for acute variceal bleeding in cirrhosis patients may reduce the likelihood of treatment failure and death, according to research published in the June 24 issue of the New England Journal of Medicine.
Abstract
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Racial Disparities in Sepsis Explained by Two Factors
TUESDAY, June 22 (HealthDay News) -- Racial differences in sepsis rates are due to higher infection rates as well as a higher risk of organ dysfunction among black patients compared with white patients, according to research published in the June 23/30 issue of the Journal of the American Medical Association.
Abstract
Full Text (subscription or payment may be required)
Brain Hemorrhage Diagnosis Delay Rare in Children
MONDAY, June 21 (HealthDay News) -- In children with uncomplicated minor head injuries, delayed diagnosis of intracranial hemorrhage is rare, according to research published online June 21 in Pediatrics.
Abstract
Full Text (subscription or payment may be required)
Rescue Antenatal Steroids Beneficial for Preterm Infants
MONDAY, June 21 (HealthDay News) -- If it has been at least 14 days since an initial dose of antenatal steroids, an additional course of rescue antenatal steroids administered to pregnant women at continued risk of premature delivery can improve their infants' postnatal respiratory function, according to research published in the June issue of the American Journal of Obstetrics & Gynecology.
Abstract
Full Text
Hepatic Encephalopathy Linked to Chronic Cognitive Effects
FRIDAY, June 18 (HealthDay News) -- Among patients with cirrhosis, episodes of overt hepatic encephalopathy (OHE) may be associated with lingering and cumulative problems with learning, working memory, and response inhibition, according to research published in the June issue of Gastroenterology.
Abstract
Full Text (subscription or payment may be required)
10 Risk Factors Associated With Most of Stroke Risk
FRIDAY, June 18 (HealthDay News) -- Worldwide, 10 risk factors are associated with 90 percent of the risk for stroke, suggesting that interventions targeting these particular factors could greatly reduce the stroke burden, according to a study published online June 18 in The Lancet.
Abstract
Full Text (subscription or payment may be required)
Comment (subscription or payment may be required)
Computed Tomography Angiography May Be Avoidable
WEDNESDAY, June 16 (HealthDay News) -- The risk of a computed tomography (CT) angiogram being positive for pulmonary embolism (PE) is unlikely among patients who do not present with thromboembolic risk factors, suggesting that CT angiography is unnecessary in many patients, according to research published online June 15 in Radiology.
Abstract
Full Text (subscription or payment may be required)
MRSA Linked to Higher Mortality in Cystic Fibrosis
TUESDAY, June 15 (HealthDay News) -- Cystic fibrosis (CF) patients with methicillin-resistant Staphylococcus aureus (MRSA) infection have worse survival rates than CF patients without the infection, according to a study in the June 16 issue of the Journal of the American Medical Association.
Abstract
Full Text (subscription or payment may be required)
In COPD, Oral, Intravenous Steroids Bring Same Outcomes
TUESDAY, June 15 (HealthDay News) -- Patients with chronic obstructive pulmonary disease (COPD) exacerbations treated with low-dose oral corticosteroids have outcomes similar to those treated with more costly and invasive high-dose intravenous corticosteroid therapy, according to research published in the June 16 issue of the Journal of the American Medical Association.
Abstract
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Tranexamic Acid Reduces Mortality in Trauma Patients
TUESDAY, June 15 (HealthDay News) -- Tranexamic acid may be an effective option for reducing bleeding and mortality among trauma patients, without increasing the risk of serious complications such as myocardial infarction, stroke, or pulmonary embolism, according to a study published online June 15 in The Lancet.
Full Text
Comment
Incidental Findings Frequently Seen in Pediatric Brain Imaging
MONDAY, June 14 (HealthDay News) -- Nearly 7 percent of children involved in a magnetic resonance imaging (MRI) study had incidental intracranial findings, calling attention to issues related to counseling families when such findings arise in clinical situations, according to research published online June 14 in Pediatrics.
Abstract
Full Text (subscription or payment may be required)
Private Insurance Linked to Lower Hospital Mortality
FRIDAY, June 11 (HealthDay News) -- Patients with private insurance who are hospitalized for acute myocardial infarction (AMI), stroke or pneumonia have significantly lower in-hospital mortality than patients who are uninsured or have Medicaid, according to research published online June 10 in the Journal of Hospital Medicine.
Abstract
Full Text (subscription or payment may be required)
Hospira Expands Propofol and Lipsoyn Recall
FRIDAY, June 11 (HealthDay News) -- Hospira has alerted health care providers that it is expanding its March 31 recall of Propofol Injectable Emulsion 1 percent and Liposyn (Intravenous Fat Emulsion) products that include Liposyn II 10 percent, Liposyn II 20 percent, Liposyn III 10 percent, Liposyn III 20 percent, and Liposyn III 30 percent, as some of the containers may contain sub-visible inert stainless steel particles.
More Information
Suppressed Anger in CAD Linked to Adverse Cardiac Events
THURSDAY, June 10 (HealthDay News) -- In patients with coronary artery disease (CAD), suppressing anger is associated with a higher risk of adverse cardiac events, according to research published in the June 1 issue of the American Journal of Cardiology.
Abstract
Full Text
No Increased Mortality Seen With Ultrasound Contrast Agent
THURSDAY, June 10 (HealthDay News) -- There is no increased mortality risk for critically ill patients who undergo echocardiography with an ultrasound contrast agent (UCA), compared to those who do not have contrast during their echocardiogram, according to research published in the June issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.
Abstract
Full Text (subscription or payment may be required)
FDA: Defibtech's DBP-2800 Battery Packs Recalled
THURSDAY, June 10 (HealthDay News) -- Defibtech has alerted customers of a voluntary recall of 5,418 DBP-2800 Battery Packs used in the Lifeline Automatic External Defibrillator (AED) and ReviveR AED, as these AEDs may incorrectly recognize an error condition during charging for a shock and discontinue the charge, not providing therapy when the defected battery packs are used.
www.defibtech.com
FDA's MedWatch Adverse Event Reporting Program
More Information
Long-Term Acute Care Hospital Utilization Increasing
TUESDAY, June 8 (HealthDay News) -- Hospitalizing patients in long-term acute care hospitals after critical illness is an expensive but increasingly utilized option, according to research published in the June 9 issue of the Journal of the American Medical Association.
Abstract
Full Text (subscription or payment may be required)
Fatal Medication Errors Rise in July at Teaching Hospitals
TUESDAY, June 8 (HealthDay News) -- In July there is a significant increase in fatal medication errors at medical institutions, and this spike is at least partly due to the arrival of new medical residents, according to a study published online May 29 in the Journal of General Internal Medicine.
Abstract
Full Text
Many Adults With Pediatric Disorders Use Pediatric ERs
TUESDAY, June 8 (HealthDay News) -- Many adult patients with chronic pediatric disorders, known as transition patients, use pediatric emergency departments -- often for complaints unrelated to their pediatric disorders -- and these patients have high rates of intensive care unit and hospital admissions, according to a study in the June issue of the Archives of Pediatrics & Adolescent Medicine.
Abstract
Full Text (subscription or payment may be required)
Revised, Evidence-Based Brain Death Guideline Issued
MONDAY, June 7 (HealthDay News) -- A new guideline for determining brain death has been issued by the American Academy of Neurology, updating the 1995 version and including a checklist to provide doctors with clarity and direction. The guideline has been published in the June 8 issue of Neurology.
Abstract
Full Text (subscription or payment may be required)
Many Hospital Patients Readmitted Within Two Years
MONDAY, June 7 (HealthDay News) -- Approximately 25 percent of hospital patients were readmitted to the hospital within a two-year period for the same conditions that prompted their initial admission, according to a recent report from the Agency for Healthcare Research and Quality (AHRQ).
Full Text
Non-Married at Greater Risk of Hospitalization for Sepsis
FRIDAY, June 4 (HealthDay News) -- Single, separated, and widowed adults have a higher risk of hospitalization for sepsis than do their married peers, and some face higher mortality rates as well, according to research published in the June issue of Chest.
Abstract
Full Text (subscription or payment may be required)
Smoking History, Not Symptoms, Predictive of COPD
FRIDAY, June 4 (HealthDay News) -- Even though about half of all cases of chronic obstructive pulmonary disease (COPD) are undiagnosed, selecting symptomatic people for spirometric screening adds little to the strategy of screening older smokers, according to research published in the June issue of Chest.
Abstract
Full Text (subscription or payment may be required)
Many Ischemic Stroke Patients Arrive at ER Within Hour
FRIDAY, June 4 (HealthDay News) -- A substantial portion of ischemic stroke patients present to emergency departments within an hour of onset, and they are more likely to receive thrombolytic therapy than those who arrive later, but both factors present room for improvement, according to research published online June 3 in Stroke.
Abstract
Full Text (subscription or payment may be required)
Low HDL Predicts Development of Abdominal Aortic Aneurysm
FRIDAY, June 4 (HealthDay News) -- There appears to be a consistent association between low levels of high-density lipoprotein (HDL) and the presence of abdominal aortic aneurysms (AAAs) in men aged 65 years or older, according to research published in the May 15 issue of the American Journal of Cardiology.
Abstract
Full Text (subscription or payment may be required)
Early Heparin Beneficial in Pulmonary Embolism
THURSDAY, June 3 (HealthDay News) -- For patients with acute pulmonary embolism (PE), starting heparin early, while the patient is still in the emergency department, is associated with decreased mortality, according to research published in the June issue of Chest.
Abstract
Full Text (subscription or payment may be required)
Stroke Patients Benefit From Early Lipid-Lowering Therapy
THURSDAY, June 3 (HealthDay News) -- Early initiation of lipid-lowering therapy (LLT) during hospitalization for ischemic stroke or transient ischemic attack correlates with improved clinical outcomes, according to research published in the May 15 issue of the American Journal of Cardiology.
Abstract
Full Text (subscription or payment may be required)
Risk Score Predicts Bleeding in Acute Coronary Syndromes
WEDNESDAY, June 2 (HealthDay News) -- Researchers have developed and tested a practical risk score designed to predict the risk and implications of major bleeding in acute coronary syndromes (ACS), and have found it effective for identifying at-risk patients, according to research published in the June 8 issue of the Journal of the American College of Cardiology.
Abstract
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Post-CPR Hyperoxia Linked to Higher Mortality Risk
TUESDAY, June 1 (HealthDay News) -- Both hyperoxia after cardiopulmonary resuscitation (CPR) and non-adherence to recommended timing of interventions after ST-elevation myocardial infarction (STEMI) result in significant increases in mortality, according to two studies published in the June 2 issue of the Journal of the American Medical Association.
Abstract - Kilgannon
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Abstract - Lambert
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
In Heart Failure, Discharges Earlier, Readmission Rates Up
TUESDAY, June 1 (HealthDay News) -- Patients admitted to hospitals for heart failure in 2006 fared better in-hospital than did those in 1993, but were discharged more often to nursing homes, and readmitted more frequently, according to research published in the June 2 issue of the Journal of the American Medical Association.
Abstract
Full Text
FDA: Claris IV Medications Recalled Due to Contamination
TUESDAY, June 1 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care professionals not to use intravenous medications including metronidazole, ciprofloxacin and ondansetron manufactured by Claris Lifesciences, as the products may be contaminated.
More Information
Ventilation Strategies Result in Similar Outcomes
TUESDAY, June 1 (HealthDay News) -- High-frequency oscillatory ventilation (HFOV), in which the lungs are continuously inflated and oscillate at a high rate through use of small volume changes, appears to be no better and no worse than conventional ventilation in preterm infants, according to research published online June 1 in The Lancet.
Abstract
Full Text (subscription or payment may be required)
Comment (subscription or payment may be required)
Heart Fatty Acid-Binding Protein Levels May Indicate ACS Risk
TUESDAY, June 1 (HealthDay News) -- Obtaining the concentration of heart fatty acid-binding protein (H-FABP) in patients with suspected acute coronary syndrome (ACS) may help physicians identify high-risk patients who are troponin-negative, according to research published in the June 8 issue of the Journal of the American College of Cardiology.
Abstract
Full Text (subscription or payment may be required)
