June 2011 Briefing - Critical Care

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

Black Patients Have Slower Transfer for Revascularization

THURSDAY, June 30 (HealthDay News) -- Black patients who have an acute myocardial infarction (AMI) and present to a nonrevascularization hospital are transferred more slowly to revascularization hospitals than their white counterparts, according to a study published in the July issue of Medical Care.

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Same Donor Post-Stem Cell Transplant Boosts Outcomes

THURSDAY, June 30 (HealthDay News) -- Patients who undergo living-donor lobar lung transplantation (LDLLT) after hematopoietic stem cell transplantation (HSCT) have a higher success rate when the same living donor is used, according to a study published online June 14 in the American Journal of Transplantation.

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Later Parenteral Nutrition Linked to Faster Recovery

WEDNESDAY, June 29 (HealthDay News) -- Late initiation of parenteral nutrition may have fewer complications and encourage faster recovery than early parenteral nutrition in critically ill adults, according to a study published online June 29 in the New England Journal of Medicine.

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COPD Rates Remain Stable in U.S. Between 1998 and 2009

WEDNESDAY, June 29 (HealthDay News) -- The prevalence of chronic obstructive pulmonary disease (COPD) remained stable in the United States between 1998 and 2009, according to a report published online June 29 by the U.S. Centers for Disease Control and Prevention's (CDC's) National Center for Health Statistics (NCHS).

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U.S. Territories Have Higher Mortality Rates Than States

WEDNESDAY, June 29 (HealthDay News) -- Hospitals in the U.S. territories have significantly higher risk-standardized all-cause mortality rates (RSMR) and lower performance on every core process measure than hospitals in the U.S. states, according to a study published online June 27 in the Archives of Internal Medicine.

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E-Alerts Found to Help Prevent Thromboembolism

WEDNESDAY, June 29 (HealthDay News) -- Electronic alerts (e-alerts) may be a cost-effective prophylactic strategy to prevent venous thromboembolism (VTE) in hospitalized patients, according to a study published in the June issue of the Journal of Thrombosis and Haemostasis.

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Integrated Care Linked to Lower Door-In-Door-Out Time

WEDNESDAY, June 29 (HealthDay News) -- The presence of prehospital, emergency department, and emergency medical service (EMS) processes of care in hospitals which do not provide percutaneous coronary intervention (PCI) is associated with a significant reduction in the door-in-door-out times of patients with ST-segment elevation myocardial infarction (STEMI) requiring transfer to PCI hospitals, according to a study published online June 28 in Circulation: Cardiovascular Quality and Outcomes.

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Normal CT Scan Tied to Favorable Head Trauma Result

MONDAY, June 27 (HealthDay News) -- Children with minor blunt head injury with normal initial computed tomography (CT) scan results and a Glasgow Coma Scale (GCS) score of 14 to 15 are very unlikely to need neurosurgical intervention, according to a study published online June 17 in the Annals of Emergency Medicine.

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Racial Gap for Stroke Admissions in U.S. Hospitals

FRIDAY, June 24 (HealthDay News) -- Likelihood of admission to high-quality hospitals, for African-American and Hispanic patients with stroke, has increased from 2000 to 2006, according to a study published in the Spring issue of Ethnicity and Disease.

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Increase in Global Proportion of Asbestos Used in Asia

THURSDAY, June 23 (HealthDay News) -- The use of asbestos has increased drastically in Asia since 1970, with 64 percent of global use from 2001 to 2007 attributable to Asia, according to a review published online March 30 in Respirology.

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Syndrome Caused by E. coli Mostly in Adults, Women

WEDNESDAY, June 22 (HealthDay News) -- A large, ongoing outbreak of the hemolytic-uremic syndrome caused by Shiga-toxin-producing Escherichia coli (E. coli) in Germany is occurring mostly in adults, primarily women, according to a study published online June 22 in the New England Journal of Medicine.

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Shorter Door-In to Door-Out Time Tied to Better Outcomes

WEDNESDAY, June 22 (HealthDay News) -- A door-in to door-out (DIDO) time of 30 minutes or less for patients with ST-elevation myocardial infarction (STEMI), transferred for primary percutaneous coronary intervention (PCI) is associated with shorter reperfusion delays and reduced in-hospital mortality, according to a study published online June 22/29 in the Journal of the American Medical Association.

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Longer Peri- and Preshock Pauses Linked to Poor Survival

TUESDAY, June 21 (HealthDay News) -- For patients who suffer cardiac arrest and present with a shockable rhythm, longer perishock and preshock pauses are independently associated with a decrease in survival to hospital discharge, according to a study published online June 20 in Circulation.

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Colorectal Surgery Linked to Venous Thromboembolism

MONDAY, June 20 (HealthDay News) -- Open colorectal (OC) surgery is associated with a significantly higher risk of perioperative venous thromboembolism (VTE) than laparoscopic colorectal (LC) surgery, according to a study published in the June issue of the Archives of Surgery.

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Anonymized Information May Decrease Violence Injuries

FRIDAY, June 17 (HealthDay News) -- Combining police intelligence with anonymized information from patients injured in violence can be used to prevent violence causing wounding, but not for more minor violence, according to a study published online June 16 in BMJ.

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Hospital Surgery Volume Tied to Arthroplasty Complications

FRIDAY, June 17 (HealthDay News) -- For patients undergoing primary elective total hip arthroplasty (THA) in hospitals with a low annual volume of surgeries, the risk of venous thromboembolism and one-year mortality is significantly higher than in high-volume hospitals, and for patients aged 65 or older undergoing total knee arthroplasty (TKA) at a low-volume hospital, there is an associated risk of increased one-year mortality, according to a study published online June 7 in Arthritis & Rheumatism.

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Flecainide Treatment Linked to Sudden Cardiac Death

THURSDAY, June 16 (HealthDay News) -- Patients with atrial fibrillation (AF) treated with flecainide develop an increased risk of sudden cardiac death (SCD) or proarrhythmic events, according to a study published online June 2 in the Journal of Internal Medicine.

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Increased Risk of Femoral Arterial Thrombosis in Children

THURSDAY, June 16 (HealthDay News) -- For children with indwelling arterial catheters (IACs), the incidence of arterial thrombosis is increased in the femoral artery and is independently associated with age, according to a study published in the June issue of the Journal of Thrombosis and Haemostasis.

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New Meningococcal A Conjugate Vaccine Is Effective

WEDNESDAY, June 15 (HealthDay News) -- A new meningococcal A (MenA) conjugate vaccine (PsA-TT) has been found to have a stronger antibody response to group A meningococci than a quadrivalent polysaccharide reference vaccine (PsACWY), according to a study published in the June 16 issue of the New England Journal of Medicine.

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New Rotavirus Vaccine Reduces Cases of Infant Diarrhea

WEDNESDAY, June 15 (HealthDay News) -- In Mexico and Brazil, use of the new monovalent rotavirus vaccine (RV1) is associated with a short-term risk of intussusception in vaccinated infants but prevents a far higher number of hospitalizations and deaths from diarrhea, according to a study published in the June 16 issue of the New England Journal of Medicine.

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Increased Mortality Risk Linked to Use of Mist Inhaler

WEDNESDAY, June 15 (HealthDay News) - Patients with chronic obstructive pulmonary disease who use a tiotropium mist inhaler may have an increased risk of mortality, according to a review published online June 14 in BMJ.

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Increased Recurrent Stroke Risk in Type 2 Diabetes

WEDNESDAY, June 15 (HealthDay News) -- Patients enrolled in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial who have type 2 diabetes may have increased incidence of recurrent stroke and cardiovascular events, but the effect of atorvastatin treatment is independent of whether the patients have type 2 diabetes, or metabolic syndrome (MetS), according to a study published online June 13 in the Archives of Neurology.

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Life Expectancy in U.S. Counties Below Many Nations

WEDNESDAY, June 15 (HealthDay News) -- Most counties within the United States fall behind the international frontier with the best life expectancies in the world, according to a study published online June 15 in Population Health Metrics.

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Inappropriate Medicines Tied to Serious Avoidable Adverse Events

WEDNESDAY, June 15 (HealthDay News) -- Use of the Screening Tool of Older Persons' potentially inappropriate prescriptions (STOPP) criteria has identified an association between potentially inappropriate medicine (PIM) prescriptions and the likelihood of a serious adverse drug event (ADE) in older people; and, when hospitalized, older people are at risk of being prescribed PIMs and actually inappropriate medicines (AIMs), especially in intensive care units (ICUs), according to a study and research letter published in the June 13 issue of the Archives of Internal Medicine.

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Similar Number for Outpatient, Inpatient Malpractice Claims

TUESDAY, June 14 (HealthDay News) -- The number of paid malpractice claims is similar in both inpatient and outpatient settings, according to a study published in the June 15 issue of the Journal of the American Medical Association.

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New Diagnostic Strategy for Patients With Suspected PE

FRIDAY, June 10 (HealthDay News) -- A proposed diagnostic strategy combines clinical assessment, D-dimer testing, ultrasonography, and lung scan to give a noninvasive diagnosis for the majority of outpatients with suspected pulmonary embolism (PE), according to a study published in the June issue of Chest.

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Diagnosis of Secondary DVTs Increased From 1989 to 2006

THURSDAY, June 9 (HealthDay News) -- The incidence of secondary deep vein thrombosis (DVT) in hospitalized patients increased significantly from 1989 to 2006 in the United States, according to a study published in the June issue of Chest.

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ICU Care by Nonphysician Staff Is Safe and Effective

WEDNESDAY, June 8 (HealthDay News) -- An acute care team comprised of nonphysicians can provide critical care to severely ill patients in a medical intensive care unit (MICU) with no significant difference in clinical outcomes when compared with a traditional, house staff-based team, according to a study published in the June issue of Chest.

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NSAID Use Linked to Increased Venous Thromboembolism Risk

WEDNESDAY, June 8 (HealthDay News) -- The use of nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) or cyclooxygenase-2-selective inhibitors (COX2Is) is associated with an increased risk of venous thromboembolism (VTE), according to a study published online May 18 in the Journal of Thrombosis and Haemostasis.

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Aortic-Valve Replacement Procedures Similarly Effective

TUESDAY, June 7 (HealthDay News) -- The use of transcatheter aortic-valve replacement in high-risk patients with severe aortic stenosis is associated with similar rates of survival at one year as surgical replacement, though there are differences in periprocedural risks, according to a study published online June 5 in the New England Journal of Medicine.

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Patients' Mobile Phones Carry Multidrug-Resistant Bacteria

TUESDAY, June 7 (HealthDay News) -- Mobile phones of patients carry more multidrug-resistant pathogenic bacteria than mobile phones of health care workers, according to a study published in the June issue of the American Journal of Infection Control.

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More Strokes Treated With Thrombolytics in the U.S.

FRIDAY, June 3 (HealthDay News) -- The use of recombinant tissue plasminogen activator (rtPA) to treat acute ischemic stroke (AIS) increased significantly between 2005 and 2009 in the United States, according to a study published online June 2 in Stroke.

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Blast-Related Brain Injuries May Involve Axonal Injury

WEDNESDAY, June 1 (HealthDay News) -- Blast-related traumatic brain injuries may involve axonal injury even though diffusion tensor imaging (DTI) may be normal, according to a study published in the June 2 issue of the New England Journal of Medicine.

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Hospital Volume May Affect Surgical Mortality Rate

WEDNESDAY, June 1 (HealthDay News) -- Mortality rates for certain high-risk surgical procedures have decreased in the United States, which is partially due to increased market concentration and hospital volume, according to a study published in the June 2 issue of the New England Journal of Medicine.

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Fibroblast Growth Factor Not Effective in Limb Ischemia

WEDNESDAY, June 1 (HealthDay News) -- Treatment with non-viral 1 fibroblast growth factor (NV1FGF) does not reduce the risk of amputation or death in patients with critical limb ischemia, according to a study published online May 31 in The Lancet.

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Corticosteroids May Shorten Pneumonia Hospital Stay

WEDNESDAY, June 1 (HealthDay News) -- Non-immunocompromised patients with community-acquired pneumonia treated with intravenous dexamethasone in addition to antibiotic therapy may have a shorter hospital stay, according to a study published online June 1 in The Lancet.

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