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March 2009 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for March 2009. 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.

Safe Practice Scores Do Not Add Up to Fewer Patient Deaths

TUESDAY, March 31 (HealthDay News) -- In hospitals, higher self-reported scores for improvements in safe practices do not correlate with reduced mortality rates, researchers report in the April 1 issue of the Journal of the American Medical Association.

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Social Isolation Worsens Stroke Outcomes in Mouse Study

MONDAY, March 30 (HealthDay News) -- Mice housed in isolation are more likely to experience major ischemic damage and die of a stroke than their socially housed cohorts, according to research published online March 23 in the Proceedings of the National Academy of Sciences.

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Children's Lung Function Linked to Genetic Variants

MONDAY, March 30 (HealthDay News) -- In children, variants in GST mu genes are associated with decreased lung capacity and small airway flow, according to a study published in the April 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Cancer Patients Often Not Involved in Treatment Decisions

FRIDAY, March 27 (HealthDay News) -- In patients with incurable cancer, fewer than half are involved in the decision-making process concerning the limitation of life-prolonging treatment, according to a study published online ahead of print March 23 in the Journal of Clinical Oncology.

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NHLBI Discontinues Hypertonic Saline Trial

FRIDAY, March 27 (HealthDay News) -- A U.S.-Canadian trial to assess in-ambulance administration of a hypertonic saline solution to trauma patients in shock from severe bleeding has been halted due to lack of a survival benefit, the National Heart, Lung, and Blood Institute (NHLBI) announced on March 26.

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ACCF/AHA Update Covers Heart Failure in Adults

FRIDAY, March 27 (HealthDay News) -- Updated American College of Cardiology Foundation/American Heart Association guidelines on heart failure in adults include new recommendations for hospitalized patients, and the guidelines were published online March 26 in the Journal of the American College of Cardiology.

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Lung Hypertension Common in Heart Failure Patients

FRIDAY, March 27 (HealthDay News) -- Pulmonary hypertension is common in patients with preserved ejection fraction heart failure, and pulmonary artery systolic pressure may be effective in diagnosing heart failure with preserved ejection fraction (HFpEF) and predicting the risk of death, researchers report in the March 31 issue of the Journal of the American College of Cardiology.

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Electric Current Leak Can Trigger Defibrillator Shock

WEDNESDAY, March 25 (HealthDay News) -- An electric current leak that is not noticeable under ordinary circumstances can trigger a serious shock in someone who has an implanted cardioverter-defibrillator (ICD), according to a letter in the March 26 issue of the New England Journal of Medicine.

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Cost Barriers Slow Adoption of Electronic Health Records

WEDNESDAY, March 25 (HealthDay News) -- Citing cost barriers, relatively few U.S. hospitals have adopted electronic health records, posing a major obstacle for policy makers who say health information technology is critical to the improvement of health care quality and cost-effectiveness, according to an article published online March 25 in the New England Journal of Medicine.

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Low Cholesterol, Blood Pressure Show CAD Benefits

WEDNESDAY, March 25 (HealthDay News) -- In patients with coronary artery disease (CAD), those with the lowest levels of low-density lipoprotein (LDL) cholesterol and systolic blood pressure had the slowest progression of coronary atherosclerosis, according to research published in the March 31 issue of the Journal of the American College of Cardiology.

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Genetic Heart Disease Often Deadly for Children

TUESDAY, March 24 (HealthDay News) -- A genetic cardiomyopathy that strikes children is associated with serious heart dysfunction and often death, according to a report in the March 25 issue of the Journal of the American Medical Association.

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Antibiotic Dressing Reduces Catheter-Related Infections

TUESDAY, March 24 (HealthDay News) -- An antibiotic-impregnated catheter dressing reduces catheter-related infections better than standard dressings in critically ill patients, according to a report in the March 25 issue of the Journal of the American Medical Association.

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Smoking Linked to Risk of Acute, Chronic Pancreatitis

TUESDAY, March 24 (HealthDay News) -- Smoking is independently associated with an increased risk of pancreatitis, according to study findings published in the March 23 issue of the Archives of Internal Medicine.

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Intensive Glucose Control Spikes Mortality in Critically Ill

TUESDAY, March 24 (HealthDay News) -- Intensively controlling blood glucose in a study group of critically ill patients increased their mortality rate and hypoglycemia in comparison to a group receiving conventional glucose control, according to research reported online March 24 in advance of publication in the March 26 issue of the New England Journal of Medicine.

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Hospital Quality Measure Inaccurate, May Increase Bias

WEDNESDAY, March 18 (HealthDay News) -- A widely used hospital quality measure that compares mortality rates and takes into account the mix of cases is inaccurate and may increase the bias that case mix adjustment is intended to decrease, according to research published March 18 in BMJ Online First.

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Drug Ineffective in Treating Hereditary High Cholesterol

TUESDAY, March 17 (HealthDay News) -- Pactimibe treatment does not improve atherosclerosis and leads to an increase in the incidence of major cardiovascular events in patients with hereditary high cholesterol compared with placebo, according to a study in the March 18 issue of the Journal of the American Medical Association.

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Religious More Likely to Use Life-Prolonging Care

TUESDAY, March 17 (HealthDay News) -- Patients with advanced cancer who rely more strongly on religion to cope with illness are more likely to receive mechanical ventilation and intensive life-prolonging care at the end of life, according to a study in the March 18 issue of the Journal of the American Medical Association.

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Survival in Transplant Patients Hinges on Key Risk Factors

TUESDAY, March 17 (HealthDay News) -- Low-risk combined heart and kidney transplantation recipients with a low estimated glomerular filtration rate (eGFR) have improved survival after the transplantation when compared with isolated heart transplant recipients, according to research published in the March issue of the Archives of Surgery.

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Delays in Seeking Heart Attack Care Vary Worldwide

MONDAY, March 16 (HealthDay News) -- Delay seeking medical care for acute myocardial infarction was longest in Argentina and Brazil and shortest in Australia/New Zealand during a six-year study period, according to research published in the March 1 issue of the American Journal of Cardiology.

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Drug Errors Widespread in Intensive Care Units

FRIDAY, Mar. 13 (HealthDay News) -- Errors in giving parenteral medications appear to be common in intensive care units around the world, according to research published online Mar. 12 in BMJ.

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Drugs Don't Boost Survival in Older Heart Failure Patients

THURSDAY, Mar. 12 (HealthDay News) -- People over 80 years of age who have heart failure with preserved ejection fraction, a prevalent condition in the elderly, do not benefit significantly from commonly prescribed cardiac medications, according to research published in the Mar. 15 issue of the American Journal of Cardiology.

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Pulmonary Embolism Common in Acute COPD Patients

FRIDAY, Mar. 6 (HealthDay News) -- Pulmonary embolism may occur in one-quarter of patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (COPD), according to research published in the March issue of Chest.

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Depression Symptoms in Stable COPD Linked to Mortality

FRIDAY, Mar. 6 (HealthDay News) -- Depression symptoms occurring in patients with stable chronic obstructive pulmonary disease (COPD) are associated with all-cause mortality, according to a report published in the March issue of Chest.

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Use of Stroke Prevention Services Can Be Improved

FRIDAY, Mar. 6 (HealthDay News) -- There is widespread underutilization of stroke secondary prevention services, according to a report published online Mar. 5 in Stroke.

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Transdermal Patches Pose Burn Risk During Scans

FRIDAY, Mar. 6 (HealthDay News) -- The U.S. Food and Drug Administration has issued a warning about the risk of burns as a result of wearing medicated patches, such as those used for smoking cessation or pain relief, during MRI scans.

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Obama Wants to Spend $630 Billion on Health Care Reform

THURSDAY, Mar. 5 (HealthDay News) -- Achieving health care reform is one of President Barack Obama's major challenges, and his newly released spending plan calls on Congress to commit $630 billion over the next decade to finance that reform, according to an article published online Mar. 4 in the New England Journal of Medicine.

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Proton Pump Inhibitors May Reduce Benefits of Clopidogrel

TUESDAY, Mar. 3 (HealthDay News) -- Acute coronary syndrome patients who are prescribed clopidogrel in combination with a proton pump inhibitor are at increased risk of adverse outcomes compared with patients prescribed clopidogrel alone, according to a report published in the Mar. 4 issue of the Journal of the American Medical Association.

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Oseltamivir-Resistant Flu Viruses Increasing

TUESDAY, Mar. 3 (HealthDay News) -- The 2008 to 2009 influenza season will see a higher prevalence of oseltamivir-resistant viruses, and certain strains of the virus are highly pathogenic to high-risk patients, according to two studies published online Mar. 2 in the Journal of the American Medical Association. Another study reports that intranasal live attenuated influenza vaccine is associated with more medical encounters than trivalent inactivated vaccine.

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Vitamin K Doesn't Reduce Bleeding in Warfarin Patients

TUESDAY, Mar. 3 (HealthDay News) -- In patients receiving warfarin, vitamin K does not reduce bleeding, according to study findings published in the Mar. 3 issue of the Annals of Internal Medicine.

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US Motor Vehicle-Related Death Rates Vary Geographically

MONDAY, Mar. 2 (HealthDay News) -- Although the mortality rate related to motor vehicles remained almost unchanged from 1999 to 2005 in the United States, on closer inspection the data reveals wide variations from state to state, as well as by gender and ethnicity, according to a report published in the Feb. 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Glycemic Control Approaches Lead to Similar Outcomes

MONDAY, Mar. 2 (HealthDay News) -- Different approaches to glycemic control in type 2 diabetics following myocardial infarction were associated with similar risk of later cardiovascular events, according to research published in the March issue of Diabetes Care.

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CT Perfusion May Predict Hemorrhagic Transformation

MONDAY, Mar. 2 (HealthDay News) -- In patients with acute ischemic stroke, admission perfusion-derived permeability-surface area product (PS) measurement may differentiate those who are and are not likely to develop hemorrhagic transformation, according to the results of a pilot study published in the March issue of Radiology.

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Patients' Rights Documents Usually Difficult to Understand

MONDAY, Mar. 2 (HealthDay News) -- Patients' bill of rights documents in U.S. hospitals are generally written at a complexity level that far exceeds the average adult's reading ability, according to a report published online Feb. 3 in the Journal of General Internal Medicine.

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