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March 2012 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for March 2012. 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.

Cardiac Shock Wave Therapy Improves Angina Symptoms

FRIDAY, March 30 (HealthDay News) -- Cardiac shock wave therapy (CSWT) can significantly improve symptoms, ischemic threshold during exercise, and specific quality-of-life parameters for patients with chronic refractory angina pectoris, according to a study published online March 23 in Cardiovascular Therapeutics.

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New Guidelines Issued for Red Blood Cell Transfusions

MONDAY, March 26 (HealthDay News) -- A restrictive red blood cell transfusion strategy should be employed for hemodynamically stable adults and children, according to a clinical practice guideline issued by the AABB (formerly the American Association of Blood Banks) and published online March 26 in the Annals of Internal Medicine.

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Post-Sleep Apnea Surgery Complications Examined

THURSDAY, March 22 (HealthDay News) -- The overall complication rate of multilevel surgery for obstructive sleep apnea (OSA) is 7.1 percent, according to research published online March 19 in the Archives of Otolaryngology -- Head & Neck Surgery.

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Health Care Team Members Key for Antimicrobial Stewardship

THURSDAY, March 22 (HealthDay News) -- Antimicrobial stewardship programs (ASPs) that use health care epidemiologists (HEs) and infection preventionists (IPs) have a crucial role to play in the effort to combat health care-associated infections (HAIs), including those caused by multidrug-resistant organisms (MDROs), according to the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America position paper published in the March issue of the American Journal of Infection Control.

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Circulating Endothelial Cells Potential Biomarker for MI

THURSDAY, March 22 (HealthDay News) -- Circulating endothelial cell (CEC) counts are elevated among patients with myocardial infarction (MI), and the cells have distinct morphological features, according to a study published in the March 21 issue of Science Translational Medicine.

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Tenecteplase Superior to Alteplase for Stroke Treatment

WEDNESDAY, March 21 (HealthDay News) -- Tenecteplase is superior to alteplase for the treatment of acute ischemic stroke for select patients, according to a study published in the March 22 issue of the New England Journal of Medicine.

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Dexmedetomidine Non Inferior for Maintaining Sedation

WEDNESDAY, March 21 (HealthDay News) -- The α2-agonist dexmedetomidine is not inferior to the standard sedatives midazolam or propofol in its ability to maintain light-to-moderate sedation during mechanical ventilation, according to research published in the March 21 issue of the Journal of the American Medical Association.

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Survey Describes Docs' Online Professionalism Violations

TUESDAY, March 20 (HealthDay News) -- Most medical licensing authorities receive and act upon reports of physicians' online professionalism violations, according to a research letter published in the March 21 issue of the Journal of the American Medical Association.

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Antimicrobial Stewardship Saves Millions of Dollars

TUESDAY, March 20 (HealthDay News) -- Antimicrobial stewardship programs save hospitals millions of dollars, according to a study published in the April issue of Infection Control and Hospital Epidemiology.

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Most California Hospitals Implementing Infection Control

FRIDAY, March 16 (HealthDay News) -- Most California hospitals implement some policies to improve infection control for multidrug-resistant organisms (MDRO), primarily methicillin-resistant Staphylococcus aureus (MRSA), but few policies are associated with lower MDRO rates, according to a study published in the March issue of the American Journal of Infection Control.

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Poorer Health Literacy Linked to Increased Mortality

FRIDAY, March 16 (HealthDay News) -- A considerable proportion of older adults in England have medium or low health literacy, which is associated with increased mortality, according to a study published online March 15 in BMJ.

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Hyperammonemia Disrupts Sleep in Patients With Cirrhosis

FRIDAY, March 16 (HealthDay News) -- For patients with cirrhosis, hyperammonemia induced by an amino acid challenge (AAC) leads to an increase in daytime subjective sleepiness and changes in sleep patterns, according to a study published in the March issue of Hepatology.

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Personal Mobile Computers Improve Resident Efficiency

WEDNESDAY, March 14 (HealthDay News) -- The use of personal mobile computers (Apple iPads) by internal medicine residents improves efficiency, according to a research letter published in the March 12 issue of the Archives of Internal Medicine.

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Endoscopic Necrosectomy Tied to Better Pancreatitis Outcomes

TUESDAY, March 13 (HealthDay News) -- A less invasive procedure, endoscopic transgastric necrosectomy, reduces the proinflammatory response and significant complications in patients with infected necrotizing pancreatitis, compared with surgical necrosectomy, according to a study published in the March 14 issue of the Journal of the American Medical Association.

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Survival Up for Hispanics With Preserved Ejection Fraction

TUESDAY, March 13 (HealthDay News) -- Hispanic heart failure patients with preserved left ventricular ejection fraction (EF) have better survival than non-Hispanic whites, according to a study published online March 13 in Circulation: Heart Failure.

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Higher Spending by Hospitals Improves Outcomes

TUESDAY, March 13 (HealthDay News) -- Hospitals that are part of the universal health care system in Canada that spend more on inpatient care have lower rates of deaths and hospital readmissions, according to a study published in the March 14 issue of the Journal of the American Medical Association.

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Practical Strategies Can Ease Death Notification in the ER

TUESDAY, March 13 (HealthDay News) -- By using practical strategies based on available literature, notifying survivors of a death in the emergency department can be less traumatic for both the survivor and the physician, nurse, or other health care provider tasked with delivering the news, according to an article published in the March issue of the Journal of Emergency Nursing.

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U.S. Mortality Rates Dropped 60 Percent From 1935 to 2010

TUESDAY, March 13 (HealthDay News) -- From 1935 to 2010, the death rate in the United States decreased considerably, although the single-year improvements in mortality were often small, according to a March data brief issued by the National Center for Health Statistics (NCHS).

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Aggressive Care Improves QoL in Traumatic Brain Injury

MONDAY, March 12 (HealthDay News) -- Compared with routine care, an aggressive-care approach to the treatment of patients with severe traumatic brain injury (TBI), which follows the Brain Trauma Foundation guidelines, is estimated to improve quality of life and significantly lower associated costs, regardless of patient age, according to research published online March 6 in the Journal of Neurosurgery.

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MRI Use Increasing for Evaluating Stroke Patients

MONDAY, March 12 (HealthDay News) -- The use of magnetic resonance imaging (MRI) in the evaluation of hospitalized stroke patients has dramatically increased over the past decade, according to an article published in the February issue of the Annals of Neurology.

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Flu Vaccine Up Among Medical Staff When They Believe It Works

FRIDAY, March 9 (HealthDay News) -- Hospital health care workers (HCWs) are more likely to receive the seasonal influenza vaccination if they believe it works and are committed to preventing this highly contagious virus, according to research published in the April issue of Occupational & Environmental Medicine.

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Surrogates Tend to Misinterpret Poor Prognosis Information

FRIDAY, March 9 (HealthDay News) -- Surrogate decision makers for critically ill patients interpret prognostic statements expressing a low risk of death accurately, but interpret statements conveying poor prognosis optimistically, according to a study published in the March 6 issue of the Annals of Internal Medicine.

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Buprenorphine Maintenance Therapy Not Recommended

THURSDAY, March 8 (HealthDay News) -- Opioid substitution therapy with buprenorphine is not recommended for opioid-addicted health care professionals (HCPs), according to research published in the March issue of the Mayo Clinic Proceedings.

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In Suspected PE, A-fib Doesn't Raise Odds of the Diagnosis

WEDNESDAY, March 7 (HealthDay News) -- In general, the presence of atrial fibrillation (AF) does not increase the likelihood of pulmonary embolism (PE), according to a study published in the March issue of the Journal of Thrombosis and Haemostasis.

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Financial Burden of Medical Care Affects One in Three

WEDNESDAY, March 7 (HealthDay News) -- In the first half of 2011, one in three individuals was in a family that experienced the financial burden of medical care in the United States, according to the results of the National Health Interview Survey published March 7 by the National Center for Health Statistics (NCHS).

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Positive Whole-Body CT Can Detect but Not Eliminate Trauma

TUESDAY, March 6 (HealthDay News) -- For assessing severe trauma, single-pass whole-body computed tomography (CT), or pan-scanning, can detect, but not definitively exclude, the presence of injuries, according to a study published online March 5 in CMAJ, the journal of the Canadian Medical Association.

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AHA Supports Shared Decision Making in Heart Failure

MONDAY, March 5 (HealthDay News) -- Shared decision making in advanced heart failure has become more challenging and more important, with increased disease duration and available treatment options, according to a scientific statement from the American Heart Association (AHA) published online March 5 in Circulation.

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Drug Relieves Opioid-Induced Constipation in Critically Ill

MONDAY, March 5 (HealthDay News) -- For critically ill patients with opioid-induced constipation, treatment with methylnaltrexone (MNTX) is associated with improved bowel function compared with standard rescue therapy, according to a study published in the March issue of the Mayo Clinic Proceedings.

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Barriers Identified to Pediatric Advance Care Discussions

MONDAY, March 5 (HealthDay News) -- Prognostic understanding and parental attitude are significant barriers to advance care discussions (ACD) for children with life-threatening conditions, according to a study published online March 5 in Pediatrics.

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Device Stratifies Sickle Cell Disease Severity

FRIDAY, March 2 (HealthDay News) -- A device that measures the resistance of blood flow after deoxygenation can differentiate patients with benign or severe sickle cell disease, according to a study published in the Feb. 29 issue of Science Translational Medicine.

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