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May 2010 Briefing - Critical Care

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

FDA: Baxter Recalling Hyaluronidase Human Injection

THURSDAY, May 27 (HealthDay News) -- Baxter International Inc. has announced a voluntary recall of hyaluronidase human injection (Hylenex recombinant), as particulate matter was found in a limited number of vials during standard stability testing.

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Stents, Endarterectomy Equally Effective at Preventing Stroke

WEDNESDAY, May 26 (HealthDay News) -- Carotid-artery stenting and carotid endarterectomy are equally effective in preventing stroke in the long term, according to a study published online May 26 in the New England Journal of Medicine to coincide with its presentation at the European Stroke Conference, held from May 25 to 28 in Barcelona, Spain.

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Early Antibiotics in COPD Hospitalizations Beneficial

TUESDAY, May 25 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) patients hospitalized for exacerbations of their illness who receive antibiotic treatment within the first two days of their hospitalization fare better than those who do not, according to research published in the May 26 issue of the Journal of the American Medical Association.

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H1N1 in Pregnant Women Is Serious Threat to Fetuses

TUESDAY, May 25 (HealthDay News) -- Pregnant women admitted to the hospital with pandemic novel influenza A(H1N1) are at increased risk for abdominal and gastrointestinal symptoms, fetal distress and mortality, emergency cesarean delivery, and premature births, according to research published in the May 24 issue of the Archives of Internal Medicine.

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Low Phosphorus Linked to Early Death in HIV Therapy

MONDAY, May 24 (HealthDay News) -- Low blood phosphorus levels are associated with high death rates among HIV-infected patients beginning antiretroviral therapy (ART) in sub-Saharan Africa, according to a study published online May 18 in PLoS ONE.

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Stroke Incidence Falls in Cincinnati/Northern Kentucky

FRIDAY, May 21 (HealthDay News) -- The incidence of stroke decreased significantly among whites, but not blacks, in the Greater Cincinnati/Northern Kentucky area from 1999 to 2005, according to research published online May 20 in Stroke.

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Sagent Announces Recall of Metronidazole Injection

WEDNESDAY, May 19 (HealthDay News) -- Sagent Pharmaceuticals Inc. has announced a nationwide voluntary recall of all lots of metronidazole injection, USP 500 mg/100 mL, distributed by the company and manufactured by Claris Lifesciences, due to non-sterility in two lots of the product, according to the U.S. Food and Drug Administration (FDA).

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Sildenafil of Mixed Value in Idiopathic Pulmonary Fibrosis

TUESDAY, May 18 (HealthDay News) -- In patients with advanced idiopathic pulmonary fibrosis, treatment with sildenafil does not significantly increase walking distance compared to placebo but may be associated with some symptomatic improvements, according to a study published online May 18 in the New England Journal of Medicine to coincide with presentation at the American Thoracic Society (ATS) International Conference in New Orleans.

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Racial Disparities Reduced in Quality Monitoring Program

TUESDAY, May 18 (HealthDay News) -- Hospitals enrolled in a national quality monitoring and improvement program showed improvements in adherence to evidence-based guidelines for acute myocardial infarction (AMI), as well as reductions or elimination of racial/ethnic care disparities, according to research published May 17 in the journal Circulation.

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Antibiotic Patterns for S. Aureus in Children Have Changed

MONDAY, May 17 (HealthDay News) -- Since the emergence of community-associated methicillin-resistant Staphylococcus aureus (S. aureus) infections, antibiotic treatment for hospitalized children with S. aureus infections has changed dramatically, and clindamycin has become the primary antibiotic treatment for those infections, according to research published online May 17 in Pediatrics.

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CPAP Found Feasible for Extremely Preterm Infants

MONDAY, May 17 (HealthDay News) -- In extremely preterm infants, early treatment with continuous positive airway pressure (CPAP) may be a viable alternative to early treatment with intubation and surfactant, according to a study published online May 16 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 14 to 19 in New Orleans. The study also found that a lower target range of oxygen saturation does not reduce a composite of severe retinopathy or death and may be associated with increased mortality.

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Earliest Receipt of Alteplase Benefits Stroke Outcomes Most

FRIDAY, May 14 (HealthDay News) -- The thrombolytic drug alteplase should be given as soon as possible after a stroke, as the odds of a favorable outcome decrease as the time to treatment increases, according to a pooled analysis published online May 15 in The Lancet.

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Low Umbilical Artery pH Linked to Adverse Outcomes

FRIDAY, May 14 (HealthDay News) -- Low umbilical artery pH at birth is strongly associated with adverse long-term outcomes, including death and hypoxic ischemic encephalopathy, according to research published online May 13 in BMJ.

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Many General Internists Leave Field by Mid-Career

FRIDAY, May 14 (HealthDay News) -- Roughly one out of six general internists are leaving internal medicine by mid-career, a substantially higher proportion compared to internal medicine subspecialists, according to survey results published April 29 in the Journal of General Internal Medicine.

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Stroke Sign Awareness Doesn't Translate to Calling 911

FRIDAY, May 14 (HealthDay News) -- Most adults cannot correctly identify stroke warning signs, and even those who can may not respond to them by calling 911, according to research published online May 13 in Stroke.

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FDA and GE Issue Class I Recall of Anesthesia Systems

THURSDAY, May 13 (HealthDay News) -- The U.S. Food and Drug Administration and GE Healthcare have alerted health care professionals of a Class I recall of specific lots of Aisys and Avance Anesthesia Systems due to a defect in the control board wiring harnesses.

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New Implantable Cardioverter-Defibrillator Tested Effectively

WEDNESDAY, May 12 (HealthDay News) -- A new type of implantable cardioverter-defibrillator (ICD) with leads that can be implanted subcutaneously, rather than transvenously as with conventional ICDs, has successfully detected and converted ventricular fibrillation in a series of evaluation trials, according to a report published online May 12 in the New England Journal of Medicine.

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New FDA Program Targets Misleading Drug Advertising

WEDNESDAY, May 12 (HealthDay News) -- The U.S. Food and Drug Administration has announced the launch of a new program to educate health care providers regarding their role in making certain that advertisements and promotions for prescription drugs are truthful and not misleading.

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COPD Exacerbations May Raise Risk of Cardiovascular Events

TUESDAY, May 11 (HealthDay News) -- Exacerbations of chronic obstructive pulmonary disease (COPD) appear to increase the risk of myocardial infarction (MI) and stroke, according to research published in the May issue of Chest.

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D-Dimer May Be Marker for Adverse Events in A-Fib Patients

TUESDAY, May 11 (HealthDay News) -- During anticoagulation therapy for atrial fibrillation, D-dimer values may be useful in prediction of thromboembolic and cardiovascular events, according to a study in the May 18 issue of the Journal of the American College of Cardiology.

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Fluctuating Blood Pressure May Increase Risk of CVD in Elderly

MONDAY, May 10 (HealthDay News) -- High blood pressure (BP) and greater BP fluctuations are associated with an increased risk for cerebrovascular disease in older adults, according to research published in the May issue of the Archives of Neurology.

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In-Hospital Pediatric Mortality Tied to Patient Characteristics

MONDAY, May 10 (HealthDay News) -- Patient characteristics, including age and severity of diagnosis are substantive factors associated with pediatric in-patient deaths, and reducing variability within and between pediatric hospitals may improve mortality rates, according to research published online May 10 in Pediatrics.

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Bronchoscopy Skills Acquired Faster With Simulation Training

MONDAY, May 10 (HealthDay News) -- The rate at which bronchoscopy skills are learned can be enhanced by certain educational interventions, and these skills can be evaluated via performance-based metrics, according to research published in the May issue of Chest.

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Iron Deficiency in ICU Patients Tied to Higher Transfusion Rate

FRIDAY, May 7 (HealthDay News) -- In patients admitted to an intensive care unit (ICU), functional iron deficiency -- defined as low reticulocyte hemoglobin content (CHr) -- is common, and is strongly associated with higher transfusion requirements, according to a study in the May issue of Anesthesiology.

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Job Satisfaction Up for Specialty-Certified Critical Care Nurses

THURSDAY, May 6 (HealthDay News) -- Nurses certified in critical care are more satisfied with their jobs and careers and feel more empowered than their non-certified peers, and may be less likely to leave a job or the profession altogether, according to research published in the May 1 issue of the American Journal of Critical Care.

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Bar-Code Technology Reduces Medication Errors in Hospitals

WEDNESDAY, May 5 (HealthDay News) -- Use of bar-code verification technology can substantially decrease both transcription errors and medication administration errors in hospitals, according to research published in the May 6 issue of the New England Journal of Medicine.

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FDA Orders Recall of Colleague Volumetric Infusion Pumps

WEDNESDAY, May 5 (HealthDay News) -- The U.S. Food and Drug Administration has notified Baxter Healthcare Corp. that the company must recall and destroy all Colleague Volumetric Infusion Pumps currently being used in the United States, which may number 200,000.

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Stent Type Does Not Affect Non-Cardiac Surgery Events

WEDNESDAY, May 5 (HealthDay News) -- Patients who undergo non-cardiac surgery after receiving a stent, especially within 42 days, are at increased risk for complications including death -- particularly after an acute coronary syndrome -- but the type of stent used is not an influencing factor, according to research published online May 4 in Circulation: Cardiovascular Interventions.

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Prognosis Varies Per Glycemic Index Pre-Revascularization

WEDNESDAY, May 5 (HealthDay News) -- Having a low -- but not too low -- glycemic index prior to surgery is optimal for best cardiovascular outcomes after coronary revascularization in patients with type 2 diabetes mellitus (DM), according to a study in the April 1 issue of the American Journal of Cardiology.

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Kidney Disease Therapy May Increase Cardiovascular Risks

TUESDAY, May 4 (HealthDay News) -- For patients with chronic kidney disease (CKD), therapy with erythropoiesis-stimulating agents (ESA) that target higher levels of hemoglobin increases the risk of stroke, hypertension and thrombosis, according to a meta-analysis published online May 3 in the Annals of Internal Medicine.

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Most People Don't Know Which Hospitals Are Stroke-Certified

TUESDAY, May 4 (HealthDay News) -- Despite believing that it is important to know where to get specialty stroke care, most Americans do not know which hospitals in their area are considered stroke-certified, according to the results of a survey released by the American Stroke Association on May 3.

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