Here are what the editors at HealthDay consider to be the most important developments in Critical Care for September 2008. 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.
News Media Under-Report Drug Company Funding of Research
TUESDAY, Sept. 30 (HealthDay News) -- Reports on medication research published in general news media often fail to disclose that the research received pharmaceutical company funding and frequently refer to drugs by brand name rather than using the generic name, according to an article published in the Oct. 1 issue of the Journal of the American Medical Association.
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Road Traffic Accidents High on Presidential Election Days
TUESDAY, Sept. 30 (HealthDay News) -- There are more fatal road traffic accidents on the days of U.S. presidential elections than usual, and the increase is even greater than that of Super Bowl Sundays, according to a research letter published in the Oct. 1 issue of the Journal of the American Medical Association.
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Flu Vaccination Rises in Adults But Still Low in Children
MONDAY, Sept. 29 (HealthDay News) -- During the 2006-2007 flu season, influenza vaccination coverage increased among adults, but only one in five children aged 6 months to 23 months were fully vaccinated, according to two reports from researchers at the U.S. Centers for Disease Control and Prevention published in the Sept. 26 issue of the Morbidity and Mortality Weekly Report.
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Early Warning About Increased Mortality in Epoetin Alfa Trial
MONDAY, Sept. 29 (HealthDay News) -- The U.S. Food and Drug Administration has issued a warning to researchers conducting clinical trials of epoetin alfa in the treatment of stroke patients, after a German trial of the drug to treat acute ischemic stroke reported increased mortality among the study group versus controls.
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Platelet Reactivity Levels May Predict Coronary Risk
FRIDAY, Sept. 26 (HealthDay News) -- High residual platelet reactivity after clopidogrel administration prior to percutaneous coronary intervention (PCI) is associated with higher incidence of 30-day major adverse cardiac events, according to a report published in the Sept. 30 issue of the Journal of the American College of Cardiology.
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No Easy Answer to How Much Should Be Spent on Health Care
FRIDAY, Sept. 26 (HealthDay News) -- Although capping health care expenditure as a fixed proportion of gross domestic product (GDP) may control costs, it is not necessarily the best way to reflect the priority that a society places on health, according to two Head to Head articles published online Sept. 25 in BMJ.
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Implantable Cardioverter-Defibrillators Re-Examined
THURSDAY, Sept. 25 (HealthDay News) -- There is a compelling rationale for clinicians to critically analyze evidence-based guidelines when using implantable cardioverter-defibrillators (ICDs) for the prevention of sudden cardiac death, according to a report published in the Sept. 30 issue of the Journal of the American College of Cardiology.
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Post-Surgical Risks Analyzed in Aortic Dissection
THURSDAY, Sept. 25 (HealthDay News) -- In patients with acute type B aortic dissection, a large maximal false lumen area and a higher branch-vessel involvement greatly increase the risk of in-hospital post-surgical complications, according to research published in the Sept. 30 issue of the Journal of the American College of Cardiology.
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Drug-Eluting Stents May Cut Mortality After Heart Attack
WEDNESDAY, Sept. 24 (HealthDay News) -- Two years after undergoing stenting for acute myocardial infarction, patients who received drug-eluting stents have significantly lower rates of death and repeat revascularization than those who received bare-metal stents, researchers report in the Sept. 25 issue of the New England Journal of Medicine.
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Bisphosphonate Infusion Linked to Ocular Complication
WEDNESDAY, Sept. 24 (HealthDay News) -- Physicians should be aware that bisphosphonate infusions can result in a serious but rare complication: orbital inflammatory disease, according to a case study published in the Sept. 25 issue of the New England Journal of Medicine.
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Inhaled Anticholinergics Increase Cardiovascular Risk
TUESDAY, Sept. 23 (HealthDay News) -- Use of inhaled anticholinergics raises the risk of cardiovascular death, heart attack or stroke in patients with chronic obstructive pulmonary disease (COPD), according to a meta-analysis published in the Sept. 24 issue of the Journal of the American Medical Association.
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Out-of-Hospital Cardiac Arrest Outcomes Differ
TUESDAY, Sept. 23 (HealthDay News) -- There were significant differences in survival of out-of-hospital cardiac arrest cases treated by emergency medical services (EMS) across North American cities, according to a study published in the Sept. 24 issue of the Journal of the American Medical Association. The American Heart Association guidelines may enable identification of appropriate cases for increased cardiopulmonary resuscitative efforts, according to another study.
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Parents Make Decisions Based on Hope, Not Science
MONDAY, Sept. 22 (HealthDay News) -- Parents of babies who die as a result of extreme prematurity or potentially lethal congenital abnormalities report that religion, spirituality and hope guided their decisions about resuscitation rather than the physician's predictions about morbidity and death, according to an article published in the September issue of Pediatrics.
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No Change to 2009 Part B Medicare Premium
MONDAY, Sept. 22 (HealthDay News) -- There will be no change to the Part B Standard Medicare premium in 2009 compared with 2008. This is the first time since 2000 that the premium has not risen over the prior year, according to an announcement by the Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS).
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Physician's Office Hours Affect Time to Stroke Treatment
FRIDAY, Sept. 19 (HealthDay News) -- People who experience a transient ischemic attack or a minor stroke outside their primary physician's office hours wait longer before seeking treatment than those who have a stroke during general practice opening hours, according to a report published online Sept. 18 in BMJ.
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Antibiotic Resistance Has Become a Global Pandemic
FRIDAY, Sept. 19 (HealthDay News) -- A concerted international and national response, behavior change by consumers and providers, and the development of antibacterial agents are all urgently needed to tackle the global problem of rapidly increasing antibiotic resistance, according to an article published online Sept. 18 in BMJ.
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History, Physical Exam Provide Accurate Cardiac Estimates
THURSDAY, Sept. 18 (HealthDay News) -- Estimates of hemodynamic parameters from a history and physical exam are largely accurate and can predict death or rehospitalization in patients with advanced heart failure, according to study findings published in the September issue of Circulation: Heart Failure.
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Alteplase Still Safe Treatment Up to 4.5 Hours
MONDAY, Sept. 15 (HealthDay News) -- Although intravenous alteplase has been approved for use in stroke patients within three hours of onset, it can be safely and effectively used up to 4.5 hours after onset, according to the results of a study published online Sept. 15 in The Lancet.
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Day of Discharge Doesn't Affect Guideline Compliance
MONDAY, Sept. 15 (HealthDay News) -- Staff adherence to guideline recommendations when treating patients hospitalized with acute coronary syndrome is not affected by day of discharge (weekday versus weekend), researchers report in the Sept. 15 issue of the American Journal of Cardiology.
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Lab Test Ratio Predicts Risk Among Coronary Patients
MONDAY, Sept. 15 (HealthDay News) -- The neutrophil/lymphocyte ratio (NLR) is a comparatively inexpensive marker of inflammation that identifies high-risk patients and may allow for risk stratification of patients with acute coronary syndromes, according to a report in the Sept. 15 issue of the American Journal of Cardiology.
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Detoxifying Protein Levels Lower in COPD Lungs
FRIDAY, Sept. 12 (HealthDay News) -- Levels of a protein involved in detoxifying oxidants are lower in the lungs of patients with chronic obstructive pulmonary disease (COPD) due to lower levels of a stabilizing protein, researchers report in the Sept. 15 issue of the American Journal of Respiratory and Critical Care Medicine.
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Heparin-Induced Thrombocytopenia Costly
THURSDAY, Sept. 11 (HealthDay News) -- The economic impact on hospitals -- primarily increased length of stay and acute care cost -- associated with heparin-induced thrombocytopenia (HIT) may need to be taken into account when making formulary decisions regarding parenteral anticoagulants, according to a report in the September issue of Chest.
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Vytorin May Increase Cancer Risk
TUESDAY, Sept. 2 (HealthDay News) -- Ezetimibe plus simvastatin (Vytorin) may be associated with an increased risk of cancer, according to two studies published online Sept. 2 in the New England Journal of Medicine and presented at the European Society of Cardiology Congress held Aug. 30-Sept. 3 in Munich, Germany.
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Telmisartan Shows Modest Cardiovascular Benefit
MONDAY, Sept. 1 (HealthDay News) -- Telmisartan, an angiotensin-receptor blocker (ARB), is a potential option for patients intolerant of angiotensin-converting enzyme (ACE) inhibitors, although the cardiovascular benefits appear less robust, according to a study and editorial published online Aug. 31 in The Lancet and presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany.
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Omega-3 Fatty Acids Reduce Heart Failure Mortality
MONDAY, Sept. 1 (HealthDay News) -- Omega-3 polyunsaturated fatty acids have beneficial effects on cardiovascular morbidity and mortality while treatment with rosuvastatin does not affect clinical outcomes in patients with chronic heart failure, according to two studies published online Aug. 31 in The Lancet and also presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany.
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Ivabradine Improves Outcomes in Some Heart Patients
MONDAY, Sept. 1 (HealthDay News) -- Use of ivabradine, a heart-rate lowering drug, may improve outcomes in patients with coronary artery disease and a high heart rate, according to a study published online Aug. 31 in The Lancet and also presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany. A second study indicates that a higher resting heart rate in patients with heart disease is a strong, independent risk factor for death.
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