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September 2009 Briefing - Critical Care

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

Post-Surgery Complications, Mortality in Hospitals Analyzed

WEDNESDAY, Sept. 30 (HealthDay News) -- While post-surgery complication rates were similar across hospitals, the death rate for hospitals in the quintile with the highest complication-related mortality were nearly twice that of the lowest quintile, according to a study in the Oct. 1 issue of the New England Journal of Medicine.

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Cooling Can Reduce Neurologic Damage in Perinatal Asphyxia

WEDNESADY, Sept. 30 (HealthDay News) -- Reducing the body temperature of newborn infants who have perinatal asphyxia encephalopathy did not reduce the rates of death or severe disability, but lessened the neurologic damage among survivors, according to a study in the Oct. 1 issue of the New England Journal of Medicine.

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Bacterial Infections Are a Factor in Many H1N1 Deaths

WEDNESDAY, Sept. 30 (HealthDay News) -- Many patients who have died of H1N1 influenza this year had a bacterial co-infection that likely contributed to their deaths, according to a Sept. 29 early release of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Spinal Opioid Infusion Deemed Probable Cause of Deaths

TUESDAY, Sept. 29 (HealthDay News) -- An investigation into a cluster of deaths in patients being treated for non-cancer pain with intrathecal opioid pumps found that the pain relief therapy was the probable cause of death, according to a report in the October issue of Anesthesiology.

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Efficacy of Rapid Influenza Diagnostic Test Explored

MONDAY, Sept. 28 (HealthDay News) -- Although the rapid influenza diagnostic test can accurately predict confirmed infection with pandemic H1N1 influenza, the test produces too many false negatives to be of use in the management of the disease pandemic, according to a study in the Sept. 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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H1N1 Virus's Genetic Makeup Appears to Be Staying Stable

MONDAY, Sept. 28 (HealthDay News) -- The genetic makeup of the H1N1 flu has remained stable, which means the yet-to-be-released vaccine is likely to be a good match for the virus, the U.S. Centers for Disease Control and Prevention announced at a Sept. 25 media briefing.

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Drain Can Reduce Hematoma Recurrence and Mortality

FRIDAY, Sept. 25 (HealthDay News) -- Placement of a soft silicon drain tube during the surgical procedure to drain a chronic subdural hematoma reduces both recurrence of the brain hematoma and mortality, according to a study in the Sept. 26 issue of The Lancet.

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Multiple Strokes Linked to Higher Risk for Post-Stroke Dementia

FRIDAY, Sept. 25 (HealthDay News) -- The risk of developing dementia after stroke is higher in patients who have had multiple strokes, according to a study published online Sept. 24 in The Lancet Neurology.

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Folate Linked to Fewer Deaths in Coronary Artery Disease

THURSDAY, Sept. 24 (HealthDay News) -- The use of folate may reduce the long-term risk of death in patients with coronary artery disease and elevated homocysteine, according to research published in the Sept. 15 issue of the American Journal of Cardiology.

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Meta-Analysis Finds Flu Linked to Heart Attack and Death

THURSDAY, Sept. 24 (HealthDay News) -- For people with heart disease, getting influenza increases the risk of heart attack and death, and cardiac patients should be strongly encouraged to get vaccinated, according to a literature review and meta-analysis reported in the October issue of The Lancet Infectious Diseases.

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Review Advises Hand Washing, Other Antiviral Measures

WEDNESDAY, Sept. 23 (HealthDay News) -- Hand washing, wearing a mask, and isolating potential cases are all effective in interrupting the spread of viral respiratory infections and should be given greater attention when planning for widespread outbreaks, according to research published Sept. 22 in BMJ.

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Intensive Care Patients Can Benefit From Physical Medicine

WEDNESDAY, Sept. 23 (HealthDay News) -- Efforts to prevent neuromuscular complications after critical illness can begin in intensive care as soon as a patient is physiologically stabilized, according to a study in the October issue of Critical Care Medicine.

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Spotlight on Social Networking Use Among Medical Students

TUESDAY, Sept. 22 (HealthDay News) -- A majority of medical schools report instances of medical students posting unprofessional content on social networking Web sites, including some instances of violations of patient confidentiality, according to a report in the Sept. 23/30 issue of the Journal of the American Medical Association.

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Physician Medical Errors Linked to Fatigue and Burnout

TUESDAY, Sept. 22 (HealthDay News) -- The incidence of medical error is associated with a host of factors related to physician fatigue, burnout, and mental and emotional well-being, according to a study in the Sept. 23/30 issue of the Journal of the American Medical Association.

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Hormone Replacement Linked to Lung Cancer Deaths

MONDAY, Sept. 21 (HealthDay News) -- Treatment with estrogen plus progestin in postmenopausal women is associated with higher death rates from lung cancer, according to a study published early online Sept. 20 in The Lancet to coincide with the European Cancer Organisation meeting in Berlin. In a related study published the same day in the The Lancet, researchers found that pemetrexed is effective maintenance therapy in patients with advanced non-small-cell lung cancer.

Abstract - Chlebowski
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Abstract - Ciuleanu
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Hispanics Show Lower Artery Bypass Rate After PCI

FRIDAY, Sept. 18 (HealthDay News) -- Despite having a higher cardiovascular risk profile than Caucasians, Hispanics are less likely to have coronary artery bypass graft (CABG) surgery in the year after percutaneous coronary intervention (PCI), according to research published in the Sept. 15 issue of the American Journal of Cardiology.

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Most Pediatric Emergency Asthma Cases Not Followed Up

FRIDAY, Sept. 18 (HealthDay News) -- In reference to children with asthma who are seen at a hospital emergency room, most cases are never followed up and the mother's education level is associated with odds of a child being taken for a check-up, according to a study published in the September issue of the Journal of Emergency Nursing.

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SPDEF Tied to Overproduction of Mucus in Lung Disorders

THURSDAY, Sept. 17 (HealthDay News) -- SPDEF (SAM Pointed Domain Ets-like Factor) plays an important role in regulating a transcriptional network that induces pulmonary goblet cell differentiation and overproduction of mucus, according to research published online Sept. 14 in the Journal of Clinical Investigation.

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Guideline Adherence Can Improve Pneumonia Outcomes

THURSDAY, Sept. 17 (HealthDay News) -- Adult and elderly patients with community-acquired pneumonia (CAP) achieve better outcomes when treated with empirical antimicrobial therapy in accordance with the 2007 professional guidelines for CAP, according to a pair of studies in the Sept. 14 issue of the Archives of Internal Medicine.

Abstract - Arnold
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Abstract - McCabe
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Taxes on Sugared Sodas Could Cut Consumption

WEDNESDAY, Sept. 16 (HealthDay News) -- Imposing a tax on sugar-sweetened beverages could reduce consumption and generate income for obesity reduction and healthy eating education interventions, according to an article published online Sept. 16 in the New England Journal of Medicine.

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Treatments for Acute Respiratory Failure Compared

WEDNESDAY, Sept. 16 (HealthDay News) -- For patients suffering acute respiratory failure, extracorporeal membrane oxygenation (ECMO) is superior to conventional ventilation support in terms of survival without disability, according to a study published online Sept. 16 in The Lancet.

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FDA Approves Four Vaccines for H1N1 Influenza

TUESDAY, Sept. 15 (HealthDay News) -- The U.S. Food and Drug Administration has approved four H1N1 influenza vaccines, according to a Sept. 15 news release issued by the agency.

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Drug Interaction E-Alerts Show Benefit to Patient Safety

MONDAY, Sept. 14 (HealthDay News) -- Drug interaction alerts from electronic prescribing likely improve patient safety and reduce costs in outpatient care, despite the fact that over 90 percent of the alerts are overridden by physicians, according to a study in the Sept. 14 issue of Archives of Internal Medicine.

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Depression May Help Predict Mortality in Cancer Patients

MONDAY, Sept. 14 (HealthDay News) -- In cancer patients, depression is associated with a statistically significant but relatively small increased risk of death, but it is not associated with an increased risk of disease progression, according to a study published online Sept. 14 in Cancer.

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Drug Shown to Aid Patients With Resistant Hypertension

MONDAY, Sept. 14 (HealthDay News) -- The vasodilator darusentan significantly lowers blood pressure in patients whose hypertension is resistant to current drugs, according to a study published online Sept. 14 in The Lancet.

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Quick Stenting Beneficial in Heart Attacks in Remote Areas

FRIDAY, Sept. 11 (HealthDay News) -- Patients with ST-segment elevation myocardial infarction (STEMI) who live in rural areas with long transfer times to angioplasty have significant improvements in the rate of death, reinfarction, and stroke if they receive angioplasty immediately after thrombolysis, according to a study presented at the 2009 European Society of Cardiology Congress and published online Sept. 9 in the Journal of the American College of Cardiology.

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Mutated H1N1 Virus Resistant to Antiviral Drug Oseltamivir

FRIDAY, Sept. 11 (HealthDay News) -- The discovery of H1N1 mutations resistant to the neuraminidase inhibitor oseltamivir in two adolescent girls sharing a cabin at a North Carolina camp prompted a new recommendation from the U.S. Centers for Disease Control and Prevention on the proper prophylactic use of antiviral drugs, according to a case report in the Sept. 11 issue of the CDC's Morbidity and Mortality Weekly Report.

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Current Health Policy May Not Serve Young People Well

FRIDAY, Sept. 11 (HealthDay News) -- A high proportion of deaths in young people worldwide are due to intentional and unintentional injury, and the current adolescent health policy focus on HIV/AIDS and maternal mortality is not enough to prevent mortality amongst youngsters, according to a study in the Sept. 12 issue of The Lancet.

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Poverty-Mortality Association Unchanged in England

FRIDAY, Sept. 11 (HealthDay News) -- Despite myriad medical, public health, social, economic and political changes, the association between poverty and mortality in England and Wales is as strong today as it was at the start of the 20th century, according to a study published online Sept. 10 in BMJ.

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S. pneumoniae Leads to Death in Many Under 5

FRIDAY, Sept. 11 (HealthDay News) -- Approximately 11 percent of all deaths in children aged 1 to 59 months are due to infection with Streptococcus pneumoniae, and greater efforts to prevent and treat disease associated with the bacterium could help attain the United Nations Millennium Development Goal 4 of reducing child mortality by two-thirds between 1990 and 2015, according to a study published in the Sept. 12 issue of The Lancet.

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One Dose of H1N1 Vaccine May Offer Substantial Protection

FRIDAY, Sept. 11 (HealthDay News) -- Preliminary research indicates that just a single dose of the 2009 H1N1 vaccine can substantially increase protective antibodies, but vaccinations with seasonal flu vaccine provide minimal cross-reactive antibody response, according to several studies published online Sept. 10 in the New England Journal of Medicine.

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Cardiology Work Force Crisis Looms as Cases Set to Rocket

THURSDAY, Sept. 10 (HealthDay News) -- The cardiology work force will need to double by 2050 if it is to keep pace with the growing number of patients requiring specialist cardiology care, according to an American College of Cardiology (ACC) study published online Sept. 10 in the Journal of the American College of Cardiology, and presented at an ACC media telebriefing earlier today.

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Statins May Offer Improved Outcomes for COPD Patients

THURSDAY, Sept. 10 (HealthDay News) -- Statins appear to be beneficial in the treatment of chronic obstructive pulmonary disease (COPD), but more interventional trials are needed to specifically assess the drugs' effect on relevant COPD outcomes, according to a literature review in the Sept. 1 issue of Chest.

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Kenyan Immunization May Reduce Sickle-Cell Death

THURSDAY, Sept. 10 (HealthDay News) -- Sickle-cell anemia is more than 25 times more common in Kenyan children with bacterial infections, and immunization may prevent death since the bacterial species are the same as those in developed countries, according to a study published online Sept. 10 in The Lancet.

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Neonatologists Need to Brush Up on Communication Skills

THURSDAY, Sept. 10 (HealthDay News) -- Although neonatologists graduate with a high degree of training in the technical skills they need, they typically lack adequate training in how to best communicate with families facing end-of-life decisions, according to a study published in the September issue of the Archives of Pediatrics & Adolescent Medicine.

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Viruria Could Help Predict Rare Condition in Multiple Sclerosis

WEDNESDAY, Sept. 9 (HealthDay News) -- Analyzing the urine of multiple sclerosis patients for JC virus could help identify those at risk of developing another rare demyelinating disease after natalizumab (Tysabri) treatment, according to a study in the Sept. 10 issue of the New England Journal of Medicine. And two additional reports detail cases of this rare condition, progressive multifocal leukoencephalopathy (PML).

Abstract - Chen
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Most H1N1 Flu Patients Don't Need Antiviral Medication

WEDNESDAY, Sept. 9 (HealthDay News) -- Antiviral medications should be used to treat H1N1 swine flu only in people who are hospitalized from the flu or are at high risk of complications from it, according to the U.S. Centers for Disease Control and Prevention.

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Guideline Reduces Antibiotics Usage, Adverse Drug Effects

TUESDAY, Sept. 8 (HealthDay News) -- In the management of lower respiratory tract infections, procalcitonin-based guidelines may lead to lower rates of antibiotic exposure and associated adverse effects without increasing adverse outcomes, according to a study published in the Sept. 9 issue of the Journal of the American Medical Association.

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H1N1 Vaccines Appear Safe for Adults, Children

MONDAY, Sept. 7 (HealthDay News) -- The new H1N1 swine flu vaccine appears to be as safe as the seasonal flu variety, according to experts from the U.S. National Institute of Allergy and Infectious Diseases; and, intravenous use of the antiviral zanamivir (Relenza) may provide a lifesaving alternative for severe cases of H1N1 pneumonitis, according to a report published online Sept. 4 in The Lancet.

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AHA Advocates Atherosclerosis Assessment in Children

FRIDAY, Sept. 4 (HealthDay News) -- In a scientific statement published online Sept. 3 in Hypertension, the American Heart Association has promulgated recommendations for a standardized approach to the noninvasive assessment of children and adolescents for the earliest signs of approaching atherosclerosis.

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Top Hospitals Have Slightly Better Heart Failure Outcomes

WEDNESDAY, Sept. 2 (HealthDay News) -- Although hospitals ranked by the U.S. News & World Report as the best providers of heart care and surgery achieve better 30-day mortality rates than their non-ranked counterparts, readmission rates are similar regardless of ranking, according to a study published online Sept. 1 in Circulation: Cardiovascular Quality and Outcomes.

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Academic Medical Centers Active and Diverse in Research

TUESDAY, Sept. 1 (HealthDay News) -- Research at academic medical centers is active and diverse, with nearly a quarter of life-science researchers receiving no funding, and relationships with industry more commonly seen among translational and clinical researchers than basic science researchers, according to a study in the Sept. 2 issue of the Journal of the American Medical Association.

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