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April 2008 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for April 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.

FDA Clears Coronary Plaque Imaging Device

TUESDAY, April 29 (HealthDay News) -- The U.S. Food and Drug Administration announced Tuesday that it has cleared for marketing a device that physicians can use during cardiac angiography to assess the fat content of atherosclerotic plaques on coronary arteries.

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Physicians Lack Feedback on Accuracy of Diagnoses

TUESDAY, April 29 (HealthDay News) -- Clinical diagnosis is a largely open-loop system in which there is no systematic way for clinicians to obtain feedback on the outcome of their diagnoses, according to an article published in a supplement to the May issue of The American Journal of Medicine.

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Palliative Care Can Improve Patient Care Most, Poll Finds

MONDAY, April 28 (HealthDay News) -- In an international poll conducted by BMJ to determine which area of health care would enable doctors to make the greatest difference to patients, palliative care for non-malignant disease received the most votes, the BMJ Group announced at the International Forum on Quality and Safety in Health Care in Paris this week.

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Aspects of Coronary Syndromes in India Studied

FRIDAY, April 25 (HealthDay News) -- In India, patients who present with acute coronary syndromes have a higher rate of ST elevation myocardial infarction (STEMI) than patients in developed countries. In addition, patients with lower socioeconomic status are less likely to receive evidence-based treatments and have a higher 30-day mortality rate, according to a study published in the April 26 issue of The Lancet.

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Heparin Contaminant Activates Contact System

THURSDAY, April 24 (HealthDay News) -- The serious allergic-type reactions recently reported in patients receiving intravenous heparin appear to be due to the presence of a contaminant, oversulfated chondroitin sulfate (OSCS), which leads to activation of the contact system and release of vasoactive mediators, according to an article first published online April 23 in the New England Journal of Medicine.

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Airway Endoscopy Best for Diagnosing Cause of Stridor

WEDNESDAY, April 23 (HealthDay News) -- In diagnosing the cause of stridor, a high-pitched breathing sound, in children, airway fluoroscopy has high specificity but low sensitivity when compared with airway endoscopy, according to a study in the April issue of the Archives of Otolaryngology -- Head and Neck Surgery.

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Admission Time Does Not Affect Outcome of Heart Attack

TUESDAY, April 22 (HealthDay News) -- Patients who are hospitalized in off-hours after acute myocardial infarction do not have a higher risk of mortality than those who are admitted during regular hours despite the fact that they experience significantly longer door-to-balloon times and are less likely to undergo primary percutaneous coronary intervention, according to a study published online April 21 in Circulation.

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Number of Surgeons Decreases 26 Percent in 25 Years

MONDAY, April 21 (HealthDay News) -- From 1981 to 2005 there was a 25.91 percent drop in the number of surgeons in the United States, according to a study published in the April issue of the Archives of Surgery.

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Mouse Model Sheds Light on Scleroderma Lung Damage

MONDAY, April 21 (HealthDay News) -- Transforming growth factor Β may play a key role in determining fibrosis after epithelial lung injury, and lung fibroblasts may regulate the response of alveolar epithelial cells (AECs) to injury, offering insight into factors underlying scleroderma-associated pulmonary fibrosis (SSc-PF), according to research in the April Arthritis & Rheumatism.

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Cesarean is Independent Risk Factor for Postpartum Stroke

MONDAY, April 21 (HealthDay News) -- Women who undergo cesarean delivery have a higher risk of postpartum stroke than those who deliver vaginally, according to research published in the April issue of the American Journal of Obstetrics & Gynecology.

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Elderly on Antipsychotics Face Higher Pneumonia Risk

MONDAY, April 21 (HealthDay News) -- The use of antipsychotic medications is associated with an increased risk of pneumonia in elderly patients, particularly shortly after they begin treatment, according to research published in the April Journal of the American Geriatrics Society.

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Merits of Abdominal Aortic Aneurysm Screening Debated

FRIDAY, April 18 (HealthDay News) -- The recent decision by the United Kingdom's Department of Health to establish programs to screen all men aged 65 for abdominal aortic aneurysm within 10 years is based on data showing that screening reduces mortality, but some feel that screening may cause more harm than good. This controversy is covered in a Head to Head article published in the April 19 issue of BMJ.

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Two Methods Equal for Pulmonary Embolism Exclusion

FRIDAY, April 18 (HealthDay News) -- In patients with suspected pulmonary embolism, D-dimer measurement and multislice computed tomography (MSCT) is as effective as D-dimer measurement, venous compression ultrasonography of the leg and MSCT for exclusion of pulmonary embolism, researchers report in the April 19 issue of The Lancet.

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Suicide Leading Cause of Violent Deaths

TUESDAY, April 15 (HealthDay News) -- More than half of all violent deaths in the United States are caused by suicide, with higher rates among males than females, according to a report published in the April 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Individualized Health Care Budgets Improve Care

FRIDAY, April 11 (HealthDay News) -- The U.K.'s National Health Service (NHS) should allow patients individual control of their health care budgets, an approach that has been shown in pilot studies to improve outcomes and patient satisfaction in a cost-effective manner, according to an analysis published April 12 in BMJ.

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Consider Health Literacy Level When Writing for Patients

THURSDAY, April 10 (HealthDay News) -- Giving patients clearly written educational materials that convey key messages without resorting to jargon is an important part of engaging patient compliance with treatment and can contribute to health literacy, according to an article published in the April issue of Chest.

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Most Mumps Cases Occurred in Immunized Young Adults

WEDNESDAY, April 9 (HealthDay News) -- Despite high national coverage rates with two doses of mumps vaccine, the largest outbreak of mumps in two decades occurred in 2006, suggesting that changes to the mumps vaccine or vaccine policy may be needed to avert future outbreaks, researchers report in the April 10 issue of the New England Journal of Medicine.

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Doctors Vote on the Ways to Make Biggest Difference

WEDNESDAY, April 9 (HealthDay News) -- The BMJ has begun accepting votes on which areas of health care allow doctors to make the biggest difference to patient care, with a shortlist of six areas each being championed by eminent doctors and researchers. The winning topic will gain special coverage in the BMJ and the BMJ Group's 24 other specialist journals and online education products.

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Possible Person-to-Person Transmission of Bird Flu

WEDNESDAY, April 9 (HealthDay News) -- Person-to-person transmission of bird flu may have taken place between a father and son in China in late 2007, according to a study published online April 8 in The Lancet.

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Factors Affecting Respiratory Distress Risk Identified

TUESDAY, April 8 (HealthDay News) -- A number of factors increase the risk of acute respiratory distress syndrome (ARDS) in patients on mechanical ventilation, including high airway pressures, positive fluid balance, plasma transfusion, sepsis and tidal volume, according to research published in the April issue of the journal Chest.

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Blood Pressure Lowering in Hemorrhagic Stroke Studied

TUESDAY, April 8 (HealthDay News) -- Early intensive blood pressure-lowering therapy in patients with acute intracerebral hemorrhage appears safe and may decrease hematoma size, but more research is needed to see if this strategy improves outcomes, according to research published online April 7 in The Lancet Neurology.

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Kidney Function Predicts Risk of Cardiac Arrest in Women

TUESDAY, April 8 (HealthDay News) -- Impaired kidney function is an independent predictor of sudden cardiac death among women with heart disease, according to research published online April 7 in Hypertension.

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Over 90,000 U.S. Infants Non-Fatally Mistreated Annually

MONDAY, April 7 (HealthDay News) -- From October 2005 through September 2006, approximately 905,000 U.S. children, nearly 20 percent of whom were younger than 1 year of age, were victims of maltreatment, according to a report published in the April 4 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Child Gymnasts at High Risk for Injury

MONDAY, April 7 (HealthDay News) -- Gymnastics has one of the highest injury rates of all girls' sports, accounting for an average 26,600 hospital emergency department treatments a year in children, according to an article published in the April issue of Pediatrics.

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The Lancet Launches Two New Global Partnerships

FRIDAY, April 4 (HealthDay News) -- The Lancet has entered into two new partnerships that will address issues of global health and global warming, according to two commentaries published in the April 5 issue of The Lancet.

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Adding Clopidogrel to Aspirin Reduces Cardiac Risk

WEDNESDAY, April 2 (HealthDay News) -- Treatment with aspirin plus clopidogrel reduces the risk of major cardiovascular events in high-risk patients but has no effect on mortality compared with aspirin alone, although the risk of major bleeding is much higher with combination treatment, according to the results of a study published in the April 1 issue of the American Journal of Cardiology.

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Hands-Only Compressions Beneficial in Sudden Heart Attack

TUESDAY, April 1 (HealthDay News) -- Bystanders who witness an out-of-hospital cardiac arrest and want to help need only perform continuous compression-only cardiopulmonary resuscitation (CPR) and do not need to have mouth-to-mouth contact, according to an article published online March 31 in Circulation: Journal of the American Heart Association.

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CDC: Atlas Shows Geographic Variation in U.S. Strokes

TUESDAY, April 1 (HealthDay News) -- Among Medicare beneficiaries, blacks and individuals residing in certain parts of the southeastern United States are those most likely to be hospitalized for stroke, according to a report released March 28 by the U.S. Centers for Disease Control and Prevention in collaboration with the Centers for Medicare and Medicaid Services.

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Physician's Briefing