August 2012 Briefing - Emergency Medicine

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

Novel Pathogenic Virus Identified in Missouri

THURSDAY, Aug. 30 (HealthDay News) -- A novel pathogenic virus dubbed the Heartland virus, which is a member of the phlebovirus genus, has been identified in two patients from Missouri, according to a report published in the Aug. 30 issue of the New England Journal of Medicine.

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No 30-Day Mortality Reduction With Intraaortic Balloon Pump

WEDNESDAY, Aug. 29 (HealthDay News) -- In patients with cardiogenic shock complicating acute myocardial infarction, for whom early revascularization strategy is planned, intraaortic balloon counterpulsation does not significantly lower 30-day mortality, according to a study published online Aug. 27 in the New England Journal of Medicine to coincide with presentation at the annual European Society of Cardiology Congress, held from Aug. 25 to 29 in Munich.

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STEMI Mortality Down in France From 1995 to 2010

TUESDAY, Aug. 28 (HealthDay News) -- ST-segment elevation myocardial infarction (STEMI) mortality declined in France from 1995 to 2010 due to greater use of reperfusion therapy and early admission and medications as well as changes in patient characteristics, according to a study published online Aug. 27 in the Journal of the American Medical Association to coincide with presentation at the annual European Society of Cardiology Congress, held from Aug. 25 to 29 in Munich.

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New Diagnostic Definition of Myocardial Infarction Issued

TUESDAY, Aug. 28 (HealthDay News) -- An updated universal definition of myocardial infarction (MI) includes detection of a rise and/or fall in cardiac biomarker values, preferably cardiac troponin (cTn), according to a statement published online Aug. 26 in Circulation to coincide with presentation at the annual European Society of Cardiology Congress, held from Aug. 25 to 29 in Munich.

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Prasugrel, Clopidogrel Similar for Acute Coronary Syndromes

MONDAY, Aug. 27 (HealthDay News) -- For patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization, intensified platelet inhibition with prasugrel does not reduce the frequency of the primary end point (death from cardiovascular causes, myocardial infarction, or stroke) and has similar risks of bleeding as clopidogrel, according to a study published online Aug. 26 in the New England Journal of Medicine to coincide with presentation at the annual European Society of Cardiology Congress, held from Aug. 25 to 29 in Munich.

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Mortality Rates Down for Adult Trauma Patients in Last Decade

THURSDAY, Aug. 23 (HealthDay News) -- The mortality rate for adult patients admitted to trauma centers in Pennsylvania has declined over the past decade, according to research published in the August issue of the Archives of Surgery.

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Racial Disparity ID'd in Health Behaviors of Fifth-Graders

THURSDAY, Aug. 23 (HealthDay News) -- Harmful health-related behaviors are more common among black and Latino fifth-graders than among white fifth-graders, according to a study published in the Aug. 23 issue of the New England Journal of Medicine.

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Nearly Half of U.S. Physicians Have Symptoms of Burnout

THURSDAY, Aug. 23 (HealthDay News) -- Nearly half of all U.S. physicians report at least one symptom of burnout, with family, internal, and emergency medicine specialists reporting the highest rates of burnout, according to research published online Aug. 20 in the Archives of Internal Medicine.

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Low Back Pain Outcomes Not Improved by Early Imaging

WEDNESDAY, Aug. 22 (HealthDay News) -- For workers with low back pain, early magnetic resonance imaging (MRI) is not associated with better health outcomes at one year, according to a study published in the Aug. 15 issue of Spine.

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Drug-Eluting Stents Lead to Fewer Adverse Cardiac Events

TUESDAY, Aug. 21 (HealthDay News) -- Among ST-segment elevation myocardial infarction (STEMI) patients, the use of biolimus-eluting stents with biodegradable polymer results in a lower rate of major adverse cardiac events, compared with patients with bare-metal stents, at one year following primary percutaneous coronary intervention (PCI), according to a study published in the Aug. 22/29 issue of the Journal of the American Medical Association.

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2012 Indicators of Well-Being for Older Americans Issued

MONDAY, Aug. 20 (HealthDay News) -- The estimates of selected indicators for well-being for older Americans for 2012 have been released by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Prevalence of TB, Hepatitis C, HIV High Among Homeless

MONDAY, Aug. 20 (HealthDay News) -- The global prevalence of tuberculosis, hepatitis C virus infection, and HIV is high among homeless people, although significant heterogeneity is seen in prevalence estimates, according to a study published online Aug. 20 in The Lancet Infectious Diseases.

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Study Links Eating Egg Yolks With Carotid Plaque Area

FRIDAY, Aug. 17 (HealthDay News) -- Eating three or more egg yolks, which are high in cholesterol, per week may increase the rate of carotid plaque area build-up, according to a study published online Aug. 10 in Atherosclerosis.

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Ecallantide Efficacious for Hereditary Angioedema Attacks

FRIDAY, Aug. 17 (HealthDay News) -- Patients with unpredictable and recurring attacks of acute hereditary angioedema (HAE) may be effectively treated with ecallantide, with relapse occurring in a small proportion of patients and little evidence of rebound, according to a study published in the September issue of Allergy.

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Post-Intracerebral Bleed, BP Control Poorer for Blacks

THURSDAY, Aug. 16 (HealthDay News) -- Blood pressure (BP) control is poor at 30 days and one year after intracerebral hemorrhage (ICH), particularly among black patients, according to a study published online Aug. 16 in Stroke.

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Exenatide Has Hemodynamic Effects in Healthy Men

THURSDAY, Aug. 16 (HealthDay News) -- The glucagon-like peptide-1 agonist, exenatide, used in the treatment of type 2 diabetes mellitus, has significant acute hemodynamic effects on healthy volunteers, according to a study published in the September issue of the British Journal of Clinical Pharmacology.

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Catastrophizing Doesn't Predict Low Back Pain Evolution

THURSDAY, Aug. 16 (HealthDay News) -- For adult patients with acute or chronic low back pain (LBP), assessing the baseline score for catastrophizing does not help clinicians in routine clinical practice predict the evolution of LBP or the patient's disability at three months, according to a study published online July 23 in The Spine Journal.

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FDA: Codeine May Be Fatal in Subset of Children

WEDNESDAY, Aug. 15 (HealthDay News) -- Some children may be at risk for serious adverse events, including death, after taking codeine for relief of pain following tonsillectomy and/or adenoidectomy for obstructive sleep apnea, according to a safety communication issued Aug. 15 by the U.S. Food & Drug Administration.

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Chronic Kidney Disease Increases Stroke Risk in A-Fib

WEDNESDAY, Aug. 15 (HealthDay News) -- Patients with atrial fibrillation who have chronic kidney disease are at higher risk of stroke or systemic thromboembolism and bleeding, according to a study published in the Aug. 16 issue of the New England Journal of Medicine.

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Hospital Deaths From Head Trauma Higher on Weekends

WEDNESDAY, Aug. 15 (HealthDay News) -- Older adults admitted for substantial head trauma during a weekend have a significantly increased mortality risk compared to those admitted on a weekday, according to a study published online July 9 in the Journal of Surgical Research.

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ABO Blood Group Correlated With Coronary Heart Disease

WEDNESDAY, Aug. 15 (HealthDay News) -- There is a significantly elevated risk of incident coronary heart disease (CHD) among individuals with blood group A, B, or AB compared with those with blood group O, according to a study published online Aug. 14 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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One-Hour Algorithm Safe for Rule-Out/Rule-In of Acute MI

WEDNESDAY, Aug. 15 (HealthDay News) -- An algorithm using high-sensitivity cardiac troponin T (hs-CTnT) levels at baseline and after one hour can be used to successfully rule out or accurately diagnose acute myocardial infarction (AMI) in the majority of patients who present with acute chest pain, according to research published online Aug. 13 in the Archives of Internal Medicine.

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Universal Domestic Violence Screening Not Beneficial

TUESDAY, Aug. 14 (HealthDay News) -- Screening for partner violence at the primary care level does not improve women's health or quality of life, or reduce further partner violence, according to a study published in the Aug. 15 issue of the Journal of the American Medical Association.

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Underinsurance Tied to Higher Death Risk After Cardio Events

FRIDAY, Aug. 10 (HealthDay News) -- Being underinsured correlates with increased mortality after acute cardiovascular events, while race is not associated with increased mortality, according to a study published online July 21 in the Journal of General Internal Medicine.

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Racial Disparity in CT Use for Children With Head Trauma

WEDNESDAY, Aug. 8 (HealthDay News) -- Minority children with minor blunt head trauma and low or intermediate risk for clinically important traumatic brain injury are significantly less likely to receive cranial computed tomography (CT) in the emergency department than their nonminority peers with the same risk, according to a study published in the August issue of the Archives of Pediatrics & Adolescent Medicine.

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Overcrowding Up in Hospitals With Large Minority Population

WEDNESDAY, Aug. 8 (HealthDay News) -- California hospitals serving large minority populations are more likely to be overcrowded and to divert ambulances, according to research published in the August issue of Health Affairs.

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Implantable Defibrillators Cut Out-of-Hospital Cardiac Arrests

MONDAY, Aug. 6 (HealthDay News) -- The use of implantable cardiac defibrillators (ICDs) has been responsible for about one-third of the reduction in out-of-hospital cardiac arrests (OHCAs) having ventricular fibrillation (VF) as the initial recorded rhythm, according to a study published online Aug. 6 in Circulation.

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Unsuspected PE Does Not Up Mortality Risk in Cancer Patients

MONDAY, Aug. 6 (HealthDay News) -- Cancer patients with an unsuspected pulmonary embolism (UPE) do not have an increased mortality risk and have a similar risk of recurrent venous thromboembolism (VTE) to those with clinically suspected pulmonary embolism (PE), according to research published online July 27 in the Journal of Thrombosis and Haemostasis.

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Clinicians Can Unintentionally Prompt Nocebo Effect

THURSDAY, Aug. 2 (HealthDay News) -- The nocebo effect, or induction of a symptom perceived as negative by sham treatment and/or the suggestion of negative expectation, may arise from suggestions by doctors and nurses, according to a study published in Deutsches Ärzteblatt International.

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Environmental Factors Affect Risk of Hypothermia in Trauma

THURSDAY, Aug. 2 (HealthDay News) -- Aside from injury severity, environmental conditions are significant factors impacting the risk of onset of hypothermia in trauma patients being transported to the hospital by emergency medical services (EMS), according to a study published online July 31 in Critical Care.

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Multiple Factors Motivate No Reperfusion in STEMI

THURSDAY, Aug. 2 (HealthDay News) -- For patients presenting with ST-segment elevation myocardial infarction (STEMI), the decision for no reperfusion is usually multifactorial, with the most common factor being advanced age, according to a study published in the Aug. 15 issue of The American Journal of Cardiology.

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