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August 2014 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for August 2014. 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.

Report Highlights Progress, Challenges in Health IT

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Progress has been made toward widespread adoption of electronic health records (EHRs), although there are still barriers to adoption of advanced use of EHRs, according to a report published by the Robert Wood Johnson Foundation.

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Doctors Frequently Experience Ethical Dilemmas

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For physicians trying to balance various financial and time pressures, ethical dilemmas are common, according to an article published Aug. 7 in Medical Economics.

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Ebola Outbreak Could Infect 20,000 People, U.N. Says

THURSDAY, Aug. 28, 2014 (HealthDay News) -- The deadly Ebola outbreak hitting four West African nations could eventually infect more than 20,000 people, the World Health Organization announced Thursday.

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NIH Press Release
WHO Statement

Lupin in Gluten-Free Food May Trigger Allergies

THURSDAY, Aug. 28, 2014 (HealthDay News) -- A new ingredient in gluten-free products, lupin, which belongs to the same plant family as peanuts, could cause allergic reactions, according to a news release from Kansas State University.

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AMGA: Physician Turnover Still High in 2013

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For the second year running, physician turnover remains at the highest rate since 2005, according to a report published by the American Medical Group Association (AMGA).

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Health Care Protective Gear Lacking in Ebola Outbreak

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- Health care workers in poor nations often do not have enough protective gear to keep them safe from being infected with blood-borne viruses such as Ebola and HIV, according to a study published online Aug. 8 in Tropical Medicine & International Health.

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CDC Director: Ebola has 'Upper Hand' in Outbreak

TUESDAY, Aug. 26, 2014 (HealthDay News) -- While officials and health experts have the means to prevent Ebola from spreading, the deadly virus currently has the "upper hand" in an outbreak that has killed more than 1,400 people in West Africa, according to the director of the U.S. Centers for Disease Control and Prevention.

Health Highlights: Aug. 26, 2014

FDA: Steer Clear of Dietary Supplements for Concussions

TUESDAY, Aug. 26, 2014 (HealthDay News) -- As the fall sports season starts and young players face the risk of concussions, the U.S. Food and Drug Administration warns that dietary supplements that claim to prevent, treat, or cure concussions are untested, unproven, and possibly dangerous.

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Frequent ER Visits for Heart Failure Cause Majority of Costs

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Individuals with frequent emergency department visits for acute heart failure syndrome (AHFS) account for the majority of hospitalizations and hospital charges for AHFS, according to a study published online Aug. 19 in Circulation: Cardiovascular Quality and Outcomes.

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Hospitals Should Follow CDC Recommendations for Ebola Care

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Hospital and health care providers should follow the U.S. Centers for Disease Control and Prevention's recommendations for care of patients with Ebola, according to an ideas and opinions piece published online Aug. 21 in the Annals of Internal Medicine.

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Restrictive, Non-Solicitation Covenants Are Valid

MONDAY, Aug. 25, 2014 (HealthDay News) -- Restrictive and non-solicitation covenants are valid and can be enforced, according to an article published Aug. 5 in Medical Economics.

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State Medical Cannabis Laws Cut Opioid Overdose Mortality

MONDAY, Aug. 25, 2014 (HealthDay News) -- State medical cannabis laws correlate with reduced state-level opioid overdose mortality rates, according to a study published online Aug. 25 in JAMA Internal Medicine.

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U.S. to Tighten Access to Certain Narcotic Painkillers

FRIDAY, Aug. 22, 2014 (HealthDay News) -- The U.S. Drug Enforcement Administration (DEA) is going ahead with tough new controls on painkillers containing hydrocodone, which has been tied to a surge in dangerous addictions across the United States.

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Many Americans Harbor Unfounded Fears About Ebola

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Many Americans know little about how Ebola is transmitted and harbor unfounded fears about the possibility of an outbreak in the United States, a new survey shows. About four in 10 adults said they are worried that there will be a major Ebola outbreak in the United States, and one-quarter are concerned that they or an immediate family member will get sick with the deadly virus in the next year, according to the latest Harvard School of Public Health poll.

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Futile Care Linked to Delays in Care for Other Patients

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Futile care, which is used to prolong life without achieving a meaningful benefit for the patient, can cause delays in care for other patients waiting to be admitted to the intensive care unit (ICU), according to a study published in the September issue of Critical Care Medicine.

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Telemedicine Improves Stroke Care in Rural Areas

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Telemedicine can improve stroke care in rural areas, according to a study published online Aug. 21 in Stroke.

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U.S. Health Care Workers With Ebola Released From Hospital

THURSDAY, Aug. 21, 2014 (HealthDay News) -- The two American health care workers infected with the deadly Ebola virus while doing missionary medical work in West Africa have been released from the Atlanta hospital where they have been slowly recovering for several weeks, officials said Thursday.

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Infections May Up Pediatric Stroke Risk in Short Term

THURSDAY, Aug. 21, 2014 (HealthDay News) -- Minor infections appear to have a strong, but short-lived, effect on pediatric stroke risk, according to a study published online Aug. 20 in Neurology.

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Organized Processes Help Practices Hire Well

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- A defined process is necessary to help physicians hire the right staff for their practice, according to an article published July 24 in Medical Economics.

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Clarithromycin Linked to Increased Risk of Cardiac Death

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- There is a significantly increased risk of cardiac death associated with clarithromycin use, according to a study published online Aug. 19 in BMJ.

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Hospitalization Less Likely With Artificially Altered Oximetry

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Among infants presenting to an emergency department with mild to moderate bronchiolitis, hospitalization is less likely for those with an artificially elevated pulse oximetry reading, according to a study published in the Aug. 20 issue of the Journal of the American Medical Association.

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Docs Must Consider Liability When Ordering Screening Tests

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Physicians and health care providers must be aware of their potential liability when ordering screening tests, according to an article published July 24 in Medical Economics.

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Boxed Warnings Are Common in Novel Therapeutics

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Boxed warnings are common on recent drug approvals, and many occur years after approval, according to a research letter published online Aug. 15 in JAMA Internal Medicine.

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Commentary Focuses on 2014 Ebola Outbreak in West Africa

TUESDAY, Aug. 19, 2014 (HealthDay News) -- The Ebola epidemic is spreading in West Africa, with little hope for treatment, and an experimental therapy is unlikely to be provided to African patients, according to two commentaries published online Aug. 19 in the Annals of Internal Medicine.

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Hospitalizations for Acute CVD, Stroke Down From 1999 to 2011

TUESDAY, Aug. 19, 2014 (HealthDay News) -- From 1999 through 2011 there were considerable declines in hospitalizations for acute cardiovascular disease and stroke, outpacing those of other conditions, according to a study published online Aug. 18 in Circulation.

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Liberia Ebola Clinic Attack Could Harm Efforts to Control Outbreak

MONDAY, Aug. 18, 2014 (HealthDay News) -- An attack on an Ebola quarantine center in Liberia's capital and the possible disappearance of a number of patients could be a major setback in efforts to contain and halt the outbreak of the deadly disease.

Health Highlights: Aug. 18, 2014

WHO: Scope of Ebola Outbreak May Be 'Vastly Underestimated'

FRIDAY, Aug. 15, 2014 (HealthDay News) -- The magnitude of the Ebola outbreak in West Africa may be far greater than the current statistics indicate, officials from the World Health Organization said Friday.

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Overdoses From Synthetic Drug Spur State of Emergency in N.H.

FRIDAY, Aug. 15, 2014 (HealthDay News) -- New Hampshire has declared a state of emergency after 44 overdoses linked to a synthetic marijuana-like product sold in convenience stores as potpourri. Nearly all of the overdoses that occurred in people who smoked or ingested a product called "Smacked" occurred in the Manchester area. None of the overdose patients died, NBC News reported.

Health Highlights: Aug. 15, 2014

FDA Warns of Fake Ebola Treatments on the Internet

FRIDAY, Aug. 15, 2014 (HealthDay News) -- As the death toll in the West Africa Ebola outbreak passes 1,000, the U.S. Food and Drug Administration is warning against products sold online that claim to treat the deadly disease or prevent infection.

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Malnutrition Prevalent Among Seniors Presenting to ER

FRIDAY, Aug. 15, 2014 (HealthDay News) -- More than half of older patients presenting to the emergency department are malnourished or at risk of malnutrition, according to a study published online Aug. 12 in the Annals of Emergency Medicine.

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Limited Sensitivity for Plain Anteroposterior Pelvic Imaging

THURSDAY, Aug. 14, 2014 (HealthDay News) -- For children with pelvic fractures or dislocations after blunt trauma, plain anteroposterior pelvic radiographs have limited sensitivity, according to a study published online July 29 in the Annals of Emergency Medicine.

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Research Offers Clues to How Ebola Disarms Immune System

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Researchers say they've discovered how the deadly Ebola virus disables the immune system. They hope the findings will prove valuable in efforts to find treatments for the disease taking hundreds of lives in Africa. The current Ebola outbreak in West Africa has killed more than 1,000 people, and the death rate among those infected with the virus is up to 90 percent, according to the World Health Organization.

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Viral Infections in 14 Kansas City-Area Infants Under Investigation

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Similar viral infections among 14 infants in the Kansas City area are being investigated by health officials. The infections were caused by HPeV3, a virus that can cause meningitis and other inflammation. No deaths have occurred, but all of the infants have been hospitalized, CBS News/Associated Press reported.

Health Highlights: Aug. 13, 2014

Delayed Cardioversion With A-Fib Ups Thromboembolic Risk

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- A delay to cardioversion of 12 hours or longer from onset of acute atrial fibrillation symptoms is associated with a greater risk of thromboembolic complications, according to a research letter published in the Aug. 13 issue of the Journal of the American Medical Association.

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WHO Experts Give Nod to Using Untested Ebola Drugs

TUESDAY, Aug. 12, 2014 (HealthDay News) -- A panel of ethicists specially appointed by the World Health Organization says it is ethical to give untested treatments to people battling Ebola in the current outbreak.

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Meta-Analysis Strategy Impacts Estimation of Tx Outcome

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Estimation of treatment outcome varies with the meta-analysis strategy, according to a study published in the Aug. 13 issue of the Journal of the American Medical Association.

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Children's Hospitals Vary in Admission Rates

TUESDAY, Aug. 12, 2014 (HealthDay News) -- U.S. children's hospitals show three-fold variation in admission rates for common pediatric conditions, even when adjusting for severity of illness, according to a study published online Aug. 11 in Pediatrics.

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Digoxin Ups Death Risk in Newly Diagnosed A-Fib Patients

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Among patients with newly diagnosed atrial fibrillation (AF), the use of digoxin is associated with increased risk of death, according to research published in the Aug. 19 issue of the Journal of the American College of Cardiology.

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Review: Troponin Has Prognostic Value in CKD Without ACS

MONDAY, Aug. 11, 2014 (HealthDay News) -- For patients with chronic kidney disease (CKD) without suspected acute coronary syndrome (ACS), troponin levels may have prognostic and diagnostic value, according to two reviews published online Aug. 12 in the Annals of Internal Medicine.

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Ethicists Weigh Questions Over Early Release of Ebola Drugs

MONDAY, Aug. 11, 2014 (HealthDay News) -- As the number of dead in the West African Ebola outbreak nears 1,000, many people are calling for the wider production and release of untested medicines that might help patients.

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EHR Adoption Increasing, But Stage 2 Criteria Often Not Met

MONDAY, Aug. 11, 2014 (HealthDay News) -- Most U.S. hospitals and office-based physicians have adopted electronic health records (EHR), according to two studies published in the August issue of Health Affairs.

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Guidelines Updated for Contrast Agent Use in Clinical Echoes

MONDAY, Aug. 11, 2014 (HealthDay News) -- Initiatives have been developed to improve the appropriate use of contrast media in echocardiography. The guidelines were published in the August issue of the Journal of the American Society of Echocardiography.

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Impact Location Has Limited Effect on Concussion Outcome

MONDAY, Aug. 11, 2014 (HealthDay News) -- For high school football players who sustain concussion due to player-to-player collisions, impact location has a minimal effect on outcome, according to a study published online Aug. 11 in Pediatrics.

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Emergency Department Closures Up Inpatient Mortality Nearby

MONDAY, Aug. 11, 2014 (HealthDay News) -- Emergency department closures are associated with increased mortality for admissions that occur nearby, according to research published in the August issue of Health Affairs.

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Neighborhood's Socioeconomic Status Tied to Readmissions

MONDAY, Aug. 11, 2014 (HealthDay News) -- Neighborhood socioeconomic status (SES) is linked to six-month, all-cause readmission among patients with heart failure, even after adjustment for patient-level factors, according to a study published online July 29 in Circulation: Cardiovascular Quality and Outcomes.

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WHO Declares Ebola Outbreak a 'Public Health Emergency'

FRIDAY, Aug. 8, 2014 (HealthDay News) -- The World Health Organization on Friday declared the outbreak of deadly Ebola virus in West Africa a "public health emergency."

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CDC Raises Ebola Outbreak Response to Highest Alert

FRIDAY, Aug. 8, 2014 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention on Wednesday raised the level of its response to the West African Ebola outbreak to its highest alert status, and CDC is offering resources for clinicians on Ebola virus disease management.

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FAQ: Management of Patients With EVD in U.S. Hospitals

Nomogram Predicts Risk of Second Kidney Stone Episode

FRIDAY, Aug. 8, 2014 (HealthDay News) -- The Recurrence of Kidney Stone (ROKS) nomogram identifies patients with kidney stones who are at high risk for a second symptomatic episode, according to research published online Aug. 7 in the Journal of the American Society of Nephrology.

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FDA: Some Home Tattoo Kits Recalled Due to Infection Risk

THURSDAY, Aug. 7, 2014 (HealthDay News) -- Inks in some home tattoo kits are contaminated and could cause skin infections, the U.S. Food and Drug Administration says.

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Diagnostic Algorithm for Appendicitis Cuts Pediatric CT Use

THURSDAY, Aug. 7, 2014 (HealthDay News) -- For pediatric patients, implementation of a diagnostic algorithm for appendicitis correlates with a significant reduction in computed tomography (CT) use without impacting diagnostic accuracy, according to a study published in the August issue of Surgery.

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VA Health Care Reform Bill Signed Into Law

THURSDAY, Aug. 7, 2014 (HealthDay News) -- A bill signed into law Thursday by President Barack Obama is meant to provide veterans with easier access to government-paid health care.

Health Highlights: Aug. 7, 2014

Centralizing Stroke Services Improves Outcomes

THURSDAY, Aug. 7, 2014 (HealthDay News) -- Centralizing acute stroke services in urban areas can cut morality and length of hospital stay, according to a study published online Aug. 5 in BMJ.

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U.S. Hospitals See Big Rise in Drug-Related Suicide Attempts

THURSDAY, Aug. 7, 2014 (HealthDay News) -- Drug-related suicide attempts in the United States increased over a recent six-year period, with dramatic increases seen among young and middle-aged adults, health officials reported Thursday.

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Fears of U.S. Ebola Outbreak Unwarranted, Experts Say

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- The decision to bring two American aid workers infected with Ebola back to the United States has kicked up controversy, causing some to fear a local outbreak of the virus. But experts in infectious disease say there's close to no chance that this will cause an Ebola outbreak on these shores.

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Review: Earlier Alteplase Benefits Acute Ischemic Stroke More

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Alteplase delivered within 4.5 hours of acute ischemic stroke onset is associated with increased odds of a good stroke outcome irrespective of age or stroke severity and despite an increased risk of fatal intracranial hemorrhage, with earlier treatment associated with bigger proportional benefits, according to a review published online Aug. 6 in The Lancet.

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Mortality Up With CKD in PCI Contrast-Induced Nephropathy

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Contrast-induced nephropathy (CIN) is associated with long-term mortality in patients with, but not those without, chronic kidney disease (CKD), according to a study published in the Aug. 1 issue of The American Journal of Cardiology.

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Patients Give Higher Scores for Nursing Care Than Do Nurses

TUESDAY, Aug. 5, 2014 (HealthDay News) -- A survey has revealed that patients at a single level-1 trauma center emergency room consistently rate the nursing care received higher than do the nurses, according to research published in the July issue of the Journal of Emergency Nursing.

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Experimental Serum May Have Been Key to Ebola Recovery

TUESDAY, Aug. 5, 2014 (HealthDay News) -- An experimental serum never before tried in people may have been pivotal in helping treat two Americans stricken with Ebola, according to media reports.

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Influenza-Like Illness Carries High Pediatric Risk

TUESDAY, Aug. 5, 2014 (HealthDay News) -- More than one in three children presenting to the emergency department with influenza-like illness develop severe complications, according to a study published online Aug. 4 in Pediatrics.

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Many Physicians Have Secondary Income

MONDAY, Aug. 4, 2014 (HealthDay News) -- Many physicians report earning income from sources other than their primary practice/employer, according to an article published July 24 in Medical Economics.

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Review: Ketamine Does Not Adversely Affect Outcomes

MONDAY, Aug. 4, 2014 (HealthDay News) -- For intubated patients, ketamine is unlikely to adversely affect patient outcomes compared with other intravenous sedatives, according to a review published online July 22 in the Annals of Emergency Medicine.

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CT Effective in Detection of Significant Cervical Spine Injury

MONDAY, Aug. 4, 2014 (HealthDay News) -- Computed tomography (CT) is effective in detecting clinically significant cervical spine (CS) injuries in patients with neurologic deficit or CS pain, according to a study published online July 30 in JAMA Surgery.

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Interventions Avert Contrast-Induced Acute Kidney Injury

MONDAY, Aug. 4, 2014 (HealthDay News) -- A quality improvement program helps prevent contrast-induced acute kidney injury (CI-AKI) in patients undergoing percutaneous coronary intervention, according to research published online July 29 in Circulation: Cardiovascular Quality and Outcomes.

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Guidelines Issued for Cardiac Management of Noncardiac Sx

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Recommendations have been developed for perioperative cardiovascular management of patients undergoing noncardiac surgery. These revised guidelines were published online Aug. 1 in the Journal of the American College of Cardiology.

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Off-Hour Arrival at Hospital Impacts Heart Attack Outcomes

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Time of presentation to the hospital may influence treatment and mortality for patients with myocardial infarction, according to research published online July 29 in Circulation: Cardiovascular Quality and Outcomes.

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Florida Officials Issue Warning on Vibrio Bacteria

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Florida health officials are cautioning visitors to the state's beaches about the threat of Vibrio vulnificus bacteria in warm seawater this summer.

Health Highlights: July 31, 2014

Physician's Briefing

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