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February 2009 Briefing - Emergency Medicine

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

Risk Score May Help Predict Atrial Fibrillation

FRIDAY, Feb. 27 (HealthDay News) -- A newly developed risk score based on readily available clinical factors can predict an individual's absolute risk of developing atrial fibrillation, allowing high-risk individuals to be targeted for prevention, according to research published in the Feb. 28 issue of The Lancet.

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Drug-Resistant Meningitis Present in North America

WEDNESDAY, Feb. 25 (HealthDay News) -- Ciprofloxacin-resistant meningitis has appeared in North America, although the bacteria remain susceptible to other antibiotics, according to a report in the Feb. 26 issue of the New England Journal of Medicine.

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Insurance Essential for Good Health, Well-Being

TUESDAY, Feb. 24 (HealthDay News) -- Having health insurance is vital for health and well-being, and when rates of uninsurance are high, even insured people are more likely to struggle to obtain necessary care, according to a new report from the Institute of Medicine released online Feb. 24.

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US Health Spending May Have Hit $2.4 Trillion in 2008

TUESDAY, Feb. 24 (HealthDay News) -- Health spending in the United States was estimated to be $2.4 trillion last year, and is expected to account for an unprecedented share of the economy this year, according to a report published online Feb. 24 in Health Affairs.

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Long-Term Epilepsy Risk High After Traumatic Brain Injury

MONDAY, Feb. 23 (HealthDay News) -- In children and young adults with traumatic brain injury, the risk of epilepsy persists for 10 years or longer, according to a report published online Feb. 23 in The Lancet.

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Heat Increases Respiratory Hospital Admissions in Elderly

MONDAY, Feb. 23 (HealthDay News) -- Increasing temperatures in Europe in the spring and summer are associated with an increase in hospital admissions for respiratory problems in the elderly, which may become worse with global warming and an aging population, researchers report in the Mar. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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PCI Shows Benefit in Elderly With MI, Cardiogenic Shock

FRIDAY, Feb. 20 (HealthDay News) -- Among patients with myocardial infarction and cardiogenic shock who underwent percutaneous coronary intervention, elderly patients showed similar one-year survival and other outcomes as younger patients, according to research published in the February Journal of the American College of Cardiology: Cardiovascular Interventions.

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Gunshot Victims May Lie About Source of Their Injuries

FRIDAY, Feb. 20 (HealthDay News) -- Emergency-department personnel should be alert to the possibility that some patients may conceal the fact that their injuries were caused by gunfire, according to a letter published in the Feb. 21 issue of The Lancet.

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Proposed Changes to Health Care Would Reduce Costs

THURSDAY, Feb. 19 (HealthDay News) -- Simultaneous gains in universal health coverage, improved health outcomes and slowed spending growth would have a major impact on the development of public policy, according to a perspective published in the Feb. 26 issue of the New England Journal of Medicine.

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Transparency, Globalization Growing in Clinical Research

THURSDAY, Feb. 19 (HealthDay News) -- All clinical trial data and the U.S. Food and Drug Administration database should be publicly available, and global clinical research should be conducted in relevant populations for potential applications of the intervention, according to two articles published in the Feb. 19 issue of the New England Journal of Medicine.

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Pharmacogenetic Algorithm Improves Warfarin Dosage

WEDNESDAY, Feb. 18 (HealthDay News) -- A pharmacogenetic dosing algorithm for warfarin is better able to predict the stable therapeutic dose, providing a basis for a larger clinical trial to test the efficacy of these algorithms, according to research published in the Feb. 19 issue of the New England Journal of Medicine.

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Implementing a Quality Improvement Faculty Path

WEDNESDAY, Feb. 18 (HealthDay News) -- A new career pathway in academic medicine, termed clinicians in quality improvement, is a justified concept to achieve and recognize excellence in patient safety, according to a commentary published in the Feb. 18 issue of the Journal of the American Medical Association.

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Possible Risk of Herpes Zoster with Anti-TNF-α Therapy

TUESDAY, Feb. 17 (HealthDay News) -- Monoclonal antibodies directed against tumor necrosis factor-alpha (TNF-α), a class of drugs that treat a variety of systemic inflammatory diseases, are associated with an increased risk of herpes zoster, according to research published in the Feb. 18 issue of the Journal of the American Medical Association.

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Incidence of ICU MRSA Infections Declining

TUESDAY, Feb. 17 (HealthDay News) -- Incidence of methicillin-resistant Staphylococcus aureus (MRSA) central line-associated bloodstream infections has decreased over recent years in most intensive care units (ICUs), according to research published Feb. 18 in the Journal of the American Medical Association.

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Ads Featuring 'Drug Facts Box' Help Educate Consumers

TUESDAY, Feb. 17 (HealthDay News) -- Replacing the brief summary in direct-to-consumer ads with a "drug facts box" may result in improved consumer knowledge and judgment about medication benefits and side effects, according to study findings released online Feb. 17 in advance of publication in the Apr. 21 issue of the Annals of Internal Medicine.

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Pauses in CPR Chest Compressions Detrimental

FRIDAY, Feb. 13 (HealthDay News) -- In patients with ventricular fibrillation or tachycardia, the likelihood of return of spontaneous circulation falls steadily as pre-shock pauses in cardiopulmonary resuscitation (CPR) chest compressions grow longer, according to research published Feb. 6 in BMC Medicine.

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Thrombolysis Window May Be Longer Than Thought

THURSDAY, Feb. 12 (HealthDay News) -- Patients with acute stroke may have a diffusion-perfusion mismatch after nine hours of stroke onset, particularly those with proximal arterial occlusion, suggesting the treatment window for stroke may be extended in some cases, according to the results of a study published in the March issue of Radiology.

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Agencies Must Do More to Prevent Foodborne Disease

THURSDAY, Feb. 12 (HealthDay News) -- U.S. agencies responsible for food safety must take steps to prevent outbreaks of foodborne illness such as the current Salmonella outbreak linked to peanut butter products, according to a perspective published online Feb. 11 in the New England Journal of Medicine.

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Contrast Echocardiography Improves Cardiac Evaluation

THURSDAY, Feb. 12 (HealthDay News) -- Using contrast echocardiography to assess patients' ventricular function significantly reduces the number of procedures, improves the accuracy of drug prescription and improves patient management, according to a report published online Feb. 11 in the Journal of the American College of Cardiology.

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Dronedarone May Offer Benefits in Atrial Fibrillation

WEDNESDAY, Feb. 11 (HealthDay News) -- In patients with atrial fibrillation, the use of dronedarone -- which is similar in profile to amiodarone -- was associated with a lower rate of hospitalization for cardiovascular events or death, according to research published in the Feb. 12 issue of the New England Journal of Medicine.

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Stroke Risk in Women Needs More Research

WEDNESDAY, Feb. 11 (HealthDay News) -- Women account for the majority of stroke deaths in the United States, yet there are major gaps in awareness of risk factors specific to women, and in the knowledge of the causes and treatment of strokes in women, according to several reports published a special themed issue of Stroke released online Feb. 10 and dedicated to the epidemic of stroke among women.

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Care Coordination Programs Don't Benefit Medicare Patients

TUESDAY, Feb. 10 (HealthDay News) -- For Medicare beneficiaries with chronic illnesses, most care coordination programs have little impact on reducing hospitalizations and costs or improving quality of care, according to a report published in the Feb. 11 issue of the Journal of the American Medical Association.

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Medication Safety Alerts Frequently Ignored

TUESDAY, Feb. 10 (HealthDay News) -- Medication safety alerts, which are part of the decision support mechanism of electronic prescribing systems, are frequently overridden by clinicians and may not adequately protect patients, according to the results of a study published in the Feb. 9 issue of the Archives of Internal Medicine.

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Corticosteroid Use Associated with Pneumonia in COPD

MONDAY, Feb. 9 (HealthDay News) -- Long-term inhaled corticosteroid use in patients with chronic obstructive pulmonary disease (COPD) is associated with an increased risk of pneumonia, though without a significantly higher risk of pneumonia-related death, according to a review article published in the Feb. 9 issue of the Archives of Internal Medicine.

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FDA OKs Drug Produced Using Genetically Engineered Goats

MONDAY, Feb. 9 (HealthDay News) -- For the first time, the U.S. Food and Drug Administration has approved a product that is produced using genetically engineered animals, according to a release issued by the agency.

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CDC Analyzes Salmonella Peanut Butter Outbreak

MONDAY, Feb. 9 (HealthDay News) -- The widespread outbreaks of Salmonella infections that hospitalized 116 patients and may have contributed to the deaths of eight people were traced to peanut butter and peanut paste used in other products manufactured by Peanut Corporation of America at its factory in Blakely, Ga., according to a report published in the Feb. 6 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Trichloramine at Ohio Waterpark Sickened 665 People

MONDAY, Feb. 9 (HealthDay News) -- Exposure to airborne trichloramine caused eye and respiratory irritations in 665 people who were patrons and lifeguards of an indoor waterpark resort in Ohio, according to a report published in the Feb. 6 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Rapid Treatment for Minor Strokes Reduces Hospital Use

FRIDAY, Feb. 6 (HealthDay News) -- Rapid assessment and early treatment of transient ischemic attack (TIA) and minor stroke in a specialty outpatient clinic were associated with less subsequent hospital use and disability, according to research published online Feb. 5 in The Lancet Neurology.

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Asthma Not Linked to More School Absences in Study

THURSDAY, Feb. 5 (HealthDay News) -- In a Texas school district, children with and without asthma missed similar amounts of school, according to research published in the February issue of Chest.

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Baby Formula with Melamine Linked to Urinary Tract Stones

WEDNESDAY, Feb. 4 (HealthDay News) -- Exposure to infant formula contaminated with melamine was associated with kidney stones in children in China, Hong Kong and Taiwan, though conventional signs and symptoms of nephrolithiasis were lacking, according to a study and two letters published online Feb. 4 in the New England Journal of Medicine.

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RSV Causes High Morbidity Among Children

WEDNESDAY, Feb. 4 (HealthDay News)-- Respiratory syncytial virus (RSV) is a substantial cause of morbidity among U.S. children, affecting not just high-risk but also previously healthy children, according to a study published in the Feb. 5 issue of the New England Journal of Medicine.

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Cardiac Imaging Use Must Consider Risks and Rewards

WEDNESDAY, Feb. 4 (HealthDay News) -- The decision to use cardiac imaging tests should take into account the potential risks of malignancy due to radiation exposure, as well as the benefits of the test, according to an American Heart Association science advisory published online Feb. 2 in Circulation: Journal of the American Heart Association.

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Resting Heart Rate Can Predict Women's Heart Death Risk

WEDNESDAY, Feb. 4 (HealthDay News) -- A low-tech and inexpensive test to measure women's resting heart rate can predict the risk of myocardial infarction and coronary death, according to research published online Feb. 3 in BMJ.

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Diabetes, Heart Disease Raise Coronary Event Risk in HIV

WEDNESDAY, Feb. 4 (HealthDay News) -- Both diabetes mellitus and pre-existing coronary heart disease (CHD) are associated with an increased risk of a CHD event in individuals with HIV, indicating the need for diabetes screening in this population, according to research published online Feb. 2 in Circulation: Journal of the American Heart Association.

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Sedatives Effective for Critically Ill on Ventilation

MONDAY, Feb. 2 (HealthDay News) -- Dexmedetomidine is similar to midazolam in effectively sedating critically ill patients on mechanical ventilation for prolonged periods, but with less delirium and shorter time to extubation, according to research published online Feb. 2 in the Journal of the American Medical Association, released early to coincide with the Society of Critical Care Medicine's annual meeting in Nashville.

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Muscle Problems Among Many Possible Statin Effects

MONDAY, Feb. 2 (HealthDay News) -- Mitochondrial factors may play a role in the muscle-related complaints associated with the use of statin drugs, as well as many other adverse effects, according to a review published in December in the American Journal of Cardiovascular Drugs.

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Physician's Briefing
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