February 2012 Briefing - Emergency Medicine

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

Care Protocol for Comatose Patients May Need Revision

WEDNESDAY, Feb. 29 (HealthDay News) -- Although neurological tests are highly reliable predictors of death in patients who remain in a coma following cardiopulmonary resuscitation (CPR), withdrawal-of-treatment decisions may need to be delayed for those who undergo mild hypothermia therapy, according to a Dutch study published in the February issue of the Annals of Neurology.

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Family Tree Clarifies Risk of Death Due to Arrhythmia

WEDNESDAY, Feb. 29 (HealthDay News) -- In six inherited arrhythmia syndromes, the Family Tree Mortality Ratio (FTMR) method is useful for identifying the age during which mortality risk becomes manifest in an untreated population, according to research published online Feb. 28 in Circulation: Cardiovascular Genetics.

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Neurophysiological Deficits Persist Following Concussion

WEDNESDAY, Feb. 29 (HealthDay News) -- For athletes who suffer a concussion, neurophysiological deficits persist and are present at least six months following a concussion, and adolescents appear to be more vulnerable to the consequences of concussion, according to a study published in the March issue of Brain Injury.

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Hearing Loss Linked to Falls in Those Under Age 70

WEDNESDAY, Feb. 29 (HealthDay News) -- Hearing loss is associated with increased odds of falling, according to research published in the Feb. 27 issue of the Archives of Internal Medicine.

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FDA Approves Label Changes for Statins

TUESDAY, Feb. 28 (HealthDay News) -- The recommendation to remove routine monitoring of liver enzymes is among safety label changes recently approved by the U.S. Food & Drug Administration for statins, according to a Feb. 28 Drug Safety Communication issued by the agency.

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Sleeping Pill Use Linked to Greater Mortality Risk

TUESDAY, Feb. 28 (HealthDay News) -- Even relatively small doses of sleeping pills are associated with a more than three-fold higher risk of death, according to a study published online Feb. 27 in BMJ Open.

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Adults With Disabilities at Increased Risk of Violence

TUESDAY, Feb. 28 (HealthDay News) -- Adults with disabilities face an increased risk of violence, with an even higher risk evident for those with mental illness, according to a review published online Feb. 28 in The Lancet.

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Rapid Flu Tests Effective for Ruling In (But Not Out) Diagnosis

TUESDAY, Feb. 28 (HealthDay News) -- Rapid influenza tests are useful for diagnosing influenza; and oral oseltamivir and inhaled zanamivir may be beneficial for the treatment of influenza, according to two reviews published online Feb. 27 in the Annals of Internal Medicine.

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Poor Asthma Control Prevalent in the United States

MONDAY, Feb. 27 (HealthDay News) -- Many patients with asthma who do not use controller medications have persistent disease, and among those patients who do use controller medications, few have well-controlled disease, according to a study published in the March issue of the Annals of Allergy, Asthma & Immunology.

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Febrile Children Self-Referred to ER Usually Less Severely Ill

MONDAY, Feb. 27 (HealthDay News) -- In 45 percent of self-referred cases, parents properly judge their child's febrile illness as urgent when they bring their child to the emergency department, according to a study published online Feb. 27 in Pediatrics.

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Body Clock Linked to Sudden Cardiac Death

FRIDAY, Feb. 24 (HealthDay News) -- A body clock-dependent protein is associated with variations in electrical stability in the heart, which may explain why people are at higher risk of sudden cardiac death in the morning, according to research published online Feb. 22 in Nature.

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Plasma Protein S100-B Useful Screening Tool in Head Trauma

FRIDAY, Feb. 24 (HealthDay News) -- Measuring plasma levels of the protein S100-B has a high negative predictive value compared with computed tomography (CT) scans for patients with minor head injuries, according to research published in the March issue of the Annals of Emergency Medicine.

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Women With MI More Likely to Present Without Chest Pain

TUESDAY, Feb. 21 (HealthDay News) -- Women suffering a myocardial infarction (MI) are more likely than men of the same age to present without chest pain and have higher in-hospital mortality, according to a study published in the Feb. 22 issue of the Journal of the American Medical Association.

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Small Risk of Febrile Seizures With DTaP-IPV-Hib Vaccine

TUESDAY, Feb. 21 (HealthDay News) -- The combined diphtheria-tetanus toxoids-acellular pertussis-inactivated poliovirus-Haemophilus influenza type b (DTaP-IPV-Hib) vaccine is associated with a small increased risk of febrile seizures on the day of the first and second vaccinations, according to a study published in the Feb. 22 issue of the Journal of the American Medical Association.

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Pharmacist-Led Intervention Reduces Medical Errors

TUESDAY, Feb. 21 (HealthDay News) -- For clinics with computerized medical records, a pharmacist-led intervention significantly reduces the risk of medical errors and is likely to be cost-effective, according to a study published online Feb. 21 in The Lancet.

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Alcohol Dependence Significant Problem for U.S. Surgeons

TUESDAY, Feb. 21 (HealthDay News) -- A considerable number of U.S. surgeons have alcohol abuse and dependence, which is more likely in those who have recently reported major errors, are burned out, and are depressed, according to a study published in the February issue of the Archives of Surgery.

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CT Myelography More Accurately Detects CSF Leakage

MONDAY, Feb. 20 (HealthDay News) -- Cerebrospinal fluid (CSF) leakage may be detected more accurately in patients with spontaneous intracranial hypotension (SIH) using epidural collection on computed tomography myelography (CTM) rather than paraspinal radioisotope (RI) accumulation on radioisotope cisternography (RIC), according to a study published in the Feb. 15 issue of Spine.

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High Uric Acid Level Predictive of Adverse Cardiac Events

FRIDAY, Feb. 17 (HealthDay News) -- A high serum uric acid level is an independent predictor of in-hospital and long-term adverse cardiac events in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), according to research published in the Feb. 15 issue of The American Journal of Cardiology.

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MRI Alone Not Ideal in Pulmonary Embolism Diagnosis

FRIDAY, Feb. 17 (HealthDay News) -- Magnetic resonance imaging (MRI) should not be used as a stand-alone test to diagnose pulmonary embolism (PE), according to a study published online Feb. 9 in the Journal of Thrombosis and Haemostasis.

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Study Evaluates Clinical Value of Stroke Biomarkers

FRIDAY, Feb. 17 (HealthDay News) -- While 136 different stroke biomarkers have been identified, the clinical value of these biomarkers remains unclear, according to a study published online Feb. 9 in the British Journal of Clinical Pharmacology.

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Smoking Cessation Drug May Also Reduce Drinking

FRIDAY, Feb. 17 (HealthDay News) -- The smoking cessation drug varenicline (VAR) may also reduce alcohol consumption in social drinkers by increasing alcohol's aversive effects, according to a study published online Feb. 16 in Alcoholism: Clinical & Experimental Research.

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Overdose Prevention Programs Using Opioid Antagonist

THURSDAY, Feb. 16 (HealthDay News) -- Naloxone, an opioid antagonist, is being used by at least 188 overdose prevention programs in the United States, but many states with high death rates due to heroin or other opioid overdose do not include naloxone distribution in their programs, according to research published in the Feb. 17 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Ectopic Pregnancy Death Rate Spikes in Florida

THURSDAY, Feb. 16 (HealthDay News) -- Although Florida's rate of ectopic pregnancy-related deaths was on a par with that of the rest of the nation in 2008, about 0.6 deaths per 100,000 births, the number jumped to 2.5 per 100,000 in 2009 to 2010, according to research published in the Feb. 17 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Chickens Harbor E. coli Found in Human UTIs

THURSDAY, Feb. 16 (HealthDay News) -- Retail purchased chicken may be the source of extraintestinal pathogenic Escherichia coli (ExPEC) that causes urinary tract infections (UTIs) in humans, according to a study published online Feb. 15 in Emerging Infectious Diseases.

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Smoking Bans Lead to Less, Not More, Smoking at Home

THURSDAY, Feb. 16 (HealthDay News) -- Smoke-free legislation leads to less smoking in smokers' homes, not more, according to research published online Feb. 13 in Tobacco Control.

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Intramuscular Midazolam As Safe As Intravenous Lorazepam

WEDNESDAY, Feb. 15 (HealthDay News) -- Intramuscular midazolam is as safe and effective as intravenous lorazepam for treatment of patients with seizures by paramedics, according to a study published in the Feb. 16 issue of the New England Journal of Medicine.

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Study Finds Antibiotic for Acute Rhinosinusitis Is Not Helpful

TUESDAY, Feb. 14 (HealthDay News) -- Treatment of acute, uncomplicated rhinosinusitis with amoxicillin does not result in a significant difference in symptoms compared with the use of placebo, according to a study published in the Feb. 15 issue of the Journal of the American Medical Association.

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Patient Satisfaction Linked to Varied Health Care Utilization

TUESDAY, Feb. 14 (HealthDay News) -- Higher patient satisfaction is associated with less emergency department use, but with greater inpatient admissions, expenditures, and higher mortality, according to a study published online Feb. 13 in the Archives of Internal Medicine.

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Home O2 Reduces Hospital Admits in Pediatric Bronchiolitis

MONDAY, Feb. 13 (HealthDay News) -- Home oxygen (O2) is a safe and effective way to decrease hospital admissions in select pediatric patients with bronchiolitis, according to a study published online Feb. 13 in Pediatrics.

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Zioptan Eyedrops Approved for Glaucoma, Ocular Hypertension

MONDAY, Feb. 13 (HealthDay News) -- Merck's Zioptan drops (tafluprost ophthalmic solution) have been approved by the U.S. Food and Drug Administration to lower pressure within the eye among people with high blood pressure of the eye (ocular hypertension) or open-angle glaucoma, the most common form of the disease.

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No Increase in Pediatric ER CT Scan Use from 2003 to 2010

MONDAY, Feb. 13 (HealthDay News) -- From 2003 to 2010, there was no overall increase in computed tomography (CT) scan utilization in pediatric emergency departments (PEDs), and decreased trends for CT use are being seen when alternative nonradiation-based modalities are available, according to a study published Feb. 13 in Pediatrics.

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Risk of Collision Doubles for Drivers Using Cannabis

FRIDAY, Feb. 10 (HealthDay News) -- Drivers under the influence of cannabis are twice as likely to be involved in motor vehicle collisions, particularly fatal collisions, according to research published online Feb. 9 in BMJ.

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Radiation Risks From Diagnostic Procedures Examined

THURSDAY, Feb. 9 (HealthDay News) -- National strategies should be developed for the use of evidence-based criteria and improved oversight of equipment to minimize radiation exposure for patients undergoing diagnostic procedures, according to a study published online Feb. 3 in CA: A Cancer Journal for Clinicians.

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Guidelines for VTE Prophylaxis in Nonsurgical Patients Issued

THURSDAY, Feb. 9 (HealthDay News) -- New evidence-based clinical practice guidelines have been issued for the prophylaxis of venous thromboembolism (VTE) in nonsurgical patients; the guidelines have been published in a supplement to the February issue of CHEST.

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Males With ACL Injury, Females Share Lateral Knee Geometry

THURSDAY, Feb. 9 (HealthDay News) -- Female patients with and without anterior cruciate ligament (ACL) injury, and male patients with ACL injury, share a common lateral tibiofemoral geometry, according to a study published in the Feb. 1 issue of The Journal of Bone & Joint Surgery.

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Prescription Shampoo Approved to Treat Head Lice

WEDNESDAY, Feb. 8 (HealthDay News) -- Sklice Lotion, a prescription-strength shampoo to treat head lice, has been approved by the U.S. Food and Drug Administration for people 6 months and older, the French product maker Sanofi said.

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Cefpodoxime Not Recommended for Acute, Uncomplicated Cystitis

TUESDAY, Feb. 7 (HealthDay News) -- Cefpodoxime should not be used as a first-line fluoroquinolone-sparing antimicrobial for acute uncomplicated cystitis, according to a study published in the Feb. 8 issue of the Journal of the American Medical Association.

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Fluoxetine, Venlafaxine Tied to Drop in Adult Suicide Behaviors

MONDAY, Feb. 6 (HealthDay News) -- Treatment with the antidepressants fluoxetine hydrochloride and venlafaxine hydrochloride is associated with a reduction in suicidal thoughts and behavior in adult and geriatric patients and has no impact on such thoughts or behavior in youths, according to a study published online Feb. 6 in the Archives of General Psychiatry.

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DRAGON Score Helps Predict Functional Outcomes in Stroke

MONDAY, Feb. 6 (HealthDay News) -- A new scoring method can aid clinicians in predicting functional outcomes for patients with ischemic stroke receiving intravenous (IV) alteplase, according to a study published in the Feb. 7 issue of Neurology.

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Noroviruses Are Leading Cause of Hospital Infections

MONDAY, Feb. 6 (HealthDay News) -- Norovirus outbreaks are the leading cause of infection outbreaks in hospitals, particularly in the non-acute care setting, and often lead to unit closure, according to an article published in the February issue of the American Journal of Infection Control.

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Startle Response Up in Early-Onset Alcohol Dependence

MONDAY, Feb. 6 (HealthDay News) -- Early-onset alcohol-dependent patients have increased acoustic startle responses compared with late-onset alcohol-dependent patients or healthy controls, according to a study published online Jan. 24 in Alcoholism: Clinical & Experimental Research.

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More Than 4,500 Children Hospitalized for Abuse in 2006

MONDAY, Feb. 6 (HealthDay News) -- More than 4,500 children were hospitalized due to serious physical abuse in 2006, and 300 of these children died in the hospital due to physical abuse, according to a study published online Feb. 6 in Pediatrics.

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Many Self-Harming Youth Get Inadequate Mental Health Care

FRIDAY, Feb. 3 (HealthDay News) -- Many adolescents who are treated in emergency departments for deliberately harming themselves do not receive adequate mental health assessments or follow-up community care, according to research published in the February issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

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Patients With IBD Experience More Travel-Related Illness

FRIDAY, Feb. 3 (HealthDay News) -- Patients with inflammatory bowel disease (IBD) experience more travel-related illness when visiting industrialized, but not developing, countries than healthy individuals, according to research published in the February issue of Clinical Gastroenterology and Hepatology.

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National Suicide Guidelines Help Cut Suicide Rates

THURSDAY, Feb. 2 (HealthDay News) -- Local implementation of national suicide recommendations reduces suicide rates, particularly in deprived catchment areas, according to a study published online Feb. 2 in The Lancet.

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Geographic Pattern of Lyme Disease Mapped in Eastern U.S.

THURSDAY, Feb. 2 (HealthDay News) -- Two Lyme disease risk foci have been identified in the Northeast and upper Midwest of the United States, according to a study published in the February issue of The American Journal of Tropical Medicine and Hygiene.

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Occasional Hard Drug Use in Mid-Life Hikes Mortality Risks

THURSDAY, Feb. 2 (HealthDay News) -- The occasional use of hard drugs in middle age is linked to significantly increased risk of all-cause mortality, according to a study published online Jan. 25 in the Journal of General Internal Medicine.

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AAP: Childhood Vaccination Schedules Approved for 2012

WEDNESDAY, Feb. 1 (HealthDay News) -- The 2012 recommended childhood and adolescent vaccination schedules have been approved, according to a policy statement from the American Academy of Pediatrics (AAP) published in the February issue of Pediatrics.

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Proton Pump Inhibitor Use Ups Hip Fracture Risk for Women

WEDNESDAY, Feb. 1 (HealthDay News) -- Postmenopausal women are at a 35 percent increased risk of hip fractures if they regularly use proton pump inhibitors (PPIs), and that risk increases to more than 50 percent among women with a history of smoking, according to a study published online Jan. 31 in BMJ.

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Decision Support Tools Help Optimize Acute PE Detection

WEDNESDAY, Feb. 1 (HealthDay News) -- Implementing evidence-based clinical decision support (CDS) significantly improves the efficiency of computed tomographic (CT) angiography use to detect acute pulmonary embolism (PE) for patients presenting to an emergency department, according to a study published in the February issue of Radiology.

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