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January 2011 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for January 2011. 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.

Long Febrile Seizures Linked to Developmental Delays

MONDAY, Jan. 31 (HealthDay News) -- A prolonged first febrile seizure is likely to occur at a younger age and is associated with developmental delay, according to a study published online Jan. 11 in the Annals of Neurology.

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Heart Failure Patients in General Wards Have Worse Prognosis

THURSDAY, Jan. 27 (HealthDay News) -- Patients with heart failure who are admitted to general hospital wards are at an increased risk of mortality compared to those admitted to cardiology wards, according to a study published online Dec. 20 in Heart.

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Research Implementation Barriers for Nurses Revealed

THURSDAY, Jan. 27 (HealthDay News) -- Emergency nurses are motivated to learn more about conducting and using research to improve clinical practice, but barriers may be preventing this from occurring, according to a study published in the January issue of the Journal of Emergency Nursing.

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Immune-Mediated Diseases May Up Thromboembolism Risk

THURSDAY, Jan. 27 (HealthDay News) -- People admitted to the hospital with immune-mediated diseases may have a higher risk of getting venous thromboembolism (VTE), according to research published online Jan. 10 in BMC Medicine.

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Ventricular Tachycardia More Common in Public Settings

THURSDAY, Jan. 27 (HealthDay News) -- Ventricular fibrillation or pulseless ventricular tachycardia happens more frequently when cardiac arrests are witnessed in a public setting as opposed to at home, according to research published in the Jan. 27 issue of the New England Journal of Medicine.

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Electronic Health Records May Not Improve Care Quality

WEDNESDAY, Jan. 26 (HealthDay News) -- Electronic health records (EHRs) and clinical decision support (CDS) do not appear to improve the quality of clinical care, according to a study published online Jan. 24 in the Archives of Internal Medicine.

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Contrast-Stress Echocardiography Predicts Coronary Syndromes

WEDNESDAY, Jan. 26 (HealthDay News) -- Exercise-electrocardiogram testing may not accurately predict the risk of a cardiovascular event in patients with nondiagnostic electrocardiographic findings and normal 12-hour cardiac troponin levels, as compared to contrast-stress echocardiograms, according to a study published in the Jan. 15 issue of The American Journal of Cardiology.

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Stroke Center Admission Likely Improves Patient Outcomes

TUESDAY, Jan. 25 (HealthDay News) -- Admission of patients with acute ischemic stroke to a designated stroke center may lower mortality and improve use of thrombolytic therapy, and the occurrence of stroke among patients undergoing coronary artery bypass graft (CABG) surgery appears to be declining despite increases in patient risk profiles, according to two studies published online Jan. 25 in the Journal of the American Medical Association.

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Extra Implanted Defibrillator Shocks Raise Mortality

TUESDAY, Jan. 25 (HealthDay News) -- Inappropriate shocks by implantable cardioverter-defibrillators (ICDs) are associated with a higher mortality risk, according to a study published in the Feb. 1 issue of the Journal of the American College of Cardiology.

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Vulnerable Populations Have Poor Access to Trauma Care

THURSDAY, Jan. 20 (HealthDay News) -- Difficult access to trauma care is not uncommon among specific segments of the U.S. population, and warfarin use in trauma patients has increased and is associated with a higher mortality risk, according to two articles published in the January issue of the Archives of Surgery.

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Rise in Stroke Patients With Comorbid HIV

THURSDAY, Jan. 20 (HealthDay News) -- U.S. hospitals are treating significantly more stroke patients who have co-existing HIV infections, according to a study published online Jan. 19 in Neurology.

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Repeated Acetaminophen Can Cause Infant Liver Failure

TUESDAY, Jan. 18 (HealthDay News) -- Acetaminophen is generally considered child-safe, but repeated doses in infants can result in acute liver failure, according to a case report published online Jan. 17 in Pediatrics.

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Macrolides Mixed With BP Drugs Can Lead to Hypotension

MONDAY, Jan. 17 (HealthDay News) -- Simultaneous use of calcium-channel blockers and some macrolide antibiotics may result in hypotension, which may require hospital admission, according to a study published online Jan. 17 in CMAJ, the journal of the Canadian Medical Association.

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FDA: Severe Liver Injury Tied to Dronedarone (Multaq)

MONDAY, Jan. 17 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care professionals and patients of the risk of acute liver failure associated with the heart medication dronedarone (Multaq).

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Metrics Proposed to Monitor Care at Stroke Centers

FRIDAY, Jan. 14 (HealthDay News) -- The American Heart Association has proposed a set of metrics intended to provide a framework for standard data collection at comprehensive stroke centers (CSCs). These metrics, published online Jan. 13 in Stroke, will help monitor quality of care in these centers and may lead to the development of national performance standards.

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CDC Report Highlights Important Health Disparities

THURSDAY, Jan. 13 (HealthDay News) -- Among Americans, disparities in income, race and ethnicity, gender, and other social attributes have an impact on whether an individual is healthy or ill or will die prematurely, according to a report by the U.S. Centers for Disease Control and Prevention, released as a supplement to the Jan. 14 issue of the Morbidity and Mortality Weekly Report.

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FDA Limits Acetaminophen in Combo Prescription Products

THURSDAY, Jan. 13 (HealthDay News) -- The U.S. Food and Drug Administration is requesting that manufacturers of prescription combination products containing acetaminophen limit the amount of acetaminophen to a maximum of 325 mg in each tablet or capsule to reduce the risk of liver toxicity. In addition, the agency is directing manufacturers to update labels of all prescription combination products to warn consumers of the possible risk for severe liver injury.

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High Cost of Hospitalization for Pelvic Inflammatory Disease

THURSDAY, Jan. 13 (HealthDay News) -- Ambulatory treatment, either in emergency rooms or outpatient clinics, was more cost-effective than hospitalizing teen girls with pelvic inflammatory disease (PID), according to a study published online Nov. 5 in Sexually Transmitted Diseases.

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Bottle Rockets Tied to Significant Ocular Injuries

WEDNESDAY, Jan. 12 (HealthDay News) -- Bottle rockets are associated with significant ocular injuries among children and adolescents, including permanent loss of vision, according to a study published online Jan. 10 in the Archives of Ophthalmology.

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FDA Warns of Morphine Sulfate Oral Solution Overdose

TUESDAY, Jan. 11 (HealthDay News) -- The U.S. Food and Drug Administration and Roxane Laboratories have notified health care professionals of serious adverse events and deaths associated with accidental overdose of morphine sulfate oral solutions, especially with the high potency (100 mg per 5 mL) product. In most cases, solutions ordered in milligrams (mg) were mistakenly interchanged for milliliters (mL) of the product.

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Obesity Prevalent Among 2009 H1N1-Infected Californians

TUESDAY, Jan. 11 (HealthDay News) -- One-half of Californians ≥20 years of age hospitalized with 2009 H1N1 infection were obese, with extreme obesity associated with increased odds of death, according to a study published online Jan. 4 in Clinical Infectious Diseases.

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Statins May Be Inadvisable After Hemorrhagic Stroke

TUESDAY, Jan. 11 (HealthDay News) -- Statin use for primary or secondary prevention of cardiovascular events may be inadvisable in patients with a high risk of recurrent intracerebral hemorrhage (ICH), according to a study published online Jan. 10 in the Archives of Neurology.

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Latent Tuberculosis Therapy May Be Risky in the Elderly

MONDAY, Jan. 10 (HealthDay News) -- People over the age of 65 appear to be at significantly increased risk for serious adverse events requiring admittance to a hospital when receiving therapy for latent tuberculosis, according to research published online Jan. 10 in CMAJ, the journal of the Canadian Medical Association.

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Burnout Levels Particularly High in Residents

MONDAY, Jan. 10 (HealthDay News) -- The incidence of burnout and risk for burnout are high in physicians, particularly residents, and more than a quarter of anesthesiology chairs meet criteria for high burnout, according to two articles published in the January issue of Anesthesiology.

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For Teen Athletes, Concussion Symptoms Differ by Gender

MONDAY, Jan. 10 (HealthDay News) -- High school-age boys and girls tend to present with different symptoms after a concussion, but their recovery time is the same, according to research published in the January/February issue of the Journal of Athletic Training.

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Prehospital Intravenous Fluids May Harm Trauma Patients

MONDAY, Jan. 10 (HealthDay News) -- Trauma patients receiving prehospital intravenous fluid have a higher mortality rate than those who do not, according to a study published online Dec. 20 in the Annals of Surgery.

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Invasive Strategy Can Reduce Mortality in Elderly With MI

THURSDAY, Jan. 6 (HealthDay News) -- Applying the invasive strategy of coronary angiography to older patients with acute myocardial infarctions (AMIs) complicated by cardiogenic shock reduces in-hospital and six-month mortality rates, according to research published in the January issue of The American Journal of Cardiology.

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Type II Odontoid Fractures on the Rise

WEDNESDAY, Jan. 5 (HealthDay News) -- The number and frequency of type II odontoid fractures has been increasing over the last two decades, according to a study published in the December issue of the Journal of Spinal Disorders & Techniques.

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CDC: Self-Reported Seat Belt Use in U.S. Has Risen

TUESDAY, Jan. 4 (HealthDay News) -- Seat belt use has increased nationally, particularly in states with primary enforcement laws, and nonfatal motor vehicle-occupant injuries treated in emergency departments have declined, though they still affect a substantial number of people, according to a report in the Jan. 4 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Six Lots of Acetadote Injection Voluntarily Recalled

TUESDAY, Jan. 4 (HealthDay News) -- The U.S. Food and Drug Administration and Cumberland Pharmaceuticals Inc. have notified health care professionals of a recall of six lots of acetylcysteine (Acetadote) injection (20 percent solution [200 mg/mL] in 30 mL single dose glass vials) due to the potential presence of particulate matter.

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Hospitalizations Fall After Varicella Vaccination Program

TUESDAY, Jan. 4 (HealthDay News) -- The number and rate of varicella-related hospitalizations declined significantly after implementation of a one-dose varicella vaccination program in 1995, according to a study published online Jan. 3 in Pediatrics.

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