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July 2008 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for July 2008. 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.

Joint Replacement Linked to Cardiac Complications

THURSDAY, July 31 (HealthDay News) -- Among total joint replacement surgery patients, two new risk factors -- revision surgery and bilateral joint replacement -- as well as traditional risk factors increase odds of cardiac complications, according to an article published in the July issue of Arthritis & Rheumatism.

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Device May Decrease Musculoskeletal Procedure Pain

THURSDAY, July 31 (HealthDay News) -- A reciprocating procedure device decreases patient's pain during musculoskeletal procedures, improves outcomes and may decrease needlestick injuries to health care workers, according to an article published in the July issue of Arthritis & Rheumatism.

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Endothelial Function Linked to Cardio Risk in Sedentary

THURSDAY, July 31 (HealthDay News) -- Endothelial function is significantly associated with cardiovascular risk in women in sedentary professions, with cardiorespiratory fitness being the best predictor of endothelial function, according to study findings published in the Aug. 1 issue of the American Journal of Cardiology.

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Nurses Approach Issue of ER Overcrowding

WEDNESDAY, July 30 (HealthDay News) -- Staff participation, such as deciding on the criteria for the closure of a hospital emergency department waiting room, is an effective way to conduct research into operational change, according to a study published in the August issue of the Journal of Emergency Nursing.

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Use of Antibiotic Prophylaxis for Endocarditis Discouraged

TUESDAY, July 29 (HealthDay News) -- Antibiotic prophylaxis should no longer routinely be given to prevent infective endocarditis in patients undergoing dental and other medical procedures, according to updated guidelines published online July 28 in the Journal of the American College of Cardiology. The guidelines were jointly developed by the American College of Cardiology and the American Heart Association.

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Taser Injuries Require Preparation in ERs

MONDAY, July 28 (HealthDay News) -- Given law enforcement officers' growing use of Tasers and accumulating accounts of deaths from the electroshock devices, emergency nurses and other care providers need to be prepared to handle Taser-related injuries, according to a paper in the August Journal of Emergency Nursing.

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Medical Errors Have Impact After Hospital Discharge

MONDAY, July 28 (HealthDay News) -- Medical errors affect patients in the months after hospital discharge as well as during their hospital stays, leading to excess costs, deaths and hospital readmissions, according to a study published online July 25 in Health Services Research.

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ER Physicians Perceive Evolving MI Patients as High Risk

FRIDAY, July 25 (HealthDay News) -- Physicians usually perceive patients with evolving myocardial infarction (EMI) as high risk and give them similar treatment to patients presenting with non-ST elevation myocardial infarction, according to an article published in the August issue of the Emergency Medicine Journal.

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West Nile Virus Cases Reported in 14 States

FRIDAY, July 25 (HealthDay News) -- There were 43 cases of West Nile virus reported from 14 states this year up to July 22, according to a report published in the July 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Non-Pharmaceutical Fentanyl Linked to Overdose Deaths

FRIDAY, July 25 (HealthDay News) -- Illicitly manufactured non-pharmaceutical fentanyl was associated with 1,013 deaths in six U.S. counties or states from April 2005 to March 2007, according to a report published in the July 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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'Tier 4' Drugs Raise Questions About Affordability

WEDNESDAY, July 23 (HealthDay News) -- The emergence of a fourth tier of copayment for expensive drugs calls into question how Americans are going to handle the rising costs of health care, according to a perspective article in the July 24 issue of the New England Journal of Medicine.

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Consequences of Genetic Non-Discrimination Act Examined

WEDNESDAY, July 23 (HealthDay News) -- The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

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Physicians to Get Bonus for Electronic Prescribing

WEDNESDAY, July 23 (HealthDay News) -- Doctors using an electronic prescriptions system will be eligible for a bonus from Medicare from 2009 onwards for four years, according to U.S. health officials.

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Shifts in Focus Could Reduce Tuberculosis

TUESDAY, July 22 (HealthDay News) -- Focusing on some foreign-born individuals with latent tuberculosis infection may represent one of the more effective options for improving TB control in this group in the United States, and a framework of strategic activities in HIV care programs could address pressing global concerns related to TB, according to two studies in the July 23/30 issue of the Journal of the American Medical Association.

Abstract - Cain
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Abstract - Havlir
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Anesthetic Accidents More Common in Afternoon

MONDAY, July 21 (HealthDay News) -- Anesthetic adverse events are more common in surgeries performed after 4 p.m., and are exacerbated by the shortage of anesthesia care providers, which has increased working hours and therefore fatigue, according to an article published in the July issue of the AORN Journal.

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Report Finds U.S. Health System Lagging Further Behind

FRIDAY, July 18 (HealthDay News) -- The U.S. health system is operating poorly compared to its potential, with America falling further behind other nations that are leading on performance indicators, according to a report released by The Commonwealth Fund on July 17.

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Violent Attacks Becoming Less Frequent But More Serious

FRIDAY, July 18 (HealthDay News) -- In contrast to the strong media, public and government reaction to a spate of recent knife killings in the United Kingdom, violent crime has decreased in frequency from 2000 to 2007, with knife crimes remaining stable at approximately 7 percent of the total. However, hospital admissions for violent crime have increased, pointing to more serious injuries sustained as a result of violent crime, according to an editorial published online July 16 in BMJ.

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Exception Reporting Improves Pay-for-Performance Benefits

THURSDAY, July 17 (HealthDay News) -- Pay-for-performance programs benefit from use of exclusion reporting, whereby certain patients are excluded from quality calculations, and the practice of excluding patients to disguise missed targets, known as gaming, is rare, according to study findings published in the July 17 issue of the New England Journal of Medicine.

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Medical Education Must Adapt to Changing Times

THURSDAY, July 17 (HealthDay News) -- Medical schools must adapt their admission requirements and curricula to changes in scientific theory, and are also facing a challenge to the traditional definition of who is suited to the study of medicine, according to two articles published in the July 17 issue of the New England Journal of Medicine.

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AMA Actions Fostered U.S. Medical Racial Divide

TUESDAY, July 15 (HealthDay News) -- From the post-Civil War years to the civil rights era a century later, the American Medical Association (AMA) made decisions that helped support a division between white and black Americans in the field of medicine in the United States, according to an article in the July 16 issue of the Journal of the American Medical Association.

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Exposure to Violence Aggravates Health Inequalities

TUESDAY, July 15 (HealthDay News) -- Exposure to violence makes a direct contribution to health inequalities by restricting people's ability to exercise outdoors and inhibiting delivery of health-related services, according to a report published online July 15 in the Journal of Epidemiology and Community Health.

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Model Predicts Hospital Admissions in Patients Over 40

TUESDAY, July 15 (HealthDay News) -- A population model can predict urgent hospital admissions for patients 40 years of age and older based on prior admissions and medication use, according to an article published in the July 14 issue of the Archives of Internal Medicine.

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Revised Mental Exam Cut Score May Benefit Well-Educated

TUESDAY, July 15 (HealthDay News) -- A cut score of 27 on the Mini-Mental State Examination (MMSE) may be more useful in identifying dementia in older patients with a college education than the traditional cut score of 24, according to research published in the July issue of the Archives of Neurology.

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Peptide Reduces Mortality After Heart Attack in Rats

FRIDAY, July 11 (HealthDay News) -- Early treatment with ghrelin soon after a myocardial infarction prevents an increase in cardiac sympathetic nerve activity and reduces mortality in rats, according to the results of a study published online July 3 in Endocrinology.

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Ventilation Does Not Improve Mortality Rate in Lung Edema

WEDNESDAY, July 9 (HealthDay News) -- Non-invasive ventilation improves symptoms of respiratory distress but not short-term mortality in patients with acute cardiogenic pulmonary edema, researchers report in the July 10 issue of the New England Journal of Medicine.

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Health Cash Incentives for Poor People Debated

WEDNESDAY, July 9 (HealthDay News) -- Should disadvantaged people be paid to take care of their health? That's the question of a "Head to Head" debate published online July 8 in BMJ.

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Survival Benefit Seen with Extracorporeal CPR

MONDAY, July 7 (HealthDay News) -- Extracorporeal cardiopulmonary resuscitation (CPR) was associated with improved survival rates at discharge, one month and one year following in-hospital cardiac arrest, according to an article published online July 7 in The Lancet.

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Spray Reduces Cannulation Pain Quickly in Children

WEDNESDAY, July 2 (HealthDay News) -- A vapocoolant spray provides quick pain relief for children undergoing intravenous cannulation with a higher cannulation success rate than a placebo, according to research published in the July 1 issue of CMAJ, the journal of the Canadian Medical Association.

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New Recommendations for Quality Performance Measures

TUESDAY, July 1 (HealthDay News) -- Health care quality performance measures should be developed with the participation of end users and should take a cautious and flexible approach, according to an article published in the July 1 issue of the Annals of Internal Medicine.

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Physician's Briefing