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June 2010 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for June 2010. 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.

Biomarker Aids in Heart Attack Risk Stratification

WEDNESDAY, June 30 (HealthDay News) -- Mid-regional pro-adrenomedullin (sAM) levels can predict mortality or heart failure in non-ST-elevation myocardial infarction (NSTEMI) patients, complementing other risk stratification tools, according to a study published in the July 6 issue of the Journal of the American College of Cardiology.

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Doctors Agree Malpractice Fears Drive Overuse of Tests

MONDAY, June 28 (HealthDay News) -- A large majority of physicians agree that the practice of defensive medicine -- stemming from malpractice concerns -- is responsible for an overuse of medical tests and procedures, according to a research letter in the June 28 issue of the Archives of Internal Medicine.

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Venous Thromboembolism Risk Factors Vary by Race

MONDAY, June 28 (HealthDay News) -- Black Americans with venous thromboembolism (VTE) are less likely to have commonly recognized transient risk factors for the condition, are more likely to have cardiovascular disease risk factors, and are more likely to progress to pulmonary embolism than are white Americans, according to research published in the July issue of the American Journal of Hematology.

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Diabetes May Complicate COPD Hospital Admissions

THURSDAY, June 24 (HealthDay News) -- Patients admitted to the hospital with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who have comorbid diabetes mellitus (DM) have trends toward longer hospital length of stay and an increased risk of death compared with those without DM, according to research published online June 4 in Respirology.

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Early Shunting Controls Bleeding in Cirrhotic Patients

WEDNESDAY, June 23 (HealthDay News) -- Typically reserved as a rescue therapy, the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) soon after hospital admittance for acute variceal bleeding in cirrhosis patients may reduce the likelihood of treatment failure and death, according to research published in the June 24 issue of the New England Journal of Medicine.

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New 2009 H1N1 Influenza Virus Test Authorized by FDA

WEDNESDAY, June 23 (HealthDay News) -- The U.S. Food and Drug Administration has authorized a new test that uses molecular biology techniques to diagnose 2009 H1N1 influenza virus infection in humans.

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Racial Disparities in Sepsis Explained by Two Factors

TUESDAY, June 22 (HealthDay News) -- Racial differences in sepsis rates are due to higher infection rates as well as a higher risk of organ dysfunction among black patients compared with white patients, according to research published in the June 23/30 issue of the Journal of the American Medical Association.

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Some Moist Toilet Paper Can Cause Severe Reaction

TUESDAY, June 22 (HealthDay News) -- A preservative used in moist toilet paper can cause a severe allergic reaction in some people, as demonstrated by four case reports published online June 21 in the Archives of Dermatology.

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Brain Hemorrhage Diagnosis Delay Rare in Children

MONDAY, June 21 (HealthDay News) -- In children with uncomplicated minor head injuries, delayed diagnosis of intracranial hemorrhage is rare, according to research published online June 21 in Pediatrics.

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ER Visits for Prescription Drug Misuse Climbing

FRIDAY, June 18 (HealthDay News) -- From 2004 to 2008, emergency department visits involving the non-medical use of prescription drugs increased substantially in the United States, according to research published in the June 18 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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10 Risk Factors Associated With Most of Stroke Risk

FRIDAY, June 18 (HealthDay News) -- Worldwide, 10 risk factors are associated with 90 percent of the risk for stroke, suggesting that interventions targeting these particular factors could greatly reduce the stroke burden, according to a study published online June 18 in The Lancet.

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Computed Tomography Angiography May Be Avoidable

WEDNESDAY, June 16 (HealthDay News) -- The risk of a computed tomography (CT) angiogram being positive for pulmonary embolism (PE) is unlikely among patients who do not present with thromboembolic risk factors, suggesting that CT angiography is unnecessary in many patients, according to research published online June 15 in Radiology.

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In COPD, Oral, Intravenous Steroids Bring Same Outcomes

TUESDAY, June 15 (HealthDay News) -- Patients with chronic obstructive pulmonary disease (COPD) exacerbations treated with low-dose oral corticosteroids have outcomes similar to those treated with more costly and invasive high-dose intravenous corticosteroid therapy, according to research published in the June 16 issue of the Journal of the American Medical Association.

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Tranexamic Acid Reduces Mortality in Trauma Patients

TUESDAY, June 15 (HealthDay News) -- Tranexamic acid may be an effective option for reducing bleeding and mortality among trauma patients, without increasing the risk of serious complications such as myocardial infarction, stroke, or pulmonary embolism, according to a study published online June 15 in The Lancet.

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Private Insurance Linked to Lower Hospital Mortality

FRIDAY, June 11 (HealthDay News) -- Patients with private insurance who are hospitalized for acute myocardial infarction (AMI), stroke or pneumonia have significantly lower in-hospital mortality than patients who are uninsured or have Medicaid, according to research published online June 10 in the Journal of Hospital Medicine.

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Suppressed Anger in CAD Linked to Adverse Cardiac Events

THURSDAY, June 10 (HealthDay News) -- In patients with coronary artery disease (CAD), suppressing anger is associated with a higher risk of adverse cardiac events, according to research published in the June 1 issue of the American Journal of Cardiology.

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FDA: Defibtech's DBP-2800 Battery Packs Recalled

THURSDAY, June 10 (HealthDay News) -- Defibtech has alerted customers of a voluntary recall of 5,418 DBP-2800 Battery Packs used in the Lifeline Automatic External Defibrillator (AED) and ReviveR AED, as these AEDs may incorrectly recognize an error condition during charging for a shock and discontinue the charge, not providing therapy when the defected battery packs are used.

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FDA's MedWatch Adverse Event Reporting Program
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Rate of Myocardial Infarction, 30-Day Mortality Decreasing

THURSDAY, June 10 (HealthDay News) -- The incidence of acute myocardial infarction (MI) has steadily decreased since 2000, and 30-day mortality has significantly decreased over the same time period, according to research published in the June 10 issue of the New England Journal of Medicine.

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Health Care Facilities See Rise in Violent Crimes

WEDNESDAY, June 9 (HealthDay News) -- The incidence of violent crimes, including rape, assault and murder, is climbing at health care facilities, according to a Sentinel Event Alert released June 3 by the Joint Commission.

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Delaying Gallbladder Removal Ups Complications, Costs

WEDNESDAY, June 9 (HealthDay News) -- Delaying cholecystectomy in elderly adults hospitalized due to acute cholecystitis often results in hospital readmissions within two years and increased patient morbidity, mortality and costs, according to research published in the May issue of the Journal of the American College of Surgeons.

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Alcohol Dependence Treatment Tied to Social Cost Savings

WEDNESDAY, June 9 (HealthDay News) -- Treatment for alcohol dependence may result in reduced median social costs associated with arrests, vehicle accidents and health care, according to a study in the May issue of Medical Care.

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Pediatric Migraine Treatment Practices Vary Widely in ER

WEDNESDAY, June 9 (HealthDay News) -- In a sample of Canadian emergency departments, children seen for migraine headaches reported frequent occurrence of attacks, and were subject to significant treatment variations by emergency department physicians, according to research published online June 7 in Pediatrics.

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Fatal Medication Errors Rise in July at Teaching Hospitals

TUESDAY, June 8 (HealthDay News) -- In July there is a significant increase in fatal medication errors at medical institutions, and this spike is at least partly due to the arrival of new medical residents, according to a study published online May 29 in the Journal of General Internal Medicine.

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Non-Emergency ER Admissions Have Different Needs

TUESDAY, June 8 (HealthDay News) -- Non-emergency patients admitted to hospitals through the emergency department (EDNEs) need specific health care services, including improved access, fast tracking, and continuity of care, according to research published in the May issue of the Journal of Emergency Nursing.

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Many Adults With Pediatric Disorders Use Pediatric ERs

TUESDAY, June 8 (HealthDay News) -- Many adult patients with chronic pediatric disorders, known as transition patients, use pediatric emergency departments -- often for complaints unrelated to their pediatric disorders -- and these patients have high rates of intensive care unit and hospital admissions, according to a study in the June issue of the Archives of Pediatrics & Adolescent Medicine.

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Revised, Evidence-Based Brain Death Guideline Issued

MONDAY, June 7 (HealthDay News) -- A new guideline for determining brain death has been issued by the American Academy of Neurology, updating the 1995 version and including a checklist to provide doctors with clarity and direction. The guideline has been published in the June 8 issue of Neurology.

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Many Hospital Patients Readmitted Within Two Years

MONDAY, June 7 (HealthDay News) -- Approximately 25 percent of hospital patients were readmitted to the hospital within a two-year period for the same conditions that prompted their initial admission, according to a recent report from the Agency for Healthcare Research and Quality (AHRQ).

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Overlap Exists in TBI, Fractures Attributable to Abuse

MONDAY, June 7 (HealthDay News) -- In children younger than 3, considerable overlap exists in the occurrence of traumatic brain injuries (TBIs) and fractures attributable to abuse, though accidental falls occur more commonly than abuse, even among very young children, according to a study published online June 7 in Pediatrics.

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WHO Maintains Pandemic H1N1 Influenza Alert

FRIDAY, June 4 (HealthDay News) -- The World Health Organization has decided to maintain an H1N1 flu pandemic alert based on the recommendation of 15 international influenza experts, as new cases of H1N1 are expected in the short-term during the flu season in the southern hemisphere.

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Many Ischemic Stroke Patients Arrive at ER Within Hour

FRIDAY, June 4 (HealthDay News) -- A substantial portion of ischemic stroke patients present to emergency departments within an hour of onset, and they are more likely to receive thrombolytic therapy than those who arrive later, but both factors present room for improvement, according to research published online June 3 in Stroke.

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Early Heparin Beneficial in Pulmonary Embolism

THURSDAY, June 3 (HealthDay News) -- For patients with acute pulmonary embolism (PE), starting heparin early, while the patient is still in the emergency department, is associated with decreased mortality, according to research published in the June issue of Chest.

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Stroke Patients Benefit From Early Lipid-Lowering Therapy

THURSDAY, June 3 (HealthDay News) -- Early initiation of lipid-lowering therapy (LLT) during hospitalization for ischemic stroke or transient ischemic attack correlates with improved clinical outcomes, according to research published in the May 15 issue of the American Journal of Cardiology.

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Post-CPR Hyperoxia Linked to Higher Mortality Risk

TUESDAY, June 1 (HealthDay News) -- Both hyperoxia after cardiopulmonary resuscitation (CPR) and non-adherence to recommended timing of interventions after ST-elevation myocardial infarction (STEMI) result in significant increases in mortality, according to two studies published in the June 2 issue of the Journal of the American Medical Association.

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Cardiac Arrest, CPR Attempts Vary by Neighborhood

TUESDAY, June 1 (HealthDay News) -- Some neighborhoods consistently have more cardiac arrests than others and fewer bystanders who attempt to perform emergency cardiopulmonary resuscitation (CPR), according to research published online June 1 in the Annals of Internal Medicine.

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Heart Fatty Acid-Binding Protein Levels May Indicate ACS Risk

TUESDAY, June 1 (HealthDay News) -- Obtaining the concentration of heart fatty acid-binding protein (H-FABP) in patients with suspected acute coronary syndrome (ACS) may help physicians identify high-risk patients who are troponin-negative, according to research published in the June 8 issue of the Journal of the American College of Cardiology.

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DPFC Embosurgery Effective, Safe for Recurrent Epistaxis

TUESDAY, June 1 (HealthDay News) -- For recurrent or uncontrollable epistaxis, embosurgery of the distal internal maxillary artery (IMax) via detachable platinum fibered coils (DPFCs) is a safe and effective procedure, according to research published in the June issue of the Journal of Neurointerventional Surgery.

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Ambulatory Cardiac Telemetry Detects Serious Arrhythmias

TUESDAY, June 1 (HealthDay News) -- Ambulatory cardiac telemetry may provide clinical information that could potentially be lifesaving in patients with serious arrhythmic events, according to research published in the May 1 issue of the American Journal of Cardiology.

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