June 2011 Briefing - Emergency Medicine

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

Bottles of Tylenol Recalled

THURSDAY, June 30 (HealthDay News) -- The manufacturer of Tylenol is recalling one lot of U.S.-distributed Tylenol Extra Strength Caplets 225 count bottles, according to an announcement by the U.S. Food and Drug Administration.

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Black Patients Have Slower Transfer for Revascularization

THURSDAY, June 30 (HealthDay News) -- Black patients who have an acute myocardial infarction (AMI) and present to a nonrevascularization hospital are transferred more slowly to revascularization hospitals than their white counterparts, according to a study published in the July issue of Medical Care.

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U.S. Territories Have Higher Mortality Rates Than States

WEDNESDAY, June 29 (HealthDay News) -- Hospitals in the U.S. territories have significantly higher risk-standardized all-cause mortality rates (RSMR) and lower performance on every core process measure than hospitals in the U.S. states, according to a study published online June 27 in the Archives of Internal Medicine.

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Integrated Care Linked to Lower Door-In-Door-Out Time

WEDNESDAY, June 29 (HealthDay News) -- The presence of prehospital, emergency department, and emergency medical service (EMS) processes of care in hospitals which do not provide percutaneous coronary intervention (PCI) is associated with a significant reduction in the door-in-door-out times of patients with ST-segment elevation myocardial infarction (STEMI) requiring transfer to PCI hospitals, according to a study published online June 28 in Circulation: Cardiovascular Quality and Outcomes.

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E-Alerts Found to Help Prevent Thromboembolism

WEDNESDAY, June 29 (HealthDay News) -- Electronic alerts (e-alerts) may be a cost-effective prophylactic strategy to prevent venous thromboembolism (VTE) in hospitalized patients, according to a study published in the June issue of the Journal of Thrombosis and Haemostasis.

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Normal CT Scan Tied to Favorable Head Trauma Result

MONDAY, June 27 (HealthDay News) -- Children with minor blunt head injury with normal initial computed tomography (CT) scan results and a Glasgow Coma Scale (GCS) score of 14 to 15 are very unlikely to need neurosurgical intervention, according to a study published online June 17 in the Annals of Emergency Medicine.

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Cocaine Use Linked to Ear and Trunk Retiform Purpura

MONDAY, June 27 (HealthDay News) -- Use of cocaine may be associated with clinical findings of ear purpura, retiform purpura of the trunk, and neutropenia, according to a study published online June 9 in the Journal of American Academy of Dermatology.

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Induction of Labor May Not Raise Emergency Cesarean Risk

MONDAY, June 27 (HealthDay News) -- Induction of labor does not increase the risk of emergency cesarean section (CS), when comparing gestational weeks 39, 40, or 41 with a later induced or spontaneous labor, according to a study published online June 16 in the Acta Obstetricia et Gynecologica Scandinavica.

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Racial Gap for Stroke Admissions in U.S. Hospitals

FRIDAY, June 24 (HealthDay News) -- Likelihood of admission to high-quality hospitals, for African-American and Hispanic patients with stroke, has increased from 2000 to 2006, according to a study published in the Spring issue of Ethnicity and Disease.

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Glow Gel Enhances Hand-Washing Ability in Children

FRIDAY, June 24 (HealthDay News) -- The use of glow gel to wash hands is an effective way to improve hand hygiene in children, even without specific education, according to a study published in the July issue of Infection Control and Hospital Epidemiology.

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Syndrome Caused by E. coli Mostly in Adults, Women

WEDNESDAY, June 22 (HealthDay News) -- A large, ongoing outbreak of the hemolytic-uremic syndrome caused by Shiga-toxin-producing Escherichia coli (E. coli) in Germany is occurring mostly in adults, primarily women, according to a study published online June 22 in the New England Journal of Medicine.

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Shorter Door-In to Door-Out Time Tied to Better Outcomes

WEDNESDAY, June 22 (HealthDay News) -- A door-in to door-out (DIDO) time of 30 minutes or less for patients with ST-elevation myocardial infarction (STEMI), transferred for primary percutaneous coronary intervention (PCI) is associated with shorter reperfusion delays and reduced in-hospital mortality, according to a study published online June 22/29 in the Journal of the American Medical Association.

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Multidetector CT Scan Diagnostic of Appendicitis

TUESDAY, June 21 (HealthDay News) -- Multidetector computed tomography (MDCT) is a highly sensitive and specific test for routine evaluation of suspected appendicitis in adults, according to a study published in the June 21 issue of the Annals of Internal Medicine.

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Longer Peri- and Preshock Pauses Linked to Poor Survival

TUESDAY, June 21 (HealthDay News) -- For patients who suffer cardiac arrest and present with a shockable rhythm, longer perishock and preshock pauses are independently associated with a decrease in survival to hospital discharge, according to a study published online June 20 in Circulation.

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Colorectal Surgery Linked to Venous Thromboembolism

MONDAY, June 20 (HealthDay News) -- Open colorectal (OC) surgery is associated with a significantly higher risk of perioperative venous thromboembolism (VTE) than laparoscopic colorectal (LC) surgery, according to a study published in the June issue of the Archives of Surgery.

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Portable Pools May Pose Submersion Risk for Children

MONDAY, June 20 (HealthDay News) -- The majority of pediatric submersion events in portable pools involve children younger than 5 years and take place in the child's own yard, according to a study published online June 20 in Pediatrics.

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U.S. Food Allergy Prevalence Higher Than Reported

MONDAY, June 20 (HealthDay News) -- The prevalence and severity of childhood food allergy in the United States is greater than previously reported, with disparities in childhood allergy and its clinical diagnosis, according to a study published online June 20 in Pediatrics.

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Anonymized Information May Decrease Violence Injuries

FRIDAY, June 17 (HealthDay News) -- Combining police intelligence with anonymized information from patients injured in violence can be used to prevent violence causing wounding, but not for more minor violence, according to a study published online June 16 in BMJ.

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Hospital Surgery Volume Tied to Arthroplasty Complications

FRIDAY, June 17 (HealthDay News) -- For patients undergoing primary elective total hip arthroplasty (THA) in hospitals with a low annual volume of surgeries, the risk of venous thromboembolism and one-year mortality is significantly higher than in high-volume hospitals, and for patients aged 65 or older undergoing total knee arthroplasty (TKA) at a low-volume hospital, there is an associated risk of increased one-year mortality, according to a study published online June 7 in Arthritis & Rheumatism.

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Flecainide Treatment Linked to Sudden Cardiac Death

THURSDAY, June 16 (HealthDay News) -- Patients with atrial fibrillation (AF) treated with flecainide develop an increased risk of sudden cardiac death (SCD) or proarrhythmic events, according to a study published online June 2 in the Journal of Internal Medicine.

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New Meningococcal A Conjugate Vaccine Is Effective

WEDNESDAY, June 15 (HealthDay News) -- A new meningococcal A (MenA) conjugate vaccine (PsA-TT) has been found to have a stronger antibody response to group A meningococci than a quadrivalent polysaccharide reference vaccine (PsACWY), according to a study published in the June 16 issue of the New England Journal of Medicine.

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New Rotavirus Vaccine Reduces Cases of Infant Diarrhea

WEDNESDAY, June 15 (HealthDay News) -- In Mexico and Brazil, use of the new monovalent rotavirus vaccine (RV1) is associated with a short-term risk of intussusception in vaccinated infants but prevents a far higher number of hospitalizations and deaths from diarrhea, according to a study published in the June 16 issue of the New England Journal of Medicine.

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Increased Mortality Risk Linked to Use of Mist Inhaler

WEDNESDAY, June 15 (HealthDay News) - Patients with chronic obstructive pulmonary disease who use a tiotropium mist inhaler may have an increased risk of mortality, according to a review published online June 14 in BMJ.

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Increased Recurrent Stroke Risk in Type 2 Diabetes

WEDNESDAY, June 15 (HealthDay News) -- Patients enrolled in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial who have type 2 diabetes may have increased incidence of recurrent stroke and cardiovascular events, but the effect of atorvastatin treatment is independent of whether the patients have type 2 diabetes, or metabolic syndrome (MetS), according to a study published online June 13 in the Archives of Neurology.

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Life Expectancy in U.S. Counties Below Many Nations

WEDNESDAY, June 15 (HealthDay News) -- Most counties within the United States fall behind the international frontier with the best life expectancies in the world, according to a study published online June 15 in Population Health Metrics.

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Similar Number for Outpatient, Inpatient Malpractice Claims

TUESDAY, June 14 (HealthDay News) -- The number of paid malpractice claims is similar in both inpatient and outpatient settings, according to a study published in the June 15 issue of the Journal of the American Medical Association.

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Benzodiazepine Admissions Almost Tripled From '98 to '08

FRIDAY, June 10 (HealthDay News) -- Benzodiazepine abuse-related admissions nearly tripled from 1998 to 2008 and are accompanied by abuse of another substance in 95 percent of cases, according to the Treatment Episode Data Set (TEDS) report published online June 2 by the Substance Abuse and Mental Health Services Administration (SAMHSA).

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New Diagnostic Strategy for Patients With Suspected PE

FRIDAY, June 10 (HealthDay News) -- A proposed diagnostic strategy combines clinical assessment, D-dimer testing, ultrasonography, and lung scan to give a noninvasive diagnosis for the majority of outpatients with suspected pulmonary embolism (PE), according to a study published in the June issue of Chest.

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Despite Psychiatric Care, Youths Continue to Visit ERs

THURSDAY, June 9 (HealthDay News) -- Most youths who repeatedly present to an emergency department report having a connection to outpatient mental health care, according to a study published in the June 1 issue of Psychiatric Services.

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Diagnosis of Secondary DVTs Increased From 1989 to 2006

THURSDAY, June 9 (HealthDay News) -- The incidence of secondary deep vein thrombosis (DVT) in hospitalized patients increased significantly from 1989 to 2006 in the United States, according to a study published in the June issue of Chest.

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NSAID Use Linked to Increased Venous Thromboembolism Risk

WEDNESDAY, June 8 (HealthDay News) -- The use of nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) or cyclooxygenase-2-selective inhibitors (COX2Is) is associated with an increased risk of venous thromboembolism (VTE), according to a study published online May 18 in the Journal of Thrombosis and Haemostasis.

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Appendectomy, Tonsillectomy May Increase AMI Risk

FRIDAY, June 3 (HealthDay News) -- Youth who undergo appendectomy or tonsillectomy before age 20 may have an increased risk of acute myocardial infarction (AMI) later in life, according to a study published online June 1 in the European Heart Journal.

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More Strokes Treated With Thrombolytics in the U.S.

FRIDAY, June 3 (HealthDay News) -- The use of recombinant tissue plasminogen activator (rtPA) to treat acute ischemic stroke (AIS) increased significantly between 2005 and 2009 in the United States, according to a study published online June 2 in Stroke.

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ER Waiting Times Linked to Higher Adverse Events Risk

THURSDAY, June 2 (HealthDay News) -- Patients who present to emergency departments during shifts with long mean waiting times are at increased risk for adverse events, according to a study published online June 1 in BMJ.

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Blast-Related Brain Injuries May Involve Axonal Injury

WEDNESDAY, June 1 (HealthDay News) -- Blast-related traumatic brain injuries may involve axonal injury even though diffusion tensor imaging (DTI) may be normal, according to a study published in the June 2 issue of the New England Journal of Medicine.

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Hospital Volume May Affect Surgical Mortality Rate

WEDNESDAY, June 1 (HealthDay News) -- Mortality rates for certain high-risk surgical procedures have decreased in the United States, which is partially due to increased market concentration and hospital volume, according to a study published in the June 2 issue of the New England Journal of Medicine.

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