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March 2009 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for March 2009. 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.

Safe Practice Scores Do Not Add Up to Fewer Patient Deaths

TUESDAY, March 31 (HealthDay News) -- In hospitals, higher self-reported scores for improvements in safe practices do not correlate with reduced mortality rates, researchers report in the April 1 issue of the Journal of the American Medical Association.

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Little Clinical Evidence to Support Bed Bug Treatments

TUESDAY, March 31 (HealthDay News) -- Although bed bugs (Cimex lectularius) have been associated with dozens of human diseases and their bites are treated with a range of drugs, there is no clinical trial-based evidence for the efficacy of treatments, and there is little evidence that they are communicable disease vectors, according to a review published in the April 1 issue of the Journal of the American Medical Association.

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Social Isolation Worsens Stroke Outcomes in Mouse Study

MONDAY, March 30 (HealthDay News) -- Mice housed in isolation are more likely to experience major ischemic damage and die of a stroke than their socially housed cohorts, according to research published online March 23 in the Proceedings of the National Academy of Sciences.

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NHLBI Discontinues Hypertonic Saline Trial

FRIDAY, March 27 (HealthDay News) -- A U.S.-Canadian trial to assess in-ambulance administration of a hypertonic saline solution to trauma patients in shock from severe bleeding has been halted due to lack of a survival benefit, the National Heart, Lung, and Blood Institute (NHLBI) announced on March 26.

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ACCF/AHA Update Covers Heart Failure in Adults

FRIDAY, March 27 (HealthDay News) -- Updated American College of Cardiology Foundation/American Heart Association guidelines on heart failure in adults include new recommendations for hospitalized patients, and the guidelines were published online March 26 in the Journal of the American College of Cardiology.

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Mass Antibiotic Program Can Offer Trachoma Herd Protection

FRIDAY, March 27 (HealthDay News) -- Herd immunity to trachoma can be achieved through repeated rounds of mass antibiotic administration to children, who are a core means of transmission for the eye disease, according to a report published in the March 28 issue of The Lancet.

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Lung Hypertension Common in Heart Failure Patients

FRIDAY, March 27 (HealthDay News) -- Pulmonary hypertension is common in patients with preserved ejection fraction heart failure, and pulmonary artery systolic pressure may be effective in diagnosing heart failure with preserved ejection fraction (HFpEF) and predicting the risk of death, researchers report in the March 31 issue of the Journal of the American College of Cardiology.

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Most US Adults Should Reduce Sodium Intake

FRIDAY, March 27 (HealthDay News) -- Nearly 70 percent of U.S. adults are in groups at high risk of hypertension and should reduce their sodium intake to less than a teaspoon of salt a day, officials from the U.S. Centers for Disease Control and Prevention report in the March 27 issue of the Morbidity and Mortality Weekly Report.

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Report Calls for Separate US Food Safety Agency

THURSDAY, March 26 (HealthDay News) -- A dedicated agency for food safety is needed to combat food-related health threats, according to a report, Keeping America's Food Safe, produced by Trust for America's Health and the Robert Wood Johnson Foundation.

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Electric Current Leak Can Trigger Defibrillator Shock

WEDNESDAY, March 25 (HealthDay News) -- An electric current leak that is not noticeable under ordinary circumstances can trigger a serious shock in someone who has an implanted cardioverter-defibrillator (ICD), according to a letter in the March 26 issue of the New England Journal of Medicine.

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Cost Barriers Slow Adoption of Electronic Health Records

WEDNESDAY, March 25 (HealthDay News) -- Citing cost barriers, relatively few U.S. hospitals have adopted electronic health records, posing a major obstacle for policy makers who say health information technology is critical to the improvement of health care quality and cost-effectiveness, according to an article published online March 25 in the New England Journal of Medicine.

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U.S. Emergency Care Access Varies Widely

WEDNESDAY, March 25 (HealthDay News) -- While most people in the United States can get to an emergency department within a half-hour, there are geographic inequities that could impact medical outcomes in time-critical medical emergencies, such as heart attack, stroke or major trauma, according to a report in the Feb. 9 online edition of the Annals of Emergency Medicine.

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Genetic Heart Disease Often Deadly for Children

TUESDAY, March 24 (HealthDay News) -- A genetic cardiomyopathy that strikes children is associated with serious heart dysfunction and often death, according to a report in the March 25 issue of the Journal of the American Medical Association.

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Whole-Body Scans at Trauma Centers Save Lives

TUESDAY, March 24 (HealthDay News) -- Whole-body computed tomography (CT) should be incorporated into the standard diagnostic process during early resuscitation for patients with blunt trauma injury, according to the results of a study published online March 24 in The Lancet.

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Smoking Linked to Risk of Acute, Chronic Pancreatitis

TUESDAY, March 24 (HealthDay News) -- Smoking is independently associated with an increased risk of pancreatitis, according to study findings published in the March 23 issue of the Archives of Internal Medicine.

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Illegal Immigrants Pose Ethical Dilemma for US Nurses

THURSDAY, March 19 (HealthDay News) -- Even though under federal law illegal immigrants in the United States for less than five years are not eligible for Medicaid, emergency department nurses have a range of ethical and legal obligations that require them to protect the safety of all patients regardless of their citizenship status, according to an article published in the March issue of the Journal of Emergency Nursing.

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Fall Model May Not Be Reliable for Emergency Department

THURSDAY, March 19 (HealthDay News) -- The risk model that helps identify those at risk of falls in an inpatient setting may not be reliable in predicting those at risk in the emergency department, researchers report in the March issue of the Journal of Emergency Nursing.

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Hospital Quality Measure Inaccurate, May Increase Bias

WEDNESDAY, March 18 (HealthDay News) -- A widely used hospital quality measure that compares mortality rates and takes into account the mix of cases is inaccurate and may increase the bias that case mix adjustment is intended to decrease, according to research published March 18 in BMJ Online First.

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Aspirin Dose Over 100 mg May Do Heart More Harm Than Good

TUESDAY, March 17 (HealthDay News) -- The optimum daily dose of aspirin for prevention of cardiovascular events is probably between 75 and 81 mg, as a 100-mg dose or more has no obvious benefit and may cause harm in patients who are also taking clopidogrel, according to a report published in the March 17 issue of the Annals of Internal Medicine.

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Delays in Seeking Heart Attack Care Vary Worldwide

MONDAY, March 16 (HealthDay News) -- Delay seeking medical care for acute myocardial infarction was longest in Argentina and Brazil and shortest in Australia/New Zealand during a six-year study period, according to research published in the March 1 issue of the American Journal of Cardiology.

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Drugs Don't Boost Survival in Older Heart Failure Patients

THURSDAY, Mar. 12 (HealthDay News) -- People over 80 years of age who have heart failure with preserved ejection fraction, a prevalent condition in the elderly, do not benefit significantly from commonly prescribed cardiac medications, according to research published in the Mar. 15 issue of the American Journal of Cardiology.

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Blood Glucose Affects Survival in Non-Diabetic STEMI Cases

THURSDAY, Mar. 12 (HealthDay News) -- In non-diabetic patients with ST-elevation myocardial infarction (STEMI), high blood glucose at hospital admission is independently associated with an increased risk of short- and mid-term death, according to a report published in the Mar. 1 issue of the American Journal of Cardiology.

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Warmer Weather Linked to Increased Headache Risk

TUESDAY, Mar. 10 (HealthDay News) -- Higher outdoor temperatures were associated with a short-term increase in headache risk, according to the results of a study published in the Mar. 10 issue of Neurology.

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Faster Diagnosis Benefits Acute Chest Pain Patients

TUESDAY, Mar. 10 (HealthDay News) -- In low-risk patients who present to hospitals with acute chest pain, an accelerated diagnostic protocol may be associated with less impairment of quality of life than usual care, according to a report published in the Mar. 1 issue of the American Journal of Cardiology.

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Children, Teens Most Likely to Survive Cardiac Arrest

TUESDAY, Mar. 10 (HealthDay News) -- The incidence of out-of-hospital cardiac arrest in infants approaches that of adults, is less frequent in children and adolescents, and children and adolescents are twice as likely to survive to discharge, according to research published online Mar. 9 in Circulation: Journal of the American Heart Association.

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Pulmonary Embolism Common in Acute COPD Patients

FRIDAY, Mar. 6 (HealthDay News) -- Pulmonary embolism may occur in one-quarter of patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (COPD), according to research published in the March issue of Chest.

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Use of Stroke Prevention Services Can Be Improved

FRIDAY, Mar. 6 (HealthDay News) -- There is widespread underutilization of stroke secondary prevention services, according to a report published online Mar. 5 in Stroke.

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Transdermal Patches Pose Burn Risk During Scans

FRIDAY, Mar. 6 (HealthDay News) -- The U.S. Food and Drug Administration has issued a warning about the risk of burns as a result of wearing medicated patches, such as those used for smoking cessation or pain relief, during MRI scans.

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Obama Wants to Spend $630 Billion on Health Care Reform

THURSDAY, Mar. 5 (HealthDay News) -- Achieving health care reform is one of President Barack Obama's major challenges, and his newly released spending plan calls on Congress to commit $630 billion over the next decade to finance that reform, according to an article published online Mar. 4 in the New England Journal of Medicine.

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Suicide Risk Greater Following Post-Traumatic Stress

WEDNESDAY, Mar. 4 (HealthDay News) -- Post-traumatic stress disorder (PTSD) after a traumatic event in childhood can independently predict attempted suicide risk, although trauma alone cannot, according to research presented in the March issue of the Archives of General Psychiatry.

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Proton Pump Inhibitors May Reduce Benefits of Clopidogrel

TUESDAY, Mar. 3 (HealthDay News) -- Acute coronary syndrome patients who are prescribed clopidogrel in combination with a proton pump inhibitor are at increased risk of adverse outcomes compared with patients prescribed clopidogrel alone, according to a report published in the Mar. 4 issue of the Journal of the American Medical Association.

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Oseltamivir-Resistant Flu Viruses Increasing

TUESDAY, Mar. 3 (HealthDay News) -- The 2008 to 2009 influenza season will see a higher prevalence of oseltamivir-resistant viruses, and certain strains of the virus are highly pathogenic to high-risk patients, according to two studies published online Mar. 2 in the Journal of the American Medical Association. Another study reports that intranasal live attenuated influenza vaccine is associated with more medical encounters than trivalent inactivated vaccine.

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Vitamin K Doesn't Reduce Bleeding in Warfarin Patients

TUESDAY, Mar. 3 (HealthDay News) -- In patients receiving warfarin, vitamin K does not reduce bleeding, according to study findings published in the Mar. 3 issue of the Annals of Internal Medicine.

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US Motor Vehicle-Related Death Rates Vary Geographically

MONDAY, Mar. 2 (HealthDay News) -- Although the mortality rate related to motor vehicles remained almost unchanged from 1999 to 2005 in the United States, on closer inspection the data reveals wide variations from state to state, as well as by gender and ethnicity, according to a report published in the Feb. 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Glycemic Control Approaches Lead to Similar Outcomes

MONDAY, Mar. 2 (HealthDay News) -- Different approaches to glycemic control in type 2 diabetics following myocardial infarction were associated with similar risk of later cardiovascular events, according to research published in the March issue of Diabetes Care.

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Much Lung Cancer Disparity Appears to Be Due to Smoking

MONDAY, Mar. 2 (HealthDay News) -- Smoking appeared to explain much -- but not all -- of the inequality in lung cancer risk attributable to differences in education in a large sample of Europeans, according to research published in the Mar. 4 issue of the Journal of the National Cancer Institute.

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CT Perfusion May Predict Hemorrhagic Transformation

MONDAY, Mar. 2 (HealthDay News) -- In patients with acute ischemic stroke, admission perfusion-derived permeability-surface area product (PS) measurement may differentiate those who are and are not likely to develop hemorrhagic transformation, according to the results of a pilot study published in the March issue of Radiology.

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Age Stereotypes Affect Disease Risk Later in Life

MONDAY, Mar. 2 (HealthDay News) -- People who have negative views about aging are more likely to have a cardiovascular event later in life, according to research published online Feb. 13 in Psychological Science.

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Patients' Rights Documents Usually Difficult to Understand

MONDAY, Mar. 2 (HealthDay News) -- Patients' bill of rights documents in U.S. hospitals are generally written at a complexity level that far exceeds the average adult's reading ability, according to a report published online Feb. 3 in the Journal of General Internal Medicine.

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