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March 2012 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for March 2012. 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.

Cardiac Shock Wave Therapy Improves Angina Symptoms

FRIDAY, March 30 (HealthDay News) -- Cardiac shock wave therapy (CSWT) can significantly improve symptoms, ischemic threshold during exercise, and specific quality-of-life parameters for patients with chronic refractory angina pectoris, according to a study published online March 23 in Cardiovascular Therapeutics.

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911 Operators May Experience Posttraumatic Stress Disorder

FRIDAY, March 30 (HealthDay News) -- Emergency dispatchers experience high levels of peritraumatic distress, which is positively associated with posttraumatic stress disorder (PTSD), according to a study published online March 29 in the Journal of Traumatic Stress.

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Antipsychotic Medications Increase Risk of Heart Attack

WEDNESDAY, March 28 (HealthDay News) -- For older patients treated with cholinesterase inhibitors, taking antipsychotic agents (APs) for dementia is associated with a modest and time-limited increased risk of myocardial infarction (MI), according to a study published online March 26 in the Archives of Internal Medicine.

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Change in Health Insurance Status Linked to ER Use

WEDNESDAY, March 28 (HealthDay News) -- Recent changes in health insurance status are linked to greater emergency department use by newly insured and newly uninsured adults, according to a study published online March 26 in the Archives of Internal Medicine.

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Cost Sharing Reduces Use of Asthma Medication

TUESDAY, March 27 (HealthDay News) -- Higher out-of-pocket expenses are tied to a slight reduction in use of asthma medications in children aged 5 years or older, which results in increased hospitalizations, according to a study published in the March 28 issue of the Journal of the American Medical Association.

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Review Compares Drug Options for Irritable Bowel Syndrome

TUESDAY, March 27 (HealthDay News) -- Tricyclic antidepressants and alosetron are associated with significant harm in treating irritable bowel syndrome (IBS) compared with rifaximin, and selective serotonin reuptake inhibitors (SSRIs) and lubiprostone appear to be safe, according to a meta-analysis published in the April issue of The American Journal of Medicine.

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Policy Statement Issued on Pediatric Sudden Cardiac Arrest

MONDAY, March 26 (HealthDay News) -- Pediatricians need to recognize the warning signs and appropriately manage patients with sudden cardiac arrest (SCA), according to a policy statement issued by the American Academy of Pediatrics (AAP) and published online March 26 in Pediatrics.

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Long Arm Cast Best for Immobilizing Forearm

MONDAY, March 26 (HealthDay News) -- Use of a long arm cast provides the best restriction of forearm rotation, according to a study published in the March 7 issue of The Journal of Bone & Joint Surgery.

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Ibuprofen Cuts Incidence, Severity of Altitude Sickness

THURSDAY, March 22 (HealthDay News) -- For healthy adults ascending from low to high altitude, ibuprofen effectively reduces the incidence and severity of acute mountain sickness, compared with placebo, according to a study published online March 22 in the Annals of Emergency Medicine.

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New Guidelines Issued for Acute Bacterial Rhinosinusitis

THURSDAY, March 22 (HealthDay News) -- As the majority of rhinosinusitis cases are viral, antimicrobial therapy should be initiated after establishment of a clinical diagnosis of bacterial rhinosinusitis, and β-lactam agents are recommended for initial therapy, according to the Infectious Diseases Society of America's first rhinosinusitis guidelines published online March 20 in Clinical Infectious Diseases.

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Circulating Endothelial Cells Potential Biomarker for MI

THURSDAY, March 22 (HealthDay News) -- Circulating endothelial cell (CEC) counts are elevated among patients with myocardial infarction (MI), and the cells have distinct morphological features, according to a study published in the March 21 issue of Science Translational Medicine.

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Health Care Team Members Key for Antimicrobial Stewardship

THURSDAY, March 22 (HealthDay News) -- Antimicrobial stewardship programs (ASPs) that use health care epidemiologists (HEs) and infection preventionists (IPs) have a crucial role to play in the effort to combat health care-associated infections (HAIs), including those caused by multidrug-resistant organisms (MDROs), according to the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America position paper published in the March issue of the American Journal of Infection Control.

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Tenecteplase Superior to Alteplase for Stroke Treatment

WEDNESDAY, March 21 (HealthDay News) -- Tenecteplase is superior to alteplase for the treatment of acute ischemic stroke for select patients, according to a study published in the March 22 issue of the New England Journal of Medicine.

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In Out-of-Hospital Cardiac Arrest, Epi Use Linked to Outcomes

TUESDAY, March 20 (HealthDay News) -- Use of epinephrine for resuscitation in patients with out-of-hospital cardiac arrest (OHCA) is associated with increased odds of return of spontaneous circulation, but does not improve patient outcomes, according to a study published in the March 21 issue of the Journal of the American Medical Association.

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Survey Describes Docs' Online Professionalism Violations

TUESDAY, March 20 (HealthDay News) -- Most medical licensing authorities receive and act upon reports of physicians' online professionalism violations, according to a research letter published in the March 21 issue of the Journal of the American Medical Association.

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Nurse-Initiated Steroids Improve Pediatric Asthma Care

TUESDAY, March 20 (HealthDay News) -- Nurse initiation of oral corticosteroids before physician assessment of pediatric patients with asthma improves quality and efficiency of care provided in the pediatric emergency department, according to a study published online March 19 in Pediatrics.

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Synthetic Cannabinoid Toxicity Among Teenagers on the Rise

MONDAY, March 19 (HealthDay News) -- Smoking synthetic versions of marijuana is landing some teens in the emergency room complaining of restlessness, agitation, and diaphoresis, according to a case report published online March 19 in Pediatrics.

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Most California Hospitals Implementing Infection Control

FRIDAY, March 16 (HealthDay News) -- Most California hospitals implement some policies to improve infection control for multidrug-resistant organisms (MDRO), primarily methicillin-resistant Staphylococcus aureus (MRSA), but few policies are associated with lower MDRO rates, according to a study published in the March issue of the American Journal of Infection Control.

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Poorer Health Literacy Linked to Increased Mortality

FRIDAY, March 16 (HealthDay News) -- A considerable proportion of older adults in England have medium or low health literacy, which is associated with increased mortality, according to a study published online March 15 in BMJ.

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Mutations in CIZ1 May Cause Adult-Onset Cervical Dystonia

THURSDAY, March 15 (HealthDay News) -- Mutations in CIZ1 may cause adult-onset primary cervical dystonia, according to a study published online Feb. 1 in the Annals of Neurology.

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Analgesic Use After Surgery Linked to Long-Term Use

THURSDAY, March 15 (HealthDay News) -- Older patients prescribed opioids or nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief after short-stay surgery appear to be at increased risk for becoming long-term analgesic users, according to a study published in the March 12 issue of the Archives of Internal Medicine.

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Personal Mobile Computers Improve Resident Efficiency

WEDNESDAY, March 14 (HealthDay News) -- The use of personal mobile computers (Apple iPads) by internal medicine residents improves efficiency, according to a research letter published in the March 12 issue of the Archives of Internal Medicine.

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Most Hospital Errors in Developing Countries Preventable

WEDNESDAY, March 14 (HealthDay News) -- Nearly 10 percent of patients admitted to a hospital in a developing country experience at least one adverse event, most of which are preventable and are largely due to inadequate training and supervision rather than an absence of resources, according to a study published online March 13 in BMJ.

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Higher Spending by Hospitals Improves Outcomes

TUESDAY, March 13 (HealthDay News) -- Hospitals that are part of the universal health care system in Canada that spend more on inpatient care have lower rates of deaths and hospital readmissions, according to a study published in the March 14 issue of the Journal of the American Medical Association.

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Practical Strategies Can Ease Death Notification in the ER

TUESDAY, March 13 (HealthDay News) -- By using practical strategies based on available literature, notifying survivors of a death in the emergency department can be less traumatic for both the survivor and the physician, nurse, or other health care provider tasked with delivering the news, according to an article published in the March issue of the Journal of Emergency Nursing.

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U.S. Mortality Rates Dropped 60 Percent From 1935 to 2010

TUESDAY, March 13 (HealthDay News) -- From 1935 to 2010, the death rate in the United States decreased considerably, although the single-year improvements in mortality were often small, according to a March data brief issued by the National Center for Health Statistics (NCHS).

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Youth Agricultural Injuries a Significant Problem

MONDAY, March 12 (HealthDay News) -- In the United States, more than 26,000 youth agricultural injuries, which tend to be more severe and costly than nonagricultural injuries, occur annually, at a cost of $1.4 billion per year, according to research published online March 12 in Pediatrics.

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Use of Head CT Varies Between Emergency Physicians

MONDAY, March 12 (HealthDay News) -- In the emergency department, there is wide interphysician variation in the use of head computed tomography (CT) overall, and for patients diagnosed with atraumatic headache, according to a study published online Feb. 13 in the American Journal of Medicine.

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MRI Use Increasing for Evaluating Stroke Patients

MONDAY, March 12 (HealthDay News) -- The use of magnetic resonance imaging (MRI) in the evaluation of hospitalized stroke patients has dramatically increased over the past decade, according to an article published in the February issue of the Annals of Neurology.

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Stair-Related Injuries in Young Children Declining

MONDAY, March 12 (HealthDay News) -- Stair-related injuries among young children have been on the decline for the last decade or so in the United States but are still an important source of injury, according to a study published online March 12 in Pediatrics.

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Aggressive Care Improves QoL in Traumatic Brain Injury

MONDAY, March 12 (HealthDay News) -- Compared with routine care, an aggressive-care approach to the treatment of patients with severe traumatic brain injury (TBI), which follows the Brain Trauma Foundation guidelines, is estimated to improve quality of life and significantly lower associated costs, regardless of patient age, according to research published online March 6 in the Journal of Neurosurgery.

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Suicide Rates for U.S. Army Soldiers Increasing

FRIDAY, March 9 (HealthDay News) -- The number of U.S. army soldiers committing suicide has increased as the number of clinically treated mental disorders has increased, making these soldiers good targets for suicide prevention interventions, according to study published online March 7 in Injury Prevention.

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Flu Vaccine Up Among Medical Staff When They Believe It Works

FRIDAY, March 9 (HealthDay News) -- Hospital health care workers (HCWs) are more likely to receive the seasonal influenza vaccination if they believe it works and are committed to preventing this highly contagious virus, according to research published in the April issue of Occupational & Environmental Medicine.

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Surrogates Tend to Misinterpret Poor Prognosis Information

FRIDAY, March 9 (HealthDay News) -- Surrogate decision makers for critically ill patients interpret prognostic statements expressing a low risk of death accurately, but interpret statements conveying poor prognosis optimistically, according to a study published in the March 6 issue of the Annals of Internal Medicine.

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Buprenorphine Maintenance Therapy Not Recommended

THURSDAY, March 8 (HealthDay News) -- Opioid substitution therapy with buprenorphine is not recommended for opioid-addicted health care professionals (HCPs), according to research published in the March issue of the Mayo Clinic Proceedings.

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In Suspected PE, A-fib Doesn't Raise Odds of the Diagnosis

WEDNESDAY, March 7 (HealthDay News) -- In general, the presence of atrial fibrillation (AF) does not increase the likelihood of pulmonary embolism (PE), according to a study published in the March issue of the Journal of Thrombosis and Haemostasis.

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Financial Burden of Medical Care Affects One in Three

WEDNESDAY, March 7 (HealthDay News) -- In the first half of 2011, one in three individuals was in a family that experienced the financial burden of medical care in the United States, according to the results of the National Health Interview Survey published March 7 by the National Center for Health Statistics (NCHS).

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Positive Whole-Body CT Can Detect but Not Eliminate Trauma

TUESDAY, March 6 (HealthDay News) -- For assessing severe trauma, single-pass whole-body computed tomography (CT), or pan-scanning, can detect, but not definitively exclude, the presence of injuries, according to a study published online March 5 in CMAJ, the journal of the Canadian Medical Association.

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Risk of Stroke Increases With Each Year of Having Diabetes

THURSDAY, March 1 (HealthDay News) -- The risk of stroke increases with the length of time a patient has diabetes, according to a study published online March 1 in Stroke.

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