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May 2010 Briefing - Emergency Medicine

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

Underage Drinking Emergency Room Visits Rise Over Holiday

MONDAY, May 31 (HealthDay News) -- Daily underage drinking-related visits to hospital emergency departments are higher over the three-day Memorial Day weekend than on an average day, according to a new study from the Substance Abuse and Mental Health Services Administration (SAMHSA).

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CT Contrast Agents May Cause Delayed Adverse Reactions

FRIDAY, May 28 (HealthDay News) -- Delayed adverse reactions (DARs) occur more frequently in patients undergoing contrast-enhanced computed tomography (CT) than in those undergoing unenhanced CT, according to a study in the June issue of Radiology.

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FDA: Baxter Recalling Hyaluronidase Human Injection

THURSDAY, May 27 (HealthDay News) -- Baxter International Inc. has announced a voluntary recall of hyaluronidase human injection (Hylenex recombinant), as particulate matter was found in a limited number of vials during standard stability testing.

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Early Antibiotics in COPD Hospitalizations Beneficial

TUESDAY, May 25 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) patients hospitalized for exacerbations of their illness who receive antibiotic treatment within the first two days of their hospitalization fare better than those who do not, according to research published in the May 26 issue of the Journal of the American Medical Association.

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H1N1 in Pregnant Women Is Serious Threat to Fetuses

TUESDAY, May 25 (HealthDay News) -- Pregnant women admitted to the hospital with pandemic novel influenza A(H1N1) are at increased risk for abdominal and gastrointestinal symptoms, fetal distress and mortality, emergency cesarean delivery, and premature births, according to research published in the May 24 issue of the Archives of Internal Medicine.

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Alfalfa Sprouts Recalled Due to Salmonella Outbreak

MONDAY, May 24 (HealthDay News) -- Caldwell Fresh Foods has issued a recall of raw alfalfa sprouts due to a Salmonella Newport outbreak in 10 states, according to the U.S. Food and Drug Administration.

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Recent Outbreak of Dengue in Key West Raises Concern

MONDAY, May 24 (HealthDay News) -- A recent outbreak of 28 dengue cases in Key West, Fla., should prompt clinicians to consider dengue in diagnosing patients who live in or have recently traveled to subtropical parts of the United States, according to a report published in the May 21 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Battery Ingestions Have Devastating Complications

MONDAY, May 24 (HealthDay News) -- The increased use of 20-mm lithium button batteries has led to a rise in devastating complications from their ingestion. Prevention should be encouraged through education and secure household product design, and, when prevention doesn't work, the removal of batteries from the esophagus must be expedited to prevent major complications, according to two studies published online May 24 in Pediatrics.

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AAP Statement Urges Drowning Prevention Efforts

MONDAY, May 24 (HealthDay News) -- With drowning a leading cause of accidental death in children, the American Academy of Pediatrics (AAP) is urging pediatricians to actively educate and counsel parents and support community drowning prevention efforts in a revised policy statement published online May 24 in Pediatrics.

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Misoprostol Does Not Decrease Postpartum Hemorrhage

FRIDAY, May 21 (HealthDay News) -- The prostaglandin analogue misoprostol, when added to standard uterotonic therapy, does not result in decreased postpartum blood loss, according to research published in the May 22 issue of The Lancet.

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Stroke Incidence Falls in Cincinnati/Northern Kentucky

FRIDAY, May 21 (HealthDay News) -- The incidence of stroke decreased significantly among whites, but not blacks, in the Greater Cincinnati/Northern Kentucky area from 1999 to 2005, according to research published online May 20 in Stroke.

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Sagent Announces Recall of Metronidazole Injection

WEDNESDAY, May 19 (HealthDay News) -- Sagent Pharmaceuticals Inc. has announced a nationwide voluntary recall of all lots of metronidazole injection, USP 500 mg/100 mL, distributed by the company and manufactured by Claris Lifesciences, due to non-sterility in two lots of the product, according to the U.S. Food and Drug Administration (FDA).

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Racial Disparities Reduced in Quality Monitoring Program

TUESDAY, May 18 (HealthDay News) -- Hospitals enrolled in a national quality monitoring and improvement program showed improvements in adherence to evidence-based guidelines for acute myocardial infarction (AMI), as well as reductions or elimination of racial/ethnic care disparities, according to research published May 17 in the journal Circulation.

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Brain-Injured Youths Have More Postconcussive Symptoms

TUESDAY, May 18 (HealthDay News) -- Postconcussive symptoms (PCSs) are not unique to children with mild traumatic brain injuries (MTBIs), but children with such injuries experience more PCSs and different neurocognitive recovery than their non-head-injured peers, according to research published online May 17 in Pediatrics.

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Race May Impact Clinician's Infant Drug Screening Choices

MONDAY, May 17 (HealthDay News) -- Health care providers may be impacted by maternal race in determining whether to screen for illicit drug exposure in infants, regardless of their institution's standard criteria for screening, according to a study published online May 17 in Pediatrics.

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Earliest Receipt of Alteplase Benefits Stroke Outcomes Most

FRIDAY, May 14 (HealthDay News) -- The thrombolytic drug alteplase should be given as soon as possible after a stroke, as the odds of a favorable outcome decrease as the time to treatment increases, according to a pooled analysis published online May 15 in The Lancet.

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Low Umbilical Artery pH Linked to Adverse Outcomes

FRIDAY, May 14 (HealthDay News) -- Low umbilical artery pH at birth is strongly associated with adverse long-term outcomes, including death and hypoxic ischemic encephalopathy, according to research published online May 13 in BMJ.

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Many General Internists Leave Field by Mid-Career

FRIDAY, May 14 (HealthDay News) -- Roughly one out of six general internists are leaving internal medicine by mid-career, a substantially higher proportion compared to internal medicine subspecialists, according to survey results published April 29 in the Journal of General Internal Medicine.

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Interrupted Doctors Spend Less Time on Clinical Tasks

FRIDAY, May 14 (HealthDay News) -- Emergency department doctors who are interrupted may decrease the time they spend on clinical tasks and even delay or fail to return to some tasks, which could have a negative impact on patient safety, according to a study published online May 12 in Quality and Safety in Health Care.

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Stroke Sign Awareness Doesn't Translate to Calling 911

FRIDAY, May 14 (HealthDay News) -- Most adults cannot correctly identify stroke warning signs, and even those who can may not respond to them by calling 911, according to research published online May 13 in Stroke.

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FDA Warns Consumers Against Swallowing Topical Benadryl

THURSDAY, May 13 (HealthDay News) -- The U.S. Food and Drug Administration has alerted consumers regarding potentially serious side effects associated with mistakenly swallowing Benadryl Extra Strength Itch Stopping Gel, an over-the-counter (OTC) product intended only for topical use.

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New Implantable Cardioverter-Defibrillator Tested Effectively

WEDNESDAY, May 12 (HealthDay News) -- A new type of implantable cardioverter-defibrillator (ICD) with leads that can be implanted subcutaneously, rather than transvenously as with conventional ICDs, has successfully detected and converted ventricular fibrillation in a series of evaluation trials, according to a report published online May 12 in the New England Journal of Medicine.

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New FDA Program Targets Misleading Drug Advertising

WEDNESDAY, May 12 (HealthDay News) -- The U.S. Food and Drug Administration has announced the launch of a new program to educate health care providers regarding their role in making certain that advertisements and promotions for prescription drugs are truthful and not misleading.

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Community Prevention Program Reduces Falls Over 12 Months

WEDNESDAY, May 12 (HealthDay News) -- A comprehensive community fall prevention program may lower the number of falls and improve clinical outcomes in older individuals at high risk for falls, according to a study published online May 11 in BMJ.

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COPD Exacerbations May Raise Risk of Cardiovascular Events

TUESDAY, May 11 (HealthDay News) -- Exacerbations of chronic obstructive pulmonary disease (COPD) appear to increase the risk of myocardial infarction (MI) and stroke, according to research published in the May issue of Chest.

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D-Dimer May Be Marker for Adverse Events in A-Fib Patients

TUESDAY, May 11 (HealthDay News) -- During anticoagulation therapy for atrial fibrillation, D-dimer values may be useful in prediction of thromboembolic and cardiovascular events, according to a study in the May 18 issue of the Journal of the American College of Cardiology.

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Fluctuating Blood Pressure May Increase Risk of CVD in Elderly

MONDAY, May 10 (HealthDay News) -- High blood pressure (BP) and greater BP fluctuations are associated with an increased risk for cerebrovascular disease in older adults, according to research published in the May issue of the Archives of Neurology.

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In-Hospital Pediatric Mortality Tied to Patient Characteristics

MONDAY, May 10 (HealthDay News) -- Patient characteristics, including age and severity of diagnosis are substantive factors associated with pediatric in-patient deaths, and reducing variability within and between pediatric hospitals may improve mortality rates, according to research published online May 10 in Pediatrics.

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Opioid Misuse Risk Factors Differ for Men and Women

MONDAY, May 10 (HealthDay News) -- Men at risk for the misuse of prescription opioids taken for pain are more likely to have legal and behavioral problems, while women who misuse are more likely to have emotional or psychological issues, according to a study in the April issue of the Journal of Pain.

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Motor Vehicle Accidents Leading Cause of Teen Death

WEDNESDAY, May 5 (HealthDay News) -- On average, more than 16,000 12- to 19-year-olds die each year in the United States, and the leading cause of death among this age group is motor vehicle accidents, according to a new report from the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Early Heart Failure Follow-Up Tied to Lower Readmission Rate

TUESDAY, May 4 (HealthDay News) -- Patients who are hospitalized for heart failure are unlikely to have early follow-up after discharge, but those who are discharged from hospitals that have a higher rate of following up within one week have a lower risk of being readmitted within 30 days, according to a study published in the May 5 issue of the Journal of the American Medical Association.

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Most People Don't Know Which Hospitals Are Stroke-Certified

TUESDAY, May 4 (HealthDay News) -- Despite believing that it is important to know where to get specialty stroke care, most Americans do not know which hospitals in their area are considered stroke-certified, according to the results of a survey released by the American Stroke Association on May 3.

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Children's and Infants' Liquid Medicines Recalled

MONDAY, May 3 (HealthDay News) -- McNeil Consumer Healthcare and the U.S. Food and Drug Administration have alerted health care professionals of the voluntary recall of various over-the-counter liquid products for children and infants, including Tylenol, Motrin, Zyrtec and Benadryl products, as some of them may not meet quality standards.

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