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October 2010 Briefing - Emergency Medicine

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

CDC Warns Travelers of Cholera Outbreak in Haiti

FRIDAY, Oct. 29 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has warned those traveling to Haiti to celebrate All Saints' Day and All Souls' Day to take precautions to protect themselves from cholera.

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Left Arm Splints Significantly Degrade Driving

FRIDAY, Oct. 29 (HealthDay News) -- Immobilization of a limb does not prevent many people from driving, but wearing an arm splint appears to have a detrimental effect on this skill, according to research published in the Oct. 6 issue of the Journal of Bone & Joint Surgery.

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Red Yeast Rice Supplements Lacking Standardization

WEDNESDAY, Oct. 27 (HealthDay News) -- Red yeast rice, a popular dietary supplement for reducing cholesterol, contains widely differing concentrations of monacolins, the active ingredients, by brand, and some contain a potentially toxic substance, according to research published in the Oct. 25 issue of the Archives of Internal Medicine.

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Electronic Tracking Ups Capture of Endoscopy Complications

WEDNESDAY, Oct. 27 (HealthDay News) -- An electronic tracking system picks up more outpatient endoscopic-related complications requiring an emergency department visit/hospitalization than does standard physician reporting, according to research published in the Oct. 25 issue of the Archives of Internal Medicine. These visits add substantially to the real cost of endoscopic procedures.

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Primary Care Trails Other Specialties in Hourly Wages

TUESDAY, Oct. 26 (HealthDay News) -- Primary care physicians have substantially lower hourly wages than other specialists, and although most physicians find Medicare reimbursement inequitable, they show little consensus on how to reform it, according to two studies published in the Oct. 25 issue of the Archives of Internal Medicine.

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HealthGrades: Lower Mortality Seen at High-Ranked Hospitals

MONDAY, Oct. 25 (HealthDay News) -- Patients at hospitals performing better than average on a variety of procedures and diagnoses have a lower risk of mortality compared to patients at low-performing hospitals, according to research released Oct. 20 by HealthGrades.

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Children Comprise Two-Thirds of ER Visits for Drug Ingestion

MONDAY, Oct. 25 (HealthDay News) -- Children under the age of 5 made up two-thirds of emergency department visits for accidental ingestion of drugs in 2008, according to a new report issued by the Substance Abuse and Mental Health Services Administration (SAMHSA).

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Pediatric Hospitalizations for ATV Injuries on the Rise

MONDAY, Oct. 25 (HealthDay News) -- Since the first four-wheeled all-terrain vehicle (ATV) debuted in the mid-1980s, pediatric injuries and deaths related to the use of ATVs have increased notably, more than doubling between 1997 and 2006, according to research published online October 18 in the Journal of Trauma: Injury, Infection, and Critical Care.

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New Guidelines for Recurrent Stroke Prevention Published

FRIDAY, Oct. 22 (HealthDay News) -- A joint committee representing the American Heart Association and the American Stroke Association has published updated evidence-based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack; the statement has been published online Oct. 21 in Stroke.

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HIV Drug Invirase Gets New Label Reflecting Risk

THURSDAY, Oct. 21 (HealthDay News) -- New risk information has been added to the label of the HIV antiviral drug Invirase (saquinavir), notifying patients and health care professionals that the drug can have potentially life-threatening adverse effects when used in combination with another antiviral drug, according to an announcement by the U.S. Food and Drug Administration.

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Titrated Oxygen Linked to Reduced Mortality in COPD

TUESDAY, Oct. 19 (HealthDay News) -- In patients with chronic obstructive pulmonary disease (COPD), the use of titrated oxygen -- compared to routine high-flow oxygen -- in the prehospital setting is associated with reduced mortality, according to research published online Oct. 19 in BMJ.

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Invasive Dental Procedures May Up Vascular Event Risk

TUESDAY, Oct. 19 (HealthDay News) -- Whether due to inflammatory effects or to a brief cessation of daily aspirin or other antiplatelet therapy, invasive dental treatments appear to be associated with a transient increased risk of a vascular event, particularly in the first four weeks after surgery, according to research published in the Oct. 19 issue of the Annals of Internal Medicine.

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New CPR Guidelines Emphasize Chest Compression First

TUESDAY, Oct. 19 (HealthDay News) -- Lay and professional rescuers using cardiopulmonary resuscitation (CPR) to revive someone stricken by cardiac arrest should begin chest compressions first to quickly restore blood circulation, rather than risk the delay to clear the patient's airway and restart breathing, according to the "2010 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care," published online Oct. 18 in Circulation.

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Offspring of Maternal Suicides at Risk for Suicide Attempt

MONDAY, Oct. 18 (HealthDay News) -- Children who lose a mother to suicide appear to be at increased risk for suicide attempt-related hospitalization compared with children who lose a mother to a fatal accident, but this association doesn't hold for children who lose a father to suicide, according to research published online Oct. 18 in Pediatrics.

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CDC Compares Accuracy of Fever Screening Systems

MONDAY, Oct. 18 (HealthDay News) -- Two of three infrared thermal detection systems (ITDS) tested by the U.S. Centers for Disease Control and Prevention reliably distinguish people with and without fever better than individual self reports, according to research published in the November issue of Emerging Infectious Diseases.

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"Natural" Weight Loss Products Pose Danger

FRIDAY, Oct. 15 (HealthDay News) -- An examination of poisoning cases in Hong Kong linked to over-the-counter (OTC) weight loss products often advertised to contain only "natural" ingredients" revealed the products to be laced with multiple illicit ingredients with toxicities that can cause illness or even death, according to a report published online Oct. 13 in the British Journal of Clinical Pharmacology.

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Chest-Compression-Only CPR Should Be Recommended

FRIDAY, Oct. 15 (HealthDay News) -- Chest-compression-only cardiopulmonary resuscitation (CPR) should be recommended by emergency medical services to bystanders caring for individuals experiencing out-of-hospital cardiac arrest rather than standard CPR with mouth-to-mouth, according to research published online Oct. 15 in The Lancet.

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Use of 'Poppers' Linked to Vision Loss in Several Patients

WEDNESDAY, Oct. 13 (HealthDay News) -- Alkyl nitrite "poppers" -- which have long been used as a recreational drug -- may be associated with phosphenes and prolonged vision loss, according to a letter published in the Oct. 14 issue of The New England Journal of Medicine.

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Prior Aspirin Use Is Marker for Recurrent MI Risk After ACS

WEDNESDAY, Oct. 13 (HealthDay News) -- Patients with a history of aspirin use who experience an incident of acute coronary syndrome (ACS) are at modestly higher risk of recurrent myocardial infarction (MI), but not mortality, compared with non-prior aspirin users, according to a study in the Oct. 19 issue of the Journal of the American College of Cardiology.

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ER Nurses Have Important Role in Psychosocial Interventions

MONDAY, Oct. 11 (HealthDay News) -- Nurses play a critical role in calming and comforting emergency department patients, and, with knowledge of what causes patients' fear and anxiety, may be able to apply evidence-based psychosocial interventions to decrease fear and increase comfort, according to a literature review published in the September issue of the Journal of Emergency Nursing.

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Cesarean Rates in England Vary Considerably

THURSDAY, Oct. 7 (HealthDay News) -- An analysis of cesarean deliveries among different National Health Service (NHS) trusts in England found that, while maternal characteristics differ among the trusts, variation remains, even after adjusting for these characteristics. The researchers recommend examining issues linked to emergency procedures; their work was published Oct. 6 in BMJ.

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Emergency Nurses May Be at High Risk for Burnout

THURSDAY, Oct. 7 (HealthDay News) -- Many emergency nurses report moderate to high levels of burnout and compassion fatigue, according to research published in the September issue of the Journal of Emergency Nursing.

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Epinephrine for Anaphylaxis by Trained Individuals Endorsed

WEDNESDAY, Oct. 6 (HealthDay News) -- The Wilderness Medical Society has endorsed the administration of epinephrine to treat anaphylaxis in the field under emergency conditions by trained non-medical professionals, according to a panel statement published in the September issue of Wilderness & Environmental Health.

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Increasing Catheter Size Tied to Greater Thrombosis Risk

WEDNESDAY, Oct. 6 (HealthDay News) -- Previous deep vein thrombosis (DVT) and increasing catheter size are related to an increased risk for peripherally inserted central catheter (PICC)-associated DVT, according to a study in the October issue of Chest.

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For Bystander Resuscitation, Compression-Only CPR Better

TUESDAY, Oct. 5 (HealthDay News) -- Compression-only cardiopulmonary resuscitation (COCPR) administered by laypersons in out-of-hospital cardiac arrest situations is associated with higher survival rates than conventional CPR, according to research published in the Oct. 6 issue of the Journal of the American Medical Association.

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Hypertonic Saline Not Better for TBI Resuscitation

TUESDAY, Oct. 5 (HealthDay News) -- Initial resuscitation with hypertonic saline with or without dextran is not superior to normal saline resuscitation in non-hypovolemic patients with severe traumatic brain injury (TBI), according to research published in the Oct. 6 issue of the Journal of the American Medical Association.

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CT, MRI During Injury-Related ER Visits on the Rise

TUESDAY, Oct. 5 (HealthDay News) -- The use of advanced radiographic techniques during injury-related emergency department visits has increased despite no real change in the number of life-threatening or admission-requiring diagnoses, according to research published in the Oct. 6 issue of the Journal of the American Medical Association.

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Children With ADHD at Risk for Depression, Suicide Later

TUESDAY, Oct. 5 (HealthDay News) -- Young children with attention-deficit/hyperactivity disorder (ADHD) have more than a four-fold increased risk of depression and a nearly four-fold increased risk of suicide attempt by age 18, according to research published in the October issue of the Archives of General Psychiatry.

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