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September 2008 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for September 2008. 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.

News Media Under-Report Drug Company Funding of Research

TUESDAY, Sept. 30 (HealthDay News) -- Reports on medication research published in general news media often fail to disclose that the research received pharmaceutical company funding and frequently refer to drugs by brand name rather than using the generic name, according to an article published in the Oct. 1 issue of the Journal of the American Medical Association.

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Road Traffic Accidents High on Presidential Election Days

TUESDAY, Sept. 30 (HealthDay News) -- There are more fatal road traffic accidents on the days of U.S. presidential elections than usual, and the increase is even greater than that of Super Bowl Sundays, according to a research letter published in the Oct. 1 issue of the Journal of the American Medical Association.

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Reduced Dosing Schedule Acceptable for Anthrax Vaccine

TUESDAY, Sept. 30 (HealthDay News) -- A three-dose intramuscular (3-IM) regimen of anthrax vaccine adsorbed (AVA) achieves a similar serological response compared to a four-dose intramuscular (4-IM) or subcutaneous (4-SQ) regimen, and fewer injection site adverse effects are seen with IM administration, according to a report in the Oct. 1 issue of the Journal of the American Medical Association .

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Flu Vaccination Rises in Adults But Still Low in Children

MONDAY, Sept. 29 (HealthDay News) -- During the 2006-2007 flu season, influenza vaccination coverage increased among adults, but only one in five children aged 6 months to 23 months were fully vaccinated, according to two reports from researchers at the U.S. Centers for Disease Control and Prevention published in the Sept. 26 issue of the Morbidity and Mortality Weekly Report.

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Early Warning About Increased Mortality in Epoetin Alfa Trial

MONDAY, Sept. 29 (HealthDay News) -- The U.S. Food and Drug Administration has issued a warning to researchers conducting clinical trials of epoetin alfa in the treatment of stroke patients, after a German trial of the drug to treat acute ischemic stroke reported increased mortality among the study group versus controls.

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Minimally Invasive Procedures Changing Spinal Surgery

FRIDAY, Sept. 26 (HealthDay News) -- Minimally invasive surgery of the spine is an emerging neurosurgical field with multifaceted uses, according to a report in the August issue of Neurosurgical Focus.

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No Easy Answer to How Much Should Be Spent on Health Care

FRIDAY, Sept. 26 (HealthDay News) -- Although capping health care expenditure as a fixed proportion of gross domestic product (GDP) may control costs, it is not necessarily the best way to reflect the priority that a society places on health, according to two Head to Head articles published online Sept. 25 in BMJ.

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Implantable Cardioverter-Defibrillators Re-Examined

THURSDAY, Sept. 25 (HealthDay News) -- There is a compelling rationale for clinicians to critically analyze evidence-based guidelines when using implantable cardioverter-defibrillators (ICDs) for the prevention of sudden cardiac death, according to a report published in the Sept. 30 issue of the Journal of the American College of Cardiology.

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Bisphosphonate Infusion Linked to Ocular Complication

WEDNESDAY, Sept. 24 (HealthDay News) -- Physicians should be aware that bisphosphonate infusions can result in a serious but rare complication: orbital inflammatory disease, according to a case study published in the Sept. 25 issue of the New England Journal of Medicine.

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Inhaled Anticholinergics Increase Cardiovascular Risk

TUESDAY, Sept. 23 (HealthDay News) -- Use of inhaled anticholinergics raises the risk of cardiovascular death, heart attack or stroke in patients with chronic obstructive pulmonary disease (COPD), according to a meta-analysis published in the Sept. 24 issue of the Journal of the American Medical Association.

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Out-of-Hospital Cardiac Arrest Outcomes Differ

TUESDAY, Sept. 23 (HealthDay News) -- There were significant differences in survival of out-of-hospital cardiac arrest cases treated by emergency medical services (EMS) across North American cities, according to a study published in the Sept. 24 issue of the Journal of the American Medical Association. The American Heart Association guidelines may enable identification of appropriate cases for increased cardiopulmonary resuscitative efforts, according to another study.

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Nurse Manager's Leadership Style May Affect Staff Retention

TUESDAY, Sept. 23 (HealthDay News) -- Emergency department nurse managers who adopt a Transformational leadership style may be able to reduce staff turnover, according to the results of a study published in the October issue of the Journal of Emergency Nursing.

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No Racial or Gender Bias in Time to Electrocardiogram

TUESDAY, Sept. 23 (HealthDay News) -- Among chest pain cases presenting at hospital emergency departments, there are no racial or gender disparities in terms of time from admission to electrocardiogram (EKG), but patients over the age of 60 tend to be tested more promptly than their younger counterparts, according to a report published in the October issue of the Journal of Emergency Nursing.

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No Change to 2009 Part B Medicare Premium

MONDAY, Sept. 22 (HealthDay News) -- There will be no change to the Part B Standard Medicare premium in 2009 compared with 2008. This is the first time since 2000 that the premium has not risen over the prior year, according to an announcement by the Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS).

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Physician's Office Hours Affect Time to Stroke Treatment

FRIDAY, Sept. 19 (HealthDay News) -- People who experience a transient ischemic attack or a minor stroke outside their primary physician's office hours wait longer before seeking treatment than those who have a stroke during general practice opening hours, according to a report published online Sept. 18 in BMJ.

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Antibiotic Resistance Has Become a Global Pandemic

FRIDAY, Sept. 19 (HealthDay News) -- A concerted international and national response, behavior change by consumers and providers, and the development of antibacterial agents are all urgently needed to tackle the global problem of rapidly increasing antibiotic resistance, according to an article published online Sept. 18 in BMJ.

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History, Physical Exam Provide Accurate Cardiac Estimates

THURSDAY, Sept. 18 (HealthDay News) -- Estimates of hemodynamic parameters from a history and physical exam are largely accurate and can predict death or rehospitalization in patients with advanced heart failure, according to study findings published in the September issue of Circulation: Heart Failure.

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Cardiac Ultrasound Identifies Low-Risk Patients

THURSDAY, Sept. 18 (HealthDay News) -- Despite the cost of performing myocardial contrast echocardiography (MCE) in all patients with suspected cardiac chest pain and a non-diagnostic electrocardiogram (ECG), MCE can identify low-risk patients with non-cardiac chest pain that can safely be discharged and potentially reduce unnecessary hospitalizations and costs, according to the results of a study published in the Sept. 15 issue of the American Journal of Cardiology.

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Alteplase Still Safe Treatment Up to 4.5 Hours

MONDAY, Sept. 15 (HealthDay News) -- Although intravenous alteplase has been approved for use in stroke patients within three hours of onset, it can be safely and effectively used up to 4.5 hours after onset, according to the results of a study published online Sept. 15 in The Lancet.

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Day of Discharge Doesn't Affect Guideline Compliance

MONDAY, Sept. 15 (HealthDay News) -- Staff adherence to guideline recommendations when treating patients hospitalized with acute coronary syndrome is not affected by day of discharge (weekday versus weekend), researchers report in the Sept. 15 issue of the American Journal of Cardiology.

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Lab Test Ratio Predicts Risk Among Coronary Patients

MONDAY, Sept. 15 (HealthDay News) -- The neutrophil/lymphocyte ratio (NLR) is a comparatively inexpensive marker of inflammation that identifies high-risk patients and may allow for risk stratification of patients with acute coronary syndromes, according to a report in the Sept. 15 issue of the American Journal of Cardiology.

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Vytorin May Increase Cancer Risk

TUESDAY, Sept. 2 (HealthDay News) -- Ezetimibe plus simvastatin (Vytorin) may be associated with an increased risk of cancer, according to two studies published online Sept. 2 in the New England Journal of Medicine and presented at the European Society of Cardiology Congress held Aug. 30-Sept. 3 in Munich, Germany.

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Telmisartan Shows Modest Cardiovascular Benefit

MONDAY, Sept. 1 (HealthDay News) -- Telmisartan, an angiotensin-receptor blocker (ARB), is a potential option for patients intolerant of angiotensin-converting enzyme (ACE) inhibitors, although the cardiovascular benefits appear less robust, according to a study and editorial published online Aug. 31 in The Lancet and presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany.

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Omega-3 Fatty Acids Reduce Heart Failure Mortality

MONDAY, Sept. 1 (HealthDay News) -- Omega-3 polyunsaturated fatty acids have beneficial effects on cardiovascular morbidity and mortality while treatment with rosuvastatin does not affect clinical outcomes in patients with chronic heart failure, according to two studies published online Aug. 31 in The Lancet and also presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany.

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Ivabradine Improves Outcomes in Some Heart Patients

MONDAY, Sept. 1 (HealthDay News) -- Use of ivabradine, a heart-rate lowering drug, may improve outcomes in patients with coronary artery disease and a high heart rate, according to a study published online Aug. 31 in The Lancet and also presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany. A second study indicates that a higher resting heart rate in patients with heart disease is a strong, independent risk factor for death.

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