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May 2012 Briefing - Critical Care

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

Repeat CT Scan Urged for Head Trauma Patients on Warfarin

WEDNESDAY, May 30 (HealthDay News) -- Minor head trauma patients taking warfarin should have a repeat computed tomography (CT) scan prior to discharge to detect delayed hemorrhage, particularly in those with an initial international normalized ratio (INR) higher than 3, according to research published in the June issue of the Annals of Emergency Medicine.

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Hypothermia of Some Benefit to Neonates With Encephalopathy

WEDNESDAY, May 30 (HealthDay News) -- For infants with neonatal hypoxic-ischemic encephalopathy, undergoing whole-body hypothermia results in lower mortality rates as well as a nonsignificant reduction in the combined end point of death or an IQ score of less than 70 at age 6 to 7 years, compared with usual care, according to a study published in the May 31 issue of the New England Journal of Medicine.

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Glucose Levels at Admission Predict Death in Pneumonia

WEDNESDAY, May 30 (HealthDay News) -- For patients with community-acquired pneumonia without preexisting diabetes, serum glucose levels at admission are predictive of death at 28 and 90 days, according to a study published online May 29 in BMJ.

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Magnesium Not Recommended After Subarachnoid Bleed

FRIDAY, May 25 (HealthDay News) -- For patients with aneurysmal subarachnoid hemorrhage, intravenous magnesium sulfate is no better than placebo for reduction of poor outcome, according to a study published online May 25 in The Lancet to coincide with presentation at the European Stroke Conference, held from May 22 to 25 in Lisbon, Portugal.

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U.S. Stroke Prevalence Little Changed in Recent Years

THURSDAY, May 24 (HealthDay News) -- The prevalence of stroke in the United States has changed little over the past seven years, and disparities by race/ethnicity, education level, and geographic location still persist, according to a study published in the May 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Treatment With rt-PA Within Six Hours of Stroke Beneficial

WEDNESDAY, May 23 (HealthDay News) -- For patients with acute ischemic stroke, treatment with recombinant tissue plasminogen activator (rt-PA) within six hours is associated with improved outcomes, according to two studies published online May 23 in The Lancet to coincide with presentation at the European Stroke Conference, held from May 22 to 25 in Lisbon, Portugal.

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Characteristics of STEMI Reperfusion Systems Identified

WEDNESDAY, May 23 (HealthDay News) -- Successful ST-segment elevation myocardial infarction (STEMI) reperfusion systems share common characteristics, and these characteristics can be used to set standards for coordinated care, according to research published online May 22 in Circulation: Cardiovascular Quality and Outcomes.

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Post-Stroke Inpatient Statins Improve Discharge Outcomes

TUESDAY, May 22 (HealthDay News) -- Statin use during hospitalization for ischemic stroke significantly improves the likelihood of being discharged to home or institution, according to a study published in the May 22 issue of Neurology.

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Generic Versions of Plavix Approved

THURSDAY, May 17 (HealthDay News) -- The first generic versions of Plavix (clopidogrel bisulfate) have been approved by the U.S. Food and Drug Administration.

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Predictors of Length of Hospital Stay After Spine Surgery ID'd

THURSDAY, May 17 (HealthDay News) -- A variety of pre-, intra-, and postoperative factors contribute to increased length of stay (LOS) for patients who undergo level 1 minimally invasive (MIS) transforaminal interbody fusions (TLIF) spine surgery, according to a study published online May 8 in Spine.

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Outcomes Good for Status Asthmaticus Patients in ICU

WEDNESDAY, May 16 (HealthDay News) -- Although the majority of patients admitted to the intensive care unit (ICU) with status asthmaticus (SA) require mechanical ventilation, the rates of mortality and complications are very low, according to a study published in the March issue of Respiratory Medicine.

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Lack of Post-MI Discharge Advice Hinders Sexual Activity

TUESDAY, May 15 (HealthDay News) -- Less than half of patients who suffer an acute myocardial infarction (AMI) receive instruction regarding resuming sexual activity on hospital discharge, with those who do not receive instruction more likely to report loss of sexual activity, according to a study published in the May 15 issue of The American Journal of Cardiology.

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Better Outcomes at High-Volume Stroke Centers

TUESDAY, May 15 (HealthDay News) -- High-volume endovascular stroke centers provide faster times to treatment, and patients are more likely to have good clinical outcomes and successful reperfusion, according to a study published online May 13 in the Journal of NeuroInterventional Surgery.

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Thrombus Aspiration in Primary PCI Has No Effect on Outcomes

MONDAY, May 14 (HealthDay News) -- The use of manual or mechanical thrombus aspiration (TA) in adjunct to primary percutaneous coronary intervention (PPCI) does not affect the two-year incidence of major adverse cardiac events in patients with acute ST-segment elevation myocardial infarction (STEMI), according to a study published in the May 1 issue of Catheterization & Cardiovascular Interventions.

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Rituximab Little Use in Resistant Idiopathic Nephrotic Syndrome

FRIDAY, May 11 (HealthDay News) -- The anti-CD20 monoclonal antibody, rituximab, added to prednisone and calcineurin inhibitors, does not provide any additional benefit in terms of reduced proteinuria in the treatment of children with resistant idiopathic nephrotic syndrome (INS), according a study published online May 10 in the Journal of the American Society of Nephrology.

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Older Women With A-Fib at Greater Stroke Risk Than Men

TUESDAY, May 8 (HealthDay News) -- The risk of stroke following a recent diagnosis of atrial fibrillation (AF) in older patients is higher in women than men, regardless of warfarin use, according to a study published in the May 9 issue of the Journal of the American Medical Association.

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Hospitals Procure More Alcohol Rub, Soap During Campaign

FRIDAY, May 4 (HealthDay News) -- The implementation of the Cleanyourhands campaign increased procurement of alcohol rub and soap, which is associated with decreased rates of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and Clostridium difficile ( C. difficile) infection, according to a study published online May 3 in BMJ.

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CMS Policy Helping Hospitals to Prevent Targeted Infections

FRIDAY, May 4 (HealthDay News) -- Hospitals seem to be paying greater attention to preventing targeted health care-associated infections (HAIs) as a result of the Centers for Medicare and Medicaid Services (CMS) nonpayment policy, according to a study published in the May issue of the American Journal of Infection Control.

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Many COPD Comorbidities Independently Tied to Mortality

FRIDAY, May 4 (HealthDay News) -- Twelve comorbidities that include cancer and cardiovascular problems are associated with a higher risk of death in patients with chronic obstructive pulmonary disease (COPD), according to a study published online May 3 in the American Journal of Respiratory and Critical Care Medicine.

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New Guidelines for Aneurysmal Subarachnoid Bleeds Issued

THURSDAY, May 3 (HealthDay News) -- The latest evidence emphasizes early and aggressive care for emergency room patients diagnosed with aneurysmal subarachnoid hemorrhage (aSAH), according to revised treatment guidelines issued by the American Heart Association (AHA) and the American Stroke Association and published online May 3 in Stroke.

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Low Vitamin D Linked to Poorer Outcomes in Lung Recipients

THURSDAY, May 3 (HealthDay News) -- For lung transplant recipients, 25-hydroxyvitamin D (25[OH]D) deficiency is associated with increased incidence of acute rejection and infection, and deficiency at one year after transplant is linked with increased mortality, according to a study published online March 5 in The Journal of Heart and Lung Transplantation.

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Pulse Oximetry IDs Critical Congenital Heart Defects

WEDNESDAY, May 2 (HealthDay News) -- Pulse oximetry has high specificity, moderate sensitivity, and low false-positive rates for detecting critical congenital heart defects in asymptomatic newborns, according to a systematic review and meta-analysis published online May 2 in The Lancet.

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Methodological Heterogeneity Seen in Clinical Trials

TUESDAY, May 1 (HealthDay News) -- Clinical studies registered with ClinicalTrials.gov from 2007 and 2010 are predominately small, single-center trials and contain significant heterogeneity in methodology, according to a study published in the May 2 issue of the Journal of the American Medical Association.

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Hospital Strategies Linked to Lower Mortality After Acute MI

TUESDAY, May 1 (HealthDay News) -- Five specific hospital performance strategies have been identified that result in lower 30-day risk-standardized mortality rates (RSMRs) for patients with acute myocardial infarction (AMI), according to a study published in the May 1 issue of the Annals of Internal Medicine.

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Electronic Records Show Variation in Blood Usage

TUESDAY, May 1 (HealthDay News) -- Electronic information systems can be used to generate detailed information about blood component use by individual providers and surgical services, and they reveal significant variation in utilization, according to research published online April 23 in Anesthesiology.

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Index Identifies Clot Risk in Outpatient Surgery Patients

TUESDAY, May 1 (HealthDay News) -- Using a weighted risk index, the highest-risk outpatient surgery patients have an almost 20-fold increase in risk of venous thromboembolism (VTE) requiring therapy, according to a study published online April 13 in the Annals of Surgery.

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