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Critical Care

News, opinions and meeting coverage in critical care.

Stroke Rounds: Early Surgery Looks Safe After tPA

Performing carotid endarterectomy or stenting in patients who were recently treated with thrombolytic therapy for an acute stroke appeared to be safe, an observational study showed.

CT Appears Safe in Patients With Pacemakers, ICDs

Patients with cardiac rhythm management devices showed no clinically significant major or minor events related to computed tomography imaging over a 10-year period at two large-volume care centers, researchers reported.

ER Briefs: DIY Laptop to AED Kit -- Good Idea?

Inventors aim to resurrect laptops and tablets as AEDs. We asked Clifton Callaway, MD, PhD, an emergency medicine doctor who heads up EM research at the University of Pittsburgh, to weigh in.

Ob/Gyns Uneasy With AHA's Take on Stroke in Pregnancy

NEW ORLEANS -- Recent guidelines from the American Heart Association on the management of stroke risk in pregnant women differ significantly from those issued by the American Congress of Obstetricians and Gynecologists, maternal-fetal medicine specialists said here.

Is There a Flaw in This Large Vitamin D Trial?

A co-principal investigator of the VITAL trial addresses the possibility that out-of-study testing of vitamin D levels and initiation of high-dose supplementation could be a limitation, but not a serious one.

Heart Attack Signal Found for Spiriva in COPD

The TIOSPIR trial was used to support safety of the mist inhaler version of tiotropium (Spiriva) compared with dry powder, but the pooled data actually showed something else -- a heart attack signal, researchers argued.

CardioBuzz: More Money Needed for Heart Research?

The NIH dedicates a lot of money for research into heart disease and stroke, but it still might not be enough, a new study suggested.

10 Questions: E. Wesley Ely, MD, MPH

What's the biggest barrier to practicing medicine today? That's just the first of the 10 Questions the 番茄社区 staff is asking leading clinicians and researchers to get their personal views on their chosen profession. In this series we share their uncensored responses. Here, answers from pulmonary and critical care expert E. Wesley Ely, MD, MPH.

A Brain-Dead Mother, a Million-Dollar Baby

The costs associated with maintaining a pregnant, brain-dead, Texas woman on life support until her fetus is viable are likely to approach $1 million, and long-term costs could easily top $1.5 million.

Testosterone Level Affects Flu Shot Response

Men with high testosterone and a certain genetic cluster may not experience an antibody response after a flu shot, researchers suggested -- a finding that could affect men taking prescription testosterone.

Gene Therapy Works in SCID With No Risk of Leukemia

NEW ORLEANS -- Genetic therapy appeared to restore the immune system of patients with X-linked severe combined immunodeficiency (SCID), but without leading to leukemia as a side effect, researchers reported here.

FDA Flags Risk of Nuclear Stress Test Drugs

SILVER SPRING, Md. -- Two agents used in cardiac nuclear stress tests may carry a greater risk of heart attack and death than previously believed, the FDA said Wednesday.

Gestational Diabetes Tied to Perinatal Stroke

AUSTIN, Texas -- Perinatal arterial ischemic stroke has many possible risk factors, including gestational diabetes, researchers reported here.

TCT: Removing Clot During PCI Fails in NSTEMI

SAN FRANCISCO -- Aspiration thrombectomy during percutaneous coronary intervention (PCI) did not improve outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI), a randomized trial showed.

NICU Survivors May See Higher Autism Rates

AUSTIN, Texas -- Autism spectrum disorder incidence was significantly higher in babies who spent time in the neonatal intensive care unit, versus the general population, and was often accompanied by comorbidities, researchers said here.

Striking a Nerve: Heinz Kerry Recovers

Teresa Heinz Kerry is back at work less than 4 months after a mysterious seizure hospitalized her. Striking a Nerve is a blog by John Gever for readers interested in neurology.

Add 'Shrapnel' to Workup for Lightning Strike

A shrapnel-like injury associated with a lightening strike provided a reminder for emergency physicians not to overlook the unexpected when examining patients.

N.H. Hospital May Have Exposed Patients to CJD

Health officials in New Hampshire said eight neurosurgery patients at one hospital in the state may have been unwittingly exposed to Creutzfeldt-Jakob disease (CJD).

Lab Notes: Meth May Worsen Fungal Infection

Mice injected with methamphetamine and exposed to Cryptococcus fungi showed more extensive and hard-to-eradicate infections. Also this week: an organic pesticide fights parasitic worms.

Randy Travis Gets an LVAD, Future Uncertain

Grammy award-winning country music star Randy Travis has received the Impella pump, a temporary percutaneous left ventricular assist device, to help him as he battles viral cardiomyopathy, according to his publicist.

Xarelto Gets a No for Stent Thrombosis

SILVER SPRING, Md. -- The FDA has rejected an application for a new indication allowing rivaroxaban (Xarelto) to be used to reduce the risk of stent thrombosis in patients with acute coronary syndrome.

Honey, Cola May Disrupt Heart

A detailed history of patients with arrhythmia or syncope might need to include their cola intake or the origin of the honey they consume, two case studies suggest.

CDC: Cut Back on Doxycycline Use

A continuing shortage of doxycycline means the drug should be used only for conditions that have no alternative treatments, the CDC advised this week.

Zilver Stent Recalled, System May Break

Cook Medical's Zilver PTX drug-eluting stent for peripheral artery disease has been recalled because of a defect in its associated delivery system, the company and the FDA said.

Hypothyroidism Hikes Death Risk in Blacks

African Americans with hypothyroidism face an increased risk of death, and in patients with congestive heart failure, even mild underactive thyroid disease raises mortality risk, a retrospective cohort study found.

Is Protein the Key to Fountain of Youth?

The cardiac clocks of aging mice were turned back to a more youthful time when they received a protein taken from the blood of younger mice, researchers found.

On-Call Pay Varies Widely by Specialty

Surgeons commanded more than $1,000 a day for being on-call at the hospital, while primary care physicians reported compensation rates of around $150 a day, according to annually compiled data.

Ricin Deadly, but Not an Effective WMD

It may have been a preferred tool of Soviet hit men, but ricin generally flops as a weapon of mass destruction, several bioterrorism experts told 番茄社区.

'Latex-Free' Claims Not Valid, FDA Says

The claim "latex-free鈥� is impossible to guarantee and should not be used on labeling of medical products, according to a new FDA guidance.

ACC: Is Chelation Plus Vitamins a Winning Combo?

SAN FRANCISCO -- Vitamins alone won't improve outcomes for patients who've had a heart attack, but they do appear to have additive benefits when given in conjunction with controversial chelation therapy, researchers reported here.

Small Brain Bleeds Not So Bad for Preemies

Low-grade hemorrhage in very premature infants doesn't appear to hurt their early neurodevelopment, a longitudinal study suggested.

ECG for Eyes Sorts Strokes from Vertigo

A device described as an ECG for the eye accurately distinguishes stroke from other causes of dizziness in the emergency department, a small proof-of-concept study showed.

Is Pot Smoking a Stroke Trigger?

HONOLULU -- Middle age stroke patients were twice as likely to be pot smokers than healthy middle age controls, researchers found.

ACE Inhibitors Linked to Hallucinations in Elderly

Elderly patients with memory problems who suddenly have visual hallucinations may need to stop taking ACE inhibitors, researchers suggested.

No Need for Skin Preps to Be Sterile, FDA Told

WASHINGTON -- Requiring that antiseptic skin preparation products be sterile is unnecessary and wouldn't lead to a dramatic drop in infections, speakers told the FDA Wednesday.

Cardio Notes: Stress Test Finds Heart Disease in Seniors

Researchers are taking a second look at the accuracy of treadmill exercise testing for women over 65. Also this week, the birth of a subspecialty for adults with congenital heart disease and leg artery stenting.

Extended Apixaban Stops VTE Recurrence

ATLANTA -- Apixaban taken for an additional year after standard venous thromboembolism (VTE) treatment reduced recurrent events in a placebo-controlled trial, researchers said.

C. Difficile Inpatient Stays Long, Costly

LAS VEGAS -- Among the many factors that contribute to the burgeoning costs associated with Clostridium difficile infections are long hospital stays, particularly in intensive care units, and the need for multiple specialist consultations, a chart review determined.

FDA to Look at Tainted Skin Preps

Antiseptic skin preparation products can be contaminated by microbes, a problem the FDA will address at an upcoming public hearing.

Early Stroke Risk After Hip Replacement

Patients undergoing a total hip replacement appear to have an elevated risk of stroke in the weeks following the operation, researchers found.

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