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PrairiEDocs e-newsletter #24 Other archived PrairiEDocs e-newsletters Surveying
the land (and web) for news (and more)
Useful Cardiac Care Guidelines Online Dental Check Ups Work for Stroke Screening too? New Investigation Recommendation for SIDS vs. Child Abuse New Heart Stent Deters Restenosis New Marker May Advance Stroke Diagnostics Child and Dependent Adult Abuse Reporting in Iowa OxyContin to be Offered in Reformulated Version, if Approved Quotable
Quotes CDC
Alert Notice to States and Local Public Health Agencies Due to current events, CDC is on heightened alert status to monitor for any possible unusual disease patterns associated with today's events, including chemical and biological agents. CDC recommends that you initiate heightened surveillance for any unusual disease occurrence or increased numbers of illnesses that might be associated with recent events. If you require any assistance or become aware of any unusual occurrence, CDC is available at their emergency number of (770) 488- 7100, 24-hours per day, or (770) 488-4819. You may also contact them by e-mail at health alert@cdc.gov or access their website for further information at www.bt.cdc.gov. Useful Cardiac Care Guidelines Online There is a very useful document providing guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction in the emergency department. The authors, CV Pollack Jr and WB Gibler, suggest evidence-based standards for risk stratification, for the use of biologic markers of myocardial damage and other adjunctive diagnostic tests, and for the appropriate use of antiplatelet and antithrombin therapeutic agents. http://www.emcreg.org/docs/cdx_full_article.pdf The last four pages of this seven-page document can be paired together to create a flow chart for managing patients with elevated cardiac enzyme levels and ECG changes. This document is, itself, a summary from a 93-page document. Dental Check Ups Work for Stroke Screening too? Researchers from the Veterans Affairs Greater Los Angeles Healthcare System studied the records of 52 women who were military veterans. The average age was 70 and none displayed no overt signs or symptoms of neurological disease. However, panoramic radiography, a technique used by almost half of all dentists, revealed 16 of the women had notable calcium deposits in their carotid arteries, and they were subsequently referred on for stroke prevention interventions. The study was reported to the American Dental Association, with recommendation that all dentists be aware of this additional benefit their patients and to focus additional attention on postmenopausal women. New Investigation Recommendation for SIDS vs. Child Abuse After receiving numerous complaints from medical examiners and parents, the American Academy of Pediatrics has revised a statement originally issued in February. The original statement called for all unexplained infant deaths to be investigated in hospital emergency rooms by a child abuse expert, to more accurately discern between SIDS deaths and homicides. The National Association of Medical Examiners had complained that the February policy statement could result in illegal meddling with autopsies if outside experts examined bodies before they did. The policy also angered some parents of SIDS babies, who worried that it made them appear guilty; claiming that the policy made it seem like "…who cares what the medical examiner said, you abused your child,'' in calling for the mandatory outside consultation. The revision, published in the September issue of Pediatrics, says that investigations of sudden, unexplained infant deaths should include "appropriate utilization of available medical specialists by medical examiners and coroners.'' Such specialists could include "pediatric pathologists, pediatricians and radiologists." The Academy states that the amended policy ``provides pediatricians With information and guidelines to avoid distressing or stigmatizing families of sudden infant death syndrome victims while allowing accumulation of appropriate evidence in potential cases of death by infanticide.'' Experts do not know what causes SIDS,which kills about 3,000 infants a year. New Heart Stent Deters Restenosis A study of 238 patients in Europe and Latin America, presented Tuesday at a meeting of the European Society of Cardiology in Stockholm, found that the arteries closed up again in 26% of patients who got a regular stent. But there was no narrowing at all in any of the patients who got a new drug-coated version called Cypher. In the approximately one million patients worldwide receiving angioplasty, about 25% or 30% experience restenosis, typically within six months of the procedure. Conventional stents bring the rate of restenosis down to about 15% to 25% of patients. Repeat angioplasty typically puts a new stent inside the existing one, or receives bypass surgery. The new stent is coated with a drug used in reducing organ rejection in kidney transplant patients and gradually released over the next 45 days (the drug is known generically as sirolimus or rapamycin, trade name- Rapamune). The study was sponsored by Johnson & Johnson, which hopes to market the stent in Europe in 2002 and the US in 2003. Disney plans to install 500 automated external defibrillators starting this Month at Walt Disney World in Orlando and Disneyland in Anaheim, California. In addition to the theme parks, AEDs will be deployed in the Downtown Disney entertainment complexes, hotels, golf courses, backstage buildings and the Disney Cruise Lineships. Disney's effort is one of the largest private deployments of defibrillators in the United States. New Marker May Advance Stroke Diagnostics Biosite Incorporated announced at the Annual Meeting of the American Association for Clinical Chemistry that it has validated the diagnostic utility of six proteins as markers for stroke. Biosite said that it intends to immediately initiate development of a quantitative stroke diagnostic test that could be used to aid in the diagnosis of stroke in acute-care settings. "We have identified six markers that are not only highly correlated with stroke, but we believe that, when used together may also be significantly more accurate than CT [computed tomography] scan for diagnosing ischemic stroke ," said Ken Buechler, PhD, Biosite. "Additionally, the data suggests that a panel of these markers can be used to distinguish transient ischemic attack (TIA) from normals, particularly soon after the event." In evaluating a pool of 31 potential stroke markers, Biosite utilized 634 patient samples from 173 patients, of whom 151 were diagnosed with stroke. Another 157 normal samples were used for comparison purposes. In a patient population of 24 ischemic strokes, the CT scan diagnostic sensitivity was 33% while the panel of six markers demonstrated sensitivity of 79% and specificity of 93%. In distinguishing TIA patients from normal patients, the panel demonstrated 81% sensitivity and 92% specificity for patients presenting between zero and 12 hours after onset of an event. Child and Dependent Adult Abuse Reporting in Iowa In HF 680, the 2001 Iowa General Assembly established an abuse education review panel for "review and approval of mandatory reporter training curricula…" As stated by the director of the department of public health, "It is not the intention of the legislation to interrupt the current training system or unduly constrain mandatory reporters in obtaining continuing education regarding child and dependent adult abuse reporting. In light of the time frames required to establish a panel and develop standards for approval of curricula, existing training curricula for identifying and reporting abuse will be considered approved curricula through December 31, 2001. OxyContin to be Offered in Reformulated Version, if Approved A new "smart" version of the controversial painkiller is currently being developed by manufacturer Purdue Pharma. Since its introduction in December of 1995, OxyContin has been embroiled in controversy as the extended release formulation can be crushed and taken by abusers for a much more rapid intense effect. The version underdevelopment would embed coated naltrexone ("sequestered naltrexone") in the medicine and activate it if the drug were crushed. The company anticipates at three to five year delay as the new formulation would need to be tested and approved. In the mean time, on July 26th, the FDA called for new "Black box" warnings to be placed on current versions of the drug, warning physicians of the abuse potential. OxyContin is currently blamed for at least 100 deaths and targeted in 13 lawsuits in five states. In England, the Speaker of the House is not allowed to speak; Winston Churchill was born in a ladies' room during a dance; Al Capone's business card said he was a used furniture dealer; Mr. Rogers is an ordained minister; The characters Bert and Ernie on Sesame Street were named after Bert the cop and Ernie the taxi driver in Frank Capra's It's a Wonderful Life; The first TV commercial aired in 1941, advertising the Bulova Watch Company and cost $90; The first TV dinner rolled off the assembly line of Swansons in 1952 Containing fried chicken, mashed potatoes and corn. New
Search Engine Teoma is excellent for browsing. You get three types of search results: Web Pages, which are finds based on your search terms (like you get with most search engines); Web Pages Grouped by Topic, organized in directories; and Experts' Links, a list of similar results in related subjects. Where
Did That Phrase Come From? With your tail between your legs... Wet your whistle... Wear your heart on your sleeve...Trip the light fantastic...Salt of the earth... This site has over sixteen hundred phrases and their meanings and how they originated. The
Lazy Gourmet Feeling hungry, but not too motivated to cook? The Lazy Gourmet feels for you and fills your recipe box with easy-to-do favorites. Categories include Main and Side Dishes, Breads and Cookies, Dips and Party Dishes, and Hot Summer Bar-B-Que. The Herb and Spice Rack page helps define common ingredients. There are also pages devoted to helping you make the best wine and beer choices by providing terminology and serving suggestions. A great resource for novice cooks. Smithsonian
Online The Smithsonian Institute can't possibly display all the artifacts they hold, so they're moving to the web. See the first batch out of 3,000,000 items now online… Nick.com's
Back to School As the new schools starts, parents look for help when asked for help with their children's homework. This site, part of Nick.com, is a good place for kids to ease out of summer silliness and into school seriousness. There's the stuff kids can actually use for homework and organization-all online--like a calculator, calendar, dictionary, thesaurus, and Web search engine. And then there's the stuff they'll use just for fun: message boards, games, interactive animation funnies, and other general fun stuff. Web-Related News Online Course from Chicago to Central America Medical workers in remote areas of Central America can get training through distance education. Chicago's Center for International Rehabilitation is testing an eight-month online course that trains workers who make prosthetics. The courses were developed by Northwest University's Prosthetic Orthotic Center and educational software developer Web CT. Students study an online field manual, and mentors provide support through chat rooms and bulletin boards. The online manual can be changed as technology, data, and student queries change. In addition, students receive a CD-ROM with video and audio components. Similarly, Satellife provides medical information to African health care workers. (New York Times, 30 August 2001) MIT Computer Whizzes at it Again Students at MIT have come up with yet another indispensable application of networking technology. They've wired up the bathrooms in one of their dorm halls with sensors and route the info to a Web page that reports on whether or not the bathroom stalls are occupied. It's just the thing you need to surf with legs crossed and mouth clamped shut after a night of early-semester binge drinking. An older MIT laundry server reports on which washing and drying machines are currently in use. Bathroom
Server: http://bathroom.mit.edu/
Steven Wright, comedian: Why, in a country of free speech, are there phone bills? Doris Mortman, author: Until you make peace with who you are, you'll never be content with what you have. Bear Bryant, football coach: "In
a crisis, don't hide behind anything or anybody. They're going
to find you anyway." ERDOCS e-mail group (listserv) As a Clinician
providing acute and emergency medical care, you are invited
to visit and participate in our new ERDOCS group at eGroups,
a free, easy-to-use email group service! You have plenty of
experiences to share, questions to ask, concerns and opinions
to voice, suggestions, news to post, tips to offer, etc. and
can do so within this framework. This is a versatile system
for posting things to be sent to a group to peruse, respond
to, or simply be aware of. It eliminates conventional mail
delays and allows you to review and post at your leisure.
(We still have the more open-ended [any visitor can observe/post]
discussion group at the ACUTE
CARE, INC. web
site). Our goal is to give you a variety of feedback and communication
tools. This
e-newsletter is available through the generous unrestricted
support of
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