Here are what the editors at HealthDay consider to be the most important developments in Critical Care for October 2015. 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.
Stewardship Could Improve Appropriate Medical Imaging Use
FRIDAY, Oct. 30, 2015 (HealthDay News) — Stewardship may be a promising approach for improving appropriate use of medical imaging technology, according to a perspective piece published in the Oct. 29 issue of the New England Journal of Medicine.
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Increasing Numbers of Med School Applicants, Enrollees
FRIDAY, Oct. 30, 2015 (HealthDay News) — There has been a 25 percent increase in the number of medical school enrollees since 2002, with the number reaching an all-time high of 20,630 this year, according to a report published online Oct. 22 by the Association of American Medical Colleges (AAMC).
Early CT Scan Impacts Management of Suspected CAP
THURSDAY, Oct. 29, 2015 (HealthDay News) — Computed tomography (CT) findings affect the diagnosis and management of suspected community-acquired pneumonia (CAP), according to a study published in the Oct. 15 issue of the American Journal of Respiratory and Critical Care Medicine.
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Part D Enrollment Doesn’t Improve Outcomes After AMI
THURSDAY, Oct. 29, 2015 (HealthDay News) — For patients with acute myocardial infarction (AMI), enrollment in Part D by hospital discharge is not associated with improved outcomes, according to a study published online Oct. 27 in Circulation: Cardiovascular Quality and Outcomes.
Treatment of Post-Thrombolysis sICH Doesn’t Lower Mortality
WEDNESDAY, Oct. 28, 2015 (HealthDay News) — Treatment of thrombolysis-related symptomatic intracerebral hemorrhage (sICH) does not reduce in-hospital mortality, according to a study published online Oct. 26 in JAMA Neurology.
Nearly 15 Percent of Plans Lack In-Network Specialists
WEDNESDAY, Oct. 28, 2015 (HealthDay News) — A considerable proportion of federal marketplace plans lack at least one in-network specialist, according to a research letter published in the Oct. 27 issue of the Journal of the American Medical Association.
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Gender Gap Appears to Continue in Cardiovascular Care
TUESDAY, Oct. 27, 2015 (HealthDay News) — New research suggests that doctors don’t warn younger women when they’re at risk for cardiovascular disease as often as they warn men. And once younger women suffer an ST-segment elevation myocardial infarction (STEMI), they are less likely to receive revascularization and more likely to die in the hospital. The findings were reported in two separate studies published in the Nov. 3 issue of the Journal of the American College of Cardiology.
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Blanket + Warmed IV Best for Hypothermic Infants
THURSDAY, Oct. 22, 2015 (HealthDay News) — The combination of conventional blanket rewarming and pre-warmed intravenous (IV) infusion is most effective for rewarming postoperative hypothermic infants, according to a study published in the November issue of Pediatric Anesthesia.
EHR Use Ups Some Outcomes After Myocardial Infarction
THURSDAY, Oct. 22, 2015 (HealthDay News) — For patients with acute myocardial infarction (MI), electronic health record (EHR) implementation is associated with some improvement in outcomes, according to a study published online Oct. 20 in Circulation: Cardiovascular Quality and Outcomes.
Older Blood Appears Safe for Cardiac Surgery Patients
WEDNESDAY, Oct. 21, 2015 (HealthDay News) — Cardiac surgery patients given blood stored for more than six weeks face no greater harm than those who get blood donated within two weeks, according to a research letter published in the Oct. 20 issue of the Journal of the American Medical Association.
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Value of Bedside Exam for ICU Patients Discussed
TUESDAY, Oct. 20, 2015 (HealthDay News) — A checklist-based bedside physical examination in the intensive care unit (ICU) is suggested as clinically useful in spite of a lack of evidence demonstrating this, according to a commentary published in the October issue of the Annals of the American Thoracic Society.
‘Failure Mode and Effective Analysis’ Ups Error Awareness
MONDAY, Oct. 19, 2015 (HealthDay News) — The application of failure mode and effective analysis (FMEA) correlates with increased awareness of medical errors in the pediatric intensive care unit (PICU), according to a study published online Oct. 3 in Pediatric Anesthesia.
FDA Approves Praxbind to Reverse Pradaxa’s Effect
MONDAY, Oct. 19, 2015 (HealthDay News) — Praxbind (idarucizumab) has been approved for use in patients who are taking the anticoagulant Pradaxa (dabigatran) when there is an urgent need to reverse Pradaxa’s anticoagulant effects, according to a news release from the U.S. Food and Drug Administration.
Longer QRS Duration Predicts Cardiac Death, Heart Attack
MONDAY, Oct. 19, 2015 (HealthDay News) — Longer QRS duration predicts cardiac death and nonfatal myocardial infarction (MI) in patients with coronary artery disease, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.
Methicillin-Susceptible Staph Strain Causes More Infections
MONDAY, Oct. 19, 2015 (HealthDay News) — Invasive methicillin-susceptible Staphylococcus aureus (MSSA) infections are more common than invasive methicillin-resistant Staphylococcus aureus (MRSA) infections, according to a study published online Oct. 19 in JAMA Pediatrics.
Insulin Dose Doesn’t Up Mortality in ACCORD Trial
MONDAY, Oct. 19, 2015 (HealthDay News) — In the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, insulin dose is not associated with cardiovascular (CV) death after adjustment for baseline covariates, according to a study published online Oct. 13 in Diabetes Care.
Gene Expression Ratio May Aid Rapid Pneumonia Diagnosis
MONDAY, Oct. 15, 2015 (HealthDay News) — A ratio evaluating the expression of two molecular markers may assist in the rapid diagnosis of community-acquired pneumonia (CAP) on ICU admission, according to a study published in the Oct. 1 issue of the American Journal of Respiratory and Critical Care Medicine.
Rising Threat of Antibiotic Resistance in Surgery, Chemo
FRIDAY, Oct. 16, 2015 (HealthDay News) — As many as half of postsurgical infections and more than a quarter of infections after chemotherapy are caused by organisms already resistant to standard antibiotics, according to a study published Oct. 15 in The Lancet Infectious Diseases.
Time-Limited Strategies Feasible for ICU Critical Cancer Care
FRIDAY, Oct. 16, 2015 (HealthDay News) — For patients with poor-prognosis cancer, trials of intensive care unit (ICU) care of short duration may be sufficient, according to a study published online Oct. 15 in JAMA Oncology.
Stroke Risk Higher for People With High-Strain Jobs
THURSDAY, Oct. 15, 2015 (HealthDay News) — Exposure to high-strain jobs is associated with an increased risk of stroke, especially in women, according to a meta-analysis published online Oct. 14 in Neurology.
Safety-Net Hospitals Have Higher Costs, Worse Outcomes
THURSDAY, Oct. 15, 2015 (HealthDay News) — Intrinsic qualities of safety-net hospitals, rather than patient characteristics, lead to inferior surgical outcomes and increased costs across nine elective surgical procedures, according to a study published online Oct. 14 in JAMA Surgery.
Budesonide May Be Beneficial in Extremely Preterm Infants
THURSDAY, Oct. 15, 2015 (HealthDay News) — For extremely premature infants, early inhaled budesonide is associated with reduced incidence of bronchopulmonary dysplasia but may be linked to increased mortality, according to a study published online Oct. 14 in the New England Journal of Medicine.
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Enterovirus D68 Doesn’t Raise Mortality Risk in Children
WEDNESDAY, Oct. 14, 2015 (HealthDay News) — Enterovirus D68 (EV-D68) seems to be a more virulent pulmonary pathogen in children than rhinovirus or non-EV-D68 enterovirus, but it does not increase the risk of death, according to a study published Oct. 13 in CMAJ, the journal of the Canadian Medical Association.
Intervention Cuts Contamination in Protective Gear Removal
TUESDAY, Oct. 13, 2015 (HealthDay News) — An educational intervention can reduce contamination of the skin and clothing of health care personnel during removal of contaminated personal protective equipment (PPE), according to a study published online Oct. 12 in JAMA Internal Medicine.
Six-Minute Walk Distance Predicts Lung Transplant Survival
MONDAY, Oct. 12, 2015 (HealthDay News) — Preoperative six-minute walk distance (6MWD) is significantly associated with post-lung transplant survival, according to a study published in the Oct. 1 issue of the American Journal of Respiratory and Critical Care Medicine.
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Americans Spend More on Health Care, but Fare Worse
MONDAY, Oct. 12, 2015 (HealthDay News) — When compared to 12 other industrialized nations, Americans spend more on health care services, but they fare worst in terms of life expectancy, according to recent findings from The Commonwealth Fund.
Hospital Readmissions Up in Neonatal Abstinence Syndrome
FRIDAY, Oct. 9, 2015 (HealthDay News) — Newborns with neonatal abstinence syndrome are more likely to be readmitted to the hospital than those without the condition, according to research published in the Oct. 1 issue of Hospital Pediatrics.
Buffered Crystalloid Solution Doesn’t Cut AKI Risk
THURSDAY, Oct. 8, 2015 (HealthDay News) — Among patients receiving crystalloid fluid therapy in the intensive care unit (ICU), the risk of acute kidney injury is similar for buffered crystalloid versus saline, according to a study published online Oct. 7 in the Journal of the American Medical Association. The research was published to coincide with the annual meeting of the European Society of Intensive Care Medicine, held from Oct. 3 to 7 in Berlin.
H. Pylori Resistance to Antibiotics Increasing
WEDNESDAY, Oct. 7, 2015 (HealthDay News) — Resistance to the antibiotics clarithromycin, metronidazole, and levofloxacin is high among patients with Helicobacter pylori (H. pylori) infection, according to a study published in the September issue of Clinical Gastroenterology and Hepatology.
California Governor Signs Right-to-Die Bill Into Law
TUESDAY, Oct. 6, 2015 (HealthDay News) — California Gov. Jerry Brown signed “right-to-die” legislation on Monday that will allow the terminally ill to legally end their lives.
Therapeutic Positioning Doesn’t Affect Vital Parameters
TUESDAY, Oct. 6, 2015 (HealthDay News) — For severely disabled patients with central neurological disorders, therapeutic positioning does not affect vital parameters, according to a study published online Sept. 30 in the Journal of Clinical Nursing.
Guidelines Developed for Managing Conflicts of Interest
TUESDAY, Oct. 6, 2015 (HealthDay News) — The Guidelines International Network has developed principles for disclosure and management of conflicts of interest (COIs) during the clinical practice guideline development process, according to a report published in the Oct. 6 issue of the Annals of Internal Medicine.
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Modified SOAP Ups Student Awareness of Health Care Costs
MONDAY, Oct. 5, 2015 (HealthDay News) — Modification of the traditional Subjective-Objective-Assessment-Plan (SOAP) presentation to consider value (SOAP-V) can help medical students learn to practice high-value, cost-conscious care, according to a study published online Sept. 28 in the Journal of Hospital Medicine.
Providers Must Understand Legal Limits of Telemedicine
FRIDAY, Oct. 2, 2015 (HealthDay News) — In order to minimize risk when practicing telemedicine, providers should ensure they hold the proper medical licenses, have medical liability insurance coverage, and communicate with patients regarding the potential risks of telemedicine, according to a report published in Medical Economics.
Strategies Provided for Improving EHR Efficiency
THURSDAY, Oct. 1, 2015 (HealthDay News) — Several strategies can be implemented in order to better use electronic health records (EHRs) for patient care and efficiency, according to an article published in Medical Economics.
Colds, Flu Up Odds for Stroke in Children, Though Risk Is Low
THURSDAY, Oct. 1, 2015 (HealthDay News) — Having a cold or the flu may sometimes trigger a stroke in children — particularly those with underlying health conditions — though the overall risk remains low, according to a new study, published online Sept. 30 in Neurology.
Probiotics Reduce Rate of Infection After Liver Transplant
THURSDAY, Oct. 1, 2015 (HealthDay News) — Liver transplant recipients have a lower rate of infection with receipt of prebiotics and probiotics before surgery, according to a meta-analysis published in the September issue of Clinical Gastroenterology and Hepatology.
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