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April 2014 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for April 2014. 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.

SLIP-2 Tops Original SLIP Model for ID'ing Post-Op ARDS

FRIDAY, April 25, 2014 (HealthDay News) -- The updated surgical lung injury prediction 2 (SLIP-2) model outperforms the original SLIP model for identifying patients at risk for postoperative acute respiratory distress syndrome (ARDS), according to a study published in the May issue of Anesthesiology.

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Educational Attainment Affects Brain Injury Recovery

FRIDAY, April 25, 2014 (HealthDay News) -- Educational attainment is a robust, independent predictor of one-year disability-free recovery (DFR) after moderate to severe traumatic brain injury (TBI), according to a study published online April 23 in Neurology.

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Benzodiazepines May Worsen Respiratory Outcomes in COPD

FRIDAY, April 25, 2014 (HealthDay News) -- New use of benzodiazepines may increase the risk of adverse respiratory outcomes in older adults with chronic obstructive pulmonary disease (COPD), according to research published online April 17 in the European Respiratory Journal.

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CDC: Measles on Upswing Despite Vaccines' Effectiveness

FRIDAY, April 25, 2014 (HealthDay News) -- Vaccinations have prevented an estimated 732,000 deaths, 21 million hospitalizations, and 322 million illnesses among U.S. children born in the last 20 years, according to a government report published in the April 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Physician Groups Find Fault With Medicare Payment Data Release

THURSDAY, April 24, 2014 (HealthDay News) -- Physician groups cite major problems associated with the release of Medicare payment data, according to an article published April 16 in Medical Economics.

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Educational Changes Suggested for Patient-Centered Medicine

THURSDAY, April 24, 2014 (HealthDay News) -- Changes in medical education and training are suggested to help new physicians address the needs of patients and their families, according to an ideas and opinions piece published in the April 22 issue of the Annals of Internal Medicine.

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Research Initiatives Demonstrate Ways to Speed Stroke Care

WEDNESDAY, April 23, 2014 (HealthDay News) -- New efforts to hasten treatment in both ambulances and emergency rooms appear to have significantly improved patients' chances of survival and limited their long-term disability, according to a pair of studies published in the April 23/30 issue of the Journal of the American Medical Association.

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FDA Proposes Accelerated Medical Device Approval Plan

WEDNESDAY, April 23, 2014 (HealthDay News) -- The U.S. Food and Drug Administration has proposed a new program that would provide expedited access to high-risk medical devices intended for patients with serious conditions whose medical needs are not met by current technology.

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Frequency of Arrhythmia Up in Nocturnal Hypoglycemia

WEDNESDAY, April 23, 2014 (HealthDay News) -- For insulin-treated patients with type 2 diabetes, nocturnal hypoglycemia is associated with increased frequency of arrhythmia, according to a study published in the May issue of Diabetes.

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Considerable Sudden Death in Hypertrophic Cardiomyopathy

TUESDAY, April 22, 2014 (HealthDay News) -- Patients with hypertrophic cardiomyopathy (HC) without traditional risk factors and with no or mild symptoms have a considerable rate of sudden cardiac death, according to a study published in the May 1 issue of The American Journal of Cardiology.

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Type of Attending Doc Affects Feeding Tube Rates in Elderly

TUESDAY, April 22, 2014 (HealthDay News) -- The rate of feeding tube insertions in hospitalized patients with severe dementia varies by type of attending physician, according to a study published in the April issue of Health Affairs.

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Task Force Recommends Ways to Improve Price Transparency

MONDAY, April 21, 2014 (HealthDay News) -- Price transparency frameworks, which provide price information presented in the context of other relevant information, should be developed to meet patients' needs, according to recommendations presented in a report from the Healthcare Financial Management Association (HFMA).

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AMA Examines Economic Impact of Physicians

FRIDAY, April 18, 2014 (HealthDay News) -- Physicians who mainly engage in patient care contribute a total of $1.6 trillion in economic output, according to the American Medical Association (AMA)'s Economic Impact Study.

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Int'l Medical Education Standards Not Equivalent to U.K. Standards

FRIDAY, April 18, 2014 (HealthDay News) -- International medical graduates passing the Professional and Linguistic Assessments Board (PLAB) of the General Medical Council (GMC) have lower performance on MRCP(UK) (Membership of the Royal Colleges of Physicians) and MRCGP (Membership of the Royal College of General Practitioners) and on annual review of competence progression (ARCP) examinations, according to two studies published online April 17 in BMJ.

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White House: 8 Million People Signed Up for Health Insurance

FRIDAY, April 18, 2014 (HealthDay News) -- Eight million Americans signed up for private health insurance during the just-concluded first enrollment period under the Affordable Care Act, the White House announced Thursday afternoon.

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Patient-Clinician Relationship Impacts Health Care Outcomes

THURSDAY, April 17, 2014 (HealthDay News) -- The patient-clinician relationship has a small but significant effect on health care outcomes, according to a study published online April 9 in PLOS ONE.

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Educator Discusses Key Issues for Future Doctors to Consider

THURSDAY, April 17, 2014 (HealthDay News) -- The key issues for future physicians are discussed in an article published by the American Medical Association (AMA).

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Continued Reliance on Windows XP May Threaten Data Security

WEDNESDAY, April 16, 2014 (HealthDay News) -- Physicians who use Windows XP in their practices may be affected by Microsoft's recent discontinuation of support for the program, according to an article published April 8 in Medical Economics.

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Patients Paying Much More for Specialty Drugs

TUESDAY, April 15, 2014 (HealthDay News) -- Many Americans are paying less for prescription drugs, but some are having to deal with sharp rises in the cost of specialty medicines for rare or serious diseases, according to a new report.

Health Highlights: April 15, 2014

NSAIDs With Anticoagulant Tx Ups Major Bleeding in VTE

TUESDAY, April 15, 2014 (HealthDay News) -- Concomitant use of a nonsteroidal anti-inflammatory drug (NSAID) or aspirin in patients with venous thromboembolism receiving anticoagulant therapy is tied to increased risk of bleeding, according to a study published online April 14 in JAMA Internal Medicine.

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Serum Potassium Levels Linked to Long-Term Mortality Post-MI

MONDAY, April 14, 2014 (HealthDay News) -- For patients with acute myocardial infarction (AMI), serum potassium levels are associated with long-term mortality risk, according to a study published in the April 15 issue of The American Journal of Cardiology.

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Longer ICU Stays May Worsen Quality of Life in Recovery

MONDAY, April 14, 2014 (HealthDay News) -- Longer durations of bed rest during intensive care unit (ICU) stays for acute lung injury may cause lingering physical complications, according to research published in the April issue of Critical Care Medicine.

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CRC Resection Morbidity, Mortality Still Higher for Elderly

MONDAY, April 14, 2014 (HealthDay News) -- Despite an overall improved mortality seen during the past 10 years, advancing age is associated with higher morbidity and mortality in colorectal cancer resection, according to a study published online April 9 in JAMA Surgery.

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New Health Secretary to Confront Health Care Reform Hurdles

MONDAY, April 14, 2014 (HealthDay News) -- With the resignation of U.S. Health and Human Services Secretary Kathleen Sebelius on Friday, the Affordable Care Act will get a fresh face. But turning around public perception of the controversial health care reform law in a politically charged mid-term election year poses an enormous challenge for the department's next leader, policy experts said.

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Sebelius Stepping Down As HHS Secretary

FRIDAY, April 11, 2014 (HealthDay News) -- U.S. Health and Human Services Secretary Kathleen Sebelius is stepping down from her position, after overseeing the troubled rollout of the Affordable Care Act that remains unpopular with some Americans and virtually all Republican lawmakers.

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Benefits/Risks for Fibrinolytic Therapy in Intermediate-Risk PE

FRIDAY, April 11, 2014 (HealthDay News) -- A single intravenous bolus of tenecteplase reduces early death and hemodynamic decompensation in normotensive patients with intermediate-risk pulmonary embolism, but increases the risk of major hemorrhage and stroke, according to a study published in the April 10 issue of the New England Journal of Medicine.

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Fewer Americans Overwhelmed by Medical Bills

WEDNESDAY, April 9, 2014 (HealthDay News) -- While millions of Americans still feel hamstrung by medical expenses, a new government report shows that some people are getting relief.

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More Justification Needed for Choosing Wisely Selections

WEDNESDAY, April 9, 2014 (HealthDay News) -- Most services included in specialty medical societies' Top 5 lists for the Choosing Wisely campaign are based on evidence demonstrating equivalent but not superior benefit, with higher risk or higher costs compared to other options, according to a research letter published in the April 9 issue of the Journal of the American Medical Association.

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Some Doctors Paid at Least $3 Million Each by Medicare

WEDNESDAY, April 9, 2014 (HealthDay News) -- A small number of doctors received at least $3 million each in Medicare payments in 2012, for a total of nearly $1.5 billion, according to an analysis of Medicare claims data released Wednesday by the White House. In total, Medicare paid individual physicians nearly $64 billion in 2012. The median payment was just over $30,000, the Associated Press reported.

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Depression, Functional Disability Common Post-ICU

WEDNESDAY, April 9, 2014 (HealthDay News) -- For patients with respiratory failure or shock undergoing treatment in medical or surgical intensive care units, depression and functional disability are common, according to a study published online April 7 in The Lancet Respiratory Medicine.

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Patients Select Fewer New Docs at Bottom of Tiered Ranking

MONDAY, April 7, 2014 (HealthDay News) -- Patients are less likely to select a new physician ranked in the bottom of a tiered network, but often don't switch if their current physician is ranked at the bottom, according to research published online March 11 in Health Services Research.

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AMA Provides Resources to Aid Physicians' Collections

FRIDAY, April 4, 2014 (HealthDay News) -- The American Medical Association (AMA) has released resources to help doctors confront policy jumpers who may pose a financial risk to physicians during the Affordable Care Act's 90-day premium grace period, according to an article published March 25 in Medical Economics.

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More Elderly Americans Completing Advance Directives

FRIDAY, April 4, 2014 (HealthDay News) -- Over the past decade there has been a significant increase in the rate of completion of advance directives (ADs) among elderly Americans, according to research published online April 2 in the Journal of the American Geriatrics Society.

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Patient Safety Not Affected by Resident Hour Reforms

THURSDAY, April 3, 2014 (HealthDay News) -- In the year following 2011 work-hour reforms for residents there were no changes in patient safety outcomes when comparing patients treated by residents to those treated by hospitalists, according to a study published online Feb. 22 in the Journal of Hospital Medicine.

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Half of Uninsured Don't Intend to Sign Up for Health Coverage

WEDNESDAY, April 2, 2014 (HealthDay News) -- About 50 percent of uninsured adults do not intend to sign up for coverage through the Affordable Care Act's health care exchanges, according to an article published March 26 in Medical Economics.

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