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April 2017 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for April 2017. 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.

Meeting Organizers Overlooking Qualified Female Scientists

FRIDAY, April 28, 2017 (HealthDay News) -- Invited speakers at medical conferences tend to be disproportionately male, a disparity that can be addressed by actively preparing lists of potential speakers, according to a study published online April 18 in Nature Immunology.

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Hospital-Acquired Complications Especially Dangerous in CKD

FRIDAY, April 28, 2017 (HealthDay News) -- Preventable hospital-acquired complications (HACs) are associated with increased risk of adverse outcomes, especially among patients with chronic kidney disease (CKD), according to a study published online April 27 in Clinical Journal of the American Society of Nephrology.

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Routine Blood Tests Can Harm Patient Care

FRIDAY, April 28, 2017 (HealthDay News) -- Routine blood tests waste money and can damage patient care, according to an opinion piece published online April 27 in the BMJ.

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Risk Factors in Six Areas Tied to Physician Burnout

THURSDAY, April 27, 2017 (HealthDay News) -- Physician burnout factors include control, whether there is time to deliver excellent care, and whether the workplace is fair, according to a presentation at the Medical Group Management Association/American Medical Association 2017 Collaborate in Practice Conference, held April 9 to 11 in Chicago.

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Single-Payer Health System Bill Moves Forward in California

THURSDAY, April 27, 2017 (HealthDay News) -- A proposal to replace private insurance with government-funded health care for all moved forward in California on Wednesday as Democrats on the Senate Health Committee voted to advance the measure.

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EHR Documentation May Help in Harm Reduction Initiatives

THURSDAY, April 27, 2017 (HealthDay News) -- Electronic health record (EHR) documentation can be used to reduce preventable harm in hospitals, according to a study published online April 27 in Pediatrics.

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Children With Suspected Child Abuse Present to Hospital Late

WEDNESDAY, April 26, 2017 (HealthDay News) -- Children with suspected child abuse (SCA) present late to the hospital, and most arrive at hospitals that are not designated pediatric-capable major trauma centers, according to a study published online April 24 in the Emergency Medicine Journal.

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Fatal Case of Suspected Propofol-Induced Pancreatitis Described

WEDNESDAY, April 26, 2017 (HealthDay News) -- A fatal case of propofol-induced acute necrotizing pancreatitis has been described in a case report published online April 10 in the Journal of Clinical Pharmacy and Therapeutics.

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Checklist for Family-Centered Rounds Deemed Beneficial

WEDNESDAY, April 26, 2017 (HealthDay News) -- Implementation of a family-centered rounds (FCR) checklist and associated provider training is associated with an increase in the number of FCR elements performed, according to a study published online April 25 in Pediatrics.

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Post-Op hsTnT Linked to 30-Day Mortality After Noncardiac Sx

TUESDAY, April 25, 2017 (HealthDay News) -- Peak postoperative high-sensitivity troponin T (hsTnT) is associated with increased risk of 30-day mortality among patients undergoing noncardiac surgery, according to a study published online April 25 in the Journal of the American Medical Association.

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Neutrophil-to-Lymphocyte Ratio Predicts Mortality in CAP

MONDAY, April 24, 2017 (HealthDay News) -- Neutrophil-to-lymphocyte ratio (NLR) can predict 30-day mortality for elderly adults with community-acquired pneumonia (CAP), according to a study published online April 13 in the Journal of the American Geriatrics Society.

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More Wrong-Patient Orders in NICU Versus Non-NICU Ped Units

FRIDAY, April 21, 2017 (HealthDay News) -- The risk of wrong-patient orders is higher in the neonatal intensive care unit (NICU) versus non-NICU pediatric units, and the risk of errors can be reduced with interventions, according to a study published online April 21 in Pediatrics.

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Case Report Describes Adverse Reaction to Clindamycin

FRIDAY, April 21, 2017 (HealthDay News) -- In a case report published online April 17 in the Journal of Clinical Pharmacy and Therapeutics, acute generalized exanthematous pustulosis secondary to clindamycin therapy is described.

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1-g IV Acetaminophen Dose May Be Insufficient in Multiple Trauma

FRIDAY, April 21, 2017 (HealthDay News) -- A dosage of 1 g intravenous acetaminophen every six hours yields serum concentrations below 10 µg/mL for critically ill multiple-trauma patients, according to a study published online April 17 in the Journal of Clinical Pharmacology.

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Vertical Integration Linked to Reduction in Readmissions

THURSDAY, April 20, 2017 (HealthDay News) -- Vertical integration, merging health care providers of different levels into a single unit, is associated with a reduction in readmissions overall, although the positive effect is seen for a limited number of conditions, according to a study published in the May issue of Medical Care.

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Electronic Drug Administration Record App Cuts Errors

THURSDAY, April 20, 2017 (HealthDay News) -- Use of an electronic medication administration record (eMAR) application can reduce the rate of medication errors in medication administration recording (ME-MAR), according to a study published online April 18 in the Journal of Evaluation in Clinical Practice.

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Single hs-cTnT Measure, Non-Ischemic ECG Can Rule Out AMI

WEDNESDAY, April 19, 2017 (HealthDay News) -- For adults presenting to the emergency department with chest pain, a single high-sensitivity assay for cardiac troponin T (hs-cTnT) below the limit of detection and a non-ischemic electrocardiogram (ECG) can rule out acute myocardial infarction (AMI), according to a meta-analysis published online April 18 in the Annals of Internal Medicine.

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No Proof Azithromycin Ups Odds of Ventricular Arrhythmia

TUESDAY, April 18, 2017 (HealthDay News) -- Azithromycin doesn't appear to increase the risk of ventricular arrhythmia, according to a study published online April 18 in CMAJ, the journal of the Canadian Medical Association.

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High-Volume NICUs See More Staff Burnout

TUESDAY, April 18, 2017 (HealthDay News) -- Staff burnout in neonatal intensive care units (NICUs) is most prevalent in units with high patient volume and electronic health records, according to a study published online April 18 in Pediatrics.

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Pre-Op Training Program Improves Outcomes

TUESDAY, April 18, 2017 (HealthDay News) -- A home-based, preoperative training program can decrease hospital duration of stay and costs of care, while being well accepted by patients, according to a study published recently in Surgery.

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Doctors Need to Be Mindful of What They Post on Social Media

MONDAY, April 17, 2017 (HealthDay News) -- Young doctors often have unprofessional or offensive content on their Facebook profiles, according to a study published online April 9 in BJU International.

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Early Invasive Doesn't Beat Selective Strategy in NSTE-ACS

MONDAY, April 17, 2017 (HealthDay News) -- An early invasive strategy has no benefit for reducing the 10-year composite outcomes of death or spontaneous myocardial infarction (MI) for patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and elevated cardiac troponin T, according to a study published in the April 18 issue of the Journal of the American College of Cardiology.

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High Readmission Rates for Critical Limb Ischemia

FRIDAY, April 14, 2017 (HealthDay News) -- Patients with critical limb ischemia (CLI) have a high risk of readmission, with most of the readmissions unplanned, according to a study published in the April 18 issue of the Journal of the American College of Cardiology.

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Iodide Supplementation No Benefit for Preemies

FRIDAY, April 14, 2017 (HealthDay News) -- For preterm infants, iodide supplementation is not associated with neurodevelopmental benefit at age 2 years, according to a study published online April 14 in Pediatrics.

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6 Variables Can Predict Mortality Risk in Cardiogenic Shock

THURSDAY, April 13, 2017 (HealthDay News) -- Six variables can be combined to predict short-term mortality risk in patients with cardiogenic shock (CS), according to a study published in the April 18 issue of the Journal of the American College of Cardiology.

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Chronic Alarm Fatigue Key Determinant of Response Time

WEDNESDAY, April 12, 2017 (HealthDay News) -- Nurses are usually quick to react when alarms are urgent, but they're slower to respond at the end of the workday or when they are experiencing "chronic alarm fatigue," according to a study published online April 10 in JAMA Pediatrics.

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Residents Rate Enjoyment of Teaching As Key for ICU Doctors

WEDNESDAY, April 12, 2017 (HealthDay News) -- Behaviors that residents value in intensive care unit (ICU) attending physicians include enjoyment of teaching and treatment of patients, families, and non-physician staff, according to a study published in the April issue of the Annals of the American Thoracic Society.

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Questionnaire-Based Approach Valid for Identifying Frailty

TUESDAY, April 11, 2017 (HealthDay News) -- A questionnaire-based approach seems to be valid for identifying adults in the intensive care unit with a frailty phenotype, according to a study published online March 30 in the Annals of the American Thoracic Society.

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Integrated E-Prescribing Can Cut Prescribing, Dispensing Errors

MONDAY, April 10, 2017 (HealthDay News) -- An integrated electronic medication prescribing (e-prescribing) and dispensing system can reduce prescribing and dispensing errors, according to a study published online March 30 in the Journal of Pharmacy Practice and Research.

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Benzodiazepines May Up Risk of Pneumonia in Alzheimer's Disease

MONDAY, April 10, 2017 (HealthDay News) -- Patients with Alzheimer's disease who use benzodiazepines may have an increased risk for pneumonia, according to a study published in the April 10 issue of CMAJ, the journal of the Canadian Medical Association.

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MACRA Changes Government Approach to Doctor Payment

FRIDAY, April 7, 2017 (HealthDay News) -- Implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) has made fundamental changes to the government's approach to physician payment, according to a March 27 policy brief published in Health Affairs.

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Risk Adjustment, Reinsurance Transfer Offer Financial Benefit

THURSDAY, April 6, 2017 (HealthDay News) -- Risk adjustment and reinsurance transfer programs seem to have been effective for increasing revenues at the expense of claims costs, according to research published in the March issue of Health Affairs.

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Ruling Out Penicillin Allergy by Testing Inpatients Saves Money

WEDNESDAY, April 5, 2017 (HealthDay News) -- Inpatient penicillin allergy testing is effective for ruling out penicillin allergy, and results in increased prescription of penicillin and cephalosporin, according to a review published online March 29 in Allergy.

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Hydrocortisone Tx Doesn't Impair Neurodevelopment in Preemies

WEDNESDAY, April 5, 2017 (HealthDay News) -- For extremely preterm infants, early hydrocortisone therapy is not associated with neurodevelopmental impairment at age 2 years, according to a study published in the April 4 issue of the Journal of the American Medical Association.

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Variation in Occupational Influenza Vaccination Coverage

TUESDAY, April 4, 2017 (HealthDay News) -- There is variation in influenza vaccination coverage by industry and occupation, including among health care personnel and other occupational groups who may have first priority to receive influenza vaccination during a pandemic (tier 1), according to a study published in the April 1 issue of the American Journal of Infection Control.

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Use of Health Literacy Tools Can Promote Shared Decision Making

MONDAY, April 3, 2017 (HealthDay News) -- Use of health literacy tools is encouraged for facilitating shared decision making (SDM), according to an article published in the March issue of the AMA Journal of Ethics.

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