February 2015 Briefing - Critical Care

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

AMA: Key Steps for Minimizing Liability Risk in Telemedicine

FRIDAY, Feb. 27, 2015 (HealthDay News) -- Key steps should be taken to minimize the potential risk of liability resulting from use of telemedicine, according to an article published by the American Medical Association (AMA).

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Dr. Craig Spencer Speaks Out About His Ebola Experience

FRIDAY, Feb. 27, 2015 (HealthDay News) -- Many U.S. politicians and media outlets hyped the threat of U.S. cases of Ebola last year, according to a newly written personal account by Craig Spencer, M.D., M.P.H., the last American Ebola patient treated in the United States. He also believes that officials and the media unnecessarily maligned those who were risking their lives to combat the West African epidemic.

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CDC: In U.S., Half Million C. Difficile Infections in 2011

THURSDAY, Feb. 26, 2015 (HealthDay News) -- Almost half a million Americans were infected with the bacteria Clostridium difficile in 2011, and 29,000 died within a month of diagnosis, U.S. health officials say. The report is published in the Feb. 26 issue of the New England Journal of Medicine.

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Even Short Term Use of NSAID With Anticoagulant Ill Advised

TUESDAY, Feb. 24, 2015 (HealthDay News) -- Use of nonsteroidal anti-inflammatories (NSAIDs) may raise the risk for myocardial infarction (MI), stroke, and/or serious bleeding among MI survivors taking prescription anticoagulants, with no safe window period, according to new research. Bleeding risk rose even within the first three days of NSAID use, the team noted in a study published in the Feb. 24 issue of the Journal of the American Medical Association.

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Remote Patient Monitoring Sector Increasing Rapidly

TUESDAY, Feb. 24, 2015 (HealthDay News) -- The remote patient monitoring sector is growing rapidly and could have a considerable impact on health care, according to an article published in Medical Economics.

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Proton Pump Inhibitor Use Not Linked to Cardiac Arrhythmia

MONDAY, Feb. 23, 2015 (HealthDay News) -- In critically ill patients, proton pump inhibitor (PPI) use is not associated with cardiac arrhythmia, according to a study published online Feb. 6 in the Journal of Clinical Pharmacology.

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Patients Say Cost Matters Greatly in Choosing Doctor

FRIDAY, Feb. 20, 2015 (HealthDay News) -- The number one determining factor for selecting a doctor is whether the physician is in-network, according to a report published by Vitals.

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Ebola Transmitted Via Cough Possible, Not Likely

FRIDAY, Feb. 20, 2015 (HealthDay News) -- Based on prior evidence, health workers dealing with Ebola primarily have worried about disease transmission from a patient's blood, vomit, and feces, all of which contain high levels of virus as symptoms progress, but health care workers also might need to worry about a patient's cough, authors speculate online Feb. 19 in mBio.

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Fear of Discrimination Keeps Many LGBT Med Students Silent

THURSDAY, Feb. 19, 2015 (HealthDay News) -- Fear of discrimination is a major reason why about one-third of lesbian, gay, bisexual, and transgender (LGBT) medical students stay "in the closet," new research finds. The study was published online Feb. 16 in Academic Medicine.

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Doctors, Pharmacists Least Likely Health Pros to Divorce

THURSDAY, Feb. 19, 2015 (HealthDay News) -- Doctors appear less likely to get divorced than most other health care professionals, according to research published online Feb. 18 in The BMJ.

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Article Emphasizes Importance of Apology in Medical Error

WEDNESDAY, Feb. 18, 2015 (HealthDay News) -- Apology laws, which prohibit certain statements or expressions of sympathy by a physician from being admissible in a lawsuit, are unnecessary if physicians understand the importance of saying sorry and offering accountability after an error, according to an article published Feb. 4 in Medical Economics.

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Fondaparinux Found to Effectively Treat NSTEMI

TUESDAY, Feb. 17, 2015 (HealthDay News) -- In a new study, patients who received fondaparinux to treat non-ST-segment elevation myocardial infarction (NSTEMI) had a lower risk of major bleeding and death compared to patients who received low-molecular-weight heparin (LMWH). The findings were published in the Feb. 17 issue of the Journal of the American Medical Association.

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Methylprednisolone Use Cuts Treatment Failure in Pneumonia

TUESDAY, Feb. 17, 2015 (HealthDay News) -- For patients with severe community-acquired pneumonia and high initial inflammatory response, methylprednisolone use is associated with decreased treatment failure, according to a study published in the Feb. 17 issue of the Journal of the American Medical Association.

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Productivity Growth in U.S. Hospitals During 2002 to 2011

MONDAY, Feb. 16, 2015 (HealthDay News) -- During 2002 to 2011, U.S. hospitals experienced productivity growth in treating Medicare patients with heart attack, heart failure, and pneumonia, according to a study published in the February issue of Health Affairs.

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Electronic Beats Paper Record in Peds Trauma Resuscitations

FRIDAY, Feb. 13, 2015 (HealthDay News) -- Electronic documentation produces more complete records of pediatric trauma resuscitations than paper documentation, according to a study published in the January issue of the Journal of Emergency Nursing.

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Patients Tend to Prefer Formal Physician Attire

FRIDAY, Feb. 13, 2015 (HealthDay News) -- Patients often prefer physicians with formal attire and white coats, according to a systematic review published online Jan. 19 in BMJ Open.

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Latino Physician Shortage Has Worsened Since 1980

FRIDAY, Feb. 13, 2015 (HealthDay News) -- From 1980 to 2010 the Latino physician shortage worsened, according to a study published online Jan. 27 in Academic Medicine.

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Intervention Cuts Drug Prep Errors for Peroral Drugs

THURSDAY, Feb. 12, 2015 (HealthDay News) -- A newly developed intervention program tailored to hospitals can reduce the rate of inappropriately prepared solid peroral drugs for patients with feeding tubes, according to a study published online Feb. 5 in the Journal of Clinical Pharmacy and Therapeutics.

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Seven Tips Help Doctors Prepare for Meaningful Use Audits

WEDNESDAY, Feb. 11, 2015 (HealthDay News) -- Given that physicians are chosen for meaningful use (MU) audits at random, the best way to prepare is for a physician to assume they will be audited, according to an article published Jan. 28 in Medical Economics.

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Research Misconduct ID'd by FDA Often Unreported in Literature

TUESDAY, Feb. 10, 2015 (HealthDay News) -- A review of U.S. Food and Drug Administration inspection reports between 1998 and 2013 revealed 57 clinical trials in which regulators had uncovered violations serious enough to earn the agency's most severe classification -- "official action indicated," or OAI. The findings were published online Feb. 9 in JAMA Internal Medicine.

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Eight Clinical Signs of Impending Death Identified

MONDAY, Feb. 9, 2015 (HealthDay News) -- Researchers say they have identified eight specific physical signs that strongly indicate impending death in patients with advanced cancer. The findings have been reported online Feb. 9 in Cancer.

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Advantages of Shorter Resident Shifts Found Lacking

MONDAY, Feb. 9, 2015 (HealthDay News) -- Shorter shifts for medical residents don't appear to be making any big improvements in doctors' fatigue levels or in patient care, new research shows. The study was published online Feb. 9 in CMAJ, the journal of the Canadian Medical Association.

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Confidence Not Accurate Measure of Prescribing Competence

MONDAY, Feb. 9, 2015 (HealthDay News) -- For medical students, self-reported confidence in prescribing only weakly correlates with actual competence, according to a study published online Feb. 4 in The Journal of Clinical Pharmacology.

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Early Stroke Care Can Start With Paramedics

FRIDAY, Feb. 6, 2015 (HealthDay News) -- It's possible for paramedics to deliver immediate drug treatment to stroke patients, new research suggests. The study, funded by the National Institute of Neurological Disorders and Stroke (NINDS), was published in the Feb. 5 issue of the New England Journal of Medicine.

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Perspective on Dr. Davidson: 'Be Like Mike'

THURSDAY, Feb. 5, 2015 (HealthDay News) -- The tragic shooting of surgeon Michael Davidson can be used as an opportunity to find meaning in tragedy, according to a perspective piece published online Feb. 5 in the New England Journal of Medicine.

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Prehospital Magnesium Sulfate Doesn't Benefit Stroke Outcomes

THURSDAY, Feb. 5, 2015 (HealthDay News) -- For patients with suspected stroke, prehospital magnesium sulfate therapy is safe but does not impact the degree of disability at 90 days, according to a study published in the Feb. 5 issue of the New England Journal of Medicine.

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Early Rehab Doesn't Increase Adverse Events Post-CABG

THURSDAY, Feb. 5, 2015 (HealthDay News) -- Early enrollment in cardiac rehabilitation does not increase major adverse event rates among patients who recently underwent open heart surgery, according to a study published in the Feb. 15 issue of The American Journal of Cardiology.

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Researchers Identify Predictors of Awakening After Acute Coma

THURSDAY, Feb. 5, 2015 (HealthDay News) -- For patients with acute coma, reversal and/or limitation of lateral brain displacement is associated with awakening, according to a study published online Jan. 27 in the Annals of Neurology.

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'Battlefield' Blood Transfusion Deemed More Beneficial

TUESDAY, Feb. 3, 2015 (HealthDay News) -- A blood transfusion containing equal parts plasma, platelets, and red blood cells is the most effective treatment for someone who is in immediate danger of exsanguination, compared to a blood mix containing a larger amount of red blood cells, according to research published in the Feb. 3 issue of the Journal of the American Medical Association.

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Nutritional Supplements Can Improve Pressure Ulcer Healing

TUESDAY, Feb. 3, 2015 (HealthDay News) -- For malnourished adult patients, specific nutritional supplements (arginine, zinc, and antioxidants) are associated with improved pressure ulcer healing, according to a study published in the Feb. 3 issue of the Annals of Internal Medicine.

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Too Many Hospitalized Heart Failure Patients on IV Fluids

TUESDAY, Feb. 3, 2015 (HealthDay News) -- Potentially harmful intravenous (IV) fluids are being given to too many patients with severe heart failure, according to a new study published in the Feb. 1 issue of JACC: Heart Failure.

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Many Americans Suffering in Final Year of Life

TUESDAY, Feb. 3, 2015 (HealthDay News) -- For a growing number of Americans, the final year of life is marked by pain, depression, and other distressing symptoms, according to a study published in the Feb. 3 issue of the Annals of Internal Medicine.

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Patient Engagement Can Cut Costs, Improve Outcomes

MONDAY, Feb. 2, 2015 (HealthDay News) -- Patient engagement initiatives can decrease costs without sacrificing quality care, according to an article published Jan. 22 in Medical Economics.

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