Here are what the editors at HealthDay consider to be the most important developments in Critical Care for January 2013. 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.
Updated Guidelines Issued for Care of Acute Ischemic Stroke
THURSDAY, Jan. 31 (HealthDay News) -- For patients with acute ischemic stroke, the keys to limiting associated morbidity and mortality include the recognition of stroke, early diagnosis and treatment, and hospital care, according to updated guidelines published online Jan. 31 in Stroke.
Antibiotics Improve Outcomes in Treatment of Malnutrition
THURSDAY, Jan. 31 (HealthDay News) -- For the treatment of severe, acute malnutrition in children, the addition of antibiotics to nutritional therapeutic regimens improves rates of recovery and reduces mortality, according to a study published in the Jan. 31 issue of the New England Journal of Medicine.
Yoga Shown to Reduce Clinical Symptoms of Atrial Fibrillation
WEDNESDAY, Jan. 30 (HealthDay News) -- Yoga significantly reduces clinical symptoms and improves quality-of-life measures in patients with atrial fibrillation (AF), according to a study published online Jan. 30 in the Journal of the American College of Cardiology.
Moxifloxacin Monotherapy Equivalent to Antibiotic Combo
WEDNESDAY, Jan. 30 (HealthDay News) -- Oral monotherapy with moxifloxacin is as efficacious and safe as combination therapy with ciprofloxacin plus amoxicillin/clavulanic acid for treatment of fever in adult patients with cancer and neutropenia who are at low risk of complications, according to a study published online Jan. 28 in the Journal of Clinical Oncology.
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Mortality Risk Up for Patients Admitted on Public Holidays
WEDNESDAY, Jan. 30 (HealthDay News) -- Patients admitted to the hospital as emergencies on public holidays have significantly higher seven-day and 30-day mortality than patients admitted on non-holidays, according to a study published online Jan. 23 in the Journal of Emergency Medicine.
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Majority of Patients Will Consider ICD Deactivation
WEDNESDAY, Jan. 30 (HealthDay News) -- The majority of patients with implantable cardioverter-defibrillators (ICDs) would want ICD deactivation in at least one scenario describing deteriorating health outcomes common in patients approaching the end of life, according to a study published online Jan. 28 in JAMA Internal Medicine.
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In STEMI, Diabetes Linked to Worse Long-Term Outcomes
TUESDAY, Jan. 29 (HealthDay News) -- In patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI), diabetes is associated with worse long-term outcomes, including mortality, reinfarction, stent thrombosis, and target vessel revascularization (TVR), according to research published online Dec. 28 in Diabetes Care.
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Physicians Commonly Report Unsafe Hospital Workloads
TUESDAY, Jan. 29 (HealthDay News) -- Physicians say they often face unsafe hospital workloads, according to a study published online Jan. 28 in JAMA Internal Medicine.
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Brain Scans Show Doctors Empathize With Patients
TUESDAY, Jan. 29 (HealthDay News) -- Physicians who empathize with a patient in pain and feel relief when the patient receives effective treatment show activity in brain regions associated with pain relief and reward, according to a study published online Jan. 29 in Molecular Psychiatry.
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Even Correctly-Administered NSAIDS Can Cause AKI in Kids
TUESDAY, Jan. 29 (HealthDay News) -- Nonsteroidal anti-inflammatory drug (NSAID)-associated acute kidney injury (AKI) accounts for almost 3 percent of pediatric AKI, according to a study published online Jan. 28 in The Journal of Pediatrics.
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Chlorhexidine Baths Cut Bacteremia in Critically Ill Kids
MONDAY, Jan. 28 (HealthDay News) -- For critically ill pediatric patients, daily bathing in chlorhexidine gluconate (CHG) is associated with reduced incidence of bacteremia, according to a study published online Jan. 28 in The Lancet.
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Hyperbaric Oxygen Improves Function Long After Stroke
FRIDAY, Jan. 25 (HealthDay News) -- Hyperbaric oxygen therapy (HBOT) significantly improves neurological function and quality of life in people who had a stroke up to three years earlier, according to a study published online Jan. 15 in PLOS One.
Care Transition Initiative Decreases Rehospitalizations
WEDNESDAY, Jan. 23 (HealthDay News) -- Communities instituting quality improvement initiatives for care transitions see significant declines in the rate of 30-day rehospitalizations and hospitalizations, according to a study published in the Jan. 23/30 issue of the Journal of the American Medical Association.
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Large Teaching Hospitals Face More Readmission Penalties
WEDNESDAY, Jan. 23 (HealthDay News) -- Large hospitals, teaching hospitals, and safety-net hospitals (SNHs) are more likely than other hospitals to be penalized under the Centers for Medicare & Medicaid Services' Hospital Readmissions Reduction Program (HRRP), according to a research letter published in the Jan. 23/30 issue of the Journal of the American Medical Association.
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CPR Duration Inversely Tied to Child Cardiac Arrest Survival
WEDNESDAY, Jan. 23 (HealthDay News) -- For pediatric patients with in-hospital cardiac arrest (IHCA), the duration of cardiopulmonary resuscitation (CPR) is inversely linked to survival and favorable neurologic outcomes, according to a study published online Jan. 22 in Circulation.
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Pediatric Hospitals Highly Variable in Readmission Rates
TUESDAY, Jan. 22 (HealthDay News) -- There is significant variability in readmission rates at pediatric hospitals based on condition treated and admitting hospital, according to a study published in the Jan. 23/30 issue of the Journal of the American Medical Association.
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ER Visits Frequent Within 30-Days of Hospital Discharge
TUESDAY, Jan. 22 (HealthDay News) -- Emergency department visits account for almost 40 percent of post-discharge acute care encounters; and readmissions within 30-days occur in a considerable proportion of patients hospitalized with heart failure, acute myocardial infarction (MI), and pneumonia, according to two studies published in the Jan. 23/30 issue of the Journal of the American Medical Association.
Abstract - Vashi
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Abstract - Dharmarajan
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Not All 'Surviving Sepsis' Intervention Recs Are Adopted
MONDAY, Jan. 21 (HealthDay News) -- Not all nursing interventions recommended in the Surviving Sepsis Campaign (SSC) are actually implemented in emergency departments, according to a review published in the January issue of the Journal of Emergency Nursing.
Most With C. difficile Receive Unnecessary Antimicrobials
MONDAY, Jan. 21 (HealthDay News) -- The majority of patients with current or recent Clostridium difficile infection (CDI) receive unnecessary antimicrobials, with 26 percent receiving only unnecessary antimicrobials, according to research published in the February issue of Infection Control and Hospital Epidemiology.
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In STEMI, C-Reactive Protein at Presentation Predicts MI, Death
FRIDAY, Jan. 18 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction (STEMI), high-sensitivity C-reactive protein (hsCRP) measurements at presentation predict subsequent nonfatal MI and cardiac death; and for patients with acute coronary syndromes (ACS), fetuin-A and CRP have prognostic value, according to two studies published in the Jan. 1 issue of The American Journal of Cardiology.
Abstract - Makrygiannis
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Alcohol Disinfection Cap Cuts Contamination of Central Lines
FRIDAY, Jan. 18 (HealthDay News) -- Continuous passive disinfection of central line catheter hubs using an alcohol-containing disinfection cap reduces line contamination, organism density, and the rate of central-line associated bloodstream infections (CLABSIs), according to a study published in the January issue of the American Journal of Infection Control.
Features of Serious Pertussis Progression Identified
FRIDAY, Jan. 18 (HealthDay News) -- Rapidly rising white blood cell (WBC) counts and high heart rates and respiratory rates may indicate more serious pertussis progression in infants, according to research published online Jan. 10 in the Journal of the Pediatric Infectious Diseases Society.
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Efforts Failed to Up Primary Care, Rural Resident Training
FRIDAY, Jan. 18 (HealthDay News) -- The 2005 redistribution of graduate medical education (GME) funds did little to train more residents in primary care and in rural areas, according to a study published in the January issue of Health Affairs.
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Checklists Up Performance in Operating-Room Crises
WEDNESDAY, Jan. 16 (HealthDay News) -- Using checklists during operating-room crises can improve surgical care, according to a study published in the Jan. 17 issue of the New England Journal of Medicine.
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Letter to the Editor
Selective D-Dimer Testing Strategy Seems Safe, Effective
WEDNESDAY, Jan. 16 (HealthDay News) -- For patients with suspected deep venous thrombosis (DVT), selective D-dimer testing is a safe and a more efficient testing strategy than universal testing, according to a study published in the Jan. 15 issue of the Annals of Internal Medicine.
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Family Docs Are Early Adopters of Electronic Health Records
WEDNESDAY, Jan. 16 (HealthDay News) -- Family practice physicians are adopting electronic health record (EHR) systems at a fast pace, with 68 percent using an EHR system by 2011, and 80 percent expected to be users by 2013, according to research published in the January/February issue of the Annals of Family Medicine.
Even Brief Interruptions Dramatically Increase Errors
WEDNESDAY, Jan. 16 (HealthDay News) -- Even momentary interruptions of two to four seconds can significantly affect a person's ability to accurately complete a task requiring considerable thought, according to research published online Jan. 7 in the Journal of Experimental Psychology: General.
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No Gastric Volume Monitoring Is Not Inferior Strategy
TUESDAY, Jan. 15 (HealthDay News) -- For adults requiring invasive mechanical ventilation, enteral nutrition management without residual gastric volume monitoring is not inferior to a similar protocol which includes monitoring for protection against ventilator-associated pneumonia (VAP), according to a study published in the Jan. 16 issue of the Journal of the American Medical Association.
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Certain Online Behaviors of Docs Warrant Investigation
MONDAY, Jan. 14 (HealthDay News) -- There is high consensus among state medical boards regarding the likelihood of probable investigations for certain online behaviors, according to a study published in the Jan. 15 issue of the Annals of Internal Medicine.
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Top Five Issues for Docs and Patients Identified for 2013
MONDAY, Jan. 14 (HealthDay News) -- The top five issues that will impact physicians and patients in 2013 have been identified, according to a report published Dec. 10 by The Physicians Foundation.
National U.S. Health Care Spending Relatively Stable
FRIDAY, Jan. 11 (HealthDay News) -- The growth in national U.S. health care spending was relatively stable in 2011, but growth in personal health care spending accelerated, according to a study published in the January issue of Health Affairs.
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CDC: Rare Blood Disorder Found in Intravenous Drug Users
THURSDAY, Jan. 10 (HealthDay News) -- In 2012, 15 intravenous drug users within a relatively small geographic area developed thrombotic thrombocytopenic purpura (TTP), possibly due to reformulating and injecting an oral pain reliever, according to a report published in the Jan. 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.
SPIRIT 2013 Clinical Trial Protocol Guidelines Issued
THURSDAY, Jan. 10 (HealthDay News) -- A panel of experts, including trial investigators, trial coordinators, and representatives from ethics and regulatory agencies, has developed the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 guidelines for the minimum content of a clinical trial, according to a statement published online Jan. 8 in the Annals of Internal Medicine.
Americans Sicker, Die Younger Than Other Developed Nations
WEDNESDAY, Jan. 9 (HealthDay News) -- Americans have worse health than their peers in high-income countries, according to a report published Jan. 9 by the National Research Council and Institute of Medicine.
Multiple Stressors Contribute to Readmission Within 30 Days
WEDNESDAY, Jan. 9 (HealthDay News) -- Nearly one-fifth of Medicare patients discharged from the hospital are readmitted within 30 days, which seems to arise from a combination of factors contributing to patient vulnerability, according to research published in the Jan. 9 issue of the New England Journal of Medicine.
Health Care Use Dropped Among All During Recession
TUESDAY, Jan. 8 (HealthDay News) -- Health care use declined significantly among all races and ethnicities during the recession from 2007 to 2009, with the only ethnic disparity being fewer physician visits by Hispanics compared with whites, according to a study published online Jan. 7 in JAMA Internal Medicine.
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Low Rates of High Platelet Reactivity With Prasugrel Tx
MONDAY, Jan. 7 (HealthDay News) -- Treatment of patients with acute coronary syndromes (ACS) with percutaneous coronary intervention and a maintenance dose of prasugrel is associated with low rates of high platelet reactivity (HPR), ischemic events, and major bleeding in the first 30 days of treatment, according to research published in the Jan. 1 issue of The American Journal of Cardiology.
Shared Savings May Promote Care Coordination Entity Use
MONDAY, Jan. 7 (HealthDay News) -- Use of shared savings could encourage individuals who are dually eligible for Medicare and Medicaid to enroll in state-designed care coordination entities (CCEs), according to a perspective piece published online Jan. 2 in the New England Journal of Medicine.
CDC: Influenza Activity Increasing Across the U.S.
FRIDAY, Jan. 4 (HealthDay News) -- Flu season descended on the United States early and hard this winter, with significant increases in flu activity observed over the past month, according to an update issued Jan. 4 by the U.S. Centers for Disease Control and Prevention.
Improved Staffing Cuts Medicare Patient Readmissions
FRIDAY, Jan. 4 (HealthDay News) -- Hospital nurses with good work environments who are caring for fewer patients have significantly fewer elderly Medicare patients with heart failure, acute myocardial infarction (MI), and pneumonia who are readmitted to the hospital within the first 30 days, according to research published in the January issue of Medical Care.
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Association Between Health Care Cost, Quality Inconsistent
THURSDAY, Jan. 3 (HealthDay News) -- The direction of the association between health care cost and quality is unclear, with inconsistent evidence indicating positive, negative, mixed, and indeterminate associations, according to a review published in the Jan. 1 issue of the Annals of Internal Medicine.
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Smoking Impairs Saphenous Vein Conduits in CABG Surgery
THURSDAY, Jan. 3 (HealthDay News) -- Patients undergoing heart bypass surgery using saphenous veins are more likely to have signs of graft failure if they are smokers, even if they quit smoking more than a year earlier, according to a study published in the January issue of the Annals of Thoracic Surgery.
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TPN-Linked Hyperglycemia Ups Death for Non-Critically Ill
THURSDAY, Jan. 3 (HealthDay News) -- Non-critically ill hospitalized patients who develop hyperglycemia after total parenteral nutrition (TPN) are more than five times more likely to die in the hospital, according to research published online Dec. 6 in Diabetes Care.
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Prior Brain Injury Linked to Re-Injury Later in Life
THURSDAY, Jan. 3 (HealthDay News) -- Older adults with a history of traumatic brain injury (TBI) with loss of consciousness (LOC) have a 2.5- to almost four-fold higher risk of subsequent re-injury later in life, according to research published online Nov. 21 in the Journal of Neurology, Neurosurgery & Psychiatry.
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Ban on Ambulance Diversions Doesn't Worsen ER Crowding
THURSDAY, Jan. 3 (HealthDay News) -- A 2009 ban on ambulance diversion in Massachusetts did not worsen crowding in emergency departments or ambulance turnaround times, according to research published online Dec. 21 in the Annals of Emergency Medicine.
Restrictive Transfusion Strategy Safe for Acute GI Bleeding
WEDNESDAY, Jan. 2 (HealthDay News) -- For patients with severe acute gastrointestinal bleeding, a restrictive transfusion approach is safe and effective compared with a liberal approach, according to a study published in the Jan. 2 issue of the New England Journal of Medicine.
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House Joins Senate to Avert Medicare Cuts
WEDNESDAY, Jan. 2 (HealthDay News) -- The House of Representatives settled on an 11th-hour agreement late Tuesday night that has averted the widespread tax increases and spending cuts that would have gone into effect January 1. This agreement occurred 21 hours after the U.S. Senate did its part to steer the country clear of the "fiscal cliff."
