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January 2014 Briefing - Critical Care

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

Deal Could Trade Tort Reform for Additional Health Reform

FRIDAY, Jan. 31, 2014 (HealthDay News) -- Physicians may be willing to make a trade in accepting some additional health reform efforts in exchange for tort reform, according to an article published in the January issue of Health Affairs.

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Improving Infection Control Could Mean No More White Coats

THURSDAY, Jan. 30, 2014 (HealthDay News) -- Health care personnel should consider their clinical attire, such as white lab coats, carefully with regards to risk of transmitting infection, according to guidelines published in the February issue of Infection Control and Hospital Epidemiology.

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Validation of Delirium Screening Tools in ER Lacking

THURSDAY, Jan. 30, 2014 (HealthDay News) -- Data about ideal screening for delirium in elderly patients presenting in the emergency department are scarce, according to a review published online Dec. 18 in the Annals of Emergency Medicine.

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Docs Prefer Tablets Over Smartphones for Reading Articles

THURSDAY, Jan. 30, 2014 (HealthDay News) -- Although physicians generally use smartphones rather than tablets for professional purposes, they are more likely to read articles from medical publications and access medically oriented webcasts/podcasts on tablets, according to the results of a survey conducted by Kantar Media.

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Report Reveals Payment Methods for Physicians

THURSDAY, Jan. 30, 2014 (HealthDay News) -- Many physicians in non-solo practice settings are paid using different methods, with just over half receiving all or most of their compensation from salary, according to a report from the American Medical Association.

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Preterm Birth Tied to Increased Risk of Childhood Wheeze

THURSDAY, Jan. 30, 2014 (HealthDay News) -- Preterm birth, especially very preterm birth, is associated with an increased risk of childhood wheezing disorders, according to a study published online Jan. 28 in PLOS Medicine.

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Businesses Urge Change to ACA's Insurance Mandate

WEDNESDAY, Jan. 29, 2014 (HealthDay News) -- Beginning in 2015, U.S. businesses with 50 or more workers must provide health insurance to "full-time" employees, meaning workers who log at least 30 hours a week, on average.

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Risk of Flu-Linked Hospitalization Up for Adults With Diabetes

WEDNESDAY, Jan. 29, 2014 (HealthDay News) -- Working-age adults with diabetes are at increased risk of all-cause hospitalizations associated with influenza, according to a study published online Jan. 24 in Diabetologia.

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Handwashing Appears Best in Prevention of Common Cold

WEDNESDAY, Jan. 29, 2014 (HealthDay News) -- The evidence relating to prevention and treatment of the common cold is frequently poor, but best evidence for prevention supports physical methods such as handwashing and possibly use of zinc supplements, according to a review published online Jan. 27 in CMAJ, the journal of the Canadian Medical Association.

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Insurance Eligibility Headaches Expected With ACA

TUESDAY, Jan. 28, 2014 (HealthDay News) -- With the influx of newly insured patients under the Affordable Care Act, physician practices should be prepared to spend even more time verifying coverage, according to an article published Jan. 2 in Medical Economics.

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Framework Established to Promote Safety of Care

TUESDAY, Jan. 28, 2014 (HealthDay News) -- A framework has been established to advance clinical learning environments that promote change in the quality and safety of care, according to a perspective piece published online Jan. 27 in the New England Journal of Medicine.

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Case Series Describes Critical Illness Linked to MERS-CoV

TUESDAY, Jan. 28, 2014 (HealthDay News) -- Patients with critical illness associated with Middle East respiratory syndrome coronavirus (MERS-CoV) present with acute severe hypoxemic respiratory failure and most have extrapulmonary manifestations, according to research published online Jan. 28 in the Annals of Internal Medicine.

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CDC: Health Care Providers Shouldn't Rely on Rapid Flu Tests

MONDAY, Jan. 27, 2014 (HealthDay News) -- Doctors should not rely entirely on rapid flu tests when determining if patients have the flu, U.S. health officials say.

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Top Ten Physician Challenges of 2014 Discussed

MONDAY, Jan. 27, 2014 (HealthDay News) -- The top ten challenges for physicians in 2014 relate to payment for medical services and government mandates, as well as adapting to a changing patient population and the need to improve work-life balance, according to an article published Dec. 25 in Medical Economics.

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Writing a Blog Can Up a Doc's Visibility

FRIDAY, Jan. 24, 2014 (HealthDay News) -- Blogs can be a valuable tool to promote physician practices, according to an article published Dec. 17 in Medical Economics.

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Off-Hours Myocardial Infarction More Likely to Be Fatal

FRIDAY, Jan. 24, 2014 (HealthDay News) -- Off-hour presentation is linked with poorer outcomes in patients with acute myocardial infarction (MI), according to research published online Jan. 21 in BMJ.

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Volume of Trauma Care Affects Geriatric Trauma Outcomes

FRIDAY, Jan. 24, 2014 (HealthDay News) -- For geriatric trauma patients, larger volumes of geriatric trauma care are associated with improved outcomes, according to a study published online Jan. 22 in JAMA Surgery.

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Editorial Discusses Ultrasound in Point-of-Care Diagnostics

FRIDAY, Jan. 24, 2014 (HealthDay News) -- Ultrasound devices represent an important point-of-care diagnostic modality, which is increasingly being used in numerous specialties, according to an editorial published in the December issue of Global Heart.

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Medical Staff Performance Goals Should Be Clear, Attainable

THURSDAY, Jan. 23, 2014 (HealthDay News) -- Staff performance in medical practices needs to be appropriately managed and measured with performance goals, according to an article published Dec. 25 in Medical Economics.

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Woman's Death Highlights Danger of Overlooking Dengue

THURSDAY, Jan. 23, 2014 (HealthDay News) -- The case of a Texas woman who died after becoming infected in New Mexico with the mosquito-borne dengue virus highlights a need for U.S. doctors to recognize the disease early, experts say. This is the third locally acquired dengue-related death in the United States, according to a report published in the Jan. 24 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Results of Safety Efforts for Hospitalized Patients Are Mixed

THURSDAY, Jan. 23, 2014 (HealthDay News) -- Based on Medicare data for 2005 through 2011, adverse-event rates declined for patients hospitalized for some conditions, but not others, according to research published in the Jan. 23 issue of the New England Journal of Medicine.

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Legitimacy of Publishing Pharma-Funded Research Queried

WEDNESDAY, Jan. 22, 2014 (HealthDay News) -- The question of whether to stop publishing research funded by the drug industry is addressed in a head-to-head piece published online Jan. 15 in BMJ.

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Some Medical Schools Offering Accelerated Training

WEDNESDAY, Jan. 22, 2014 (HealthDay News) -- Some medical schools are offering an accelerated three-year program, according to a report from Kaiser Health News.

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Kidney Injury Not Uncommon After Cardiovascular Intervention

WEDNESDAY, Jan. 22, 2014 (HealthDay News) -- Acute kidney injury (AKI) is seen in about 7 percent of patients undergoing percutaneous coronary intervention (PCI) and is associated with significant in-hospital mortality, according to research published in the Jan. 1 issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

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Interhospital Transfer Less Likely for Uninsured Patients

WEDNESDAY, Jan. 22, 2014 (HealthDay News) -- Uninsured patients are significantly less likely than insured patients to be transferred between hospitals, according to research published in the Jan. 21 issue of the Annals of Internal Medicine.

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Researchers Examine FDA Decision Making Processes

TUESDAY, Jan. 21, 2014 (HealthDay News) -- The rationale behind the decision making processes of the U.S. Food and Drug Administration is discussed in three articles published in the Jan. 22/29 issue of the Journal of the American Medical Association.

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ACA Impact on Primary Practice May Depend on Location

TUESDAY, Jan. 21, 2014 (HealthDay News) -- The impact of Medicaid expansion under the Affordable Care Act (ACA) on physicians' primary care practices will vary geographically, according to an article published Dec. 25 in Medical Economics.

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Survey IDs Factors Influencing Physician Job Satisfaction

TUESDAY, Jan. 21, 2014 (HealthDay News) -- Believing that they are delivering high-quality patient care is key to physician job satisfaction, according to an article published Dec. 10 in Medical Economics.

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Multiple Medications Increase Odds of Hospital Admission

TUESDAY, Jan. 21, 2014 (HealthDay News) -- The likelihood of unplanned admission is increased with polypharmacy, but the association is modified by the number of long-term conditions, according to a study published online Jan. 16 in the British Journal of Clinical Pharmacology.

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Firearm Access in Home Ups Suicide, Homicide Risk

TUESDAY, Jan. 21, 2014 (HealthDay News) -- Access to firearms is associated with increased risk for suicide and homicide, according to a systematic review and meta-analysis published in the Jan. 21 issue of the Annals of Internal Medicine.

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Medication Synchronization Program Ups Adherence

TUESDAY, Jan. 21, 2014 (HealthDay News) -- A community pharmacy-based medication synchronization program can improve medication adherence, according to a study conducted by the National Community Pharmacists Association (NCPA).

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Doctor Urges Colleagues to Disclose Conflicts of Interest

MONDAY, Jan. 20, 2014 (HealthDay News) -- A campaign to encourage physicians to disclose potential conflicts of interest has sparked ire from doctors despite evidence that openness improves the doctor-patient relationship, according to a personal view piece published online Jan. 15 in BMJ.

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Statin Use Linked to Reduced Delirium in ICU Patients

MONDAY, Jan. 20, 2014 (HealthDay News) -- For critically ill patients in the intensive care unit (ICU), statin use is associated with a reduced risk of delirium, according to a study published online Jan. 17 in the American Journal of Respiratory and Critical Care Medicine.

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Traumatic Brain Injury Linked to Premature Death, Suicide

FRIDAY, Jan. 17, 2014 (HealthDay News) -- Traumatic brain injury (TBI) is associated with a higher risk of premature death, especially from suicide, injuries, and assaults, according to a study published online Jan. 15 in JAMA Psychiatry.

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State Insurance Marketplaces Boost Outreach Efforts

THURSDAY, Jan. 16, 2014 (HealthDay News) -- Health insurance exchanges in five states with strong enrollment growth are ramping up efforts to reach even more uninsured Americans before the end of the Affordable Care Act's open enrollment period on March 31. The March 31 deadline is for people who want health coverage for 2014.

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Reliable Emotion Words ID'd to Assess Patient Experience

THURSDAY, Jan. 16, 2014 (HealthDay News) -- A reliable set of emotion words have been identified that can serve as a tool for experience-based design questionnaires in health care, according to a study published in the December issue of Healthcare.

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'Eyeball Test' Is Poor Estimate of Cardiac Surgical Risk

THURSDAY, Jan. 16, 2014 (HealthDay News) -- Compared with subjective physician estimates, statistical risk estimates are more accurate for predicting operative and long-term mortality in patients undergoing cardiac surgery, according to research published online Jan. 14 in Circulation: Cardiovascular Quality and Outcomes.

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Survey Results Identify Drivers of Doctor Engagement

THURSDAY, Jan. 16, 2014 (HealthDay News) -- The results of a survey from the Physician Wellness Services and Cejka Search have identified the key aspects of doctor engagement.

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NCPA: Access to Controlled Substances Often Delayed

THURSDAY, Jan. 16, 2014 (HealthDay News) -- Most pharmacists report experiencing multiple delays or issues with their controlled substance orders, according to the results of the National Community Pharmacists Association (NCPA) Controlled Substances Access Survey.

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FDA Warns Against Rx With High Levels of Acetaminophen

WEDNESDAY, Jan. 15, 2014 (HealthDay News) -- The U.S. Food and Drug Administration is recommending that physicians stop prescribing and dispensing prescription combination drug products containing more than 325 mg of acetaminophen per tablet, according to a safety alert issued by the agency.

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More Than Two Million People Have Signed Up for ACA Coverage

TUESDAY, Jan. 14, 2014 (HealthDay News) -- Nearly 2.2 million Americans had selected health plans through the federal and state marketplaces as of late December, and nearly one in four was a young adult, the Obama administration disclosed Monday.

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Wednesday Is Deadline for Feb. 1 Coverage Under ACA

TUESDAY, Jan. 14, 2014 (HealthDay News) -- There's still time to enroll in a health insurance plan through one of the Affordable Care Act's new online marketplaces. Those who sign up by Wednesday will have coverage starting next month.

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CMS: New Rule Proposed for Contract Year 2015

MONDAY, Jan. 13, 2014 (HealthDay News) -- A proposed rule has been issued that will strengthen protections, improve health care quality, and reduce costs for Medicare beneficiaries with private Medicare Advantage and Part D prescription plans, according to a report from the Centers for Medicare & Medicaid Services (CMS).

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Survey: Fees, Reimbursement Top Physician Worries

FRIDAY, Jan. 10, 2014 (HealthDay News) -- The results of a new survey show that physicians are concerned about declining reimbursements and increasing administrative hassles, including negotiating with payers, obtaining prior authorizations, and cutting through government red tape, according to an article published Nov. 25 in Medical Economics.

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High Uric Acid Level Linked to Coronary Stent Restenosis

FRIDAY, Jan. 10, 2014 (HealthDay News) -- A high level of serum uric acid prior to implantation of bare-metal coronary stents predicts stent restenosis, according to research published in the Jan. 15 issue of The American Journal of Cardiology.

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EHR Use Linked to Doc-Reported Enhanced Patient Care

FRIDAY, Jan. 10, 2014 (HealthDay News) -- Use of electronic health records is associated with enhanced patient care overall, according to a study published online Dec. 21 in Health Services Research.

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CMS: Low Growth for National Health Expenditures in 2012

FRIDAY, Jan. 10, 2014 (HealthDay News) -- Overall national health expenditures were marked by a fourth consecutive year of low growth, according to a report from the Centers for Medicare & Medicaid Services.

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Female Conveners Up Number of Women at Scientific Symposia

FRIDAY, Jan. 10, 2014 (HealthDay News) -- Having at least one woman on teams that convene scientific symposia increases the proportion of invited female speakers by 72 percent, compared with teams containing all men, according to a study published online Jan. 7 in mBio.

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ACP Introduces Free 'High Value Care' Case Studies

FRIDAY, Jan. 10, 2014 (HealthDay News) -- In an effort to improve health care and eliminate wasteful practices, the American College of Physicians (ACP) has developed a series of High Value Care cases studies, available online for free.

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No Benefit for Tight Glycemic Control in Critically Ill Children

THURSDAY, Jan. 9, 2014 (HealthDay News) -- Tight glycemic control in critically ill children using intravenous insulin results in similar clinical outcomes as conventional glycemic control, but with a higher risk of hypoglycemia, according to a study published in the Jan. 9 issue of the New England Journal of Medicine.

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Smoking Rates Still Low for Most Health Care Professionals

WEDNESDAY, Jan. 8, 2014 (HealthDay News) -- Compared with 2006 to 2007, smoking rates among health care professionals for 2010 to 2011 continue to be lowest in physicians and highest in licensed practical nurses (LPNs), according to a research letter published in the Jan. 8 issue of the Journal of the American Medical Association, a theme issue on tobacco control.

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AMA Urges Med Students to Be Agents of Health Care Change

TUESDAY, Jan. 7, 2014 (HealthDay News) -- Medical students are being encouraged to be agents of change in the health care system, according to a report from the American Medical Association (AMA).

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Post-Op Health Care Costs Up for Former, Current Smokers

TUESDAY, Jan. 7, 2014 (HealthDay News) -- Health care costs in the year following discharge for an inpatient surgical procedure are increased for former and current smokers, compared with never smokers, although there are no differences with smoking status in costs for the index hospitalization, according to a study published online Jan. 1 in JAMA Surgery.

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Non-White Physicians Provide Disproportionate Minority Care

MONDAY, Jan. 6, 2014 (HealthDay News) -- Non-white physicians provide a disproportionate share of care to underserved populations, according to a research letter published online Dec. 30 in JAMA Internal Medicine.

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CDC Addresses Burden, Threat of Antibiotic Resistance

MONDAY, Jan. 6, 2014 (HealthDay News) -- The burden and threats posed by antibiotic resistance infections are discussed in a report published by the U.S. Centers for Disease Control and Prevention.

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Unrestricted Hospital Visiting Hours Up Patient Satisfaction

MONDAY, Jan. 6, 2014 (HealthDay News) -- Open visitation improves the patient and family experience and does not cause interference for hospital staff, according to research published in the Journal for Healthcare Quality.

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AMA Details Top Five Federal Issues for 2014

MONDAY, Jan. 6, 2014 (HealthDay News) -- Implementation of the Affordable Care Act, the repeal of Medicare's failed sustained growth formula, and the proposed roll-out of the International Classification of Diseases, Version 10, top the list of federal issues expected to impact physicians and patients in 2014, according to a viewpoint piece published online Dec. 30 by the American Medical Association (AMA).

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Over 100 New Accountable Care Organizations Formed

FRIDAY, Jan. 3, 2014 (HealthDay News) -- One hundred twenty-three new Accountable Care Organizations (ACOs) have been formed by doctors, hospitals, and other health care providers, which will provide access to high-quality coordinated care for about 1.5 million Medicare beneficiaries, according to a report from the U.S. Department of Health and Human Services.

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Warfarin Initiation Negatively Linked to Stroke in A-Fib Patients

FRIDAY, Jan. 3, 2014 (HealthDay News) -- Patients with atrial fibrillation are at higher risk of having a stroke in the first month after initiating treatment with the anti-clotting drug warfarin, according to a study published online Dec. 18 in European Heart Journal.

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Poor Sleep, Fatigue Linked to Clinical-Decision Regret in Nurses

FRIDAY, Jan. 3, 2014 (HealthDay News) -- Among critical care nurses, clinical-decision regret is associated with sleep disturbances and the resulting fatigue, according to a study published in the January issue of the American Journal of Critical Care.

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Impact of Transitions in Doctors' Careers Discussed

THURSDAY, Jan. 2, 2014 (HealthDay News) -- Transitions and their associated challenges are encountered throughout a doctors' medical career, according to an editorial published online Nov. 26 in BMJ.

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Worsening of Shortage of Residency Slots Feared

THURSDAY, Jan. 2, 2014 (HealthDay News) -- Despite a looming physician shortage, the number of residency positions in the United States has not changed since 1996, creating a bottleneck that will become worse with further budget cuts, according to a blog post published Dec. 7 on KevinMD.com.

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CDC: Updated Guidance for HBV Vaccination for Health Workers

THURSDAY, Jan. 2, 2014 (HealthDay News) -- Health care personnel should be vaccinated against hepatitis B virus (HBV) if they anticipate exposure to blood or body fluids, and receive serologic testing to assess for antibody against the virus, according to updated guidelines published in the Dec. 20 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Isotonic Fluids Safer for Pediatric Maintenance IV Therapy

THURSDAY, Jan. 2, 2014 (HealthDay News) -- For children requiring maintenance intravenous (IV) fluids, isotonic fluids are safer than hypotonic fluids in terms of plasma sodium (pNa) levels, according to a meta-analysis published online Dec. 30 in Pediatrics.

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C. difficile Is Carried on Hands of Health Care Workers

THURSDAY, Jan. 2, 2014 (HealthDay News) -- After routine care of patients infected with Clostridium difficile, C. difficile spores were detected on the hands of about a quarter of health care workers (HCWs), according to research published in the January issue of Infection Control and Hospital Epidemiology.

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Docs Have Until Jan. 31 to Change Medicare Status

THURSDAY, Jan. 2, 2014 (HealthDay News) -- The deadline for making changes to Medicare participation status has been extended to Jan. 31, 2014, according to a report from the American Medical Association (AMA).

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