November 2014 Briefing - Critical Care

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

Health Care Organizations See Value of Telemedicine

WEDNESDAY, Nov. 26, 2014 (HealthDay News) -- Health care organizations are developing and implementing telemedicine programs, although many have yet to receive reimbursement, according to a report published by Foley & Lardner.

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More Advanced Emergency Care May Be Worse in Cardiac Arrest

TUESDAY, Nov. 25, 2014 (HealthDay News) -- Advanced life support given by paramedics to cardiac arrest victims may cost lives rather than save them, while the best treatment might just be good cardiopulmonary resuscitation given by paramedics or emergency medical technicians and getting the patient to the hospital as fast as possible. These findings were published online Nov. 24 in JAMA Internal Medicine.

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Special Ambulance Delivers Vital Stroke Care More Quickly

MONDAY, Nov. 24, 2014 (HealthDay News) -- Stroke outcomes are better when patients are treated in an ambulance by a neurologist equipped with a computed tomography scanner and tissue plasminogen activator (tPA), according to a report published online Nov. 17 in JAMA Neurology.

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In Reperfusion Era, β-Blockers Have No Mortality Benefit in MI

MONDAY, Nov. 24, 2014 (HealthDay News) -- In the reperfusion era, β-blocker use has no mortality benefit in myocardial infarction, and patients discharged with high heart rate after myocardial infarction have increased mortality risk during the first year, according to research published in the October issue of The American Journal of Medicine.

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AMA: Gender Inequality Still Exists in Medicine

FRIDAY, Nov. 21, 2014 (HealthDay News) -- Gender inequality still exists in medicine, according to an article published by the American Medical Association (AMA).

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Early Nasoenteric Tube Feeding Doesn't Benefit Acute Pancreatitis

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- For patients with acute pancreatitis at high risk of complications, early nasoenteric tube feeding does not improve outcomes compared with an oral diet after 72 hours, according to a study published in the Nov. 20 issue of the New England Journal of Medicine.

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Low Medication Persistence for Older STEMI Patients

FRIDAY, Nov. 14, 2014 (HealthDay News) -- For older patients with non-ST-segment elevation myocardial infarction, evidence-based medication (EBM) persistence is similar after discharge from academic and nonacademic hospitals, according to a study published in the Nov. 15 issue of The American Journal of Cardiology.

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Fluid, Electrolyte Replacement Successful in Two Cases of EVD

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Aggressive fluid and electrolyte replacement successfully improved the condition of two patients with Ebola virus disease (EVD), according to case reports published online Nov. 12 in the New England Journal of Medicine.

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NICU Infants Exposed to High Levels of DEHP in Medical Care

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Premature infants in the neonatal intensive care unit (NICU) may be exposed to levels of di(2-ethylhexyl)phthalate (DEHP) that are 4,000 to 160,000 times higher than what is considered safe, according to a study published online Nov. 13 in the Journal of Perinatology.

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Triple Aim Should Be Expanded to Address Physician Burnout

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Expanding the Triple Aim approach -- which includes enhancing patient experience, improving population health, and reducing costs -- to the Quadruple Aim by adding the goal of improving health care provider work life is recommended, according to the authors of an article published in the November/December issue of the Annals of Family Medicine.

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Hospital Workers Wash Hands Less at End of Shift

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Health workers in hospitals wash their hands less often as they near the end of their shift, and this lapse -- likely due to mental fatigue -- could contribute to hundreds of thousands of patient infections a year in the United States, according to a study published online Nov. 3 in the Journal of Applied Psychology.

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U.S. Prices Soaring for Some Generic Drugs

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Market forces are dramatically driving up the cost of some generic drugs, prompting U.S. investigations into the pricing of what should be cheap alternatives to brand-name medications.

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Cancer Patients in Hospice Face Less Aggressive Treatment

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Cancer patients who choose hospice care are less likely to receive aggressive end-of-life treatment or to die in hospitals and nursing homes, according to research published in the Nov. 12 issue of the Journal of the American Medical Association.

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Pain, Depression Tied to Delirium Risk Post-Surgery

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Pain and depression before an operation may increase seniors' risk for delirium after surgery, according to a study published in the November issue of The Lancet Psychiatry.

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Cardiac Prognosis Bright for STEMI Survivors Post-PCI

TUESDAY, Nov. 11, 2014 (HealthDay News) -- Patients who survive the first month after an ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) have <1.5 percent annual risk of successive cardiac death; however, they still have an increased risk of death from noncardiac causes. These findings were published in the Nov. 18 issue of the Journal of the American College of Cardiology.

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Guideline Developed for Prophylactic Platelet Transfusion

MONDAY, Nov. 10, 2014 (HealthDay News) -- Recommendations have been developed by the AABB (formerly the American Association of Blood Banks) for prophylactic platelet transfusion. The clinical practice guideline was published online Nov. 11 in the Annals of Internal Medicine.

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CDC Spends $2.7 Million on Ebola Hospital Kits

FRIDAY, Nov. 7, 2014 (HealthDay News) -- About $2.7 million in personal protective gear has been ordered for health care workers at U.S. hospitals treating Ebola patients, the federal Centers for Disease Control and Prevention said Friday.

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Bed Position Matters in Care After Acute Ischemic Stroke

FRIDAY, Nov. 7, 2014 (HealthDay News) -- Hospital bed positioning can be critical in the first 24 hours after a person suffers an ischemic stroke, according to a report published recently in MedLink Neurology.

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Want to Be a Leader? Cultivate a Healthy Look

FRIDAY, Nov. 7, 2014 (HealthDay News) -- It's more important for potential business or political leaders to look healthy than intelligent, according to a study published online Nov. 5 in Frontiers in Human Neuroscience.

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Better Physician Communication at Shift Change Reduces Errors

FRIDAY, Nov. 7, 2014 (HealthDay News) -- Changing how doctors communicate during shift changes in hospitals reduces the risk of adverse events in patients by 30 percent, according to a study published in the Nov. 6 issue of the New England Journal of Medicine.

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Docs Spend ~16.6 Percent of Their Time on Administration

FRIDAY, Nov. 7, 2014 (HealthDay News) -- About 16.6 percent of doctors' working hours are spent on administrative work, according to a study published recently in the International Journal of Health Services.

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ACOG Issues Guidance for Care of Pregnant Women With Ebola

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Guidelines have been developed for the care of pregnant women at risk of or with suspected Ebola virus disease (EVD), according to a practice advisory published online Nov. 3 by the American College of Obstetricians and Gynecologists (ACOG).

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Hospitalizations for Pulmonary Embolism Vary by Season

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Hospitalizations for pulmonary embolism (PE) are higher in the winter and lower in the summer, according to a study published online Oct. 31 in the Journal of Thrombosis and Homeostasis.

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Walking Program Feasible, Safe for Older Adults in Hospital

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- A clinical demonstration program of supervised walking for older adults admitted to the hospital is feasible and safe, and its participants are more often discharged directly to home, according to a study published online Oct. 30 in the Journal of the American Geriatrics Society.

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Hospital MRSA Traced to U.K. Livestock

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- A strain of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals can be traced back to livestock, and the strain's resistance to antibiotics is likely due to the widespread use of antibiotics on farms, according to a study published in the December issue of Applied and Environmental Microbiology.

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Even Early Signs of Plaque in Arteries Signal Heart Risk

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Even the earlier signs of coronary artery disease significantly increase the risk of myocardial infarction (MI) and early death, according to a new study published in the Nov. 5 issue of the Journal of the American Medical Association.

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Ambulance Use With MI Tied to Higher Mortality

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Using an ambulance for hospital transport of patients with ST-segment elevation myocardial infarction (MI) is associated with higher mortality, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

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AMA: New Mapping Tool IDs Areas in Need of Physicians

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- A new interactive mapping tool can help physicians and their staff determine locations to establish or expand their practice, according to a report published by the American Medical Association (AMA).

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Atrial Fibrillation May Double Risk for 'Silent Strokes'

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Atrial fibrillation (AF) may more than double the risk of silent cerebral infarction (SCI), a new review suggests. The report was published in the Nov. 4 issue of the Annals of Internal Medicine.

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Many Americans May Get Hospice Care Too Late

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Of the more than 1.5 million patients who received hospice care in the United States in 2013, one-third died within one week, according to a new report from the National Hospice and Palliative Care Organization.

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Long-Term Shift Work May Drain the Brain

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Working non-standard hours -- "shift work" -- for many years is not only hard on the body, but may also dull the mind, new research suggests. According to the study, published online Nov. 3 in Occupational & Environmental Medicine, those who do shift work for more than 10 years seem to have the equivalent of an extra 6.5 years of age-related decline in memory and thinking skills.

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End-of-Life Care Discussions May Miss Patient Priorities

MONDAY, Nov. 3, 2014 (HealthDay News) -- Important points are often missed when doctors have end-of-life discussions with patients and their families, according to a study published online Nov. 3 in CMAJ, the journal of the Canadian Medical Association.

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Risk of Major Bleeds Up for Dabigatran Versus Warfarin

MONDAY, Nov. 3, 2014 (HealthDay News) -- Dabigatran (Pradaxa) is associated with higher risks of major bleeding and gastrointestinal bleeding compared with warfarin. However, patients taking dabigatran also have a reduced risk of intracranial bleeding compared with those taking warfarin, according to new research published online Nov. 3 in JAMA Internal Medicine.

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Ebola Elimination Possible With Early Patient Isolation

MONDAY, Nov. 3, 2014 (HealthDay News) -- Isolation of patients with Ebola in critical condition within days of symptom onset is likely to have a high chance of eliminating the disease, according to a study published online Oct. 28 in the Annals of Internal Medicine.

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AMA: Absence of Health Insurer Competition in Many Areas

MONDAY, Nov. 3, 2014 (HealthDay News) -- In most metropolitan areas, there is a significant absence of health insurer competition, according to a report published by the American Medical Association (AMA).

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Resilience Training Could Help Prevent Burnout in ICU Nurses

MONDAY, Nov. 3, 2014 (HealthDay News) -- A multimodal resilience training program is feasible and acceptable for intensive care unit (ICU) nurses, according to a study published in the November issue of the American Journal of Critical Care.

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