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September 2014 Briefing - Critical Care

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

β-Blockers Equivalent in Long QT Syndrome Genotype 1

TUESDAY, Sept. 30, 2014 (HealthDay News) -- For patients with long QT syndrome (LQTS), different β-blockers are effective for reducing the risk for first cardiac event in LQT1, but only nadolol is effective in LQT2, according to a study published in the Sept. 30 issue of the Journal of the American College of Cardiology.

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American Academy of Neurology Issues Opioid Guidelines

TUESDAY, Sept. 30, 2014 (HealthDay News) -- The risks of opioids outweigh their benefits for treating chronic noncancer pain such as chronic headaches, low back pain, and fibromyalgia, according to a new statement from the American Academy of Neurology (AAN).

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40 States, District of Columbia Reporting Enterovirus D68

TUESDAY, Sept. 30, 2014 (HealthDay News) -- Forty states and the District of Columbia now have a total of 277 confirmed cases of Enterovirus D68, the severe respiratory illness that typically targets children, U.S. health officials are reporting.

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AHA: Consider Radiation Risks of Heart Imaging Procedures

TUESDAY, Sept. 30, 2014 (HealthDay News) -- Doctors need to make sure patients understand the radiation-related risks of heart imaging tests before sending them for such procedures, a new American Heart Association scientific statement says. The statement was published online Sept. 29 in Circulation.

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FDA Criticized Over Implanted Medical Device Approval Process

TUESDAY, Sept. 30, 2014 (HealthDay News) -- Patients are receiving medical implants that may not have been rigorously tested before or after their approval by the U.S. Food and Drug Administration, two new studies contend. The findings were published online Sept. 29 in JAMA Internal Medicine.

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'Just-in-Time' Methodology Can Reduce Patient Waiting Times

MONDAY, Sept. 29, 2014 (HealthDay News) -- Having trainee physicians review cases prior to clinic hours can reduce patient waiting times, flow times, and clinic session times, according to a study published online Sept. 16 in Pain Medicine. The management process studied was first popularized by Toyota in Japan.

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AMA Launches Three Programs for Physician Wellness

MONDAY, Sept. 29, 2014 (HealthDay News) -- Physicians' personal health is a global concern and three initiatives are being developed to encourage positive change, according to a report from the American Medical Association (AMA).

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NIH Funds Study of Malpractice Risk, Cardiac Testing Incentives

FRIDAY, Sept. 26, 2014 (HealthDay News) -- The National Institutes of Health has granted $2 million to study the effect of malpractice risk and financial incentives on cardiac testing.

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Experiences Trump Things, Even Before Purchase

FRIDAY, Sept. 26, 2014 (HealthDay News) -- People derive value from the anticipation of purchasing something, and this anticipation tends to be greater for an experiential purchase than for a material purchase, according to a study published online Aug. 21 in Psychological Science.

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Depression Linked to Worse Bypass Grafting Outcomes

FRIDAY, Sept. 26, 2014 (HealthDay News) -- For patients with established ischemic heart disease undergoing coronary artery bypass grafting (CABG), depression is associated with increased mortality and poor cardiovascular outcomes, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Can Media Multitasking Alter Your Brain?

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Multitasking with smartphones, laptop computers, and other media devices could change the structure of your brain, according to a study published online Sept. 24 in PLOS ONE.

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NSAIDs Tied to Risk of Venous Thromboembolism

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Use of nonsteroidal anti-inflammatory drugs (NSAIDs) may increase risk of venous thromboembolism (VTE), according to new research published online Sept. 24 in Rheumatology.

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Blood Test Might Predict Speed of Recovery From Surgery

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Measuring the activity of subsets of white blood cells immediately after surgery might reveal which patients are likely to recover quickly and those who won't, a preliminary study suggests. The report was published in the Sept. 24 issue of Science Translational Medicine.

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More HIV+ Patients Undergoing Spinal Fusion

THURSDAY, Sept. 25, 2014 (HealthDay News) -- More HIV-positive patients are undergoing spinal fusions, and these patients have higher rates of complications resulting from the procedures, according to a study published in the Sept. 15 issue of Spine.

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Kidney Disease Doesn't Bar Thrombolytic Therapy in Stroke

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Intravenous (IV) thrombolytic therapy for acute ischemic stroke (IS) is not contraindicated in patients with chronic kidney disease (CKD), according to research published online Sept. 23 in Circulation: Cardiovascular Quality and Outcomes.

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New Clinical Guidelines Developed for NSTE-ACS

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- New guidelines for management of patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) have been developed and published online Sept. 23 in Circulation.

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Report Identifies Game Changers for U.S. Health Care

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- Imagine if doctors and hospitals got paid for providing better care, not more care, and patients had better data for making informed health choices. A new report suggests that's the direction the U.S. health system is headed.

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Clinical Practice Guideline Issued for Comorbid Conditions in CVD

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- Comorbid conditions must be considered when applying clinical practice guidelines to the treatment of cardiovascular disease, according to an article published online Sept. 11 in the Journal of the American College of Cardiology.

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Most Doctors Are Over-Extended or at Full Capacity

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- Most physicians report being over-extended or at full capacity, according to a survey conducted by Merritt Hawkins for The Physicians Foundation.

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FDA Warns Doctors of Danger From 'Fake' Drugs

TUESDAY, Sept. 23, 2014 (HealthDay News) -- The number of "rogue" wholesale distributors selling fake or unapproved prescription drugs is growing, so doctors need to be vigilant when purchasing medicines, the U.S. Food and Drug Administration warned Tuesday.

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CDC: Ebola Cases Could Reach 1.4 Million in Months

TUESDAY, Sept. 23, 2014 (HealthDay News) -- Infections from the Ebola epidemic in Liberia and Sierra Leone could soar to 1.4 million cases by mid-January unless the global community mounts a rapid response to the West African crisis. This prediction is part of a new report published in the Sept. 23 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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FDA: Blood Test for Yeast Pathogens Approved

TUESDAY, Sept. 23, 2014 (HealthDay News) -- The first blood test to detect five yeast pathogens that can cause blood infections in people with weakened immune systems has been approved by the U.S. Food and Drug Administration. The five yeast pathogens are Candida albicans and/or Candida tropicalis, Candida parapsilosis, Candida glabrata and/or Candida krusei.

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Breast Milk a Risk for Spreading Cytomegalovirus to Preemies

TUESDAY, Sept. 23, 2014 (HealthDay News) -- For babies born at very low birth weights, breast milk is more likely than a blood transfusion to lead to cytomegalovirus (CMV) infection, according to a study published online Sept. 22 in JAMA Pediatrics.

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Statins May Improve Hemorrhagic Stroke Outcomes

TUESDAY, Sept. 23, 2014 (HealthDay News) -- Patients taking statin medication while in the hospital for a hemorrhagic stroke are more than four times more likely to survive than people who aren't taking the drugs, according to a new study. The findings were published online Sept. 22 in JAMA Neurology.

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Ebola Cases Predicted to Continue Increasing

TUESDAY, Sept. 23, 2014 (HealthDay News) -- Based on data from the first nine months of the Ebola virus disease (EVD) epidemic, the numbers of cases are predicted to continue increasing, according to a study published online Sept. 23 in the New England Journal of Medicine.

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NIH Adds $10M to Encourage Gender Balance in Clinical Trials

TUESDAY, Sept. 23, 2014 (HealthDay News) -- The U.S. National Institutes of Health is investing $10 million in additional funding in scientific trials to encourage researchers to consider gender in their preclinical and clinical studies.

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Reduction of Overuse of Non-ICU Cardiac Telemetry Feasible

TUESDAY, Sept. 23, 2014 (HealthDay News) -- Efforts to reduce overuse of non-intensive care unit (ICU) cardiac telemetry correlate with reductions in telemetry use and considerable cost savings, according to a research letter published online Sept. 22 in JAMA Internal Medicine.

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Chikungunya Fever Identified in the United States

TUESDAY, Sept. 23, 2014 (HealthDay News) -- Chikungunya fever is being seen in travelers returning to the United States from affected regions and should be considered as a diagnosis for febrile travelers, according to an ideas and opinions piece published online Sept. 23 in the Annals of Internal Medicine.

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Newborn ICUs With Private Family Rooms Benefit Preemies

MONDAY, Sept. 22, 2014 (HealthDay News) -- Preemies may fare better when newborn intensive care units (NICUs) set up private rooms for parents to spend time with their infants, according to research published online Sept. 22 in Pediatrics.

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Redundant Antimicrobial Therapy Is Pervasive, Costly

MONDAY, Sept. 22, 2014 (HealthDay News) -- Redundant use of antimicrobial therapy is pervasive in U.S. hospitals and is associated with considerable, potentially avoidable, health care costs, according to a study published in the October issue of Infection Control and Hospital Epidemiology.

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Systemwide Changes Needed to Restrain Health Care Spending

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Systemwide changes are necessary to prevent excessive health care spending, and so are tools to help consumers make better, more informed medical choices, according to a white paper published in June by Vitals.

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Vitamin K Antagonist + Clopidogrel Feasible for PCI

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Vitamin K antagonists (VKA) combined with clopidogrel may be a better alternative to triple anticoagulant therapy in patients on long-term VKA undergoing percutaneous coronary intervention (PCI) and stenting, according to a review published in the Sept. 23 issue of the Journal of the American College of Cardiology.

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Presence of Peers Ups Health Workers' Hand Hygiene

FRIDAY, Sept. 19, 2014 (HealthDay News) -- The presence of other health care workers improves hand hygiene adherence, according to a study published in the October issue of Infection Control and Hospital Epidemiology.

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Electronic Health Records Tied to Shorter Time in ER

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Length of emergency room stay for trauma patients is shorter with the use of electronic health records, according to a study published in the September issue of the Journal of Emergency Nursing.

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Study Explores Docs' Roles in End-of-Life Hospitalizations

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Family physicians have several distinct roles in preventing and guiding hospitalization at the end of life, according to a study published in the September/October issue of the Annals of Family Medicine.

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Obama Calls for National Plan to Fight Antibiotic Resistance

FRIDAY, Sept. 19, 2014 (HealthDay News) -- President Barack Obama escalated the fight against antibiotic-resistant bacteria on Thursday, ordering key federal agencies to pursue a national strategy to deal with the threat.

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CDC: Almost Everyone Needs a Flu Shot

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Less than half of all Americans got a flu shot last year, so U.S. health officials on Thursday urged that everyone 6 months and older get vaccinated for the coming flu season. "It's really unfortunate that half of Americans are not getting the protection from flu they could get," said Thomas Frieden, M.D., director of the U.S. Centers for Disease Control and Prevention, during a morning news conference.

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Strategies Can Help Docs Lower Their Tax Burden

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Strategies are presented to help physicians lower their tax burden in an article published Sept. 2 in Medical Economics.

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High Mortality, Costs With C. difficile After Spine Surgery

THURSDAY, Sept. 18, 2014 (HealthDay News) -- For patients undergoing lumbar spine surgery, Clostridium difficile (C. difficile) infection is associated with longer, more expensive hospital stays, and increased mortality, according to a study published in the Sept. 1 issue of Spine.

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Insulin Rx Tied to Increased Major Adverse CV Events in DM

THURSDAY, Sept. 18, 2014 (HealthDay News) -- The rate of major adverse cardiovascular events is higher in patients with diabetes mellitus (DM) and multivessel coronary artery disease treated with insulin (ITDM) versus those not treated with insulin (non-ITDM), according to a study published in the Sept. 23 issue of the Journal of the American College of Cardiology.

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ER Timeliness to Be Improved but Some Measures May Backfire

THURSDAY, Sept. 18, 2014 (HealthDay News) -- While there is room for improvement in the timeliness of emergency department care, pressure to comply with length of stay (LOS) measures may have unintended consequences, according to two research letters published online Sept. 15 in JAMA Internal Medicine.

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Internists Report Considerable EMR-Linked Time Loss

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Use of electronic medical record (EMR) systems is associated with considerable loss of free time per clinic day, according to a research letter published online Sept. 8 in JAMA Internal Medicine.

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Researchers ID Factor in Hospital Bacterial Resistance

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Scientists have uncovered a key factor to explain why antibiotic-resistant bacteria can thrive in a hospital setting. These findings have published in the Sept. 17 issue of Science Translational Medicine.

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Long-Term Benefits Lacking for Magnesium Sulfate in Preemies

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Although magnesium sulfate is routinely given to pregnant women at risk for very preterm delivery, new research suggests it won't provide any long-term benefits for infants. The new findings were published in the Sept. 17 issue of the Journal of the American Medical Association.

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Doctors Promoting Transparency With Patients

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Efforts to increase transparency among doctors are underway, according to an article published in The Boston Globe.

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Most Treatments for Acute VTE Appear Safe, Effective

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Almost all the various treatment options for acute venous thromboembolism are equally safe and effective, according to research published in the Sept. 17 issue of the Journal of the American Medical Association.

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Obama to Step Up Aid to Fight Ebola in West Africa

TUESDAY, Sept. 16, 2014 (HealthDay News) -- On the same day that President Barack Obama was to announce a significant increase in U.S. aid to help combat West Africa's Ebola crisis, the World Health Organization warned Tuesday that the window to contain the virus was closing and infections could start doubling every three weeks.

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Over a Quarter of Hospital Orders Classified As Defensive

TUESDAY, Sept. 16, 2014 (HealthDay News) -- More than one-quarter of hospital medicine services were rated by ordering physicians as at least a partially defensive order, according to a research letter published online Sept. 15 in JAMA Internal Medicine.

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Unsupervised Prescription Drug Intake Sends Many Children to ER

MONDAY, Sept. 15, 2014 (HealthDay News) -- From 2007 to 2011, there were nearly 10,000 emergency hospitalizations per year for unsupervised prescription medication ingestion by young children, according to a study published online Sept. 15 in Pediatrics.

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INR Variability Predicts Warfarin Adverse Effects

MONDAY, Sept. 15, 2014 (HealthDay News) -- Unstable anticoagulation predicts warfarin adverse effects regardless of time in therapeutic range, according to a study published online Sept. 2 in Circulation: Cardiovascular Quality and Outcomes.

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New Role of Patient As Consumer Requires Market Changes

FRIDAY, Sept. 12, 2014 (HealthDay News) -- The new consumer retail market in U.S. health care is necessary and will benefit consumers, and as consumers take on more costs of care, access to information to help them make informed decisions is crucial, according to a recent white paper published by Vitals.

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Errata Frequently Seen in Medical Literature

MONDAY, Sept. 15, 2014 (HealthDay News) -- Errata, including those that may materially change the interpretation of data, are frequent in medical publications, according to a study published in the August issue of The American Journal of Medicine.

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Poverty Tied to Increased Respiratory Hospitalization Rate

FRIDAY, Sept. 12, 2014 (HealthDay News) -- Household income is tied to significant differences in hospitalizations for ambulatory-care-sensitive respiratory conditions, according to a study published in the September/October issue of the Annals of Family Medicine.

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Highly Sensitive Troponin Test IDs Asymptomatic Heart Damage

FRIDAY, Sept. 12, 2014 (HealthDay News) -- A high-sensitivity cardiac troponin T (hs-cTnT) test may be helpful in identifying early heart damage, eventually standing alongside cholesterol tests as a standard screening tool for heart disease risk, according to researchers who presented their study findings online Aug. 22 in Circulation.

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U.S. Ebola Survivor Gives Blood to Infected Health Care Colleague

FRIDAY, Sept. 12, 2014 (HealthDay News) -- An American medical missionary who survived infection with Ebola has donated blood to a colleague who's struggling to fight his own infection with the virus.

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Researchers Support Lung Cancer CT Screen in Older Patients

FRIDAY, Sept. 12, 2014 (HealthDay News) -- Individuals aged 65 to 74 years with a history of smoking should not be excluded from screening with low-dose computed tomography (LDCT) for lung cancer, according to researchers who published their study findings online Sept. 9 in the Annals of Internal Medicine.

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Physician Describes Impact of Malpractice Suit

THURSDAY, Sept. 11, 2014 (HealthDay News) -- A family doctor who was involved in a malpractice suit describes the impact on her practice of medicine in an article published online in the September/October issue of the Annals of Family Medicine.

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Ebola-Infected Doctor Showing Improvement in Nebraska

THURSDAY, Sept. 11, 2014 (HealthDay News) -- An American medical missionary being treated at a Nebraska medical center for Ebola infection is showing signs of improvement, according to the hospital.

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Gates Foundation Gives $50M to Fight Ebola Outbreak in Africa

THURSDAY, Sept. 11, 2014 (HealthDay News) -- Acting in response to the devastating Ebola outbreak in four West African nations, the Bill and Melinda Gates Foundation announced Wednesday that it has pledged $50 million to help combat the epidemic.

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Fear About Disease Progression Prompts ER Returns

THURSDAY, Sept. 11, 2014 (HealthDay News) -- Perceived inability to access timely follow-up care and uncertainty and fear about disease progression are the main reasons for return visits to the emergency department, according to a study published online Sept. 2 in the Annals of Emergency Medicine.

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Recommendations Developed for Sickle Cell Disease

WEDNESDAY, Sept. 10, 2014 (HealthDay News) -- Evidence-based recommendations have been developed to support health care professionals who provide care for individuals with sickle cell disease. The summary of the 2014 evidence-based report by expert panel members was published online Sept. 9 in the Journal of the American Medical Association.

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Reanalyses of RCTs Can Lead to Different Conclusions

WEDNESDAY, Sept. 10, 2014 (HealthDay News) -- More than one-third of the small number of reanalyses of randomized clinical trials (RCTs) have implied conclusions different from those of the original articles, according to a study published online Sept. 9 in the Journal of the American Medical Association.

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Meds of Questionable Benefit Often Prescribed to Elderly

TUESDAY, Sept. 9, 2014 (HealthDay News) -- Medications of questionable benefit are often prescribed for patients with advanced dementia, adding substantially to the costs of care, according to research published online Sept. 8 in JAMA Internal Medicine.

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For Some, Health Insurance More Costly Than Uninsured Penalty

TUESDAY, Sept. 9, 2014 (HealthDay News) -- For some young people in the United States, the cost of paying a penalty for not buying health insurance will be lower than the lowest-cost insurance, according to a study published online Sept. 9 in the Annals of Internal Medicine.

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Sleep Not Harmed by Caffeine for Apnea of Prematurity

FRIDAY, Sept. 5, 2014 (HealthDay News) -- Caffeine administered for treatment of apnea in premature infants does not appear to have long-term detrimental effects on sleep during childhood, according to research published online Aug. 29 in the American Journal of Respiratory and Critical Care Medicine.

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MI, CHD Incidence for Adults With Diabetes Decreases

TUESDAY, Sept. 9, 2014 (HealthDay News) -- From 1998 to 2010 there was a decrease in the incidence rates of hospitalized myocardial infarction (MI) and coronary heart disease (CHD) among adults with diabetes mellitus in Western Australia, according to a study published online Aug. 26 in Circulation: Cardiovascular Quality and Outcomes.

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Health Care-Linked Infections Down in Hospitalized Children

MONDAY, Sept. 8, 2014 (HealthDay News) -- From 2007 to 2012 the incidence of health care-associated infections (HAIs) decreased among hospitalized children, according to a study published online Sept. 8 in Pediatrics.

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Sepsis Survival Up at High-Volume Hospitals

MONDAY, Sept. 8, 2014 (HealthDay News) -- Patients with sepsis are more likely to survive this life-threatening bloodstream infection if they're treated in a hospital that handles a large number of sepsis cases, according to research published online Aug. 12 in the American Journal of Respiratory and Critical Care Medicine.

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Health Care Spending Expected to Rise in 2014 Through 2023

MONDAY, Sept. 8, 2014 (HealthDay News) -- While health spending growth was slow in 2013, health spending is expected to increase in 2014 and remain higher through 2023, according to a study published online Sept. 3 in Health Affairs.

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FDA: NephroCheck Test Approved to Predict Kidney Injury Risk

FRIDAY, Sept. 5, 2014 (HealthDay News) -- The NephroCheck test, designed to predict the risk of sudden kidney injury within 12 hours, has been approved by the U.S. Food and Drug Administration.

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Serious Childhood Burns Tied to Long-Term Mental Health Risks

FRIDAY, Sept. 5, 2014 (HealthDay News) -- Adult survivors of childhood burns are at increased risk for depression and suicidal thoughts, according to a new study published in the September issue of Burns.

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Excessive Precautions Unnecessary for Ebola Virus

FRIDAY, Sept. 5, 2014 (HealthDay News) -- Given that Ebola virus is mainly transmitted via contact, excessive precautions, including complete respiratory protection are unnecessary, according to a letter published online Aug. 29 in The Lancet.

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Potential Therapy Targets for Pulmonary Hypertension ID'd

THURSDAY, Sept. 4, 2014 (HealthDay News) -- The high-density lipoprotein mimetic peptide 4F can successfully rescue advanced pulmonary hypertension in rodent models, according to a study published in Circulation.

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British Ebola Patient Released From the Hospital

WEDNESDAY, Sept. 3, 2014 (HealthDay News) -- A British man infected with Ebola during the outbreak in West Africa has fully recovered and been released from the hospital.

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More Global Help Needed to Fight Ebola Outbreak

TUESDAY, Sept. 2, 2014 (HealthDay News) -- As the Ebola outbreak continues to overwhelm health care workers in three West African nations, medical experts from the United States and the United Nations called on Tuesday for a concerted international response to stem history's biggest outbreak of the often-fatal virus.

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