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September 2015 Briefing - Critical Care

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

CDC: Injuries Cost $671 Billion in the United States in 2013

WEDNESDAY, Sept. 30, 2015 (HealthDay News) -- Injuries from accidents and violence cost the United States $671 billion in 2013, with men accounting for far more of those costs than women, federal health officials reported Wednesday. The findings were published in the Oct. 2 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Angioedema Induced by New Classes of Drugs

WEDNESDAY, Sept. 30, 2015 (HealthDay News) -- Two newer classes of drugs, dipeptidyl peptidase IV (DPP IV) and neprilysin inhibitors, can induce angioedema, according to research published in the October issue of Allergy.

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Negative Spiritual Belief Linked to Worse Health Outcomes

WEDNESDAY, Sept. 30, 2015 (HealthDay News) -- Any degree of negative spiritual belief is associated with worse health outcomes, regardless of positive spiritual beliefs, according to a study published in the Journal of Spirituality in Mental Health.

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Intermediate Care Billing Rose From 1996 to 2010

MONDAY, Sept. 28, 2015 (HealthDay News) -- From 1996 to 2010 there was a significant increase in intermediate care billing, according to a study published online Sept. 15 in the American Journal of Respiratory and Critical Care Medicine.

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Subtypes of Delirium Linked to Shorter Survival in Terminally Ill

MONDAY, Sept. 28, 2015 (HealthDay News) -- For terminally ill patients, hypoactive and mixed subtypes of delirium are associated with shorter survival periods, according to a study published online Sept. 18 in Psychosomatic Medicine.

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Low D-Dimer Cut-Off Appears to Help Prevent Recurrent Events

FRIDAY, Sept. 25, 2015 (HealthDay News) -- Low cut-off levels used in the D-Dimer-Ultrasonography in Combination Italian Study (DULCIS) resulted in half the recurrent venous thromboembolism (VTE) events that would have occurred using other criteria in young patients at high risk, according to research published online Sept. 12 in the International Journal of Laboratory Hematology.

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Subclavian Vein Catheterization Beats Jugular, Femoral Placement

THURSDAY, Sept. 24, 2015 (HealthDay News) -- For patients in intensive care units who need a catheter, placement in the subclavian vein appears to lower the risk of bloodstream infection and deep-vein thrombosis, compared to jugular or femoral placement, a new study finds. The report was published in the Sept. 24 issue of the New England Journal of Medicine.

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Health Insurance Deductibles Rising Faster Than Wages

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- Health insurance deductibles have risen more than six times faster than American workers' average wages since 2010, a Kaiser Family Foundation report says.

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ICU for Pneumonia in Elderly Ups Survival, Not Costs

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- Admitting older, low-risk patients with pneumonia to the intensive care unit (ICU) -- compared with admission to regular wards -- is linked with higher survival rates but not higher medical expenses, new research suggests. The study was published in the Sept. 22/29 issue of the Journal of the American Medical Association.

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IOM: Most U.S. Patients Will Experience Diagnostic Error

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- A new report commissioned by the U.S. government contends that most Americans will encounter at least one diagnostic error in their lifetime, sometimes with severe consequences for their physical and mental health.

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DNR Orders After In-Hospital Cardiac Arrest Tied to Survival

TUESDAY, Sept. 22, 2015 (HealthDay News) -- For patients who receive successful resuscitation from in-hospital cardiac arrest, do-not-resuscitate (DNR) orders are generally associated with likelihood of favorable neurological survival, according to a study published in the Sept. 22/29 issue of the Journal of the American Medical Association.

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Medical Schools Teaching Students About Costs of Care

TUESDAY, Sept. 22, 2015 (HealthDay News) -- Many medical schools are integrating discussions of cost, value, and effectiveness into their curricula, according to Kaiser Health News.

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Lower Beta-Blocker Dose May Boost Survival After MI

TUESDAY, Sept. 22, 2015 (HealthDay News) -- Patients treated with low-dose beta-blockers after myocardial infarction may fare better than those given the standard dose, according to a study published in the Sept. 29 issue of the Journal of the American College of Cardiology.

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Harms From Unnecessary Abx Extend Beyond Resistance

TUESDAY, Sept. 22, 2015 (HealthDay News) -- Use of antibiotics in patients with heart failure exacerbation in the absence of compelling evidence of infection is unnecessary and potentially harmful, according to teachable moment piece published online Sept. 21 in JAMA Internal Medicine.

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Docs in Productivity Models Likely to Encounter Compensation Caps

MONDAY, Sept. 21, 2015 (HealthDay News) -- Physicians, especially those working in a productivity model, need to understand compensation caps, which are set at a specific percentile of national pay based on surveys, according to a report in Medical Economics.

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Medicaid, Non-Home Discharge Tied to Longer Hospital Stays

MONDAY, Sept. 21, 2015 (HealthDay News) -- Prolonged hospital length of stay (LOS) is more likely among patients who are Medicaid enrollees with complex hospital stays who were not discharged home, according to a study published in the September issue of the Journal of Hospital Medicine.

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Volunteer Doctors Need to Check Liability Coverage

FRIDAY, Sept. 18, 2015 (HealthDay News) -- Physicians who volunteer their medical expertise should consider their legal risks, according to an article published online Sept. 3 in Medical Economics.

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Mid-Morning May Be Best Time for Workday Break

FRIDAY, Sept. 18, 2015 (HealthDay News) -- Choosing preferred activities for a work break and taking a break earlier in the shift are linked to more resource recovery after a break, according to a study published online Aug. 10 in the Journal of Applied Psychology.

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Energy Drinks Plus Alcohol Tied to Brain Injury in Teens

FRIDAY, Sept. 18, 2015 (HealthDay News) -- The consumption of energy drinks and alcohol mixed with energy drinks increases the odds of traumatic brain injury (TBI) among adolescents, according to a study published Sept. 16 in PLOS ONE.

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Panel Develops Criteria for Appropriate Use of PICCs

THURSDAY, Sept. 17, 2015 (HealthDay News) -- An expert panel has developed the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC), according to research published in the Sept. 15 issue of the Annals of Internal Medicine.

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Complex Chronic Diseases Appear to Drive Frequent Admissions

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- Patients who are frequently admitted to U.S. academic medical centers are significantly more likely than other patients to have multiple complex chronic conditions, according to a study published in the September issue of the Journal of Hospital Medicine.

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Women Less Likely to Be Full Professors Than Men

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- In academic medicine, women are less likely to be full professors than men and have less startup funding than men, according to two studies published in the Sept. 15 issue of JAMA.

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Beta-Blockers Don't Mar Acute Variceal Bleeding Prognosis

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- For cirrhotic patients with acute variceal bleeding (AVB), being on non-selective beta-blockers (NSBB) is not a negative prognostic factor for short-term survival, according to a study published online Sept. 4 in Hepatology.

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California State Assembly Approves Right-to-Die Bill

FRIDAY, Sept. 11, 2015 (HealthDay News) -- The California State Assembly approved a bill on Wednesday that would allow doctors to prescribe life-ending medications to patients expected to die within six months.

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Physician Re-Entry Program Set to Redress Physician Shortage

THURSDAY, Sept. 10, 2015 (HealthDay News) -- An online educational program aims to help physicians get back to work and reduce the nation's physician shortage, according to an article published by the American Academy of Family Physicians (AAFP).

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4% Increase in Population of Actively Licensed Physicians

THURSDAY, Sept. 10, 2015 (HealthDay News) -- The total population of actively licensed physicians in the United States and the District of Columbia has increased by 4 percent since 2012, according to a report published in the Journal of Medical Regulation.

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Post-Op Delirium Diminishes Recovery in Older Patients

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- Patients with delirium following major surgery are more likely to have worse outcomes, including lower quality of life, disability, or even death, according to a study published online Sept. 9 in JAMA Surgery.

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Accelerated MD Program Doesn't Mar Academic Performance

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- An accelerated baccalaureate (BA)/doctor of medicine (MD) program does not impair the academic performance of medical students, according to a study published online July 3 in Academic Medicine.

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EHR Vendors Not Adhering to Usability Certification Standards

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- Among electronic health record (EHR) products, there is a lack of adherence to the U.S. Department of Health and Human Services' Office of the National Coordinator for Health Information Technology (ONC) standards, according to a research letter published in the Sept. 8 issue of the Journal of the American Medical Association.

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CHADS2 Best Predictor of Postoperative Mortality Risk

FRIDAY, Sept. 4, 2015 (HealthDay News) -- The CHADS2 atrial fibrillation (AF) risk score is the best predictor of postoperative stroke or death regardless of type of surgery, according to a study published online Aug. 13 in the Journal of Thrombosis and Haemostasis.

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Suggested Response Provided for In-Flight Medical Emergencies

FRIDAY, Sept. 4, 2015 (HealthDay News) -- In a review article published online Sept. 3 in the New England Journal of Medicine, guidance is offered for physicians providing emergency in-flight medical care.

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Fewer Repeat Hemorrhagic Strokes With Better BP Control

WEDNESDAY, Sept. 2, 2015 (HealthDay News) -- Survivors of intracerebral hemorrhage may be at higher risk for recurrence if their blood pressure (BP) isn't under control, a new study warns. The findings were published in the Sept. 1 issue of the Journal of the American Medical Association.

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Critical Care Docs Rarely Discuss Religion With Patients, Families

TUESDAY, Sept. 1, 2015 (HealthDay News) -- Religion or spirituality is important to many people nearing the end of life, but intensive care clinicians rarely talk to patients or their families about those beliefs, according to a study published online Aug. 31 in JAMA Internal Medicine.

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