December 2017 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for December 2017. 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.

Survival Down With Ventricular Arrhythmia Early Post CF-LVAD

TUESDAY, Dec. 26, 2017 (HealthDay News) -- For patients post contemporary continuous flow left ventricular assist device (CF-LVAD) implantation, early ventricular arrhythmias (VAs) are associated with significantly reduced survival, according to a study published online Dec. 20 in JACC: Clinical Electrophysiology.

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Plasma Volume Changes May Mediate Effects of Empagliflozin

TUESDAY, Dec. 26, 2017 (HealthDay News) -- The reduction in risk of cardiovascular (CV) death with empagliflozin is most mediated by changes in hematocrit and hemoglobin, according to research published online Dec. 4 in Diabetes Care.

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Gender Differences Seen in Mental Stress-Induced Ischemia

THURSDAY, Dec. 21, 2017 (HealthDay News) -- Men and women have different cardiovascular reactivity mechanisms for mental stress-induced myocardial ischemia (MSIMI), according to a study published online Dec. 21 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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CDC: 2015 to 2016 Saw Drop in Life Expectancy in United States

THURSDAY, Dec. 21, 2017 (HealthDay News) -- From 2015 to 2016, life expectancy decreased by one-tenth of a year, and there was an increase in the rate of age-adjusted drug overdose deaths, according to two December data briefs published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Cancer Probability Documentation Lacking for Some at High Risk

THURSDAY, Dec. 21, 2017 (HealthDay News) -- For patients with high-risk indeterminate pulmonary nodes (IPNs), physicians rarely provide quantitative documentation of cancer probability, according to a study published online Dec. 20 in JAMA Surgery.

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Medicare Costs Associated With Mortality Rates in AMI Patients

WEDNESDAY, Dec. 20, 2017 (HealthDay News) -- For patients hospitalized with acute myocardial infarction, Medicare expenditure growth is associated with reduced 180-day case fatality, according to a study published online Dec. 20 in JAMA Cardiology.

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Cisatracurium Ups Some ARDS Outcomes Versus Vecuronium

WEDNESDAY, Dec. 20, 2017 (HealthDay News) -- Among patients with acute respiratory distress syndrome (ARDS), cisatracurium does not improve mortality versus vecuronium but is associated with improvements in other outcomes, according to a study published online in the American Journal of Respiratory and Critical Care Medicine.

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Self-Reported Symptoms in Elderly Predict Readmission

WEDNESDAY, Dec. 20, 2017 (HealthDay News) -- Post-discharge symptoms self-reported by frail, elderly adults may predict 30-day hospital readmission and emergency department visits, according to a study published online Dec. 12 in the Journal of the American Geriatrics Society.

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Switching Dual Antiplatelet Therapy Beneficial After ACS

WEDNESDAY, Dec. 20, 2017 (HealthDay News) -- Switching dual antiplatelet therapy (DAPT) from aspirin plus ticagrelor or prasugrel to aspirin plus clopidogrel after acute coronary syndrome (ACS) provides benefits regardless of initial platelet reactivity, according to a study published in the Dec. 26 issue of JACC: Cardiovascular Interventions.

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Two Cases of Progressive Cutaneous Anthrax Described

TUESDAY, Dec. 19, 2017 (HealthDay News) -- Two cases of cutaneous anthrax which started on the right forearm and progressed are described in a case report published online Dec. 12 in the International Journal of Dermatology.

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Intensive BP Goals Reduce Risk of Cardiovascular Events

TUESDAY, Dec. 19, 2017 (HealthDay News) -- Intensive blood pressure lowering may similarly decrease cardiovascular events in both patients with and patients without type 2 diabetes mellitus, according to a study published online Dec. 6 in Diabetes Care.

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Rx Discrepancies Common in Hospital Discharge Summaries

TUESDAY, Dec. 19, 2017 (HealthDay News) -- For older patients discharged from a regional hospital, there are frequently discrepancies between the electronic discharge summaries and the National Inpatient Medication Chart (NIMC) or discharge prescription, according to a study published online Dec. 13 in the Journal of Pharmacy Practice and Research.

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STEMI Patient Perceptions Impact Emergency Medical Services Use

TUESDAY, Dec. 19, 2017 (HealthDay News) -- ST-elevation myocardial infarction (STEMI) patient perceptions, including those involving the speed of transport and concerns about resource misuse, are an important factor in determining emergency medical services (EMS) use, according to a study published online Dec. 13 in the Journal of Evaluation in Clinical Practice.

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Gingko Biloba Extract Found Effective in Acute Ischemic Stroke

TUESDAY, Dec. 19, 2017 (HealthDay News) -- For acute ischemic stroke, Ginkgo biloba extract (GBE) in combination with aspirin alleviates cognitive and neurological deficits, according to a study published online Dec. 18 in Stroke and Vascular Neurology.

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Equation Predicts Risk of End-Stage Renal Disease in Children

MONDAY, Dec. 18, 2017 (HealthDay News) -- The kidney failure risk equation (KFRE) is a simple tool that provides excellent discrimination of the risk of end-stage renal disease (ESRD) in children with chronic kidney disease (CKD), according to a study published online Dec. 18 in JAMA Pediatrics.

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Male U.S. Doctors Receive Higher Values of Industry Payments

MONDAY, Dec. 18, 2017 (HealthDay News) -- Male physicians in the United States received higher values of general payments from industry than females in 2015, according to a research letter published online Dec. 18 in JAMA Internal Medicine.

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Emergency-Only Hemodialysis Linked to Worse Outcomes

MONDAY, Dec. 18, 2017 (HealthDay News) -- Emergency-only hemodialysis treatment is associated with increased mortality compared with standard hemodialysis for undocumented immigrants with end-stage renal disease, according to a study published online Dec. 18 in JAMA Internal Medicine.

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Year One Results Out for Value-Based Payment Modifier Program

MONDAY, Dec. 18, 2017 (HealthDay News) -- Almost 30 percent of eligible practices failed to register and report data in the first year of the Physician Value-Based Payment Modifier program, according to a report published in the December issue of Health Affairs.

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Doctors Must Report on at Least 1 Patient, 1 Measure for MACRA

FRIDAY, Dec. 15, 2017 (HealthDay News) -- In order to meet the 2017 Medicare and CHIP Reauthorization Act (MACRA) participation reporting deadline and avoid a Medicare payment penalty in 2019, physicians must report on at least one patient and one measure by Dec. 31, and submit to Medicare no later than Feb. 28, 2018, according to a report from the American Medical Association (AMA).

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Functional Limitations Ongoing With Congenital Zika

FRIDAY, Dec. 15, 2017 (HealthDay News) -- Severe functional limitations are reported among children with microcephaly and laboratory evidence of Zika virus infection in infancy, according to research published in the Dec. 15 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Flu Vaccine Expected to Protect Against Most U.S. H3N2 Viruses

FRIDAY, Dec. 15, 2017 (HealthDay News) -- A novel bioinformatics approach can predict vaccine effectiveness for the influenza season, and indicates that the current vaccines are likely to be effective against H3N2 flu viruses in the U.S. 2017/2018 flu season, according to research published online Nov. 29 in F1000 Research.

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Making Insurers Participate in Marketplace Could Cut Volatility

THURSDAY, Dec. 14, 2017 (HealthDay News) -- Requiring insurers that participate in Medicare or Medicaid to also participate in Marketplaces in the same geographic area could improve access to insurance, according to a study published in the December issue of Health Affairs.

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Serial hsTnT Level IDs Risk of 30-Day Adverse Cardiac Event

WEDNESDAY, Dec. 13, 2017 (HealthDay News) -- High-sensitivity troponin (hsTnT) assay can identify patients presenting with suspected acute coronary syndrome at very low risk for 30-day adverse cardiac events (ACE), according to a study published online Dec. 13 in JAMA Cardiology.

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Amount of Opioids Prescribed After Hospital Discharge Varies

WEDNESDAY, Dec. 13, 2017 (HealthDay News) -- For postoperative patients there is considerable variation in the amount of opioids prescribed at hospital discharge, according to research published online Dec. 13 in JAMA Surgery.

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C. Difficile + Kidney Injury Admissions Are Up

WEDNESDAY, Dec. 13, 2017 (HealthDay News) -- Hospital admissions of patients with Clostridium difficile infection (CDI) and accompanying acute kidney injury (AKI) are increasing, according to a study published online Dec. 4 in the Journal of Gastroenterology and Hepatology.

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In-Hospital Deaths in A-Fib Patients Higher in Rural Areas

MONDAY, Dec. 11, 2017 (HealthDay News) -- In-hospital mortality among patients with atrial fibrillation (AF) is higher in rural hospitals than in urban hospitals, according to a study published online Dec. 11 in Heart Rhythm.

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Deceleration in Health Care Spending Growth in 2016

MONDAY, Dec. 11, 2017 (HealthDay News) -- Health care spending growth slowed in 2016 following faster growth in 2014 and 2015, according to research published online Dec. 6 in Health Affairs.

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Influenza Picking Up in U.S., Predominantly A(H3N2)

FRIDAY, Dec. 8, 2017 (HealthDay News) -- Influenza activity was low during October 2017 but started increasing in November, with influenza A, predominantly A(H3N2), most commonly identified, according to research published in the Dec. 8 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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In CAD With GI Bleeding, Higher Mortality With Triple Therapy

WEDNESDAY, Dec. 6, 2017 (HealthDay News) -- For patients with lower gastrointestinal bleeding (LGIB) and coronary artery disease (CAD), triple therapy is associated with increased risk of mortality at 90 days after adjustment for confounding variables, according to a study published online Nov. 20 in the Journal of Gastroenterology and Hepatology.

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30-Day Mortality No Different for Treatment by Locum Tenens

TUESDAY, Dec. 5, 2017 (HealthDay News) -- Overall 30-day mortality does not differ for patients treated by locum tenens and non-locum tenens internal medicine physicians, according to a study published in the Dec. 5 issue of the Journal of the American Medical Association.

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CVS-Aetna Merger Has Implications for Doctors' Offices

TUESDAY, Dec. 5, 2017 (HealthDay News) -- CVS Health's planned purchase of insurance giant Aetna, a $69 billion deal, was announced Sunday.

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Specialty Care Tied to Reduced Mortality in New-Onset A-Fib

MONDAY, Dec. 4, 2017 (HealthDay News) -- Cardiologist care is associated with a lower rate of death in patients with new-onset atrial fibrillation (AF), according to a study published in the December issue of the Canadian Journal of Cardiology.

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