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January 2018 Briefing – Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for January 2018. 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.

Regulators Trying to Reduce Physician Burden Linked to EHR

MONDAY, Jan. 29, 2018 (HealthDay News) — The Office of the National Coordinator for Health Information Technology (ONC) is trying to address some of the issues relating to physician electronic health record (EHR) burden, partly with the appointment of Don Rucker, M.D., who is skilled in informatics and board-certified in emergency and internal medicine, according to an article published in Medical Economics.

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Pharmacist Education May Cut Junior Doctor Prescription Errors

MONDAY, Jan. 29, 2018 (HealthDay News) — Pharmacist feedback and education is effective at reducing prescription writing errors by junior doctors in an inpatient setting, according to a study published online Jan. 24 in the Journal of Pharmacy Practice and Research.

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Health Care Spending Up, Mainly Due to Rising Prices

MONDAY, Jan. 29, 2018 (HealthDay News) — Americans under age 65 years who were insured through their employer spent more than ever before on health care in 2016, with faster spending growth in 2016 than in recent years, according to the Health Care Cost Institute (HCCI)’s annual Health Care Cost and Utilization Report.

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Most ICU Patient Alarms Not Clinically Accurate or Relevant

MONDAY, Jan. 29, 2018 (HealthDay News) — Most intensive care unit (ICU) patient monitoring alarms are not clinically accurate or relevant, according to a review published in the January issue of the American Journal of Critical Care.

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Heart Disease, Stroke Risk Up Even Smoking 1 Cigarette/Day

THURSDAY, Jan. 25, 2018 (HealthDay News) — Smoking one cigarette per day is still associated with a significant increased risk of coronary heart disease and stroke, according to research published online Jan. 24 in The BMJ.

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Influenza, Some Viral URIs Increase Risk of Acute MI

WEDNESDAY, Jan. 24, 2018 (HealthDay News) — Certain respiratory infections, especially influenza, are associated with an increased risk of acute myocardial infarction during the first seven days after respiratory specimen collection, according to a study published in the Jan. 25 issue of the New England Journal of Medicine.

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In-Hospital Cardiac Arrest Survival Differs With Time of Day

WEDNESDAY, Jan. 24, 2018 (HealthDay News) — Survival after in-hospital cardiac arrest (IHCA) that occurs during off-hours remains lower versus on-hours IHCA, according to a study published in the Jan. 30 issue of the Journal of the American College of Cardiology.

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Diabetes Tied to Higher Rates of Serious Infection

TUESDAY, Jan. 23, 2018 (HealthDay News) — Patients with diabetes, particularly type 1 diabetes mellitus (T1DM), are at increased risk of serious infection, according to a study published online Jan. 12 in Diabetes Care.

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Out-of-Pocket Expenditures Down With ACA Implementation

TUESDAY, Jan. 23, 2018 (HealthDay News) — Implementation of the Affordable Care Act (ACA) was associated with reduced out-of-pocket spending, although increases were noted in mean premium spending, according to a study published online Jan. 22 in JAMA Internal Medicine.

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Pharmacist Participation in Stroke Response Cuts Door➜Needle Time

FRIDAY, Jan. 19, 2018 (HealthDay News) — Having a pharmacist at bedside during acute ischemic stroke is associated with significantly shorter door-to-needle (DTN) times, according to a study published recently in the Annals of Pharmacotherapy.

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Professionals Disagree About Asking Patients About Sexuality

THURSDAY, Jan. 18, 2018 (HealthDay News) — National Health Service (NHS) England recently recommended that professionals ask all patients their sexual orientation at every opportunity, although opinions are divided on whether this is appropriate, according to an article published online Jan. 17 in The BMJ.

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USPSTF: Evidence Lacking for Nontraditional CVD Risk Factors

TUESDAY, Jan. 16, 2018 (HealthDay News) — The U.S. Preventive Services Task Force (USPSTF) has concluded that current evidence is insufficient to assess the use of nontraditional risk factors for cardiovascular disease (CVD) risk assessment. They also conclude that evidence is lacking for the use of the ankle-brachial index (ABI) to screen for peripheral arterial disease (PAD) in asymptomatic individuals. These findings form the basis of two draft recommendation statements published online Jan. 16 by the USPSTF.

Evidence Review – CVD

Draft Recommendation Statement – CVD

Comment on Recommendation Statement – CVD

Evidence Review – PAD

Draft Recommendation Statement – PAD

Comment on Recommendation Statement – PAD

Spontaneous Pharynx Perforation After Forceful or Stifled Sneeze

TUESDAY, Jan. 16, 2018 (HealthDay News) — Spontaneous pharyngeal perforation can occur after a forceful sneeze, according to a case report published online Jan. 15 in BMJ Case Reports.

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Increased Risk of Thrombosis in Myeloproliferative Neoplasms

TUESDAY, Jan. 16, 2018 (HealthDay News) — Patients with myeloproliferative neoplasms (MPNs) have increased risk of arterial thrombosis and venous thrombosis across all age groups and MPN subtypes, according to a study published online Jan. 16 in the Annals of Internal Medicine.

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Non-Ventilator Hospital-Acquired Pneumonia Risk Affects All Ages

FRIDAY, Jan. 12, 2018 (HealthDay News) — Non-ventilator hospital-acquired pneumonia (NV-HAP) is a significant burden in U.S. acute care hospitals and poses a risk to nonelderly, non-intensive unit (ICU) patients, according to research published in the January issue of the American Journal of Infection Control.

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Serial Intralesional Steroids May Improve Tracheal Stenosis Sx

FRIDAY, Jan. 12, 2018 (HealthDay News) — For adults with subglottic and proximal tracheal stenosis (SGS/PTS), serial in-office intralesional steroid injection (ISI) after endoscopic dilation is associated with a prolonged surgery-free interval (SFI), according to a study published online Jan. 11 in JAMA Otolaryngology-Head & Neck Surgery.

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Considerable Economic Burden for Asthma in United States

FRIDAY, Jan. 12, 2018 (HealthDay News) — Asthma places a considerable economic burden on the United States, with a total cost of $81.9 billion in 2013, according to a study published online Jan. 12 in the Annals of the American Thoracic Society.

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Progress in Fighting Antibiotic Resistance Shown in CDC Map

THURSDAY, Jan. 11, 2018 (HealthDay News) — The U.S. Centers for Disease Control and Prevention has released new data in its Antibiotic Resistance Investment Map, which shows states’ progress in combating antibiotic resistance.

Press Release

AMA Online Tools Address Systems-Level Physician Burnout

THURSDAY, Jan. 11, 2018 (HealthDay News) — Tools and resources have been developed to help address physician burnout at the systems level, which may affect more than half of doctors, according to a report published by the American Medical Association (AMA).

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Closure of Patent Foramen Ovale Cuts Recurrent Stroke/TIA Risk

THURSDAY, Jan. 11, 2018 (HealthDay News) — Percutaneous and transcatheter patent foramen ovale (PFO) closure prevent recurrent stroke in adults with PFO and cryptogenic stroke, according to two reviews published online Jan. 9 in the Annals of Internal Medicine.

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Neurodevelopment Not Impacted by Glucocorticoids in Preemies

WEDNESDAY, Jan. 10, 2018 (HealthDay News) — Use of inhaled glucocorticoids in extremely preterm infants for the prevention of bronchopulmonary dysplasia does not lead to a higher rate of neurodevelopmental disability at 2 years, according to a study published in the Jan. 11 issue of the New England Journal of Medicine.

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Economic Impact of Physicians Quantified for 2015

WEDNESDAY, Jan. 10, 2018 (HealthDay News) — Physicians have a large economic impact across the nation, creating an aggregate of $2.3 trillion of economic activity and supporting employment of nearly 12.6 million Americans, according to a report published by the American Medical Association.

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ICU RN Job Dissatisfaction, Burnout Linked to Moral Distress

TUESDAY, Jan. 9, 2018 (HealthDay News) — Job satisfaction and practice environment are associated with moral distress among critical care nurses, according to a study published online Jan. 3 in the American Journal of Critical Care.

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Intense End-of-Life Care Found to Be Less Likely for VA Patients

TUESDAY, Jan. 9, 2018 (HealthDay News) — Higher-intensity end-of-life care may be driven by financial incentives present in fee-for-service Medicare but not in the Veteran Affairs (VA) integrated system, according to a report published in the January issue of Health Affairs.

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Idiopathic Thrombocytopenic Purpura Tied to Higher CVD Risk

MONDAY, Jan. 8, 2018 (HealthDay News) — There is an increased risk of developing cardiovascular disease (CVD) among patients with idiopathic thrombocytopenic purpura (ITP), especially those who undergo splenectomy, according to a study published online Jan. 3 in the Journal of Thrombosis and Haemostasis.

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Kidney Injury Common After Non-Kidney Transplants in Children

MONDAY, Jan. 8, 2018 (HealthDay News) — In children who receive a non-kidney solid organ transplant, acute kidney injury (AKI) is common in the first year after surgery and is associated with an increased risk of chronic kidney disease (CKD), according to a study published online Dec. 29 in the American Journal of Transplantation.

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CV Exercise Betters Cardiac Aging in Sedentary Middle-Aged Adults

MONDAY, Jan. 8, 2018 (HealthDay News) — Two years of high-intensity exercise training (ExT) is associated with improved maximal oxygen uptake and reduced cardiac stiffness in previously sedentary healthy middle-aged adults, according to a study published online Jan. 8 in Circulation.

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Repeated Flu Vaccinations Help Prevent Severe Infection

MONDAY, Jan. 8, 2018 (HealthDay News) — Vaccination for influenza for multiple seasons is twice as effective in preventing severe influenza — compared with non-severe influenza — in older patients admitted to hospital, according to a study published in the Jan. 8 issue of CMAJ, the journal of the Canadian Medical Association.

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Physicians Frequently Continue to Work While Ill

FRIDAY, Jan. 5, 2018 (HealthDay News) — Many physicians continue working and caring for patients while they are sick, according to an article published in Medical Economics.

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For Hospitals, No Benefit for Early Adoption of Financial Incentives

FRIDAY, Jan. 5, 2018 (HealthDay News) — Hospitals that volunteered to be under financial incentives for more than a decade as part of the Premier Hospital Quality Incentive Demonstration (early adopters) do not have better process scores or lower mortality than hospitals where these incentives were implemented later under the Hospital Value-Based Purchasing program (late adopters), according to a study published online Jan. 4 in The BMJ.

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Impaired Survival With LVEF <60 Percent in Aortic Stenosis

THURSDAY, Jan. 4, 2018 (HealthDay News) — For patients with severe aortic stenosis (AS), left ventricular ejection fraction (LVEF) below 60 percent is associated with impaired survival, according to a study published online Dec. 27 in JACC: Cardiovascular Interventions.

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Certain Stresses, Burnout Causing Some Women to Leave Medicine

THURSDAY, Jan. 4, 2018 (HealthDay News) — Though equal numbers of men and women are now entering medical schools, the majority of physicians are still male, and female physicians face several unique stressors, according to a report published online in Medical Economics.

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Low Rates of Major Complications After Bariatric Surgery

THURSDAY, Jan. 4, 2018 (HealthDay News) — The rates of three major complications at less than 30 days after bariatric surgery are low and vary among surgical procedures, according to research published online Dec. 20 in Obesity Reviews.

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CVD Risk Up With β2-Agonist, Antimuscarinic Antagonist Start

THURSDAY, Jan. 4, 2018 (HealthDay News) — For patients with chronic obstructive pulmonary disease (COPD), new initiation of inhaled long-acting β2-agonists (LABAs) and long-acting antimuscarinic antagonists (LAMAs) is associated with increased risk of cardiovascular disease (CVD), according to a study published online Jan. 2 in JAMA Internal Medicine.

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Herpes Simplex Infrequently Found in Infant Meningitis Eval

WEDNESDAY, Jan. 3, 2017 (HealthDay News) — Young infants assessed for central nervous system (CNS) infection rarely have herpes simplex virus (HSV), according to a study published online Jan. 3 in Pediatrics.

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Nurses’ Experience of Compassion Impacts Delivery of Care

WEDNESDAY, Jan. 3, 2018 (HealthDay News) — Critical care nurses’ experiences of compassion satisfaction and compassion fatigue influence their ability to deliver patient-centered care, according to a study published online Dec. 21 in the Journal of Clinical Nursing.

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Silent Myocardial Infarction Linked to Heart Failure Risk

WEDNESDAY, Jan. 3, 2018 (HealthDay News) — Silent myocardial infarction (SMI) is associated with an increased long-term risk of heart failure, according to a study published in the Jan. 2 issue of the Journal of the American College of Cardiology.

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Higher Risk of Musculoskeletal Disorders in Some Physicians

WEDNESDAY, Jan. 3, 2018 (HealthDay News) — The prevalence of work-related musculoskeletal disorders (MSDs) appears to be high for at-risk physicians, according to a review published online Dec. 27 in JAMA Surgery.

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Dasiglucagon Well Tolerated for Severe Hypoglycemia

WEDNESDAY, Jan. 3, 2018 (HealthDay News) — Dasiglucagon is well tolerated and is associated with an early pharmacodynamic response similar to that of GlucaGen for severe hypoglycemia, according to a study published online Dec. 22 in Diabetes Care.

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Broader Statin Use Improves Atherosclerotic CVD Prevention

TUESDAY, Jan. 2, 2018 (HealthDay News) — Guidelines that recommend statins for more people for primary prevention of atherosclerosis are likely to prevent more atherosclerotic cardiovascular disease (ASCVD) events than guidelines that recommend fewer people take statins, according to a study published online Jan. 1 in the Annals of Internal Medicine.

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Increase Seen in Gabapentinoid Use From 2002 to 2015

TUESDAY, Jan. 2, 2018 (HealthDay News) — From 2002 to 2015 there was a substantial increase in gabapentinoid use, according to a research letter published online Jan. 2 in JAMA Internal Medicine.

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Fractional Exhaled NO Moderately Accurate to Diagnose Asthma

TUESDAY, Jan. 2, 2018 (HealthDay News) — Fractional exhaled nitric oxide (FeNO) measurement can diagnose asthma in individuals aged 5 years and older with moderate accuracy, according to a review published online Dec. 20 in Mayo Clinic Proceedings.

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Outcome Scores Predict Discharge Destination Post Stroke

TUESDAY, Jan. 2, 2018 (HealthDay News) — For patients with acute or subacute stroke, outcome measure scores are associated with discharge destination, according to a review published in the January issue of the Journal of Neurologic Physical Therapy.

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Same-Day, Low-Dose Bowel Prep Feasible for Colonoscopy

TUESDAY, Jan. 2, 2018 (HealthDay News) — A same-day, low-dose, 1-liter polyethylene glycol-based (1L-PEG) bowel preparation can achieve similar bowel cleansing to split-dose 4L-PEG bowel preparation in select high-risk patients before colonoscopy, according to a study published online Dec. 21 in the Journal of Digestive Diseases.

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