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November 2017 Briefing – Critical Care

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

Severe Hypoglycemia a Potent Marker of Cardiovascular Risk

THURSDAY, Nov. 30, 2017 (HealthDay News) — Among patients with diabetes, severe hypoglycemia is associated with high absolute risk of cardiovascular events and mortality, according to a study published online Nov. 10 in Diabetes Care.

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Wait Time Linked to Worse Outcomes in Hip Fracture Surgery

WEDNESDAY, Nov. 29, 2017 (HealthDay News) — Increased wait time is associated with an increased risk of complications and 30-day mortality among adults undergoing hip fracture surgery, according to a study published in the Nov. 28 issue of the Journal of the American Medical Association.

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1998 to 2014 Saw Drop in CVD Hospitalization Rates in Diabetes

TUESDAY, Nov. 28, 2017 (HealthDay News) — Cardiovascular disease (CVD) hospitalization rates have declined in recent years among individuals with and those without diabetes, according to a study published online Nov. 17 in Diabetes Care.

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Ablation Cuts Risk of Recurrent Stroke in Patients With A-Fib

TUESDAY, Nov. 28, 2017 (HealthDay News) — For patients with atrial fibrillation (AF) and prior cerebrovascular accident (CVA), ablation is associated with reduced risk of recurrent stroke, according to a study published online Nov. 13 in the Journal of Cardiovascular Electrophysiology.

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Similar Efficacy for Intranasal, Intramuscular Naloxone

TUESDAY, Nov. 28, 2017 (HealthDay News) — For reversal of opioid overdose, higher-concentration intranasal naloxone has similar efficacy to that of intramuscular naloxone administered at the same dose, according to a review published online Nov. 27 in the Annals of Internal Medicine.

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Essay Adds to Discourse on Impact of Suggestive Jokes

MONDAY, Nov. 27, 2017 (HealthDay News) — Seemingly benign, recurring patterns of joking around a single theme (joke cycles) can contribute to humorizing and legitimizing sexual misconduct, according to an essay published online Nov. 12 in Communication and Critical/Cultural Studies.

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New Workflows Have Potential to Address Provider Burnout

MONDAY, Nov. 27, 2017 (HealthDay News) — New solutions are needed to address burnout among health care team members, yet, in a catch-22 situation for health industry leaders, change fatigue contributes to burnout, according to a Vocera Communications report entitled In Pursuit of Resilience, Well-Being, and Joy in Healthcare.

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Female Physicians’ Spouses More Likely to Work

WEDNESDAY, Nov. 22, 2017 (HealthDay News) — Spouses of female physicians are on average more educated and work more hours outside the home than spouses of male physicians, according to a research letter published online Nov. 21 in the Annals of Internal Medicine.

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High Costs Associated With Physician Burnout, Attrition

TUESDAY, Nov. 21, 2017 (HealthDay News) — Physicians who are experiencing burnout are more than twice as likely to leave their organization within two years, and this is associated with significant economic costs, according to a report from the American Medical Association.

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NOACs Show Lower Risk of Adverse Renal Outcomes in A-Fib

TUESDAY, Nov. 21, 2017 (HealthDay News) — For patients with atrial fibrillation (AF), non-vitamin K antagonist oral anticoagulants (NOACs) are associated with lower risks of adverse renal outcomes than warfarin, according to a study published in the Nov. 28 issue of the Journal of the American College of Cardiology.

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Increased Repolarization Dispersion Seen in SCD Survivors

TUESDAY, Nov. 21, 2017 (HealthDay News) — Survivors of sudden cardiac death (SCD) with structurally normal hearts have increased dispersion of repolarization after exertion, and this is detectable on non-invasive electrocardiographic imaging (ECGi), according to a study published online Nov. 1 in the Journal of Cardiovascular Electrophysiology.

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Simple Checklist Can Identify Useful Clinical Practice Guidelines

FRIDAY, Nov. 17, 2017 (HealthDay News) — A simple, easy-to-use checklist, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST), can identify useful clinical practice guidelines, according to a study published in the September/October issue of the Annals of Family Medicine.

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Higher Positive End-Expiratory Pressure No Benefit in ARDS

FRIDAY, Nov. 17, 2017 (HealthDay News) — For patients with acute respiratory distress syndrome (ARDS), higher positive end-expiratory pressure (PEEP) levels are not likely to improve clinical outcomes, according to a review published in the October issue of the Annals of the American Thoracic Society.

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Many Health Care Providers Work While Sick

FRIDAY, Nov. 17, 2017 (HealthDay News) — More than 40 percent of health care personnel (HCP) with influenza-like illness (ILI) work while ill, according to a study published in the November issue of the American Journal of Infection Control.

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FDA OKs Drug for Hemophilia A With Factor VIII Inhibitors

FRIDAY, Nov. 17, 2017 (HealthDay News) — Hemlibra (emicizumab-kxwh) has been approved by the U.S. Food and Drug Administration to prevent or reduce the frequency of bleeding episodes among hemophilia A patients with Factor VIII inhibitors.

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Model Predicts Development of Chronic Kidney Disease

THURSDAY, Nov. 16, 2017 (HealthDay News) — A multivariable model that uses routine laboratory data is able to predict advanced chronic kidney disease after hospitalization with acute kidney injury, according to a study published online Nov. 14 in the Journal of the American Medical Association.

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PCP Care in Hospital Linked to Resource Use, Outcome

WEDNESDAY, Nov. 15, 2017 (HealthDay News) — Patients cared for in the hospital by their own primary care physician (PCP) have longer length of stay and are more likely to be discharged home than those cared for by hospitalists or other generalists, according to a study published online Nov. 13 in JAMA Internal Medicine.

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More Laboratory Tests Performed at Major Teaching Hospitals

TUESDAY, Nov. 14, 2017 (HealthDay News) — For inpatients with a primary diagnosis of bacterial pneumonia or cellulitis, significantly more laboratory tests are performed per day at major teaching hospitals versus nonteaching hospitals, according to a study published online Nov. 13 in JAMA Internal Medicine.

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Thrombectomy May Be Best in Stroke Patients With Mismatch

MONDAY, Nov. 13, 2017 (HealthDay News) — For patients with acute stroke who were last well six to 24 hours earlier and who had a mismatch between the severity of the clinical deficit and the infarct volume, thrombectomy plus standard care is associated with better outcomes than standard care alone, according to a study published online Nov. 11 in the New England Journal of Medicine to coincide with the annual meeting of the Society of Vascular and Interventional Neurology, held Nov. 8 to 11 in Boston.

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Delayed Cord Clamping Linked to Reduced Hospital Mortality

THURSDAY, Nov. 9, 2017 (HealthDay News) — Delayed cord clamping is associated with reduced hospital mortality in preterm infants, according to a review published online Oct. 30 in the American Journal of Obstetrics & Gynecology.

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Doctors Have Extra Two Weeks to Preview Performance Data

WEDNESDAY, Nov. 8, 2017 (HealthDay News) — Physicians have two extra weeks to preview their 2016 performance information as a result of a mistake related to the Centers for Medicare & Medicaid Services’ Physician Compare online resource, according to a report published by the American Academy of Family Physicians.

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Delay in Tranexamic Acid Administration Reduces Benefit

WEDNESDAY, Nov. 8, 2017 (HealthDay News) — For patients with acute severe bleeding, any delay in treatment with tranexamic acid is associated with a reduction in the survival benefit, according to a meta-analysis published online Nov. 7 in The Lancet.

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Increases in U.S. Health Spending Tied to Health Service Price

WEDNESDAY, Nov. 8, 2017 (HealthDay News) — Factors including increases in health care service price and intensity are associated with increases in U.S. health care spending from 1996 to 2013, according to a study published online Nov. 7 in the Journal of the American Medical Association.

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Current Practice Not Cost-Effective for Air Medical Triage

FRIDAY, Nov. 3, 2017 (HealthDay News) — Current practice is not cost-effective compared with the Air Medical Prehospital Triage (AMPT) score for trauma patients, and the field triage system undertriage rate for patients with severe injuries exceeds 20 percent, according to two studies published online Nov. 1 in JAMA Surgery.

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’09 to ’15 Saw Increase in Transradial Access for STEMI PCI

THURSDAY, Nov. 2, 2017 (HealthDay News) — Use of transradial access (TRA) for ST-elevation myocardial infarction (STEMI) percutaneous coronary intervention (PCI) increased from 2009 to 2015, with considerable geographic, operator, and institutional variation, according to a study published online Nov. 1 in JACC: Cardiovascular Interventions.

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Driving Impairment Warnings Often Not Given With Rx Meds

THURSDAY, Nov. 2, 2017 (HealthDay News) — Not all prescription drug users report receiving warnings about driving impairment, according to a study published online Nov. 1 in the Journal of Studies on Alcohol and Drugs.

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CMS Launches Initiative to Examine Impact of Regulations

WEDNESDAY, Nov. 1, 2017 (HealthDay News) — The Centers for Medicare & Medicaid Services (CMS) has launched an initiative to examine which provider regulations should be discarded or revamped amid concerns that the regulations are reducing the amount of time that physicians spend with patients, according to an article published in Modern Healthcare.

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Updated Guidelines Released for Ventricular Arrhythmias

WEDNESDAY, Nov. 1, 2017 (HealthDay News) — The American College of Cardiology, the American Heart Association, and the Heart Rhythm Society have released updated guidelines for the management of adults who have ventricular arrhythmias (VAs) or who are at risk for sudden cardiac death (SCD). The guidelines were published online Oct. 30 in the Journal of the American College of Cardiology.

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With ARDS, Doctors Should Keep Ventilator-Induced Injury in Mind

WEDNESDAY, Nov. 1, 2017 (HealthDay News) — When applying evidence-based recommendations for mechanical ventilation in patients with acute respiratory distress syndrome (ARDS), clinicians should be aware of the mechanisms of ventilator-induced lung injury and the rationale behind interventions to mitigate injury, according to a literature review published in the October issue of the Annals of the American Thoracic Society.

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