December 2019 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for December 2019. 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.

Samoa Ends State of Emergency Over Measles

MONDAY, Dec. 30, 2019 (HealthDay News) -- Slowing infection rates and a surge in vaccinations have prompted the South Pacific island of Samoa to end a six-week state of emergency over a measles outbreak, the BBC reported Sunday.

BBC Article

CDC: Cases of Flu Continue to Mount Across America

MONDAY, Dec. 30, 2019 (HealthDay News) -- Flu continues to spread throughout the United States and has reached elevated levels in nearly every state, according to the U.S. Centers for Disease Control and Prevention.

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Number of Children With Opioid Poisonings Increasing

MONDAY, Dec. 30, 2019 (HealthDay News) -- The severity of pediatric admissions for acute opioid ingestions, especially following attempted suicide, increased from 2005 to 2018, according to a study published online Dec. 19 in Clinical Toxicology.

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Case Study: Methylmercury Toxicity Found From Skin-Lightening Cream

FRIDAY, Dec. 27, 2019 (HealthDay News) -- In a Notes from the Field report, published in the Dec. 20 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, doctors present the case of a California woman with significant central nervous system damage after using a skin-lightening cream from Mexico that contained toxic mercury.

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Psychological Safety at Work Tied to Hospital Infection Prevention

THURSDAY, Dec. 26, 2019 (HealthDay News) -- Hospitals reporting high levels of psychological safety in their work culture are more likely to have comprehensive infection prevention and control programs, according to a study published in the January issue of the American Journal of Infection Control.

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Patient Share of Out-of-Network Costs Rising

TUESDAY, Dec. 24, 2019 (HealthDay News) -- The out-of-pocket costs for out-of-network (OON) care grew rapidly for privately insured Americans from 2012 to 2017, according to a study published in the December issue of the American Journal of Managed Care.

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Vitamin E Acetate ID'd in Lungs of Most Vaping Illness Patients

TUESDAY, Dec. 24, 2019 (HealthDay News) -- Vitamin E acetate was identified in almost all patients with electronic cigarette, or vaping, product use-associated lung injury (EVALI), and there has been a decrease in EVALI cases since a peak in September 2019, according to a study and a report published online Dec. 20 in the New England Journal of Medicine.

Abstract/Full Text - Blount
Abstract/Full Text - Hartnett

Report Estimates Readmission, Death After Vaping Illness Discharge

MONDAY, Dec. 23, 2019 (HealthDay News) -- The prevalence of rehospitalization and death after electronic cigarette, or vaping, product use-associated lung injury (EVALI) has been determined, and guidelines have been developed based on these findings. Both reports were published in the Dec. 20 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Abstract/Full Text - Mikosz
Abstract/Full Text - Evans

Enrollment in Affordable Care Act Holds Steady for Third Straight Year

MONDAY, Dec. 23, 2019 (HealthDay News) -- Enrollment in Affordable Care Act coverage for next year has surpassed 8 million, a sign that many Americans still turn to the government health insurance program to help pay for their medical care.

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Vitamin D Supplementation Offers No Benefit for Critically Ill

MONDAY, Dec. 23, 2019 (HealthDay News) -- For critically ill, vitamin D-deficient patients, early administration of high-dose enteral vitamin D3, compared with placebo, does not improve 90-day mortality or other outcomes, according to a study published online Dec. 11 in the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required)

FDA to Allow States to Import Prescription Drugs From Other Countries

WEDNESDAY, Dec. 18, 2019 (HealthDay News) -- Federal health officials have unveiled plans to allow prescription drug imports from Canada and other foreign nations.

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New Rules Seek to Increase Organ Transplants in U.S.

TUESDAY, Dec. 17, 2019 (HealthDay News) -- Two new rules meant to increase organ transplants in the United States have been proposed by the federal government.

AP News Article

Frailty May Worsen Outcomes in Traumatic Spinal Cord Injury

TUESDAY, Dec. 17, 2019 (HealthDay News) -- Frailty is an important predictor of worse outcome after traumatic spinal cord injury (tSCI) in patients <75 years of age, according to a study recently published in the Journal of Neurotrauma.

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Outcomes Worse for Rural Residents With Chronic Conditions

MONDAY, Dec. 16, 2019 (HealthDay News) -- Rural Medicare beneficiaries with complex chronic conditions have higher preventable hospitalization and mortality rates than their urban peers, which is partially explained by reduced access to specialists, according to a report published in the December issue of Health Affairs, a theme issue on rural health.

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Rates of Neonatal Abstinence Syndrome Remain High in U.S.

MONDAY, Dec. 16, 2019 (HealthDay News) -- The rate of in-hospital births with neonatal abstinence syndrome was 6.7 per 1,000 births in 2016, according to a research letter published online Dec. 16 in JAMA Pediatrics.

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Palliative Care Reaching More Inpatients With Serious Illness

MONDAY, Dec. 16, 2019 (HealthDay News) -- Inpatient palliative care teams are reaching a broader mix of patients earlier in the course of their illness, according to a study published online Dec. 6 in JAMA Network Open.

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Five-Year Mortality Up in Older Adults With Unplanned Admission

MONDAY, Dec. 16, 2019 (HealthDay News) -- Death within five years of first unplanned hospital admission is common among older adults, according to a study published in the Dec. 16 issue of CMAJ, the journal of the Canadian Medical Association.

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Hahn Confirmed as New FDA Chief

FRIDAY, Dec. 13, 2019 (HealthDay News) -- Stephen Hahn, M.D., was confirmed as commissioner of the U.S. Food and Drug Administration in a 72-18 Senate vote on Thursday.

The New York Times Article

U.S. Primary Care Doctors Face Challenges in Coordinating Care

TUESDAY, Dec. 10, 2019 (HealthDay News) -- Physicians from the United States and other high-income countries report difficulties with care coordination, with a substantial proportion of U.S. physicians not receiving timely notification or the information needed from specialists or other sites of care, according to a study published online Dec. 10 in Health Affairs.

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Fresh Red Blood Cell Transfusion No Better in Critically Ill Children

TUESDAY, Dec. 10, 2019 (HealthDay News) -- For critically ill pediatric patients, the incidence of new or progressive multiple organ dysfunction syndrome does not differ with the transfusion of fresh or standard-issue red blood cells, according to a study published in the Dec. 10 issue of the Journal of the American Medical Association.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

U.S. Health Care Spending Up 4.6 Percent in 2018

TUESDAY, Dec. 10, 2019 (HealthDay News) -- In 2018, U.S. health care spending increased 4.6 percent, a faster rate than that seen in 2017, according to a report published online Dec. 5 in Health Affairs.

Abstract/Full Text (subscription or payment may be required)

2016 to 2019 Saw Increase in Medical Students With Disabilities

MONDAY, Dec. 9, 2019 (HealthDay News) -- From 2016 to 2019, there was an increase in the proportion of medical students reporting disabilities, according to a research letter published in the Nov. 26 issue of the Journal of the American Medical Association.

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New Cardiogenic Shock Staging System IDs Mortality Risk

MONDAY, Dec. 9, 2019 (HealthDay News) -- The new Society for Cardiovascular Angiography and Intervention (SCAI) cardiogenic shock (CS) classification scheme provides risk stratification for hospital mortality, according to a study recently published in the Journal of the American College of Cardiology.

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CDC: All 50 States Now Reporting Cases of Severe Vaping-Linked Lung Injury

FRIDAY, Dec. 6, 2019 (HealthDay News) -- Cases of a serious, sometimes fatal, form of lung injury tied to vaping have now been reported in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. In total, case numbers have risen to 2,291, according to the latest update from the U.S. Centers for Disease Control and Prevention, issued Thursday.

More Information: CDC
CMAJ Report
European Respiratory Journal Report

Rural Population Underrepresented Among Medical Students

FRIDAY, Dec. 6, 2019 (HealthDay News) -- In 2017, less than 5 percent of all incoming medical students were rural students, according to a study published in the December issue of Health Affairs, a theme issue on rural health.

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Seven Deaths in California From Infections Tied to Black Tar Heroin

THURSDAY, Dec. 5, 2019 (HealthDay News) -- Infections linked to injections of black tar heroin have killed seven people in San Diego County in the past two months, health officials said Wednesday.

NBC News Article
County of San Diego Press Release

Services Affected by Rural Hospitals Joining Health Systems

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- While affiliating with health systems may boost a rural hospital's financial viability, the affiliation is often associated with reductions in critical services, according to a study published in the December issue of Health Affairs, a theme issue on rural health.

Abstract/Full Text (subscription or payment may be required)

Adults Not Living in Metro Areas Have Reduced Access to Care

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- Adults not living in metropolitan statistical areas (MSAs) are more likely to have reduced access to or use of health care services, according to a study published online Dec. 4 in the National Health Statistics Reports, a publication from the U.S. Centers for Disease Control and Prevention.

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Physician Depressive Symptoms Tied to Higher Risk for Medical Errors

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- Physicians showing depressive symptoms are at higher risk for medical errors, according to a review published Nov. 27 in JAMA Network Open.

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Digital Sepsis Monitoring May Improve Inpatient Outcomes

TUESDAY, Dec. 3, 2019 (HealthDay News) -- A digital sepsis alert is associated with improved outcomes, according to a study published online Nov. 20 in the Journal of the American Medical Informatics Association.

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Government Shut Down as Samoa Battles Measles Outbreak

MONDAY, Dec. 2, 2019 (HealthDay News) -- The government of Samoa will close on Thursday and Friday as civil servants join the fight against a measles outbreak in the South Pacific Island nation that has killed 53 people, the country's prime minister said Monday.

CNN Article

Holding Intubated Infants in ICU Found to Be Safe, Beneficial

MONDAY, Dec. 2, 2019 (HealthDay News) -- Holding intubated infants in the intensive care unit is well tolerated and does not increase adverse events, according to a study published in the December issue of Critical Care Nurse.

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