June 2019 Briefing - Critical Care

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

Medicare Advantage Patients Have Higher Readmission Rates

FRIDAY, June 28, 2019 (HealthDay News) -- Medicare Advantage patients have higher risk-adjusted hospital readmission rates than traditional Medicare patients for acute myocardial infarction, congestive heart failure, and pneumonia, according to a new study published online June 24 in the Annals of Internal Medicine.

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Infections Tied to Subsequent Risk for Acute Ischemic Stroke

FRIDAY, June 28, 2019 (HealthDay News) -- Different infection types, especially urinary tract infection (UTI), are associated with subsequent acute ischemic stroke, according to a study published online June 27 in Stroke.

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EEG May Detect Brain Activation in Some Unresponsive Patients

WEDNESDAY, June 26, 2019 (HealthDay News) -- Early after acute brain injury, 15 percent of clinically unresponsive patients have electroencephalographic (EEG) evidence of brain activation in response to spoken motor commands, according to a study published online June 26 in the New England Journal of Medicine.

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MSSP ACOs May Not Improve Spending, Quality of Care

WEDNESDAY, June 26, 2019 (HealthDay News) -- After adjustment for the nonrandom exit of clinicians, the Medicare Shared Savings Program (MSSP) is not associated with improvements in spending or quality, according to a study published online June 18 in the Annals of Internal Medicine.

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Americans Concerned About Clinician Burnout

WEDNESDAY, June 26, 2019 (HealthDay News) -- Nearly three-quarters of Americans are concerned about burnout among their clinicians, according to a survey released June 17 by the American Society of Health-System Pharmacists (ASHP).

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Smoking Confers Greatest Risk for Major Heart Attack for Women

TUESDAY, June 25, 2019 (HealthDay News) -- Smoking confers a greater increase in ST-segment elevation myocardial infarction (STEMI) risk to women than men, according to a study published in the July 2 issue of the Journal of the American College of Cardiology.

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Greater Long-Term Decline in Stroke Seen Among Older Adults

MONDAY, June 24, 2019 (HealthDay News) -- The decline in midlife ischemic strokes over time is less pronounced than the decline among older adults, according to a study published in the June issue of Stroke.

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New England Journal of Medicine Picks New Editor-in-Chief

THURSDAY, June 20, 2019 (HealthDay News) -- The new editor-in-chief of the prestigious New England Journal of Medicine is Eric J. Rubin, M.D., Ph.D., who was selected after a worldwide search and plans to start in September, according to the Massachusetts Medical Society, which publishes the journal.

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Health Care Workers With ARIs Often Work While Symptomatic

THURSDAY, June 20, 2019 (HealthDay News) -- Almost all health care workers (HCWs) with acute respiratory illness (ARI) report working at least one day while symptomatic, according to a study published online June 18 in Infection Control & Hospital Epidemiology.

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Sudden Death Can Occur in Full Spectrum of Epilepsies

WEDNESDAY, June 19, 2019 (HealthDay News) -- Sudden unexpected death in epilepsy (SUDEP) can occur across the full spectrum of epilepsies, according to a study published online June 19 in Neurology.

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Surgeons' Unprofessional Behavior Tied to Higher Complication Risk

WEDNESDAY, June 19, 2019 (HealthDay News) -- Patients whose surgeons have higher numbers of coworker reports about unprofessional behavior may be at increased risk for postsurgical complications, according to a study published online June 19 in JAMA Surgery.

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Patterns of Inpatient Opioid Use Linked to Long-Term Use

TUESDAY, June 18, 2019 (HealthDay News) -- Specific patterns of opioid administration to opioid-naive inpatients are associated with risk for long-term use after discharge, according to a study published online June 18 in the Annals of Internal Medicine.

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Many Young Children Treated in ED for Injuries From Personal Care Products

TUESDAY, June 18, 2019 (HealthDay News) -- A steady and persistent number of personal care product-related injuries were reported for young children from 2002 to 2016, most often occurring among those aged <2 years, according to a study published online June 16 in Clinical Pediatrics.

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More Aggressive Statin Tx Needed After Heart Attack in Young Patients

FRIDAY, June 14, 2019 (HealthDay News) -- The majority of young heart attack patients with familial hypercholesterolemia (FH) still have elevated cholesterol levels a year later, according to a study published in the May 21 issue of the Journal of the American College of Cardiology.

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ICU Care for STEMI Associated With Improved Mortality Rates

THURSDAY, June 13, 2019 (HealthDay News) -- Among ST-segment elevation myocardial infarction (STEMI) patients who could be treated in an intensive care unit (ICU) or a non-ICU unit, those treated in the ICU have improved mortality rates, according to a study published online June 4 in The BMJ.

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Next-Gen Sequencing of CSF Improves Diagnosis of CNS Infections

WEDNESDAY, June 12, 2019 (HealthDay News) -- Metagenomic next-generation sequencing (NGS) of cerebrospinal fluid (CSF) obtained from patients with meningitis or encephalitis can improve diagnosis of neurologic infections, according to a study published in the June 13 issue of the New England Journal of Medicine.

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Access to Health Care Has Little Impact on Longevity

MONDAY, June 10, 2019 (HealthDay News) -- Health care has modest effects on extending life expectancy in the United States, while behavioral and social determinants may have larger effects, according to a review published in the May/June issue of the Annals of Family Medicine.

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Rapid Fluid Removal May Up Mortality in Critically Ill With AKI

MONDAY, June 10, 2019 (HealthDay News) -- Among critically ill patients with acute kidney injury, use of higher net ultrafiltration (NUF) rates for continuous venovenous hemodiafiltration is associated with lower survival, according to a secondary analysis published online June 7 in JAMA Network Open.

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Rapid Cycling Work Roster Improves Resident Sleep Practices

THURSDAY, June 6, 2019 (HealthDay News) -- A rapidly cycling work roster (RCWR) is effective in reducing weekly work hours and the occurrence of >16 consecutive-hour shifts as well as improving sleep duration of resident physicians, according to a study published online May 20 in SLEEP.

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Survey Indicates Physician Misconduct Is Underreported

THURSDAY, June 6, 2019 (HealthDay News) -- Physician misconduct is being underreported and most Americans do not know where to file a complaint, according to a report published by the Federation of State Medical Boards (FSMB).

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Dietary Supplements May Up Risk for Severe Medical Events

WEDNESDAY, June 5, 2019 (HealthDay News) -- Consumption of dietary supplements, specifically those sold for muscle building, energy, and weight loss, is associated with an increased risk for severe medical events among individuals aged 0 to 25 years, according to a study published online June 5 in the Journal of Adolescent Health.

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Zerbaxa Approved for Hospital-Acquired Bacterial Pneumonia

TUESDAY, June 4, 2019 (HealthDay News) -- Zerbaxa (ceftolozane and tazobactam) has been approved for a new indication to treat hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP) in patients aged 18 years and older, the U.S. Food and Drug Administration announced yesterday.

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Peripherally Inserted Central Catheters Often Used in CKD

MONDAY, June 3, 2019 (HealthDay News) -- Peripherally inserted central catheters (PICCs) are frequently used in hospitalized patients with stage 3b or greater chronic kidney disease (estimated glomerular filtration rate [eGFR], <45 mL/min/1.73 m²), according to a study published online June 4 in the Annals of Internal Medicine.

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ACP Issues Position on Response to Physician Impairment

MONDAY, June 3, 2019 (HealthDay News) -- Providing assistance for physician impairment and rehabilitation is addressed in a position statement issued by the American College of Physicians and published online June 4 in the Annals of Internal Medicine.

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Pressure Injuries at Time of ICU Admission Tied to Longer Stays

MONDAY, June 3, 2019 (HealthDay News) -- Pressure injuries at the time of admission to an intensive care unit may predict patients at risk for longer hospital stays, according to a study published in the June issue of Critical Care Nurse.

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