Here are what the editors at HealthDay consider to be the most important developments in Critical Care for October 2014. 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.
Fewer Malpractice Claims Paid in the United States
THURSDAY, Oct. 30, 2014 (HealthDay News) -- The number of medical malpractice payments in the United States has dropped sharply since 2002, according to a new study. And compensation payment amounts and liability insurance costs for many doctors declined in recent years. These findings were published online Oct. 30 in the Journal of the American Medical Association.
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Would Alternative Payment Plan Cut Medical Bills?
THURSDAY, Oct. 30, 2014 (HealthDay News) -- New research supports replacing the traditional way of reimbursing doctors for care -- paying for each service provided -- with an alternative system that gives a set amount of money to health care organizations for patient care. The study was published in the Oct. 30 issue of the New England Journal of Medicine.
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AMA Code of Ethics Offers Guidance for Physicians
THURSDAY, Oct. 30, 2014 (HealthDay News) -- The American Medical Association (AMA) Code of Ethics and other articles provide guidance for physicians in relation to public health emergencies, according to a report from the AMA.
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Clinical Illness, Outcomes for Ebola in Sierra Leone Reviewed
WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- For patients with Ebola virus disease (EVD) from Sierra Leone, the incubation period for is six to 12 days and case fatality 74 percent, according to a study published online Oct. 29 in the New England Journal of Medicine.
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Voters' Views on Affordable Care Act Split Along Party Lines
WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Americans' opinions about the Affordable Care Act (ACA) are sharply divided along political lines, according to research published online Oct. 29 in the New England Journal of Medicine. The findings come from 27 public opinion polls conducted by 14 organizations.
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Less Competition Among Docs = Higher Medical Costs
WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Competition between medical practices helps keep health care costs lower, according to a study published in the Oct. 22/29 issue of the Journal of the American Medical Association.
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Frequent Readmissions, High Costs After Cardiac Arrest
WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Frequent readmissions and high inpatient costs are seen among older survivors of in-hospital cardiac arrest, according to a study published online Oct. 28 in Circulation: Cardiovascular Quality and Outcomes.
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Noneconomic Damages Caps Cut Malpractice Payments by 15%
TUESDAY, Oct. 28, 2014 (HealthDay News) -- Adoption of noneconomic damages caps reduces average malpractice payments by 15 percent, according to research published in the October issue of Health Affairs.
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CDC Issues Revised Interim U.S. Guidance on Ebola
MONDAY, Oct. 27, 2014 (HealthDay News) -- Today, the U.S. Centers for Disease Control and Prevention has issued a revision of their Ebola guideline document -- Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure.
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New York, New Jersey Ease Ebola Quarantines
MONDAY, Oct. 27, 2014 (HealthDay News) -- Faced with pressure from the White House and criticism from infectious disease experts, the governors of New York and New Jersey have eased their quarantine measures that required all medical workers returning from West Africa who had contact with Ebola patients to be forced into isolation.
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AAP Updates Guidelines for Bronchiolitis in Infants
MONDAY, Oct. 27, 2014 (HealthDay News) -- A new clinical practice guideline that offers physicians guidance for the diagnosis and management of infants with bronchiolitis was published online Oct. 27 in Pediatrics.
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Pharmacoinvasive STEMI Strategy Best for Smokers, Nonsmokers
FRIDAY, Oct. 24, 2014 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction, a pharmacoinvasive strategy after fibrinolysis is beneficial for smokers and nonsmokers, according to a study published in the Oct. 1 issue of The American Journal of Cardiology.
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Risk-Adjusted Readmission Rates Similar After Colorectal Sx
FRIDAY, Oct. 24, 2014 (HealthDay News) -- There is little variation in risk-adjusted hospital readmission rates after colorectal surgery, according to a study published online Oct. 22 in JAMA Surgery.
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Airborne Transmission of Ebola Highly Unlikely
FRIDAY, Oct. 24, 2014 (HealthDay News) -- People face no threat of airborne transmission of Ebola, according to a panel of Ebola experts gathered by the New England Journal of Medicine for an issue briefing Wednesday.
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New York City Health Officials Confirm First Ebola Case
FRIDAY, Oct. 24, 2014 (HealthDay News) -- New York City health officials said Thursday that a health care worker who recently returned from West Africa has tested positive for Ebola. The patient, identified as Craig Spencer, M.D., by city officials, had been working with Doctors Without Borders helping to treat Ebola patients in Guinea, one of three West Africa countries hit hard by the disease.
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Coworker Response 'Crucial' in Workplace Bullying Resolution
THURSDAY, Oct. 23, 2014 (HealthDay News) -- Targets of workplace bullying can offer chaos, report, or quest narratives about their experiences, and coworker response plays a role in narrative development, according to a study published online Sept. 25 in Management Communication Quarterly.
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Mortality Declines for Aortic Dissection Patients
THURSDAY, Oct. 23, 2014 (HealthDay News) -- Over the last decade, mortality rates for patients undergoing surgical repair for aortic dissection have improved, according to a study published online Oct. 21 in Circulation: Cardiovascular Quality and Outcomes.
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U.S. Ranks Last Among Wealthy Nations in Health Care Access
THURSDAY, Oct. 23, 2014 (HealthDay News) -- The U.S. health care system ranks last compared to other industrialized nations when it comes to affordability and patient access, according to a new survey published in the Oct. 23 issue of the New England Journal of Medicine.
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Even Severe Ebola Cases Can Be Treated With Intensive Care
THURSDAY, Oct. 23, 2014 (HealthDay News) -- Even severe Ebola virus disease (EVD), with multiple complications, can be treated effectively with routine intensive care, according to a case study published online Oct. 22 in the New England Journal of Medicine.
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Hospital Study Addresses 'Alarm Fatigue'
THURSDAY, Oct. 23, 2014 (HealthDay News) -- Monitoring devices among intensive care patients set off 2.5 million alarms in one month at a U.S. hospital, a new study of "alarm fatigue" reveals. The research was published online Oct. 22 in PLOS ONE.
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Americans Report Distrust of Medical Profession
WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Americans are less trusting of the medical profession than people in many other countries -- even though they often like their own doctor, according to a new report. The findings were published in the Oct. 23 issue of the New England Journal of Medicine.
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U.S. Residents Back From Ebola-Affected Areas to Be Tracked
WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Public health officials plan to actively monitor all U.S. residents returning home from one of the three Ebola-affected nations in West Africa, the U.S. Centers for Disease Control and Prevention announced Wednesday.
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APIC Provides Resources for Ebola Management
WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Resources are available to increase protection against Ebola transmission, according to a report from the Association for Professionals in Infection Control and Epidemiology (APIC).
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Hospice Doesn't Offset Intensive End-of-Life Ovarian Cancer Care
WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Increasing use of hospice in the final days of ovarian cancer does not offset intensive end-of-life care in older women, according to a study published online Oct. 6 in the Journal of Clinical Oncology.
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Hospital Conversion to For-Profit Status Ups Financial Margins
WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Hospital conversion to for-profit status is associated with improvements in financial margins, but has no effect on process quality metrics or mortality rates, according to a study published in the Oct. 22/29 issue of the Journal of the American Medical Association.
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CDC: 'Think Ebola' and 'Care Carefully'
TUESDAY, Oct. 21, 2014 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has issued updated guidelines for the use of personal protective equipment (PPE) by health care workers when caring for patients with Ebola, along with a reminder to health care workers to "Think Ebola" and to "Care Carefully."
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Unplanned Hospitalizations With GI Cancer Patients Common
TUESDAY, Oct. 21, 2014 (HealthDay News) -- Unplanned hospitalizations among elderly patients with gastrointestinal cancer are common, according to research published online Oct. 6 in the Journal of Clinical Oncology.
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Law Requiring Release of Health Information Upheld
TUESDAY, Oct. 21, 2014 (HealthDay News) -- A state law that requires plaintiffs to release relevant protected health information before proceeding with allegations of medical liability has been upheld by a federal appeals court, according to the American Medical Association (AMA).
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CDC Tightens Guidelines on Caring for Patients With Ebola
TUESDAY, Oct. 21, 2014 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has tightened previous infection control guidance for health care workers caring for patients with Ebola, the organization announced on Monday.
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3-Minute Diagnostic Assessment Accurately IDs Delirium
MONDAY, Oct. 20, 2014 (HealthDay News) -- A three-minute diagnostic assessment (3D-Confusion Assessment Method [CAM]) has high sensitivity and specificity for identifying delirium, according to a study published in the Oct. 21 issue of the Annals of Internal Medicine.
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Viewpoint: Getting United States Prepared for Ebola Outbreak
MONDAY, Oct. 20, 2014 (HealthDay News) -- A case of delayed Ebola diagnosis in Dallas and subsequent infection of health care workers has highlighted the lack of preparedness for a U.S. outbreak of the disease, according to a viewpoint piece published online Oct. 17 in the Journal of the American Medical Association.
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New MCAT Shifts Focus, Will Include Humanities
MONDAY, Oct. 20, 2014 (HealthDay News) -- The Medical College Admission Test (MCAT) has been revised, and the latest changes, including more humanities such as social sciences, are due to be implemented next April, according to a report from the Association of American Medical Colleges (AAMC).
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Obama Appoints Ron Klain As 'Ebola Czar'
FRIDAY, Oct. 17, 2014 (HealthDay News) -- President Barack Obama on Friday appointed Ron Klain, a former chief of staff to Vice President Joe Biden, as Ebola "czar" to oversee the federal government's response to the presence of virus in the United States.
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Specialized Care Centers May Be Needed to Contain Ebola
FRIDAY, Oct. 17, 2014 (HealthDay News) -- Specialized medical centers may be necessary to adequately treat and contain the Ebola virus in the United States, according to an ideas and opinions piece published online Oct. 16 in the Annals of Internal Medicine.
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Many Docs Believe Mobile Health Apps Can Improve Patient Care
FRIDAY, Oct. 17, 2014 (HealthDay News) -- A Manhattan Research survey recently found that many physicians believe digital communication technologies, including mobile apps, can be used to improve patient outcomes, according to an article published Oct. 8 in Medical Economics.
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Ebola Workshop Scheduled for Nov. 3 in Washington, D.C.
THURSDAY, Oct. 16, 2014 (HealthDay News) -- At the request of the U.S. Department of Health and Human Services, the Institute of Medicine and the National Research Council will host a workshop to discuss research needed to prepare for handling the occurrence of Ebola virus disease in the United States, according to a press release from the National Academies.
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Limiting Malpractice Claims May Not Curb Costly Medical Tests
THURSDAY, Oct. 16, 2014 (HealthDay News) -- Malpractice reform may not keep physicians from ordering unnecessary and expensive tests, according to a study published in the Oct. 16 issue of the New England Journal of Medicine.
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IBD Linked to Worse Prognosis After Myocardial Infarction
WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- For patients after first-time myocardial infarction (MI), inflammatory bowel disease (IBD) is associated with worse prognosis, according to a study published online Oct. 14 in Circulation: Cardiovascular Quality and Outcomes.
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Change in Doc, Public Attitudes Needed to Cut Overtreatment
WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- Reform of malpractice laws as well as inclusion of patients in medical decision making may help reduce overdiagnosis and overtreatment, according to an article published online Oct. 14 in The BMJ.
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CDC Takes Steps Toward Hospital Preparedness for Ebola
WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has sent new resources to Dallas to support the highest standard of infection control, according to a news release issued by the organization Tuesday.
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Second Health Care Worker in Dallas Tests Positive for Ebola
WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- A second health care worker who helped treat a patient who died of Ebola last week at a Dallas hospital has tested positive for the disease, health officials said Wednesday morning.
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Resident Proficiency in High-Value Care Is Hard to Test
TUESDAY, Oct. 14, 2014 (HealthDay News) -- The high-value care (HVC) subscore on the Internal Medicine In-Training Examination (IM-ITE) helps assess resident knowledge of HVC, but additional tools are needed to measure proficiency in practice, according to research published online Oct. 14 in the Annals of Internal Medicine.
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Experimental Tx Shouldn't Replace Critical Care for Ebola
TUESDAY, Oct. 14, 2014 (HealthDay News) -- Use of medications and vaccinations that have yet to be formally approved should not be a replacement for standard critical care, according to an ideas and opinions piece published in the Oct. 14 issue of the Annals of Internal Medicine.
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Health Officials Reviewing Ebola Procedures at Dallas Hospital
MONDAY, Oct. 13, 2014 (HealthDay News) -- Federal and local health officials said Monday that they were re-examining infection-control efforts at the Dallas hospital where a nurse contracted Ebola while caring for America's first diagnosed victim of the deadly disease.
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Texas Hospital Worker Tests Positive for Ebola
MONDAY, Oct. 13, 2014 (HealthDay News) -- A health care worker who helped treat the Liberian man who died of Ebola in a Dallas hospital last week has tested positive for the virus, public health officials reported Sunday.
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Specialty Drugs May Be Worth the Higher Costs
FRIDAY, Oct. 10, 2014 (HealthDay News) -- Despite high costs, specialty drugs may provide value that balances the price difference compared with traditional drugs, according to research published in the October issue of Health Affairs.
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Americans Increasingly Anxious About Ebola
FRIDAY, Oct. 10, 2014 (HealthDay News) -- One-quarter of Americans now view Ebola as a major public health threat to the United States, with many saying they'd change their travel plans due to Ebola fears, a new Harris Poll/HealthDay survey reveals.
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Medicines Are Biggest Culprit in Fatal Allergic Reactions
FRIDAY, Oct. 10, 2014 (HealthDay News) -- Over half of allergy-related deaths are caused by medications, while less than 7 percent are caused by food allergies, according to research published online Sept. 30 in the Journal of Allergy and Clinical Immunology.
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Potential Clue to Ebola Treatments Uncovered
THURSDAY, Oct. 9, 2014 (HealthDay News) -- Scientists who mapped out the shape and structure of a key protein in the Ebola virus say their discovery could help efforts to develop drugs to prevent or treat infection with the pathogen. Their research was published in the September issue of Acta Crystallographica Section D.
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Five Major U.S. Airports to Screen Travelers for Ebola
THURSDAY, Oct. 9, 2014 (HealthDay News) -- Five major U.S. airports will begin screening travelers entering the country from the three West African nations hit hardest by the ongoing Ebola epidemic, federal health officials announced Wednesday.
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Reducing Residency Work Hours Doesn't Affect Patient Outcomes
THURSDAY, Oct. 9, 2014 (HealthDay News) -- Duty-hour reforms have not adversely affected hospital mortality or length-of-stay of patients cared for by new attending physicians who were partly or fully exposed to reduced duty hours during residency, according to research published in the October issue of Health Affairs.
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Dallas Ebola Patient Has Died, Hospital Officials Confirm
WEDNESDAY, Oct. 8, 2014 (HealthDay News) -- Thomas Eric Duncan, the Liberian national who was the first person diagnosed with Ebola in the United States, died Wednesday morning at Texas Health Presbyterian Hospital in Dallas.
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CDC: U.S. Life Expectancy Hits Record High of Nearly 79 Years
WEDNESDAY, Oct. 8, 2014 (HealthDay News) -- Average life expectancy in the United States reached an all-time high of 78.8 years in 2012, the U.S. Centers for Disease Control and Prevention reported Wednesday. For people 65 years old in 2012, life expectancy was an additional 19.3 years, up slightly from the year before. Women age 65 and older in 2012 can expect to live another 20.5 years, while men may get around an additional 18 years.
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FARE, ACEP Develop New Anaphylaxis Toolkit
WEDNESDAY, Oct. 8, 2014 (HealthDay News) -- A new anaphylaxis toolkit has been developed to help answer questions about managing life-threatening allergies after patients are discharged from the emergency department, according to a report from Food Allergy Research & Education (FARE) and the American College of Emergency Physicians.
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AAFP Urges Docs to Check Accuracy of Open Payments Data
WEDNESDAY, Oct. 8, 2014 (HealthDay News) -- The American Academy of Family Physicians (AAFP) urges family doctors to check the accuracy of the first set of data published by the Centers for Medicare & Medicaid Services (CMS) Open Payments transparency program.
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About Half of All U.S. Hospital Patients Receive Antibiotics
TUESDAY, Oct. 7, 2014 (HealthDay News) -- About half of all U.S. hospital patients receive antibiotics, and these drugs are commonly the ones more likely to promote the growth of antibiotic-resistant bacteria, according to a new study, led by researchers at the U.S. Centers for Disease Control and Prevention, and published in the Oct. 8 issue of the Journal of the American Medical Association, a theme issue on infectious disease. The CDC also funded the study.
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Obama Considers Tighter Ebola Screening for Travelers
TUESDAY, Oct. 7, 2014 (HealthDay News) -- President Barack Obama said Monday that his administration is preparing additional screening measures to prevent the Ebola epidemic in West Africa from gaining a foothold in the United States.
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Insulin Dependence Ups Post-Op Complication Risk
TUESDAY, Oct. 7, 2014 (HealthDay News) -- Patients with insulin-dependent diabetes mellitus (IDDM) have an increased risk of a number of postoperative complications after lumbar fusion compared with those who have noninsulin-dependent diabetes mellitus (NIDDM) or no diabetes, according to a study published in the Oct. 1 issue of Spine.
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CDC Team Assisting Ebola Response in Dallas
MONDAY, Oct. 6, 2014 (HealthDay News) -- Experts from the U.S. Centers for Disease Control and Prevention have arrived in Texas and are working closely with Texas state and local health departments to investigate the first Ebola case in the United States, according to a news release issued by the agency.
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Heart Bypass Patients May Not Need Tight Glucose Control
MONDAY, Oct. 6, 2014 (HealthDay News) -- Coronary artery bypass graft (CABG) patients might not need to follow strict glucose control after their surgery, according to a study published in the October issue of the Annals of Thoracic Surgery. Some previous research suggested that high glucose after CABG and other types of heart surgery was associated with increased risk of health problems and death, but more recent research has found that might not be the case.
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Ebola Patient in Dallas Hospital Takes Turn for the Worse
MONDAY, Oct. 6, 2014 (HealthDay News) -- The first Ebola patient to be diagnosed in the United States has "taken a turn for the worse," federal health officials said Sunday. Thomas Eric Duncan, a native of Liberia, is receiving supportive care at Texas Health Presbyterian Hospital Dallas. Hospital officials have changed his condition from serious to critical.
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States Encouraged to Use Physician Assistant Workforce
MONDAY, Oct. 6, 2014 (HealthDay News) -- Physician assistants (PAs) have an important role in the provision of health care and their role should be encouraged by appropriate state legislation, according to a report from the National Governors Association.
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Impact of Physician Payments Sunshine Act Discussed
MONDAY, Oct. 6, 2014 (HealthDay News) -- The Physician Payments Sunshine Act is causing concern for manufacturers and providers, as well as physicians, according to a health policy brief published online Oct. 2 in Health Affairs.
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Research Suggests Stroke Risk Up With β-Blockers in Select Patients
MONDAY, Oct. 6, 2014 (HealthDay News) -- For patients without prior myocardial infarction (MI) with no heart failure, β-blocker use is not associated with lower cardiovascular events, and there may be an increased risk of stroke for patients without previous events but with multiple cardiovascular risk factors, according to a study published online Sept. 30 in Circulation: Cardiovascular Quality and Outcomes.
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Study Clarifies LMWH Treatment for Cancer-Related DVT
MONDAY, Oct. 6, 2014 (HealthDay News) -- Results of a randomized trial support the role of residual vein thrombosis (RVT) as a factor in determining the optimal duration of anticoagulant therapy in cancer patients with deep vein thrombosis (DVT) of the lower limbs. These findings were published online Sept. 29 in the Journal of Clinical Oncology.
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Physician Payments Found Not to Favor Procedures
FRIDAY, Oct. 3, 2014 (HealthDay News) -- The Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule does not systematically provide higher valuation of physician work per unit time for procedure/test codes than for evaluation and management (E/M) codes, according to a study published online Sept. 18 in the Annals of Surgery.
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Ebola Focus Shrinks to About 50 People in Texas
FRIDAY, Oct. 3, 2014 (HealthDay News) -- About 50 people in Texas are now being checked daily for possible Ebola infection, based on their prior contact with the Liberian national undergoing treatment in Dallas for the virus, health officials said Friday.
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Major Bleeds Found to Be Rare for Patients With Stable CAD
FRIDAY, Oct. 3, 2014 (HealthDay News) -- Major bleeding events are rare in patients with stable coronary artery disease (CAD); however, concomitant antiplatelet therapy (APT) when oral anticoagulation is required increases bleeding risk -- an independent predictor of mortality -- and should be reconsidered in select patients, according to research published in the Oct. 7 issue of the Journal of the American College of Cardiology.
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Transient Ischemic Attacks May Lead to PTSD
FRIDAY, Oct. 3, 2014 (HealthDay News) -- Transient ischemic attacks (TIAs) may not cause lasting physical damage but they may increase the risk of developing posttraumatic stress disorder (PTSD), according to a study published online Oct. 2 in Stroke.
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Medical Errors Should Be Used to Improve Patient Care
THURSDAY, Oct. 2, 2014 (HealthDay News) -- Medical errors occur and should be used to help improve medical processes, according to a report from the American Medical Association.
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'High-Intensity' Hospitals Save More Elderly After Surgery
THURSDAY, Oct. 2, 2014 (HealthDay News) -- Failure-to-rescue rates for elderly patients after major surgery are lower at hospitals with "high care intensity" compared with hospitals that display less intensity, according to research published online Oct. 1 in JAMA Surgery.
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Updated Count for Those Potentially Exposed to U.S. Ebola
THURSDAY, Oct. 2, 2014 (HealthDay News) -- Health officials in Texas say more than 80 people came into contact with Ebola patient Thomas Eric Duncan, on top of the 18 already under surveillance.
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CDC Offers Ebola Guidance for Health Care Providers
THURSDAY, Oct. 2, 2014 (HealthDay News) -- In the wake of the first confirmed case of a patient being diagnosed with Ebola in the United States, the U.S. Centers for Disease Control and Prevention is offering information on Ebola diagnosis and management for health care providers, including testing protocol.
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Providers Received Billions From Drug/Device Companies
THURSDAY, Oct. 2, 2014 (HealthDay News) -- About 546,000 doctors and 1,360 teaching hospitals in the United States received billions of dollars from drug and medical device makers in the second half of 2013, according to data released Tuesday by the Centers for Medicare & Medicaid Services. The financial benefits ranged from research grants to trips, and totaled nearly $3.5 billion from August through December last year, the Associated Press reported.
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CDC Issues Ebola Best Practices Reminder for Providers
WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has issued a general reminder to travelers and health care providers on best practices regarding Ebola.
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Social Support May Be Key to Heart Attack Recovery
WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- Young and middle-aged heart attack survivors are more likely to have poor health and low quality of life if they have fewer family and friends to support them in their recovery, according to a study published online Sept. 30 in the Journal of the American Heart Association.
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CDC Confirms First Patient Diagnosed With Ebola in U.S.
WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- The first confirmed case of Ebola has surfaced in the United States, involving a man who recently flew here from Liberia, federal health officials from the U.S. Centers for Disease Control and Prevention announced late Tuesday.
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Burnout on the Job Isn't Just About the Work
WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- Work, non-work, and individual factors explain a considerable part of psychological distress, depression, and emotional exhaustion, according to a study published online July 24 in Social Psychiatry and Psychiatric Epidemiology.
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