Here are what the editors at HealthDay consider to be the most important developments in Critical Care for November 2012. 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.
Political Leaders Face Voter Opposition to Medicare Cuts
WEDNESDAY, Nov. 28 (HealthDay News) -- The majority of those who voted for President Obama in the 2012 election favor implementing the Affordable Care Act (ACA), while those who voted for Republican officeholders are likely to oppose parts or all of the implementation of the ACA; both sides oppose cuts to Medicare as a means to balance the budget, according to an analysis of newly released polls published as a Special Report online Nov. 28 in the New England Journal of Medicine.
Full Text (http://www.nejm.org/doi/full/10.1056/NEJMsr1213905?query=featured_home )
State Cost of Affordable Care Act's Medicaid Expansion Modest
WEDNESDAY, Nov. 28 (HealthDay News) -- Implementation of the Affordable Care Act's (ACA) Medicaid expansion will likely result in modest state costs by 2022, but will gain health care coverage for more than 20 million uninsured Americans, according to report published by the Kaiser Family Foundation.
More Information (http://www.kff.org/medicaid/kcmu112612nr.cfm )
Warfarin D/C Within 180 Days Post-Surgery May Up Mortality
TUESDAY, Nov. 27 (HealthDay News) -- Patients who undergo bioprosthetic aortic valve replacement surgery and discontinue anticoagulant treatment within six months have a greater risk of cardiovascular death, according to a study published in the Nov. 28 issue of the Journal of the American Medical Association.
Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1456069#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1456069 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1456031 )
Doc Earnings Growth Lags Behind Other Health Professionals
TUESDAY, Nov. 27 (HealthDay News) -- Compared with other health professionals, in the last 15 years there has been considerably less growth in the earnings of physicians in the United States, according to a research letter published in the Nov. 28 issue the Journal of the American Medical Association.
Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1456053 )
Growing Number of Drugs Possibly Inhibited by Grapefruit
TUESDAY, Nov. 27 (HealthDay News) -- There are increasing numbers of newly marketed drugs that have the potential to interact with grapefruit, all of which are metabolized by the cytochrome P450 3A4 enzyme (CYP3A4), according to a review published online Nov. 26 in CMAJ, the journal of the Canadian Medical Association.
Full Text (subscription or payment may be required) (http://www.cmaj.ca/content/early/2012/11/26/cmaj.120951 )
Hemorrhage Rates Highest Within 30 Days of Warfarin Tx
MONDAY, Nov. 26 (HealthDay News) -- For older patients with atrial fibrillation starting on warfarin, the rates of hemorrhage are highest within the first 30 days, according to a study published online Nov. 26 in CMAJ, the journal of the Canadian Medical Association.
Abstract (http://www.cmaj.ca/content/early/2012/11/26/cmaj.121218 )Full Text (http://www.cmaj.ca/content/early/2012/11/26/cmaj.121218.full.pdf+html )
Obama Administration Moving Forward With Health Care Law
WEDNESDAY, Nov. 21 (HealthDay News) -- Three rules have been proposed by the Obama administration to further facilitate implementation of the Affordable Care Act, according to a Nov. 20 press release from the U.S. Centers for Medicare & Medicaid Services.
More Information (http://www.cms.gov/apps/media/press/release.asp?Counter=4478&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date )
Uninsured With Brain Tumors Have Higher Post-Op Mortality
WEDNESDAY, Nov. 21 (HealthDay News) -- Uninsured patients undergoing a craniotomy procedure for a brain tumor have higher in-hospital postoperative mortality rates than insured patients, according to research published in the November issue of the Archives of Surgery.
Abstract (http://archsurg.jamanetwork.com/article.aspx?articleid=1392156#Abstract )Full Text (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1392156 )Editorial (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1392139 )
Aspirin Resistance Ups Severity in Acute Ischemic Stroke
WEDNESDAY, Nov. 21 (HealthDay News) -- In patients with acute ischemic stroke, aspirin resistance is associated with increased stroke severity and infarct size, according to research published online Nov. 19 in the Archives of Neurology.
Abstract (http://archneur.jamanetwork.com/article.aspx?articleid=1391954#Abstract )Full Text (subscription or payment may be required) (http://archneur.jamanetwork.com/article.aspx?articleid=1391954 )
Citicoline Not Effective for Traumatic Brain Injury
TUESDAY, Nov. 20 (HealthDay News) -- There is no significant improvement in either functional or cognitive status among patients with traumatic brain injury (TBI) taking citicoline compared with placebo, according to a study published in the Nov. 21 issue of the Journal of the American Medical Association.
Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1392561#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1392561 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1392548 )
YKL-40 Is Marker of Mortality in Hospitalized Patients
TUESDAY, Nov. 20 (HealthDay News) -- For patients admitted to the hospital, the inflammatory biomarker YKL-40 is a strong predictor of mortality, regardless of diagnosis, according to a study published online Nov. 12 in the Journal of Internal Medicine.
Abstract (http://onlinelibrary.wiley.com/doi/10.1111/joim.12006/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1111/joim.12006/abstract )
Mental Illness, Job Stress Both Factors in Physician Suicides
FRIDAY, Nov. 16 (HealthDay News) -- The presence of mental illness or job problems may make physicians more vulnerable to suicide than non-physicians, according to a study published online Nov. 5 in General Hospital Psychiatry.
Abstract (http://www.ghpjournal.com/article/S0163-8343(12)00268-X/abstract )Full Text (subscription or payment may be required) (http://www.ghpjournal.com/article/S0163-8343(12)00268-X/fulltext )
Survival Improving After In-Hospital Cardiac Arrest
WEDNESDAY, Nov. 14 (HealthDay News) -- Over the past decade, there has been a trend toward improved survival and a decrease in neurologic disability following in-hospital cardiac arrest, according to a study published in the Nov. 15 issue of the New England Journal of Medicine.
Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMoa1109148 )
Massage Therapy May Enhance Immunity in Preterm Infants
TUESDAY, Nov. 13 (HealthDay News) -- For stable, preterm infants, daily massage therapy (MT) is positively associated with higher natural killer (NK) cell cytotoxicity and weight gain, according to a study published online Nov. 12 in Pediatrics.
Abstract (http://pediatrics.aappublications.org/content/early/2012/11/06/peds.2012-0196.abstract )Full Text (subscription or payment may be required) (http://pediatrics.aappublications.org/content/early/2012/11/06/peds.2012-0196.full.pdf+html )
Increased Risk of Carotid Artery Wall Thickening in COPD
MONDAY, Nov. 12 (HealthDay News) -- For older adults with chronic obstructive pulmonary disease (COPD), the likelihood of carotid artery thickening is increased and vulnerable lipid core plaques are more frequent than in controls with normal lung function, according to a study published online Nov. 9 in the American Journal of Respiratory and Critical Care Medicine.
Abstract (http://ajrccm.atsjournals.org/content/early/2012/11/09/rccm.201206-1046OC.abstract )Full Text (subscription or payment may be required) (http://ajrccm.atsjournals.org/content/early/2012/11/09/rccm.201206-1046OC.full.pdf+html )
Social Network Profile May Harm Medical Applicants
MONDAY, Nov. 12 (HealthDay News) -- Social networking profiles may harm an applicant's chances of admission to medical school or a residency program, according to a study published online Nov. 8 in the Postgraduate Medical Journal.
Abstract (http://pmj.bmj.com/content/early/2012/10/31/postgradmedj-2012-131283 )Full Text (subscription or payment may be required) (http://pmj.bmj.com/content/early/2012/10/31/postgradmedj-2012-131283.full )
FDA Approves Expanded Use of Xarelto
MONDAY, Nov. 5 (HealthDay News) -- Approval of the anti-clotting drug Xarelto (rivaroxaban) has been expanded by the U.S. Food and Drug Administration to include treating deep vein thrombosis (DVT) or pulmonary embolism (PE), and to reduce the risk of recurrent DVT and PE following initial treatment.
this approval (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm326654.htm )
Anticoagulation Therapy Appears to Be Safe After TAVI
THURSDAY, Nov. 1 (HealthDay News) -- After transcatheter aortic valve implantation (TAVI) there is no increased risk of bleeding or other adverse outcomes for those patients who have an indication for anticoagulant therapy, according to a study published online Oct. 29 in The American Journal of Cardiology.
Abstract (http://www.ajconline.org/article/S0002-9149(12)02201-1/abstract )Full Text (subscription or payment may be required) (http://www.ajconline.org/article/S0002-9149(12)02201-1/fulltext )