Hospitals' efforts to prevent falls may be harming patients who are not allowed out of bed enough to prevent muscle atrophy. Hospitals are required to track falls but not patient activity, and studies have shown that high percentages of patients leave the hospital weaker than when they were admitted.
Major teaching hospitals have a lower average 30-day mortality rate and a lower cost of surgical care than nonteaching hospitals for high-risk surgery patients, according to a study published in the Annals of Surgery. The benefits of a large teaching hospital were most apparent in patients with severe or complex medical conditions, and a 1% reduction in mortality rate was associated with a savings of $965 to $3,567, depending on the procedure.
Kristi Blackburn has returned to the Oklahoma Department of Human Services after retiring in 2016, this time as director of adult services. She says she's learned during her career that "just because I didn't have current health problems or diseases, I was only one accident away from being able to care for myself, and that we all are more alike than different."
Jobs and higher education are difficult to access in Michigan's poor and rural counties, where less public assistance is available than in urban areas and the way assets are determined can limit aid. "A lot of our problems are because we don't have jobs, but if there are jobs, do we have the workforce for them?" says University of Michigan social work professor H. Luke Shaefer.
Proton pump inhibitors reduce gastrointestinal bleeding better than placebo without raising the infection risk in adults in critical care, according to a meta-analysis presented at the CHEST annual meeting. The researchers concluded that PPIs safely reduce peptic ulcer risk in patients in whom GI bleeding is not the primary factor in ICU admission.
Surviving Sepsis Campaign member Dr. Angel Coz Yataco says broad-spectrum antibiotics should be administered immediately to all sepsis patients, but critical care specialist Dr. Jayshil Patel notes that broad-spectrum antibiotics can cause harm and a blanket approach will increase antimicrobial resistance. Patel says older, immunocompromised patients at high risk for fungal burden could benefit from broad spectrum, while Yataco says antibiotics can be changed once culture results are in, and the outpatient setting is a more appropriate target for decreasing antibiotic use.
Primary and secondary adrenal insufficiency are risk factors for ICU admissions and prolonged lengths of stay, researchers reported in the European Journal of Endocrinology. In-patient death risk was similar compared with matched controls, as were readmissions in primary adrenal insufficiency, but secondary AI was linked to higher 30-day and 1-year readmission rates compared with controls.
Researchers at University of Florida Health Shands Hospital are testing a virtual reality platform for intensive care patients that simulates soothing environments and guides meditation. Results of a pilot study have been positive, and the program might also have applications in hospice care and pediatrics, says co-developer Marko Suvajdzic.
A review of data from 42 studies found that each additional kilogram of birth weight was associated with increased likelihood of food allergy and allergic dermatitis among children. The analysis in the Journal of Allergy and Clinical Immunology did not find an association between birth weight and childhood allergic rhinitis risk.
Both men and women planning to have children should pay attention to nutrition starting at least three to six months before conception, says registered dietitian Judy Simon, who teaches maternal and infant nutrition at the University of Washington. Choline, folic acid, iodine and iron are among the nutrients important to maternal and fetal health, and trendy restrictive diets should be avoided, Simon says.