Healthcare Safety Index – January 2016

Here are healthcare safety issues that have appeared in the news and medical journals throughout the last 30 days or so:

The Centers for Disease Control and Prevention issued a recommendation that men with a pregnant partner should abstain from sex or use a condom if they live in or visited an area where mosquitos are spreading the Zika virus. Additionally, the CDC also recommended that pregnant women who have visited countries and territories plagued by the virus, mostly in Latin America, should be tested even if they do not exhibit symptoms of infection.

The Centers for Disease Control and Prevention recommended that hospitalized patients, patients with severe, complicated or progressive illness and patients at high risk for complications due to influenza be treated with antiviral medication irrespective of the outcome of rapid influenza diagnostic test results. The reasons for this are that (a) there have been reports of severe influenza with some deaths and (b) RIDT results have a high potential for false negatives.

A study published in Pediatrics found that exposure to beta-2 adrenergic agonists during pregnancy (used in asthma drugs) may increase the risk for autism spectrum disorders in children.

The American College of Physicians and the Centers for Disease Control and Prevention released a new clinical guideline on antibiotic use in adults with acute respiratory tract infections.Except for confirmed bacterial infections like streptococcal pharyngitis or acute bacterial sinusitis, antibiotics should not routinely be used.

A study published in Emerging Infectious Diseases revealed red flags about the effectiveness of a vaccine for whooping cough after an outbreak in a Florida preschool.

A study published in Pediatrics demonstrated that children with allergic rhinitis and allergic persistent wheezing at age 4 years may have increased risk for anxiety and depression.

A study published in the Journal of Allergy and Clinical Immunology found that adults with asthma have a 70% increased risk for developing shingles. The authors suggested that clinicians should consider vaccinating asthmatics at 50 years old.

The American College of Surgeons and American Geriatrics Society issued joint best practice recommendations for geriatric perioperative care.  

In a study published in Neurology, researchers discovered that the distribution of amyloid plaque in traumatic brain injury (TBI) survivors overlaps the distribution that exists in Alzheimer patients, but in TBI survivors the distribution also involves the cerebellum which is not typically involved in Alzheimer’s. The study also concluded that in TBI patients the amyloid burden appears to increase over time, suggesting a progressive neurodegenerative process following TBI.

A study published in Gut suggested that patients with alcohol-induced liver lesions had more Bifidobacteria and Streptococci and less Atopobium than patients with no liver problems. Accordingly, differences between alcoholics who develop severe liver damage and those who do not might be partly due to differences in their gut microbes.

An updated analysis of the NAPOLI-1 trial confirmed the survival benefit of liposomal irinotecan in combination with fluorouracil  and leucovorin in patients metastatic pancreatic cancer.

A study published in JAMA Pediatrics indicated that teens diagnosed with depression are not getting the appropriate follow-up care that they need.

An article published in the Annals of Internal Medicine concluded that 51 percent of the people who suffer from Sudden Cardiac Arrest experience warning symptoms within four weeks before the attack. Eighty percent of patients experienced symptoms at least one hour before SCA, and 34 percent had symptoms more than 24 hours before SCA. Chest pain and dyspnea were the most common symptoms.

A study published in the American Heart Journal concluded that use of morphine increased the risk of death in acute coronary syndromes.