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Beware of Good and Bad News About the New Common Rule
The revised Common Rule changes will go into effect on Jan. 21, 2019, but it is quite likely IRBs will be adjusting their processes without all of the federal guidance they need.
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A Review of Updated Guidelines Regarding Bradycardia and Cardiac Conduction Delay
The American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society have established updated guidelines on the evaluation and management of patients with bradycardia and conduction delays. Many key elements remain largely unchanged from prior guideline recommendations on pacemakers published in 2008 and 2012, but there also are important new definitions, recommendations, and areas of emphasis.
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Early Identification of Cardiac Amyloidosis in Carpal Tunnel Surgery Patients
In a cohort of older patients undergoing carpal tunnel release surgery, an analysis of tenosynovial tissue revealed amyloid deposits in 10% of patients. This development may facilitate early diagnosis of cardiac amyloidosis.
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Mitral Annulus Disjunction and Ventricular Arrhythmias
A patient cohort with mitral annular disjunction (MAD) identified by echo was characterized clinically and by MRI. Ventricular arrhythmias were common in MAD patients and related to the degree of MAD and papillary muscle fibrosis by MRI but not the presence of mitral valve prolapse.
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Detection of Prosthetic Heart Valve Endocarditis
A multicenter, retrospective, observational study of patients undergoing 18F-fluorodeoxyglucose PET/CT for prosthetic valve endocarditis or other indications showed that if certain obvious confounders are excluded, this imaging technique offers a high degree of accuracy for diagnosing prosthetic valve endocarditis, especially if performed early in the course of the disease.
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Study Adds Complexity to Post-TAVR Anticoagulation
In this large contemporary, prospective transcatheter aortic valve replacement registry, oral anticoagulation appears to be protective against valve degeneration but is associated with increased mortality. The strongest predictors of mortality at three years were male gender, renal failure, and atrial fibrillation.
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Presenteeism: Working Sick Appears to Be Endemic
Healthcare facilities should have specific criteria clarifying when infected healthcare workers should stay home, as gray areas and disincentives currently result in exposures to patients and colleagues, the CDC reports.
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CDC Drafts Infection Control Guidelines for HCWs
The CDC has issued draft guidelines for preventing infections in healthcare workers, urging collaboration between infection preventionists and employee health professionals. The guidelines, which are open for comment through Dec. 14, recommend that occupational health services engage administration and other departments in infection prevention activities.
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Get Patients ‘Up’ to Reduce Pneumonia, Other HAIs
The American Hospital Association’s “Up” campaign can reduce the incidence of nonventilator-associated pneumonia, the leading HAI in a recent study. The campaign urges basic interventions that reduce patient harm.
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Hospital-acquired Pneumonia, C. diff Leading HAIs
Significant progress is being made in reducing surgical site and urinary tract infections, but Clostridium difficile and pneumonia are entrenched in Centers for Disease Control and Prevention (CDC) sentinel hospitals, researchers report.