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June 2017 Briefing – Surgery

June 2017 Briefing – Surgery
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Here are what the editors at HealthDay consider to be the most important developments in Surgery for June 2017. 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.

Health of the Nation Presented in 40th Annual CDC Report

THURSDAY, June 29, 2017 (HealthDay News) — The health of the United States is summarized in the 40th annual report published by the U.S. Centers for Disease Control and Prevention.

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Doctors Urged to Take Care With Electronic Communications

THURSDAY, June 29, 2017 (HealthDay News) — Care should be taken when conveying electronic messages to patients, according to a report published by the American Medical Association (AMA).

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Most Cutaneous Procedures Seem Safe During Isotretinoin Rx

THURSDAY, June 29, 2017 (HealthDay News) — There is insufficient evidence to support delaying several cutaneous surgical procedures in the setting of systemic isotretinoin therapy, although mechanical dermabrasion and fully ablative laser are not recommended, according to a review published online June 28 in JAMA Dermatology.

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Fat Grafting May Improve Outcome in Breast Reconstruction

THURSDAY, June 29, 2017 (HealthDay News) — For patients undergoing breast reconstruction, fat grafting may improve patient-reported outcomes, according to a study published online June 28 in JAMA Surgery.

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Robotic Navigation Noninferior for CVPI in Atrial Fibrillation

THURSDAY, June 29, 2017 (HealthDay News) — For patients with atrial fibrillation (AF) undergoing circumferential pulmonary vein isolation (CPVI), use of robotic navigation (RN) systems is noninferior to manual ablation (MN), according to a study published online June 28 in JACC: Clinical Electrophysiology.

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Rx Changes, Counseling, Regular Visits Can Cut Opioid Deaths

WEDNESDAY, June 28, 2017 (HealthDay News) — Three simple steps could decrease opioid-related mortality by about a third, according to a report published online June 26 in Drug and Alcohol Dependence.

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Case Report: Development of RA in Transplanted Hands

WEDNESDAY, June 28, 2017 (HealthDay News) — In a case report published online June 27 in the Annals of Internal Medicine, rheumatoid arthritis is diagnosed in the hands of a patient who underwent bilateral hand transplantation.

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Shorter Fasting After Endoscopic Submucosal Dissection Feasible

WEDNESDAY, June 28, 2017 (HealthDay News) — For patients undergoing endoscopic submucosal dissection (ESD), a short fasting period after the procedure is associated with shorter hospital stay and greater patient satisfaction, with no impact on discomfort or bleeding, according to a study published online June 23 in the Journal of Digestive Diseases.

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Two-Step Irradiance Better for Condyloma Acuminatum

TUESDAY, June 27, 2017 (HealthDay News) — For patients with condyloma acuminatum (CA), a two-step irradiance schedule is associated with a significantly greater reduction in pain during treatment than single-dose cold compress, according to a study published online June 22 in Lasers in Surgery and Medicine.

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Reduced Cancer-Independent Life Expectancy in Head, Neck Cancer

TUESDAY, June 27, 2017 (HealthDay News) — Patients with head and neck cancer have reduced life expectancy, independent of cancer, according to a study published online June 22 in Head & Neck.

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More Racial Disparity With Medicare Advantage

MONDAY, June 26, 2017 (HealthDay News) — Medicare Advantage is associated with more racial disparity than traditional Medicare for hospital readmissions, according to a study published online June 21 in Health Affairs.

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Adding MRI to Mammography Ups Detection of Breast Cancer

MONDAY, June 26, 2017 (HealthDay News) — For women aged 50 years or younger who have undergone breast conservation therapy, the addition of annual magnetic resonance imaging (MRI) to annual mammography screening improves detection of early-stage breast cancers, according to a study published online June 22 in JAMA Oncology.

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ACOG: Shared Decision-Making Key to Breast Cancer Screening

FRIDAY, June 23, 2017 (HealthDay News) — Shared decision-making is being emphasized in new American College of Obstetricians and Gynecologists (ACOG) mammography screening guidelines for women at average risk of breast cancer.

Practice Bulletin

Opioid Rx Too Often Given to Back Pain Patients With Depression

THURSDAY, June 22, 2017 (HealthDay News) — Patients with low back pain who are depressed are more likely to be prescribed opioids, and to be prescribed higher doses, according to a study published online June 20 in PAIN Reports.

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1991-2014 Saw Minimal Change in Health Spending Per State

THURSDAY, June 22, 2017 (HealthDay News) — From 1991 to 2014 there was minimal change in health spending by state, according to a study published online June 14 in Health Affairs.

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Report Addresses Patient Refusal of Home Health Care Services

WEDNESDAY, June 21, 2017 (HealthDay News) — About 6 to 28 percent of seniors refuse home health care offered when they are discharged from the hospital, according to a report from the United Hospital Fund and the Alliance for Home Health Quality and Innovation.

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Adjusted One-Year Mortality Similar for On-, Off-Label TAVR

WEDNESDAY, June 21, 2017 (HealthDay News) — Adjusted one-year mortality is similar for individuals undergoing transcatheter aortic valve replacement (TAVR) for on-label or off-label indications, according to a study published online June 21 in JAMA Cardiology.

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Family Hx, Mutation Position Key Variables in BRCA1/2 Cancer Risk

WEDNESDAY, June 21, 2017 (HealthDay News) — Breast cancer risk peaks around the 40s for BRCA1 mutation carriers and around the 50s for BRCA2 carriers, with family history and mutation location significant factors in determining individual risk, according to a report published in the June 20 issue of the Journal of the American Medical Association.

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Guidelines Address Peri-Op Care in Rheumatic Disease

TUESDAY, June 20, 2017 (HealthDay News) — Guidelines have been developed for perioperative management of antirheumatic drug therapy in patients with rheumatic diseases undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA); the guidelines were published online June 16 in Arthritis Care & Research.

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Yoga Noninferior to Physical Therapy in Chronic Low Back Pain

TUESDAY, June 20, 2017 (HealthDay News) — Yoga may be as effective as physical therapy for pain relief and improved function in patients with chronic low back pain, according to a study published online June 20 in the Annals of Internal Medicine.

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Support for Financial Penalties Up With Emphasis on Patient Harms

TUESDAY, June 20, 2017 (HealthDay News) — Physicians who receive information about patient harms are more likely to support financial penalties targeting inappropriate antibiotic prescribing, according to a research letter published online June 20 in the Annals of Internal Medicine.

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Older Age Needn’t Be a Barrier to Herniated Disc Surgery

MONDAY, June 19, 2017 (HealthDay News) — People over age 65 shouldn’t avoid surgery for a herniated disc just because of their age, as they can benefit from the procedure as much as younger patients, according to a research letter published recently in JAMA Surgery.

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Strategies Implemented to Cut Opioid ODs, Deaths in Maryland

THURSDAY, June 15, 2017 (HealthDay News) — Strategies are being implemented to reduce opioid overdoses and deaths in Maryland, according to a report published by the American Medical Association (AMA).

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Medical Students Lacking Proficiency in BP Measurements

MONDAY, June 12, 2017 (HealthDay News) — Medical students frequently do not achieve mastery of the skills necessary for accurate measurement of blood pressure (BP), according to a study published online April 28 in the Journal of Clinical Hypertension.

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Intra-Op Liberal Fluid Therapy Effectively Cuts Post-Op Nausea

MONDAY, June 12, 2017 (HealthDay News) — For children undergoing lower abdominal surgery, intraoperative liberal fluid therapy is effective for reducing postoperative nausea and vomiting (PONV), according to a study published online June 6 in Pediatric Anesthesia.

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Review: Depression Screening As Inpatient Important, Feasible

MONDAY, June 12, 2017 (HealthDay News) — Depression affects about one-third of hospital patients and could slow their recovery, according to research published recently in the Journal of Hospital Medicine.

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Distinct Features for Quitting Smoking After Crohn’s Diagnosis

MONDAY, June 12, 2017 (HealthDay News) — For patients with Crohn’s disease (CD), smoking cessation at the time of diagnosis is positively associated with intestinal resection within three months and light smoking, according to a study published online May 26 in the Journal of Gastroenterology and Hepatology.

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Opioids Tend to Be Over-Prescribed After Cesarean Section

FRIDAY, June 9, 2017 (HealthDay News) — Women are routinely prescribed more opioid medications than they need after cesarean sections, creating a high risk for misuse, according to three studies published in the July issue of Obstetrics & Gynecology.

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Reporting Tool Shows Impact of Attacks on Health Care in Syria

FRIDAY, June 9, 2017 (HealthDay News) — Results from a real-time reporting tool have shown the impact of attacks on health care services in Syria, according to an article published online June 8 in The Lancet.

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New Bill With Tort Reforms Will Protect Iowa Physicians

FRIDAY, June 9, 2017 (HealthDay News) — A new bill with tort reforms to protect Iowa physicians will take effect July 1, according to a report published by the American Medical Association (AMA).

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Kidney Allocation System Cuts Racial Disparities in Transplant

FRIDAY, June 9, 2017 (HealthDay News) — A new kidney allocation system implemented in 2014 by the United Network for Organ Sharing reduced racial disparities in receipt of kidney transplant, according to a study published in the June issue of Health Affairs.

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Equal Wound Complications for Staples, Suture in Obese Women

FRIDAY, June 9, 2017 (HealthDay News) — The rate of surgical site wound complications is similar for obese women undergoing midline vertical incision with skin closure via staples or subcuticular suture, according to a study published in the July issue of Obstetrics & Gynecology.

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FDA Requests Removal of Opana ER From Market

FRIDAY, June 9, 2017 (HealthDay News) — Sales of reformulated Opana ER should be halted in the United States, the U.S. Food and Drug Administration says.

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Full Lymph Node Dissection Does Not Up Melanoma Survival

THURSDAY, June 8, 2017 (HealthDay News) — Complete lymph node dissection may not increase a melanoma patient’s overall chances for survival, according to a study published in the June 8 issue of the New England Journal of Medicine.

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U.S. Leads in Income-Based Health Care Inequalities

THURSDAY, June 8, 2017 (HealthDay News) — The United States has larger income-related differences in perceptions of health and health care than other middle- and high-income countries, according to a report published in the June issue of Health Affairs.

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Certain Cancer Diagnoses Up in High-Income Counties in U.S.

THURSDAY, June 8, 2017 (HealthDay News) — Americans living in high-income areas are more likely to be diagnosed with some types of cancer than people living in low-income areas, according to a perspective piece published in the June 8 issue of the New England Journal of Medicine.

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Doctors Discuss Role of Weight-Loss Surgery in Obesity

THURSDAY, June 8, 2017 (HealthDay News) — The role of weight-loss surgery (WLS) for obesity is addressed in a Grand Rounds Discussion published in the June 6 issue of the Annals of Internal Medicine.

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CDC: High-Deductible Health Plan Use Rising Among Employers

WEDNESDAY, June 7, 2017 (HealthDay News) — High-deductible health plans are becoming more common among U.S. adults with employer-sponsored health insurance coverage, according to a report issued June 6 by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS).

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Many Bariatric Surgery Patients Using Opioids Seven Years Later

WEDNESDAY, June 7, 2017 (HealthDay News) — About 20 percent of U.S. bariatric surgery patients are still using prescription opioids seven years later, according to a study published recently in Surgery for Obesity and Related Diseases.

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Nurse-Led Psych Intervention Beneficial in Breast Cancer

WEDNESDAY, June 7, 2017 (HealthDay News) — A nurse-led psychological intervention program is beneficial for patients with breast cancer at high risk of depression, according to a study published online May 30 in the Journal of Clinical Nursing.

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Positive Clinical Effects Seen for Placebos Without Deception

TUESDAY, June 6, 2017 (HealthDay News) — Open-label placebos are associated with a positive effect compared with no treatment in a variety of clinical conditions, according to a review and meta-analysis published online May 30 in the Journal of Evidence-Based Medicine.

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Small Unruptured Intracranial Aneurysms Grow Slowly

TUESDAY, June 6, 2017 (HealthDay News) — Small unruptured intracranial aneurysms (UIAs) have low growth and rupture rates, according to a review published online June 6 in the Annals of Internal Medicine.

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Marking Can Improve Accuracy of Eyelid Chalazia Curettage

MONDAY, June 5, 2017 (HealthDay News) — A new marking method can improve the accuracy of incision and curettage of eyelid chalazia, according to a letter to the editor published online May 26 in Clinical & Experimental Ophthalmology.

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U.S. Emergency Departments Commonly Overcharging Patients

FRIDAY, June 2, 2017 (HealthDay News) — Americans are routinely overcharged for emergency department care, and minority and uninsured patients are most likely to face this issue, according to a study published online May 30 in JAMA Internal Medicine.

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Costs Associated With U.S. Adult Bicycle Crashes Steadily Rising

FRIDAY, June 2, 2017 (HealthDay News) — Adult bike crashes cost an estimated $24.4 billion a year in the United States, with costs steadily rising by an average of $789 million per year, according to a study published online June 1 in Injury Prevention.

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Cool Water Works As Well As Hot for Ridding Hands of Germs

FRIDAY, June 2, 2017 (HealthDay News) — For effective hand hygiene, water temperature matters less than time, according to a study published in the June issue of the Journal of Food Protection.

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Substantial Increase in Costs With Metastases in Prostate CA

FRIDAY, June 2, 2017 (HealthDay News) — Diagnosis of subsequent metastases is associated with substantially increased costs and medical resource use (MRU) among patients initially diagnosed with localized prostate cancer (PC), according to a study published online May 23 in Cancer.

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Model Predicts Acute GI Bleeding in Anticoagulated Patients

FRIDAY, June 2, 2017 (HealthDay News) — For patients taking oral anticoagulants, a new model can predict acute gastrointestinal (GI) bleeding, which is associated with increased risk of all-cause mortality, according to a study published online May 19 in the Journal of Gastroenterology and Hepatology.

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Post-Op A-Fib Down With Low-Level Vagus Nerve Stimulation

FRIDAY, June 2, 2017 (HealthDay News) — For patients undergoing cardiac surgery, low-level vagus nerve stimulation (LLVNS) is associated with a reduction in postoperative atrial fibrillation (POAF) and with lower levels of inflammatory cytokines, according to a study published online May 31 in JACC: Clinical Electrophysiology.

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Excess Weight Increases Costs Across Health Care Settings

THURSDAY, June 1, 2017 (HealthDay News) — Excess weight is associated with increased costs across health care settings, with the highest percentage increases seen in costs for medications, according to research published online May 22 in Obesity Reviews.

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Certain Breast CA Patients Benefit From Adjuvant Capecitabine

THURSDAY, June 1, 2017 (HealthDay News) — Capecitabine (Xeloda) can extend the lives of patients with human epidermal growth factor receptor 2 (HER2)-negative breast cancer who have residual invasive disease after receipt of neoadjuvant chemotherapy, according to a study published in the June 1 issue of the New England Journal of Medicine.

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