Here are what the editors at HealthDay consider to be the most important developments in Surgery for June 2019. 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.

Outcomes Improved After ACL Repair With Three Tendon Graft Types

THURSDAY, June 27, 2019 (HealthDay News) — Patients who received patellar tendon, hamstring tendon, or “double-bundle” hamstring tendon grafts for anterior cruciate ligament (ACL) repair had no significant difference in quality of life at five years postsurgery, according to a study published in the June 5 issue of The Journal of Bone & Joint Surgery.

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MSSP ACOs May Not Improve Spending, Quality of Care

WEDNESDAY, June 26, 2019 (HealthDay News) — After adjustment for the nonrandom exit of clinicians, the Medicare Shared Savings Program (MSSP) is not associated with improvements in spending or quality, according to a study published online June 18 in the Annals of Internal Medicine.

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Americans Concerned About Clinician Burnout

WEDNESDAY, June 26, 2019 (HealthDay News) — Nearly three-quarters of Americans are concerned about burnout among their clinicians, according to a survey released June 17 by the American Society of Health-System Pharmacists (ASHP).

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Combination Biopsy Strategy May Identify More Prostate Cancers

WEDNESDAY, June 26, 2019 (HealthDay News) — A lesion visible on magnetic resonance imaging (MRI) identifies a heightened risk for clinically significant prostate cancer in men undergoing first-time prostate biopsy, and a combination of targeted and systematic biopsy may improve the chances of detecting cancer, according to a study published online June 12 in JAMA Surgery.

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Prevention Bundle May Cut Cardiac Device Infections

WEDNESDAY, June 26, 2019 (HealthDay News) — Standardized protocols and bundles can improve infection prevention in the electrophysiology laboratory, according to a study published online June 4 in Infection Control & Hospital Epidemiology.

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Older Kidney Donors With HTN at Higher Risk for ESKD Later

WEDNESDAY, June 26, 2019 (HealthDay News) — Older kidney donors with hypertension have an increased risk for end-stage kidney disease (ESKD), but not mortality, through 15 years after donation, according to a study published online June 25 in the Clinical Journal of the American Society of Nephrology.

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Mortality Not Higher With Transfusions From Female Donors

TUESDAY, June 25, 2019 (HealthDay News) — There is no increased risk for mortality among patients receiving red blood cell transfusions from female, previously pregnant, or sex-discordant donors, according to a study published in the June 11 issue of the Journal of the American Medical Association.

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Changing EHR Systems May Up Operating Times for Eye Surgery

TUESDAY, June 25, 2019 (HealthDay News) — Changing electronic health record (EHR) systems may cause longer operation times for eye surgeries, according to a study published online June 20 in JAMA Ophthalmology.

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Adrenal Incidentalomas Rarely Grow, Change Hormone Function

MONDAY, June 24, 2019 (HealthDay News) — Nonfunctioning adrenal tumors (NFATs) or adenomas causing mild autonomous cortisol excess (MACE) rarely show clinically relevant changes in size or hormone function, according to research published online June 25 in the Annals of Internal Medicine.

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Septoplasty Beats Nonsurgical Management for Deviated Septum

FRIDAY, June 21, 2019 (HealthDay News) — For adults with a deviated septum, septoplasty is more effective than nonsurgical management for nasal obstruction, according to a study published online June 18 in The Lancet.

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Many Patients Excluded From Knee Cartilage Research Studies

FRIDAY, June 21, 2019 (HealthDay News) — Common conditions are keeping many patients from participating in knee cartilage research studies, according to a review published online May 30 in npj Regenerative Medicine.

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New England Journal of Medicine Picks New Editor-in-Chief

THURSDAY, June 20, 2019 (HealthDay News) — The new editor-in-chief of the prestigious New England Journal of Medicine is Eric J. Rubin, M.D., Ph.D., who was selected after a worldwide search and plans to start in September, according to the Massachusetts Medical Society, which publishes the journal.

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Restricting Blood Transfusions OK in Cardiac Surgery

THURSDAY, June 20, 2019 (HealthDay News) — For high-risk patients undergoing cardiac surgery with cardiopulmonary bypass, a restrictive approach to red blood cell transfusions leads to fewer transfusions than a liberal approach, with no increase in the risk for acute kidney injury (AKI), according to a study published online June 20 in the Journal of the American Society of Nephrology.

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Health Care Workers With ARIs Often Work While Symptomatic

THURSDAY, June 20, 2019 (HealthDay News) — Almost all health care workers (HCWs) with acute respiratory illness (ARI) report working at least one day while symptomatic, according to a study published online June 18 in Infection Control & Hospital Epidemiology.

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Surgeons’ Unprofessional Behavior Tied to Higher Complication Risk

WEDNESDAY, June 19, 2019 (HealthDay News) — Patients whose surgeons have higher numbers of coworker reports about unprofessional behavior may be at increased risk for postsurgical complications, according to a study published online June 19 in JAMA Surgery.

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Prophylactic IVC Filters Worsen Outcomes for Bariatric Surgery

WEDNESDAY, June 19, 2019 (HealthDay News) — For patients undergoing bariatric surgery, use of prophylactic inferior vena cava filters (IVCFs) is associated with worse clinical outcomes and increased use of health care resources, according to a study published in the June 24 issue of JACC: Cardiovascular Interventions.

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Many Surgeons Still Performing Inappropriate Vascular Access Sx

WEDNESDAY, June 19, 2019 (HealthDay News) — For patients with first-time permanent hemodialysis access placement, more than one-fifth of surgeons have arteriovenous graft (AVG) use rates exceeding the recommended best practice guideline of 34 percent, according to a study published online June 12 in JAMA Surgery.

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Study Looks at Risk for Bleeding in Percutaneous Tx of PAD

WEDNESDAY, June 19, 2019 (HealthDay News) — Major bleeding occurs in about 4 percent of lower-extremity peripheral vascular intervention (PVI) procedures, according to a study published online June 17 in JACC: Cardiovascular Interventions.

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Patterns of Inpatient Opioid Use Linked to Long-Term Use

TUESDAY, June 18, 2019 (HealthDay News) — Specific patterns of opioid administration to opioid-naive inpatients are associated with risk for long-term use after discharge, according to a study published online June 18 in the Annals of Internal Medicine.

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Drug Makers Challenge New Rule Requiring Drug Prices in TV Ads

MONDAY, June 17, 2019 (HealthDay News) — Three large drug makers have launched a legal challenge against the Trump administration’s rule requiring the prices of drugs to be included in television ads.

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Head, Facial Injuries From Motorized Scooters on the Rise

FRIDAY, June 14, 2019 (HealthDay News) — Facial and head injuries from electric scooter accidents have tripled during the past decade, according to a study published online May 20 in the American Journal of Otolaryngology.

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Drug- and Alcohol-Related Deaths Higher After Bariatric Surgery

FRIDAY, June 14, 2019 (HealthDay News) — Drug- and alcohol-related mortality is significantly higher than expected in the seven years following bariatric surgery, according to a study recently published in Surgery for Obesity and Related Diseases.

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Infliximab Introduction Has Not Cut IBD-Related Hospitalizations

FRIDAY, June 14, 2019 (HealthDay News) — Marketplace introduction of infliximab has not resulted in reductions in the population rates of inflammatory bowel disease (IBD)-related hospitalizations or intestinal resections or colectomies, according to a study published online June 13 in Gut.

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Opioid-Sparing Strategy Still Provides Good Pain Control

FRIDAY, June 14, 2019 (HealthDay News) — Following implementation of an opioid-sparing pain management strategy, half of patients report using no opioids and adequate pain control, according to a study published online May 30 in the Journal of the American College of Surgeons.

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Most Providers Unaware of Online Feedback About Themselves

WEDNESDAY, June 12, 2019 (HealthDay News) — Many health care providers in the United Kingdom have little direct experience with online feedback, rarely encourage it, and often view it as having little value for improving the quality of health services, according to a study published online June 2 in the Journal of Health Services Research & Policy.

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Weight Loss Surgery May Not Relieve Acid Reflux

WEDNESDAY, June 12, 2019 (HealthDay News) — Reflux symptoms return in about half of patients who undergo gastric bypass, according to a study published online June 4 in Alimentary Pharmacology & Therapeutics.

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PDE5i Use Linked to Post-LVAD Right Heart Failure Events

WEDNESDAY, June 12, 2019 (HealthDay News) — For left ventricular assist device (LVAD) recipients, those on phosphodiesterase-5 inhibitors (PDE5i) have a higher incidence of severe early right heart failure (RHF), according to a study published online June 11 in Circulation: Heart Failure.

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Microbes Tied to Pedicle Screw Loosening, Spinal Implant Failure

WEDNESDAY, June 12, 2019 (HealthDay News) — Low-virulent microorganisms frequently detected on pedicle screws may be an important cause of spinal implant loosening and failure in patients without signs of infection, according to a study recently published in the Journal of Neurosurgery: Spine.

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Mortality No Different With TAVR for Bicuspid, Tricuspid Stenosis

TUESDAY, June 11, 2019 (HealthDay News) — For patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis, there is no significant difference in 30-day or one-year mortality for bicuspid or tricuspid aortic stenosis, according to a study published in the June 11 issue of the Journal of the American Medical Association.

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Access to Health Care Has Little Impact on Longevity

MONDAY, June 10, 2019 (HealthDay News) — Health care has modest effects on extending life expectancy in the United States, while behavioral and social determinants may have larger effects, according to a review published in the May/June issue of the Annals of Family Medicine.

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Opioid Safety Initiative Can Decrease Opioid Prescriptions

FRIDAY, June 7, 2019 (HealthDay News) — The Opioid Safety Initiative has been effective for decreasing opioid prescriptions among patients undergoing total knee arthroplasty, according to a study published online May 30 in Anesthesiology.

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Gastric Bypass Tied to Higher Fracture Risk Versus Gastric Band

THURSDAY, June 6, 2019 (HealthDay News) — There is a 73 percent increased risk for nonvertebral fracture after Roux-en-Y gastric bypass (RYGB) versus adjustable gastric banding (AGB), according to a study published online May 15 in JAMA Surgery.

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Rapid Cycling Work Roster Improves Resident Sleep Practices

THURSDAY, June 6, 2019 (HealthDay News) — A rapidly cycling work roster (RCWR) is effective in reducing weekly work hours and the occurrence of >16 consecutive-hour shifts as well as improving sleep duration of resident physicians, according to a study published online May 20 in SLEEP.

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Survey Indicates Physician Misconduct Is Underreported

THURSDAY, June 6, 2019 (HealthDay News) — Physician misconduct is being underreported and most Americans do not know where to file a complaint, according to a report published by the Federation of State Medical Boards (FSMB).

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Overdose-Death Donor Hearts Suitable for Transplant

THURSDAY, June 6, 2019 (HealthDay News) — Recipient overall survival is similar for overdose-death donor (ODD) and non-ODD cardiac transplants, according to a study published online June 6 in the Annals of Thoracic Surgery.

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Cholecystectomy Reduces Risk for Stroke in Patients With Gallstones

WEDNESDAY, June 5, 2019 (HealthDay News) — Among patients with gallstones, cholecystectomy is associated with a reduced risk for overall, ischemic, and hemorrhagic stroke, according to a study published online June 5 in the Journal of Gastroenterology and Hepatology.

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Burden of New-Onset A-Fib Considerable After TAVI, AVR

WEDNESDAY, June 5, 2019 (HealthDay News) — The burden of new-onset atrial fibrillation is considerable following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (AVR), and the odds of in-hospital mortality are increased with new-onset atrial fibrillation, according to a study published online June 3 in JAMA Internal Medicine.

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Postop Delirium May Briefly Up Risk for Cognitive Dysfunction

WEDNESDAY, June 5, 2019 (HealthDay News) — Older patients who develop delirium after surgery are more likely to show signs of cognitive dysfunction one month later, according to a study published online May 28 in Anesthesiology.

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ACP Issues Position on Response to Physician Impairment

MONDAY, June 3, 2019 (HealthDay News) — Providing assistance for physician impairment and rehabilitation is addressed in a position statement issued by the American College of Physicians and published online June 4 in the Annals of Internal Medicine.

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Decline in Nontraumatic Lower-Extremity Amputation Slowing

MONDAY, June 3, 2019 (HealthDay News) — Decreases in nontraumatic lower-extremity amputation (NLEA) have plateaued in recent years among adults with end-stage renal disease (ESRD) and diabetes, according to a study published online May 29 in Diabetes Care.

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Higher Surgical Volume May Improve Outcomes in Cervical Cancer

MONDAY, June 3, 2019 (HealthDay News) — Surgery at high-volume centers is associated with decreased local recurrence risk and improved survival for women with early-stage cervical cancer, according to a study published in the June issue of Obstetrics & Gynecology.

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