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March 2018 Briefing – Surgery

March 2018 Briefing – Surgery
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Here are what the editors at HealthDay consider to be the most important developments in Surgery for March 2018. 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.

Bariatric Surgery Lessens Knee OA Pain More in Certain Patients

FRIDAY, March 30, 2018 (HealthDay News) — Laparoscopic gastric band (LAGB) surgery is associated with more improvement in knee osteoarthritis (OA) in younger patients and those without prior knee injury, according to a study published recently in Seminars in Arthritis and Rheumatism.

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Pectoralis Major Tears Described in Deployed Military Personnel

FRIDAY, March 30, 2018 (HealthDay News) — Deployed military personnel may be at high risk for pectoralis major tears, according to a study published online in the Journal of Orthopedics & Rheumatology.

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Aortic Valve Replacement in Elderly Tied to High Mortality

FRIDAY, March 30, 2018 (HealthDay News) — The 10-year mortality rate in elderly patients who receive surgical aortic valve replacement (SAVR) is considerable, according to a study published in the April 3 issue of the Journal of the American College of Cardiology.

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Nurse Education Improves Post-Op Survival in Dementia Patients

THURSDAY, March 29, 2018 (HealthDay News) — Having more nurses in the hospital with at least a bachelor of science degree in nursing (BSN) is tied to lower post-surgical mortality among patients with Alzheimer’s disease and related dementias (ADRD), according to a study published online March 20 in the Journal of the American Geriatrics Society.

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Novel Interstitium Has Been Identified in Human Tissues

THURSDAY, March 29, 2018 (HealthDay News) — A previously unrecognized interstitium has been identified in human tissues, according to a study published online March 27 in Scientific Reports.

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Bariatric Surgery Can Lead to Changes in Relationship Status

THURSDAY, March 29, 2018 (HealthDay News) — Bariatric surgery is associated with changes in relationship status, according to a study published online March 28 in JAMA Surgery.

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Lower Thromboembolic Risk With New A-Fib After CABG Versus NVAF

THURSDAY, March 29, 2018 (HealthDay News) — For patients post coronary artery bypass graft (CABG) surgery, new-onset postoperative atrial fibrillation (POAF) is associated with lower long-term thromboembolic risk than that seen among patients with nonvalvular atrial fibrillation (NVAF), according to a study published online March 28 in JAMA Cardiology.

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mHealth Program Increases Peak VO2 After Cardiac Rehab

WEDNESDAY, March 28, 2018 (HealthDay News) — After cardiac rehabilitation (CR), a 12-week mHealth program involving physical activity trackers and health coaching can increase absolute peak VO2 and moderate-high physical activity, according to a study published in the May issue of the American Heart Journal.

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Casting, Surgery Equivalent Over Long Term for Unstable Ankle Fx

WEDNESDAY, March 28, 2018 (HealthDay News) — For older patients with acute unstable malleolar fractures, equivalence in function between close contact casting and immediate surgery strategies persists at three years, according to a research letter published in the March 27 issue of the Journal of the American Medical Association.

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2007-2013 Saw Increase in THA Revisions for 45- to 64-Year-Olds

WEDNESDAY, March 28, 2018 (HealthDay News) — Patients aged 45 to 64 years had an increase in the total hip arthroplasty (THA) revision rate from 2007 to 2013, although decreases were seen in all other age groups, according to a study published in the March 21 issue of the Journal of Bone & Joint Surgery.

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Condition Readmission Measures Don’t Reflect Overall Quality

TUESDAY, March 27, 2018 (HealthDay News) — Current publicly reported measures may not be good surrogates for overall hospital quality related to 30-day readmissions, according to a study published online March 27 in the Annals of Internal Medicine.

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EHR Usability Contributes to Possible Patient Harm Events

TUESDAY, March 27, 2018 (HealthDay News) — Electronic health record (EHR) usability may contribute to possible patient harm events, according to a research letter published in the March 27 issue of the Journal of the American Medical Association.

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Children’s Hoverboard, Skateboard Injuries Are Similar

TUESDAY, March 27, 2018 (HealthDay News) — Injury characteristics among hoverboard riders and skateboarders are similar, according to a study published online March 26 in Pediatrics.

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Ethical Duties ID’d for Short-Term Global Health Experiences

MONDAY, March 26, 2018 (HealthDay News) — In a position paper published online March 27 in the Annals of Internal Medicine, ethical obligations have been detailed for physicians participating in short-term global health experiences (STEGHs).

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Trained Navigators Help Patients With Kidney Transplant Process

MONDAY, March 26, 2018 (HealthDay News) — A trained patient navigator helps to increase access to the transplant waitlist for disadvantaged patients with kidney failure who need a longer time to get through the transplant evaluation process, according to a study published online March 26 in the Clinical Journal of the American Society of Nephrology.

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Challenges ID’d for Childbearing During Surgical Residency

MONDAY, March 26, 2018 (HealthDay News) — The challenges associated with having children during surgical residency may have considerable impact on the workforce, according to a study published online March 21 in JAMA Surgery.

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Lean Approach May Help Tackle Burnout in Health Care Providers

FRIDAY, March 23, 2018 (HealthDay News) — The Lean approach, which emphasizes reducing waste and improving customer value by focusing on the big picture, can be used to address physician burnout, according to a report published in Medical Economics.

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Frailty Associated With Failure to Rescue After Inpatient Surgery

FRIDAY, March 23, 2018 (HealthDay News) — For patients undergoing inpatient surgery, frailty is associated with failure to rescue (FTR), according to a study published online March 21 in JAMA Surgery.

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Intrauterine Adhesions Rarely Occur Post Induced Abortion

FRIDAY, March 23, 2018 (HealthDay News) — Intrauterine adhesions (IUA) following an induced abortion are rare, but risk increases when surgical evacuation is involved, according to a study published online March 13 in BJOG: An International Journal of Obstetrics & Gynaecology.

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Increase in Patient Load Linked to Poorer Urologist Ratings

FRIDAY, March 23, 2018 (HealthDay News) — Academic urologists have higher mean weighted ratings than their nonacademic peers, and those with increased patient load have poorer ratings, according to a research letter published online March 21 in JAMA Surgery.

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Unique Risks Associated With Texting Medical Orders

THURSDAY, March 22, 2018 (HealthDay News) — Despite the popularity, convenience, and speed of texting medical orders, there are unique and alarming risks associated with the practice, according to a report published in Drug Topics.

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H. Pylori Treatment Tied to Lower Metachronous Gastric Cancer Risk

WEDNESDAY, March 21, 2018 (HealthDay News) — Antibiotic treatment for Helicobacter pylori (H. pylori) in patients who underwent endoscopic resection of early-stage gastric cancer or high-grade adenoma is associated with a reduced rate of metachronous gastric cancer, according to a study published in the March 22 issue of the New England Journal of Medicine.

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Blueprint Being Developed to Address Physician Burnout

WEDNESDAY, March 21, 2018 (HealthDay News) — A new, three-pronged approach is being applied to develop a blueprint for addressing physician burnout, according to a report published in Medical Economics.

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Personal Health Info Found in Recycling at Five Hospitals

TUESDAY, March 20, 2018 (HealthDay News) — A considerable amount of personal health information (PHI) and personally identifiable information (PII) was found in the recycling at five Canadian teaching hospitals, according to a research letter published in the March 20 issue of the Journal of the American Medical Association.

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Integrative Medicine Training Tied to Less Antibiotic Prescribing

TUESDAY, March 20, 2018 (HealthDay News) — General practitioners (GPs) additionally trained in integrative medicine or complementary and alternative medicine (IM GPs) have lower antibiotic prescribing rates after general surgery than traditional practitioners, according to a study published in the March issue of BMJ Open.

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Prior Authorization Negatively Impacts Clinical Outcomes

MONDAY, March 19, 2018 (HealthDay News) — The burdens associated with prior authorization (PA) are high and include a negative impact on clinical outcomes, reported by 92 percent of physicians, according to the results of a survey conducted for the American Medical Association (AMA).

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Review Supports Rhinoplasty for Nasal Airway Obstruction

MONDAY, March 19, 2018 (HealthDay News) — For adults with nasal airway obstruction, repair of the lateral nasal wall is effective, according to a review published online March 15 in JAMA Facial Plastic Surgery.

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Costs Up for Neonates With Vocal Fold Motion Impairment

MONDAY, March 19, 2018 (HealthDay News) — For neonates undergoing congenital heart surgery (CHS), vocal fold motion impairment (VFMI) is associated with increased costs due to increased post-procedure length of stay (PPLOS), according to a study published online March 15 in JAMA Otolaryngology-Head & Neck Surgery.

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No Benefit for MRI After Normal Cervical CT in Blunt Trauma

FRIDAY, March 16, 2018 (HealthDay News) — For patients with obtunded blunt trauma to the cervical spine, magnetic resonance imaging (MRI) follow-up appears not to be beneficial after normal cervical computed tomography (CT) findings, according to a study published online March 14 in JAMA Surgery.

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Risk of Post-Tonsillectomy Complications Up for Under-3s

FRIDAY, March 16, 2018 (HealthDay News) — Children aged younger than 3 years seem to have increased risk of complications following tonsillectomy compared with children aged 3 years or older, according to a study published online March 15 in JAMA Otolaryngology-Head & Neck Surgery.

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Burn Deaths Down From 1989 to 2017 in the United States

THURSDAY, March 15, 2018 (HealthDay News) — Burn injury survival has dramatically increased over the past 30 years, according to a study published online March 9 in the Journal of the American College of Surgeons.

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VTE Risk Up in Most Emergency General Surgery Patients

THURSDAY, March 15, 2018 (HealthDay News) — Almost all emergency general surgery (EGS) patients treated operatively and nonoperatively have increased risk of venous thromboembolism (VTE) and should receive prophylactic treatment, according to a review published online March 14 in JAMA Surgery.

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Review: Virtual Reality Distracts From Pain of Medical Procedures

THURSDAY, March 15, 2018 (HealthDay News) — Virtual reality (VR) appears to be an effective distraction intervention to relieve pain and distress during various medical procedures, according to a review published online Feb. 26 in The Clinical Journal of Pain.

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Drug Copayments Often Exceed Prescription Drug Costs

WEDNESDAY, March 14, 2018 (HealthDay News) — Drug copayments frequently exceed prescription drug costs, with overpayments affecting 23 percent of all prescriptions, according to a research letter published in the March 13 issue of the Journal of the American Medical Association.

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Vaginal Birth Tied to Later Lack of Pelvic Organ Support

WEDNESDAY, March 14, 2018 (HealthDay News) — Vaginal birth is associated with worse pelvic organ support five years after a woman’s first delivery, and genital hiatus size is an independent predictor of worse support, according to a study published in the March issue of the American Journal of Obstetrics & Gynecology.

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Improved Glycemic Control With Surgical Tx of Obesity in Teens

WEDNESDAY, March 14, 2018 (HealthDay News) — Surgical treatment of severe obesity in adolescents with type 2 diabetes is associated with better glycemic control and weight reduction than medical therapy, according to a study published online March 12 in JAMA Pediatrics.

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U.S. Spends Twice As Much for Similar Health Care Utilization

TUESDAY, March 13, 2018 (HealthDay News) — Spending on health care is much higher in the United States than other high-income countries, but utilization rates are similar, according to a study published in the March 13 issue of the Journal of the American Medical Association.

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Head Injury Outcomes Better With Trauma Center Care

TUESDAY, March 13, 2018 (HealthDay News) — Patients with isolated, severe head injury have better outcomes if they are initially treated in designated trauma centers, according to a study published online March 1 in the Journal of the American College of Surgeons.

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Three-Pronged Approach Can Improve Physician Engagement

MONDAY, March 12, 2018 (HealthDay News) — The three-pronged approach implemented by one practice successfully improved physician engagement, according to an article published in Medical Economics.

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Considerable Resource Use, Costs for Cardiovascular Care

MONDAY, March 12, 2018 (HealthDay News) — The 10-year costs associated with cardiovascular disease (CVD) are considerable, according to a study published in the March 13 issue of the Journal of the American College of Cardiology.

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Racial Variation in Median Age of Female Breast Cancer Diagnosis

MONDAY, March 12, 2018 (HealthDay News) — The median age of diagnosis of female breast cancer is higher for white patients than for black, Hispanic, and Asian patients, according to a research letter published online March 7 in JAMA Surgery.

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Odds of Opioid Prescriptions Up in Head and Neck Cancer Patients

MONDAY, March 12, 2018 (HealthDay News) — The odds of opioid prescription are increased for patients with head and neck cancer (HNCA) versus those with lung or colon cancer (LCCA), according to a research letter published online March 8 in JAMA Otolaryngology-Head & Neck Surgery.

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Cataract Surgery Less Likely With Small Social Support Network

MONDAY, March 12, 2018 (HealthDay News) — Medicare beneficiaries with small social support networks are less likely to receive cataract surgery, according to a study published online March 8 in JAMA Ophthalmology.

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Median Household Income Predicts Survival in Anal Cancer

MONDAY, March 12, 2018 (HealthDay News) — Lower median household income (MHI) is associated with worse survival for patients with squamous cell carcinoma of the anus (SCCA), according to a study published online March 12 in Cancer.

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Doctors Facing Challenge to Help Needy While Protecting Practices

FRIDAY, March 9, 2018 (HealthDay News) — Physicians are increasingly being challenged to protect their practice finances while helping patients without insurance, according to an article published in Medical Economics.

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Severity of Nonfatal Firearm Injuries Increased, 1993 to 2014

FRIDAY, March 9, 2018 (HealthDay News) — The severity of hospitalized firearm injuries increased significantly from 1993 to 2014, according to a study published online Feb. 13 in Trauma Surgery & Acute Care Open.

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Sustained Collaboration Meets Needs for Bladder Exstrophy

FRIDAY, March 9, 2018 (HealthDay News) — International collaboration focused on treating bladder exstrophy-epispadias complex (BE) and penopubic epispadias (PE) in India is associated with acceptable outcomes, according to a study published online March 7 in JAMA Surgery.

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Text Message-Based Intervention Helps With Sobriety Maintenance

FRIDAY, March 9, 2018 (HealthDay News) — Mobile alcohol interventions may help liver transplant candidates with alcoholic liver disease (ALD) maintain sobriety, according to a study published online March 2 in Alcoholism: Clinical & Experimental Research.

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Backrest Elevation Has No Effect on Sacral Tissue Integrity

FRIDAY, March 9, 2018 (HealthDay News) — Level of backrest elevation is not associated with changes in tissue integrity among critically ill patients receiving mechanical ventilation, according to research published online March 1 in the American Journal of Critical Care.

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Plantar-Lateral Plating Beneficial in Simulated Jones Fracture

FRIDAY, March 9, 2018 (HealthDay News) — Compared with intramedullary screw fixation, plantar-lateral plating allows for greater cycles to failure and peak load before failure when applied to cadaver foot specimens with simulated Jones fracture, according to a study published online Feb. 21 in the American Journal of Sports Medicine.

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Botulinum Toxin Injections Improve Facial Surgical Scars

FRIDAY, March 9, 2018 (HealthDay News) — Botulinum toxin injections in surgical wound closure immediately after surgery improve facial surgery scars, according to a small study published in the March issue of Plastic and Reconstructive Surgery.

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2005 to 2015 Saw Drop in Living Kidney Donation Among Men

THURSDAY, March 8, 2018 (HealthDay News) — From 2005 to 2015, there was a decrease in living kidney donation in men, while donation was stable for women, according to a study published online March 8 in the Journal of the American Society of Nephrology.

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Patient, Caregiver Characteristics Predict LVAD Response

THURSDAY, March 8, 2018 (HealthDay News) — For patients receiving left ventricular assist device (LVAD) therapy and their caregivers, patient and caregiver characteristics predict response, according to a study published online March 7 in the Journal of the American Heart Association.

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Postpartum Abdominoplasty Improves Back Pain, Incontinence

THURSDAY, March 8, 2018 (HealthDay News) — Abdominoplasty in the postpartum population improves low back pain and urinary incontinence, according to a study published online Feb. 28 in Plastic and Reconstructive Surgery.

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Patient-Reported Outcome Tool Developed for Lumbar Spine Sx

THURSDAY, March 8, 2018 (HealthDay News) — A patient-reported outcome (PRO) tool has been developed and validated to predict response after lumbar spine surgery, according to a study published online March 7 in JAMA Surgery.

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Total Hip Arthroplasty Linked to Increased Survival for 10 Years

THURSDAY, March 8, 2018 (HealthDay News) — Total hip arthroplasty (THA) is associated with increased life expectancy during the 10 years after surgery, according to a study published online Feb. 28 in Clinical Orthopaedics and Related Research.

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Surgeons Often Do Arthroscopic Partial Meniscectomy

WEDNESDAY, March 7, 2018 (HealthDay News) — Arthroscopic partial meniscectomy (APM)-only procedures make up 66.7 percent of knee arthroscopies performed by low- and high-volume surgeons, according to a research letter published online Feb. 28 in JAMA Surgery.

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FDA Approves Mechanical Heart Valve for Newborns

WEDNESDAY, March 7, 2018 (HealthDay News) — The U.S. Food and Drug Administration has approved the world’s smallest mechanical heart valve, designed to be used in newborns and other young infants with heart defects.

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No Benefit for Aggressive Therapy in Metastatic Prostate Cancer

WEDNESDAY, March 7, 2018 (HealthDay News) — For men with metastatic prostate cancer, there is no survival advantage for aggressive therapy over conservative androgen deprivation therapy only, according to a study published online March 2 in Cancer.

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Many PICCs Placed Have Dwell Time of No More Than Five Days

WEDNESDAY, March 7, 2018 (HealthDay News) — About 25 percent of peripherally inserted central catheters (PICCs) placed have a dwell time of five days or less, and almost 10 percent of patients with a short-term PICC experience a complication, according to a study published in the February issue of the Journal of Hospital Medicine.

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Multimodal Analgesia Cuts Complications Post Arthroplasty

WEDNESDAY, March 7, 2018 (HealthDay News) — Use of multimodal analgesia is associated with fewer complications, reduced opioid prescriptions, and reduced hospital length of stay after total hip/knee arthroplasty, according to a study published online March 1 in Anesthesiology.

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Aspirin Therapy Appears Safe Before Thyroid Surgery

WEDNESDAY, March 7, 2018 (HealthDay News) — Continuing aspirin therapy before thyroid surgery does not appear to increase the risk of intraoperative bleeding, according to a study published online March 1 in JAMA Otolaryngology-Head & Neck Surgery.

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Prophylaxis Can Prevent HCV Infection in Kidney Recipients

TUESDAY, March 6, 2018 (HealthDay News) — Direct-acting antiviral prophylaxis is safe and prevents chronic hepatitis C virus (HCV) infection after kidney transplantation from HCV-infected donors to noninfected recipients, according to a study published online March 6 in the Annals of Internal Medicine.

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High Prevalence of Hearing Loss Seen After Infant Heart Surgery

FRIDAY, March 2, 2018 (HealthDay News) — The prevalence of hearing loss in preschool children who had heart surgery in infancy may be above 20 percent, according to a study published in the January issue of The Journal of Pediatrics.

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Shared Decision-Making Beneficial for Destination Therapy LVAD

FRIDAY, March 2, 2018 (HealthDay News) — A shared decision support intervention is beneficial for patients considering destination therapy left ventricular assist device (DT LVAD) placement, according to a study published online Feb. 26 in JAMA Internal Medicine.

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U.S. Trends in Gender-Affirming Surgery Explored

THURSDAY, March 1, 2018 (HealthDay News) — About 11 percent of patient encounters with a diagnosis code of transsexualism or gender identity disorder involve gender-affirming surgery, and more than half are not covered by an insurance plan, according to a study published online Feb. 28 in JAMA Surgery.

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