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

FDA Approves First Artificial Iris

THURSDAY, May 31, 2018 (HealthDay News) — The first artificial iris has been approved by the U.S. Food and Drug Administration for patients with aniridia.

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ASHP: SVP, Injectable Opioid Shortages Threaten Patient Care

THURSDAY, May 31, 2018 (HealthDay News) — The widespread shortages of injectable opioids and small-volume parenteral (SVP) solutions are jeopardizing patient care and placing a strain on hospital operations, according to a report published by the American Society of Health-System Pharmacists (ASHP).

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Worse Survival for BRCA Germline Mutation Carriers in Pancreatic CA

WEDNESDAY, May 30, 2018 (HealthDay News) — BRCA1/BRCA2 germline mutation carriers with pancreatic ductal adenocarcinoma (PDAC) have worse survival after resection, according to a study published in the April issue of the Journal of the American College of Surgeons.

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Mortality Still High After Surgery for Congenital Heart Defects

FRIDAY, May 25, 2018 (HealthDay News) — Long-term mortality after congenital heart surgery is higher than that of the general population for all forms of congenital heart defects (CHDs), according to a study published in the May 29 issue of the Journal of the American College of Cardiology.

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Congress Approves Bill Expanding Private Care for VA Patients

THURSDAY, May 24, 2018 (HealthDay News) — Patients served by the beleaguered Veterans Affairs health system may have wider access to private care, thanks to a bill approved Wednesday by the Senate. President Donald Trump is known to support the bill, which now awaits his signature.

AMA Statement
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Regional Anesthesia Tied to Lower Opioid Use in TKA, THA

THURSDAY, May 24, 2018 (HealthDay News) — Regional anesthesia is associated with a lower opioid consumption in both knee and hip replacement surgeries, compared to general anesthesia, according to a study published May 14 in PAIN Practice.

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Global Variation in Personal Health Care Access and Quality

THURSDAY, May 24, 2018 (HealthDay News) — There is considerable global variation in personal health care access and quality, according to a study published online May 23 in The Lancet.

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Post-Surgical Readmissions Higher Among Homeless Veterans

TUESDAY, May 22, 2018 (HealthDay News) — Readmissions are higher in homeless veterans discharged to the community after surgery, compared to housed veterans, according to a study published in the June issue of Medical Care.

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CDC: No Change in Level of Uninsured in U.S. in 2017

TUESDAY, May 22, 2018 (HealthDay News) — Overall, 9.1 percent of individuals in the United States were uninsured in 2017, which was not significantly different from the level in 2016, according to a report published online May 22 by the U.S. Centers for Disease Control and Prevention’s National Centers for Health Statistics.

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FDA OKs Doptelet for Liver Dz Patients Undergoing Procedures

MONDAY, May 21, 2018 (HealthDay News) — Doptelet (avatrombopag) has been approved by the U.S. Food and Drug Administration to treat adults with chronic liver disease who are slated to have a medical or dental procedure.

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Patterns of Potential Misuse Help Assess Risk of Opioid Overdose

MONDAY, May 21, 2018 (HealthDay News) — Patterns of potential opioid misuse are positively associated with subsequent opioid overdose, according to a study published online May 22 in the Annals of Internal Medicine.

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Surgical Site Infection Rate Can Be Reduced in Hysterectomy

MONDAY, May 21, 2018 (HealthDay News) — Implementation of a perioperative surgical site infection prevention bundle may reduce the rate of surgical site infection among patients undergoing hysterectomy, according to a study published online May 7 in Obstetrics & Gynecology.

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Language Used in Medical Record Can Affect Patient Care

FRIDAY, May 18, 2018 (HealthDay News) — Stigmatizing language used in medical records to describe patients can influence medical students and residents in terms of their attitudes towards the patient and their clinical decision-making, according to a study published in the May issue of the Journal of General Internal Medicine.

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Proportion of Drug-Intoxicated Organ Donors on the Rise in U.S.

FRIDAY, May 18, 2018 (HealthDay News) — The drug abuse epidemic in the United States has been associated with an increase in the recovery of organs from brain-dead donors, according to a research letter published in the May 17 issue of the New England Journal of Medicine.

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V600E BRAF Mutation Tied to Worse Survival in CRC Liver Mets

FRIDAY, May 18, 2018 (HealthDay News) — For patients undergoing resection of colorectal liver metastases (CRLM), the presence of the V600E BRAF mutation is associated with worse prognosis, according to a study published online May 16 in JAMA Surgery.

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Breath Test Shows Promise for Diagnosis of Esophagogastric CA

FRIDAY, May 18, 2018 (HealthDay News) — Breath analysis shows potential for noninvasive diagnosis of esophagogastric cancer (OGC), according to a study published online May 17 in JAMA Oncology.

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Nonprofit Manufacturer Could Keep Generic Drug Costs Down

WEDNESDAY, May 16, 2018 (HealthDay News) — A nonprofit manufacturer could help keep generic drug prices down and maintain their supply, according to a perspective piece published in the May 17 issue of the New England Journal of Medicine.

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Higher CRC Risk With Advanced Adenoma Found on Colonoscopy

WEDNESDAY, May 16, 2018 (HealthDay News) — Participants with an advanced adenoma at diagnostic colonoscopy have increased risk of developing colorectal cancer (CRC) relative to those with no adenoma, according to a study published in the May 15 issue of the Journal of the American Medical Association.

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Best Practices Developed for Use of EHR to Enhance Patient Care

WEDNESDAY, May 16, 2018 (HealthDay News) — Best practices have been developed for using electronic health records (EHRs) to enhance patient-centered care, according to an article published online in Medical Economics.

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Early Post-Op APAP Exposure May Cut AKI Risk in Peds Cardiac Sx

TUESDAY, May 15, 2018 (HealthDay News) — For pediatric patients undergoing cardiac surgery, early postoperative acetaminophen exposure may be associated with a reduced rate of acute kidney injury (AKI), according to a study published online May 14 in JAMA Pediatrics.

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Novel Algorithm Can Help Create 3-D Human Nose Prosthesis

TUESDAY, May 15, 2018 (HealthDay News) — An algorithm can be used to model and print a three-dimensional (3-D) prosthesis of a human nose, according to a study published online May 10 in JAMA Otolaryngology-Head & Neck Surgery.

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Rate of Deaths From Falls in Seniors Up From 2007 to 2016

MONDAY, May 14, 2018 (HealthDay News) — From 2007 to 2016, the rate of deaths from falls among older adults increased by an average of 3.0 percent per year, according to research published in the May 11 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

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Hemorrhage Control Training Is Beneficial for Laypersons

FRIDAY, May 11, 2018 (HealthDay News) — Hemorrhage control training for laypersons is the most efficacious method for controlling hemorrhaging, according to a study published online May 9 in JAMA Surgery.

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Vertebroplasty Does Not Up Pain Relief in Osteoporotic Fracture

THURSDAY, May 10, 2018 (HealthDay News) — For patients with acute osteoporotic vertebral compression fractures, percutaneous vertebroplasty does not result in significantly greater pain relief than a sham procedure at 12 months, according to a study published online May 9 in The BMJ.

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Low Procedure Volume for Many Surgeons Doing Hysterectomies

WEDNESDAY, May 9, 2018 (HealthDay News) — A substantial number of surgeons performing hysterectomies have low procedural volumes, according to a study published online May 9 in Obstetrics & Gynecology.

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Surgery for Hip Fx Cuts Mortality in NH Residents With Dementia

WEDNESDAY, May 9, 2018 (HealthDay News) — For nursing home (NH) residents with dementia and hip fracture, surgical hip fracture repair is associated with lower mortality, according to a study published online May 7 in JAMA Internal Medicine.

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Crowdfunding Exaggerates Efficacy of Unproven Stem Cell Tx

WEDNESDAY, May 9, 2018 (HealthDay News) — Crowdfunding campaigns for unproven stem cell-based interventions tend to exaggerate the efficacy and underemphasize the risks, according to a research letter published in the May 8 issue of the Journal of the American Medical Association.

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Peds Fasting Duration Not Tied to Adverse Sedation Outcomes

WEDNESDAY, May 9, 2018 (HealthDay News) — For children undergoing procedural sedation for a painful procedure, fasting duration is not associated with adverse events, according to a study published online May 7 in JAMA Pediatrics.

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Regulatory Requirements Drive Dissatisfaction With EHRs

TUESDAY, May 8, 2018 (HealthDay News) — Regulatory requirements are likely to be an important aspect of physician dissatisfaction with electronic health records (EHRs) that is driving burnout, according to an Ideas and Opinions piece published online May 8 in the Annals of Internal Medicine.

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High Number of Years of Life Lost Due to Police Violence in U.S.

TUESDAY, May 8, 2018 (HealthDay News) — The number of years of life lost (YLLs) due to police violence in the United States is substantial and disproportionately impacts young people of color, according to a study published online May 7 in the Journal of Epidemiology & Community Health.

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Primary, Secondary Implant Equal for Fibula Free Tissue Transfer

TUESDAY, May 8, 2018 (HealthDay News) — For patients with a fibula free tissue transfer (FFTT) for osteoradionecrosis (ORN) and osteonecrosis (ON) of the mandible, the rate of complications is similar for patients undergoing primary and secondary dental implantation, according to a study published online May 3 in JAMA Facial Plastic Surgery.

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Adverse Outcomes Up for Vaginal Birth After Previous C-Section

MONDAY, May 7, 2018 (HealthDay News) — The rates of severe maternal and neonatal morbidity and mortality are elevated with attempted vaginal delivery after single prior cesarean delivery, according to a study published in the May 7 issue of CMAJ, the journal of the Canadian Medical Association.

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Many Organizations Not Meeting Trial Reporting Requirements

FRIDAY, May 4, 2018 (HealthDay News) — Many organizations are not meeting the trial registration and results reporting requirements clarified by “The Final Rule,” which had a compliance date of April 18, 2017, according to a study published online May 1 in BMC Medicine.

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Many Patients Have Unused Opioids After Spine, Joint Surgery

THURSDAY, May 3, 2018 (HealthDay News) — Many patients undergoing elective same-day or inpatient joint and spine surgery have unused opioids at one- and six-month follow-up, according to a study published online April 17 in Anesthesia & Analgesia.

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Reporting Outcomes Per Surgeon Tied to Drop in CRC Sx Mortality

THURSDAY, May 3, 2018 (HealthDay News) — The introduction of public reporting of surgeon specific 90-day postoperative mortality in elective colorectal cancer surgery is associated with a reduction in observed 90-day mortality, according to a study published online May 2 in The BMJ.

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Nodal Response to Pre-Op Tx Tied to Survival in Esophageal Cancer

WEDNESDAY, May 2, 2018 (HealthDay News) — For patients with locally advanced esophageal cancer, the status of lymph nodes following preoperative neoadjuvant chemotherapy or chemoradiation therapy determines survival, according to a study presented at the annual meeting of the American Association for Thoracic Surgery, held from April 28 to May 1 in San Diego.

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Practices Should Be Aware of Correct Way to Fire Employees

TUESDAY, May 1, 2018 (HealthDay News) — Physicians should be aware of the correct protocol for, as well as the laws involved in, firing employees, according to a report published in Medical Economics.

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Anesthesia Before Age 3 Not Linked to Intelligence Deficits

TUESDAY, May 1, 2018 (HealthDay News) — Multiple exposures to anesthesia before the age of 3 years may have neuropsychological impacts, though intelligence does not appear to be affected, according to a study published online April 18 in Anesthesiology.

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Perioperative MACCEs More Common With Diabetes

TUESDAY, May 1, 2018 (HealthDay News) — Perioperative major adverse cardiovascular and cerebrovascular events (MACCEs) are more common among patients with diabetes mellitus (DM), according to a study published online April 4 in Diabetes Care.

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