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

Physicians Often Don’t Address Their Burnout

FRIDAY, Sept. 28, 2018 (HealthDay News) — More than half of physicians experience burnout, and many do not seek treatment for burnout, according to a report published in the American Medical Association’s AMA Wire.

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Surgical Mesh Itself Not Tied to Increased Complications

FRIDAY, Sept. 28, 2018 (HealthDay News) — Use of mesh is not independently associated with an increase in the rate of complications of pelvic organ prolapse repair, according to a study published in the August issue of The Journal of Urology.

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No Benefit to Negative Pressure Wound Therapy After C-Section

FRIDAY, Sept. 28, 2018 (HealthDay News) — For obese women, use of prophylactic negative pressure wound therapy versus standard dressings does not reduce superficial surgical site infections after cesarean section, according to a study published in the August issue of Obstetrics & Gynecology.

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Business Degree Increasingly Useful for Doctors

THURSDAY, Sept. 27, 2018 (HealthDay News) — Having a Master of Business Administration degree (M.B.A.) can help doctors with important, practice-related decisions, according to a report published recently in Physician Practice.

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Kidney Function Recovery Seen in Some Children on Dialysis

THURSDAY, Sept. 27, 2018 (HealthDay News) — Roughly 2 percent of pediatric patients on maintenance dialysis recover within two years after dialysis initiation, according to a study published online Sept. 20 in the Clinical Journal of the American Society of Nephrology.

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Practices Should Set Rules for Staff Social Media Use

THURSDAY, Sept. 27, 2018 (HealthDay News) — Medical practices can take steps to avoid problems related to use of social media by staff members, according to an article published in Medical Economics.

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PCI, CABG Both Acceptable for CKD Patients With LMCAD

WEDNESDAY, Sept. 26, 2018 (HealthDay News) — For patients with left main coronary artery disease (LMCAD), those with and without chronic kidney disease (CKD) undergoing revascularization have similar long-term outcomes with percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), according to a study published in the Aug. 14 issue of the Journal of the American College of Cardiology.

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Burnout, Career Choice Regret Prevalent in U.S. Residents

WEDNESDAY, Sept. 26, 2018 (HealthDay News) — Symptoms of burnout and career choice regret are prevalent among U.S. resident physicians, according to a study published in the Sept. 18 issue of the Journal of the American Medical Association.

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Lawn-Mower-Related Injuries Are Most Often Lacerations

WEDNESDAY, Sept. 26, 2018 (HealthDay News) — From 2006 through 2013, the weighted estimate of lawn-mower-related injuries was 51,151, with the most common injuries being lacerations, fractures, and amputations, according to a study published online Aug. 1 in Public Health Reports.

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Enlarged Kidneys in Neonates With Congenital Heart Disease

WEDNESDAY, Sept. 26, 2018 (HealthDay News) — Neonates with congenital heart disease (CHD) have enlarged kidneys on average, according to a study published online Sept. 11 in Pediatric Research.

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Persistent Post-Op Opioid Use in Young Cancer Patients Explored

WEDNESDAY, Sept. 26, 2018 (HealthDay News) — Higher inpatient pain scores and postoperative opioid consumption are associated with persistent opioid use of up to six months among children and adolescents who have undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, according to a study published in a recent issue of Pediatric Anesthesia.

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Surgeon Experience Aids Assessment of Futility

WEDNESDAY, Sept. 26, 2018 (HealthDay News) — More experienced surgeons are more confident in their assessments of perceived futility, according to a study recently published in the Journal of the American College of Surgeons.

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Initial Abx Feasible Alternative for Uncomplicated Appendicitis

TUESDAY, Sept. 25, 2018 (HealthDay News) — The cumulative incidence of appendicitis recurrence within five years is 39.1 percent among patients with uncomplicated acute appendicitis initially treated with antibiotics, according to research published in the Sept. 25 issue of the Journal of the American Medical Association.

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Physician-Group ACOs Generate Medicare Savings

TUESDAY, Sept. 25, 2018 (HealthDay News) — Physician-group accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) generated significantly more savings for Medicare that grew from 2012 to 2015 compared with hospital-integrated ACOs, according to research published in the Sept. 20 issue of the New England Journal of Medicine.

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In 2016, Proportion of Uninsured Americans Down to 10 Percent

TUESDAY, Sept. 25, 2018 (HealthDay News) — From 2013 to 2016 there was a reduction in uninsurance among Americans from 17 to 10 percent, according to a report published in September by the Robert Wood Johnson Foundation (RWJF) and the Urban Institute.

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Long-Term Outcomes of Breast Implants Explored

FRIDAY, Sept. 21, 2018 (HealthDay News) — The long-term outcomes of breast implants include increased rates of certain conditions for silicone implants, according to a study published online Sept. 14 in the Annals of Surgery.

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Some Clinicians, Patients Record Clinic Visits for Patient Use

FRIDAY, Sept. 21, 2018 (HealthDay News) — A considerable proportion of clinicians and patients report having recorded a clinic visit for the patient’s personal use, according to a study published in the September issue of the Journal of Medical Internet Research.

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Pediatric End-Stage Liver Disease Score Underestimates Mortality

FRIDAY, Sept. 21, 2018 (HealthDay News) — The Pediatric End-stage Liver Disease (PELD) score underestimates the actual probability of 90-day pretransplant mortality for children undergoing a primary liver transplant, according to a study published online Sept. 17 in JAMA Pediatrics.

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Dozens of Medical Groups Join Forces to Improve Diagnoses

FRIDAY, Sept. 21, 2018 (HealthDay News) — Every nine minutes, a patient in a U.S. hospital dies because a diagnosis was wrong or delayed — resulting in 80,000 deaths a year. That sobering estimate comes from the Society to Improve Diagnosis in Medicine (SIDM).

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More Hurt, Killed in Shootings With Semiautomatic Rifles

FRIDAY, Sept. 21, 2018 (HealthDay News) — More people are wounded and killed in active shooter incidents in which semiautomatic rifles are used, according to a research letter published in the Sept. 11 issue of the Journal of the American Medical Association.

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Research Links Doctor Burnout to Patient Safety Incidents

THURSDAY, Sept. 20, 2018 (HealthDay News) — Physician burnout is associated with increased risk of patient safety incidents, poorer quality of care due to low professionalism, and reduced patient satisfaction, according to a review published online Sept. 4 in JAMA Internal Medicine.

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Hospitals Charge 479 Percent of Cost of Drugs on Average

THURSDAY, Sept. 20, 2018 (HealthDay News) — On average, hospitals mark up drugs by 479 percent of their cost, according to a report from The Moran Company, commissioned by the Pharmaceutical Research and Manufacturers of America (PhRMA).

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Statins Improve Long-Term Survival After AAA Repair

THURSDAY, Sept. 20, 2018 (HealthDay News) — Preoperative statin therapy is associated with higher long-term survival following abdominal aortic aneurysm (AAA) repair, according to a study published in the August issue of the Journal of Vascular Surgery.

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Residents Should Take Advantage of Paid Time Off

THURSDAY, Sept. 20, 2018 (HealthDay News) — Although there are many demands on residents, taking advantage of paid vacation time is one of the perks and should be maximized, according to an article published in the American Medical Association’s AMA Wire.

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Patient Health Information Often Shared Electronically

WEDNESDAY, Sept. 19, 2018 (HealthDay News) — The most common electronically sent and received types of patient health information (PHI) include laboratory results and medication lists, according to a report published Aug. 15 by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

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Global Prevalence of Insufficient Activity 27.5 Percent

WEDNESDAY, Sept. 19, 2018 (HealthDay News) — In 2016 the age-standardized prevalence of insufficient physical activity was 27.5 percent, according to a study published in the October issue of The Lancet Global Health.

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Scribes Improve Physician Workflow, Patient Interaction

TUESDAY, Sept. 18, 2018 (HealthDay News) — Use of medical scribes is associated with decreased physician documentation burden, improved work efficiency, and improved patient interactions, according to a study published online Sept. 17 in JAMA Internal Medicine.

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Drug Prices Increase More Than Expected After Shortages

TUESDAY, Sept. 18, 2018 (HealthDay News) — Prices for drugs under shortage increase more than twice as quickly as expected in the absence of a shortage, according to a research letter published online Sept. 18 in the Annals of Internal Medicine.

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Compliance With Requirement to Report Results on EUCTR Is Poor

TUESDAY, Sept. 18, 2018 (HealthDay News) — Half of trials on the European Union Clinical Trials Register (EUCTR) are non-compliant with the European Commission’s requirement that all trials post results to the registry within 12 month of completion, according to a study published online Sept. 13 in The BMJ.

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2006 to 2015 Saw Increase in Severe Maternal Morbidity

TUESDAY, Sept. 18, 2018 (HealthDay News) — From 2006 to 2015, the proportion of women experiencing severe maternal morbidity increased 45 percent, according to a statistical brief published by the Agency for Healthcare Research and Quality.

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FDA Approves Device for Acute Coronary Artery Perforations

MONDAY, Sept. 17, 2018 (HealthDay News) — The PK Papyrus Covered Coronary Stent System has been approved by the U.S. Food and Drug Administration to treat acute coronary artery perforations.

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Association Health Plans Can Help Small Businesses Offer Coverage

MONDAY, Sept. 17, 2018 (HealthDay News) — Association health plans (AHPs) will provide small businesses with more choices, access, and coverage options, although critics warn that they may undermine the Affordable Care Act (ACA) marketplace, according to an article published in Managed Healthcare Executive.

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Model Estimates Mortality in Patients Waiting for Hearts

MONDAY, Sept. 17, 2018 (HealthDay News) — For patients with advanced heart failure who are listed for transplantation, mortality risk is related to adverse events and end-organ dysfunction that vary over time, according to a study published in the Aug. 7 issue of the Journal of the American College of Cardiology.

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Situation Framing, Language Can Influence Decision-Making

FRIDAY, Sept. 14, 2018 (HealthDay News) — How a situation is framed and the language used to describe risks can influence patients’ decision-making, according to an article published in Physicians Practice.

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Opioid Refills Rare After Rhinoplasty

FRIDAY, Sept. 14, 2018 (HealthDay News) — For patients undergoing rhinoplasty, postoperative opioid refills are extremely rare, according to a research letter published online Sept. 6 in JAMA Facial Plastic Surgery.

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Firearm Deaths Up Globally From 1990 to 2016

THURSDAY, Sept. 13, 2018 (HealthDay News) — Firearm deaths increased globally between 1990 and 2016, according to a study published in the Aug. 28 issue of the Journal of the American Medical Association.

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Physicians Need Training for Mass Casualty Incidents

THURSDAY, Sept. 13, 2018 (HealthDay News) — Proper training and post-incident steps can help lessen the secondary trauma health professionals experience providing care during mass casualty incidents (MCIs), according to an article published in the American Medical Association’s AMA Wire.

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Gains in Insurance Coverage Seen for Lesbian, Gay, Bisexual Adults

THURSDAY, Sept. 13, 2018 (HealthDay News) — Lesbian, gay, and bisexual (LGB) adults report continued problems affording care despite coverage gains offered by the Affordable Care Act, according to a study published in the August issue of Health Affairs.

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Residents Working Long Hours Can Increase Alertness

WEDNESDAY, Sept. 12, 2018 (HealthDay News) — Medical residents can take steps to maintain their energy and alertness during long shifts, according to an article published in the American Medical Association’s AMA Wire.

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Six-Step Analysis Can Help Improve Practice Logistics

WEDNESDAY, Sept. 12, 2018 (HealthDay News) — A six-step analysis can help redesign and improve the outpatient health care process, according to a study recently published in the Journal of Evaluation in Clinical Practice.

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Propofol May Decrease Delay in Neurocognitive Recovery

WEDNESDAY, Sept. 12, 2018 (HealthDay News) — For older cancer patients undergoing major cancer surgery, propofol-based general anesthesia may reduce the incidence of delayed neurocognitive recovery versus sevoflurane-based general anesthesia, according to a study published in the September issue of the British Journal of Anesthesia.

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Medicaid Work Requirements Don’t Impact Many Enrollees

TUESDAY, Sept. 11, 2018 (HealthDay News) — Medicaid work requirements will only impact a small proportion of persons and may only generate minimal savings, according to two research letters published online Sept. 10 in JAMA Internal Medicine.

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Case Report Describes 4 Breast Cancer Cases Post Transplant

TUESDAY, Sept. 11, 2018 (HealthDay News) — A single multiorgan donor transmitted breast cancer to four transplant recipients, according to a case report published recently in the American Journal of Transplantation.

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Data Age in Clinical Trials Is About Three Years at Publication

TUESDAY, Sept. 11, 2018 (HealthDay News) — The median data age in clinical trials in journals with a high impact factor is about three years at publication, according to a study published in the Aug. 10 issue of JAMA Network Open.

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Many Opportunities for Doctors Using Twitter

MONDAY, Sept. 10, 2018 (HealthDay News) — Doctors can use Twitter to build networks and learn more about research in real time, according to a blog post published by Penn Medicine News.

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New Bronchoscopic Option Used for Severe Emphysema

MONDAY, Sept. 10, 2018 (HealthDay News) — Temple University Hospital has become the first center in the U.S. to perform bronchoscopic lung volume reduction using implantation of the Zephyr Endobronchial Valve (Zephyr EBV) to treat hyperinflation associated with severe emphysema. The hospital is also the first to offer training to U.S. physicians for care and management of patients who undergo this procedure.

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Robotic Surgeries Up, but Cost Questions Remain

MONDAY, Sept. 10, 2018 (HealthDay News) — Use of robotic surgery is continuing to increase, according to a research letter published in the Aug. 28 issue of the Journal of the American Medical Association.

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Docs, Consumers Agree on Benefits of Virtual Care

MONDAY, Sept. 10, 2018 (HealthDay News) — Physicians and consumers agree on the benefits of virtual care, but physician adoption of virtual care technologies is low, according to a report on the Deloitte 2018 Survey of U.S. Physicians.

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Physician Burnout Rates Vary by Medical Specialty

MONDAY, Sept. 10, 2018 (HealthDay News) — Nearly half of physicians report being burned out, but rates vary substantially by medical specialty, according to an article published in AMA Wire.

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Personalized Weighting Could Enhance Hospital Rating Tools

FRIDAY, Sept. 7, 2018 (HealthDay News) — The weighting systems that underlie hospital performance rating tools should incorporate the needs, values, and preferences of patients, according to a perspective article published in the Aug. 30 issue of the New England Journal of Medicine.

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With New Persistent Opioid Use, Most Early Scripts From Surgeons

FRIDAY, Sept. 7, 2018 (HealthDay News) — Among surgical patients who develop new persistent opioid use, surgeons provide the majority of opioid prescriptions in the first few months after surgery, but by nine to 12 months post-surgery, most prescriptions are from primary care providers, according to a study recently published in the Journal of General Internal Medicine.

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Hospitals Using Two Strategies to Up Quality, Lower Costs

THURSDAY, Sept. 6, 2018 (HealthDay News) — Hospitals receiving bundled payments are reducing skilled nursing facility (SNF) use and improving care integration to improve quality and control costs, according to a report published in the August issue of Health Affairs.

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Hospital Groups Launch Own Generic Drug Company

THURSDAY, Sept. 6, 2018 (HealthDay News) — Three U.S. health care foundations and seven hospital groups have formed a generic drug company to combat high prices and chronic shortages of medicines.

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Better Training Needed to Boost LGBTQ Patient Health Care

THURSDAY, Sept. 6, 2018 (HealthDay News) — High-quality health care needs to be provided to lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients, and improved training is necessary to deliver that care, according to a report published in the American Medical Association’s AMA Wire.

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Increase Observed in Hearts From Drug-Intoxicated Donors

THURSDAY, Sept. 6, 2018 (HealthDay News) — Heart transplants using drug-intoxicated donors have significantly increased, but their use does not seem to adversely impact post-transplant survival, according to a study recently published in the American Journal of Transplantation.

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Revascularization Beats Amputation for Limb Ischemia

WEDNESDAY, Sept. 5, 2018 (HealthDay News) — For patients with critical limb ischemia, long-term survival and costs are similar for endovascular and surgical revascularization techniques, with longer survival and lower costs versus major amputation, according to a study published in the Aug. 21 issue of the Journal of the American Heart Association.

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Public Service Loan Forgiveness Program Has Uncertain Future

WEDNESDAY, Sept. 5, 2018 (HealthDay News) — Uncertainty surrounds the future of the Public Service Loan Forgiveness (PSLF) program, according to an Ideas and Opinions article published online Aug. 28 in the Annals of Internal Medicine.

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~3,000 Excess Deaths Estimated Due to Hurricane Maria

WEDNESDAY, Sept. 5, 2018 (HealthDay News) — The total excess mortality attributed to Hurricane Maria is estimated at 2,975 deaths, according to a report issued by George Washington University.

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Clinicians Should Learn to Engage With Transgender Patients

TUESDAY, Sept. 4, 2018 (HealthDay News) — Clinicians should learn how to engage with transgender patients and be prepared to manage unique clinical issues, according to a review published online Aug. 27 in JAMA Internal Medicine.

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Enrollment in High-Deductible Health Plans Up From ’07 to ’17

TUESDAY, Sept. 4, 2018 (HealthDay News) — Enrollment in high-deductible health plans (HDHPs) has increased among adults with employment-based insurance coverage, according to an August data brief published by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

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Breast Cancer Surgery Outcomes Poor for Nursing Home Residents

TUESDAY, Sept. 4, 2018 (HealthDay News) — For female nursing home residents who undergo breast cancer surgery, rates of one-year mortality and functional decline are high, according to a study published online Aug. 29 in JAMA Surgery.

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