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April 2014 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for April 2014. 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.

J&J Halts Sales of Device Used in Uterine Fibroid Surgery

WEDNESDAY, April 30, 2014 (HealthDay News) -- Morcellator sales have been halted due to concerns that use of the device in fibroid removal may worsen undetected uterine sarcoma, Johnson & Johnson said Tuesday.

Health Highlights: April 30, 2014

Spinal Fx Complications, Mortality Up With Ankylosing Spondylitis

WEDNESDAY, April 30, 2014 (HealthDay News) -- Spinal fracture patients with ankylosing spondylitis (AS) disorders have higher complication and mortality rates, compared with control patients, according to a study published in the May 1 issue of The Spine Journal.

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FDA Proposes to Reclassify Mesh for Transvaginal Surgery

TUESDAY, April 29, 2014 (HealthDay News) -- Surgical mesh used for transvaginal repair of pelvic organ prolapse (POP) may get stricter oversight in the future due to safety concerns, the U.S. Food and Drug Administration announced Tuesday.

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Review: Induction of Labor Tied to Lower Risk of C-Section

MONDAY, April 28, 2014 (HealthDay News) -- Induction of labor is associated with a lower risk of cesarean delivery and with benefits for the fetus and no increase in maternal death, according to a review published online April 28 in CMAJ, the journal of the Canadian Medical Association.

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AHA Releases Statement on Fetal Cardiac Disease

MONDAY, April 28, 2014 (HealthDay News) -- A writing group appointed by the American Heart Association has released a scientific statement regarding fetal cardiac care; the statement has been published online April 24 in Circulation.

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Wrong-Level Localization in Spine Surgey Rare but Still Occurs

MONDAY, April 28, 2014 (HealthDay News) -- Most surgeons admit wrong-level localization during spinal surgery during their career, according to a study published in the May 1 issue of The Spine Journal.

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Docs, Patients Have Different Attitudes Toward End-of-Life Care

FRIDAY, April 25, 2014 (HealthDay News) -- Attitudes toward end-of-life resource allocation differ for patients with cancer and their caregivers and for physicians, according to a study published online April 24 in JAMA Otolaryngology-Head & Neck Surgery.

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SLIP-2 Tops Original SLIP Model for ID'ing Post-Op ARDS

FRIDAY, April 25, 2014 (HealthDay News) -- The updated surgical lung injury prediction 2 (SLIP-2) model outperforms the original SLIP model for identifying patients at risk for postoperative acute respiratory distress syndrome (ARDS), according to a study published in the May issue of Anesthesiology.

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Physician Groups Find Fault With Medicare Payment Data Release

THURSDAY, April 24, 2014 (HealthDay News) -- Physician groups cite major problems associated with the release of Medicare payment data, according to an article published April 16 in Medical Economics.

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At-Risk Screw Misplacement Common in Spine Deformity Sx

THURSDAY, April 24, 2014 (HealthDay News) -- About one-quarter of patients undergoing surgery for pediatric spine deformity have pedicle screws close to vital structures, according to a study published in the April issue of the Journal of Spinal Disorders & Techniques.

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Educational Changes Suggested for Patient-Centered Medicine

THURSDAY, April 24, 2014 (HealthDay News) -- Changes in medical education and training are suggested to help new physicians address the needs of patients and their families, according to an ideas and opinions piece published in the April 22 issue of the Annals of Internal Medicine.

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Down Syndrome Kids Fare Better Than Others After Heart Repair

THURSDAY, April 24, 2014 (HealthDay News) -- Children with Down syndrome, compared with those without this genetic condition, are more likely to survive to discharge following surgical repair of congenital heart disease, according to research published online April 22 in Circulation: Cardiovascular Quality and Outcomes.

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FDA Proposes Accelerated Medical Device Approval Plan

WEDNESDAY, April 23, 2014 (HealthDay News) -- The U.S. Food and Drug Administration has proposed a new program that would provide expedited access to high-risk medical devices intended for patients with serious conditions whose medical needs are not met by current technology.

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Conservative Management Better for Arteriovenous Malformations

TUESDAY, April 22, 2014 (HealthDay News) -- For patients with brain arteriovenous malformations (bAVMs), use of conservative management is associated with better clinical outcomes for up to 12 years, compared to interventional treatment, according to a study published in the April 23/30 issue of the Journal of the American Medical Association.

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Economic Downturns Haven't Impacted Hip, Knee Arthroplasty

MONDAY, April 21, 2014 (HealthDay News) -- Recent economic downturns have not substantially impacted the growth in hip and knee arthroplasty in the United States, according to a study published in the April 16 issue of The Journal of Bone & Joint Surgery.

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Task Force Recommends Ways to Improve Price Transparency

MONDAY, April 21, 2014 (HealthDay News) -- Price transparency frameworks, which provide price information presented in the context of other relevant information, should be developed to meet patients' needs, according to recommendations presented in a report from the Healthcare Financial Management Association (HFMA).

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About Half of Cancelled Time in OR Due to Inpatients

MONDAY, April 21, 2014 (HealthDay News) -- About half of cancelled time in the operating room is due to inpatients, according to a study published online April 9 in Anesthesia & Analgesia.

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Some Children Gain Weight After Tonsil Removal Surgery

MONDAY, April 21, 2014 (HealthDay News) -- Younger children and those with lower pre-surgery weight percentiles are most likely to gain more weight than expected following adenotonsillectomy, according to a study published online April 17 in JAMA Otolaryngology-Head & Neck Surgery.

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AMA Examines Economic Impact of Physicians

FRIDAY, April 18, 2014 (HealthDay News) -- Physicians who mainly engage in patient care contribute a total of $1.6 trillion in economic output, according to the American Medical Association (AMA)'s Economic Impact Study.

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Int'l Medical Education Standards Not Equivalent to U.K. Standards

FRIDAY, April 18, 2014 (HealthDay News) -- International medical graduates passing the Professional and Linguistic Assessments Board (PLAB) of the General Medical Council (GMC) have lower performance on MRCP(UK) (Membership of the Royal Colleges of Physicians) and MRCGP (Membership of the Royal College of General Practitioners) and on annual review of competence progression (ARCP) examinations, according to two studies published online April 17 in BMJ.

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FDA Warns Against Procedure for Uterine Fibroids

FRIDAY, April 18, 2014 (HealthDay News) -- Laparoscopic power morcellation for treatment of fibroids could increase a woman's risk of cancer, the U.S. Food and Drug Administration warned Thursday.

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White House: 8 Million People Signed Up for Health Insurance

FRIDAY, April 18, 2014 (HealthDay News) -- Eight million Americans signed up for private health insurance during the just-concluded first enrollment period under the Affordable Care Act, the White House announced Thursday afternoon.

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One in 20 U.S. Adults a Victim of Diagnostic Errors

THURSDAY, April 17, 2014 (HealthDay News) -- Diagnostic errors affect at least one in 20 U.S. adults, according to research published online April 17 in BMJ Quality & Safety.

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Leeches Help Save Woman's Ear After Pit Bull Mauling

THURSDAY, April 17, 2014 (HealthDay News) -- A pit bull attack in July 2013 left a 19-year-old woman with her left ear ripped from her head, leaving an open wound. After preserving the ear, the surgical team started with a reconnection of a 0.3 millimeter-thick arterial branch. Stephen Sullivan, M.D., M.P.H., an assistant professor of plastic surgery at Brown University in Providence, R.I., joined his colleague Helena Taylor, M.D., Ph.D., to present the case in the April 17 issue of the New England Journal of Medicine.

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Patient-Clinician Relationship Impacts Health Care Outcomes

THURSDAY, April 17, 2014 (HealthDay News) -- The patient-clinician relationship has a small but significant effect on health care outcomes, according to a study published online April 9 in PLOS ONE.

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Educator Discusses Key Issues for Future Doctors to Consider

THURSDAY, April 17, 2014 (HealthDay News) -- The key issues for future physicians are discussed in an article published by the American Medical Association (AMA).

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Tracheal Allograft Stable After Immunosuppressive Therapy

THURSDAY, April 17, 2014 (HealthDay News) -- A composite-tissue tracheal allograft appears to have retained its structural integrity after the withdrawal of immunosuppressive therapy, according to a letter to the editor published in the April 17 issue of the New England Journal of Medicine.

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Diabetes-Related Complications Declined, 1990 to 2010

WEDNESDAY, April 16, 2014 (HealthDay News) -- Rates of diabetes-related complications have declined substantially over the past two decades, according to a study published in the April 17 issue of the New England Journal of Medicine.

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Risk for Nonelective Thoracic Aortic Sx Up for Uninsured

WEDNESDAY, April 16, 2014 (HealthDay News) -- Uninsured patients have an increased risk of nonelective thoracic aortic operations, and have increased risks of major morbidity or mortality, according to a study published online April 8 in Circulation: Cardiovascular Quality and Outcomes.

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Continued Reliance on Windows XP May Threaten Data Security

WEDNESDAY, April 16, 2014 (HealthDay News) -- Physicians who use Windows XP in their practices may be affected by Microsoft's recent discontinuation of support for the program, according to an article published April 8 in Medical Economics.

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Patients Paying Much More for Specialty Drugs

TUESDAY, April 15, 2014 (HealthDay News) -- Many Americans are paying less for prescription drugs, but some are having to deal with sharp rises in the cost of specialty medicines for rare or serious diseases, according to a new report.

Health Highlights: April 15, 2014

New Health Secretary to Confront Health Care Reform Hurdles

MONDAY, April 14, 2014 (HealthDay News) -- With the resignation of U.S. Health and Human Services Secretary Kathleen Sebelius on Friday, the Affordable Care Act will get a fresh face. But turning around public perception of the controversial health care reform law in a politically charged mid-term election year poses an enormous challenge for the department's next leader, policy experts said.

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CRC Resection Morbidity, Mortality Still Higher for Elderly

MONDAY, April 14, 2014 (HealthDay News) -- Despite an overall improved mortality seen during the past 10 years, advancing age is associated with higher morbidity and mortality in colorectal cancer resection, according to a study published online April 9 in JAMA Surgery.

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Engineered Cartilage Feasible for Nasal Reconstruction

MONDAY, April 14, 2014 (HealthDay News) -- Autologous nasal cartilage tissues can be engineered and clinically used for functional restoration of alar lobules after tumor resection, according to a study published online April 11 in The Lancet.

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Engineered Vaginal Organs Structurally, Functionally Good

FRIDAY, April 11, 2014 (HealthDay News) -- Engineered vaginal organs, derived from the patient's own cells, achieve normal structural and functional performance over eight years of follow-up, according to a study published online April 11 in The Lancet.

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Sebelius Stepping Down As HHS Secretary

FRIDAY, April 11, 2014 (HealthDay News) -- U.S. Health and Human Services Secretary Kathleen Sebelius is stepping down from her position, after overseeing the troubled rollout of the Affordable Care Act that remains unpopular with some Americans and virtually all Republican lawmakers.

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Surgical Decisions for High-Risk Patients Needs Overhaul

FRIDAY, April 11, 2014 (HealthDay News) -- High-risk elderly patients facing decisions about major surgery may not always be presented with all treatment options, including less invasive choices, according to a perspective piece published in the April 10 issue of the New England Journal of Medicine.

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1,440-nm Laser Beneficial for Photodamage in Asians

THURSDAY, April 10, 2014 (HealthDay News) -- Four treatments with 1,440-nm fractional laser produce mild improvement in select signs of photodamage in an Asian population, according to a study published March 14 in Lasers in Surgery and Medicine.

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Fewer Americans Overwhelmed by Medical Bills

WEDNESDAY, April 9, 2014 (HealthDay News) -- While millions of Americans still feel hamstrung by medical expenses, a new government report shows that some people are getting relief.

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More Justification Needed for Choosing Wisely Selections

WEDNESDAY, April 9, 2014 (HealthDay News) -- Most services included in specialty medical societies' Top 5 lists for the Choosing Wisely campaign are based on evidence demonstrating equivalent but not superior benefit, with higher risk or higher costs compared to other options, according to a research letter published in the April 9 issue of the Journal of the American Medical Association.

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Some Doctors Paid at Least $3 Million Each by Medicare

WEDNESDAY, April 9, 2014 (HealthDay News) -- A small number of doctors received at least $3 million each in Medicare payments in 2012, for a total of nearly $1.5 billion, according to an analysis of Medicare claims data released Wednesday by the White House. In total, Medicare paid individual physicians nearly $64 billion in 2012. The median payment was just over $30,000, the Associated Press reported.

Health Highlights: April 9, 2014
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Hypernatremia Linked to Post-Liver Transplant Mortality

TUESDAY, April 8, 2014 (HealthDay News) -- Pre-liver transplant (LTx) hyponatremia does not affect post-LTx survival, but hypernatremia is a significant risk factor for post-LTx mortality, according to a study published online Feb. 25 in Liver Transplantation.

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Newly Eligible for Expanded Medicaid Are Healthier

MONDAY, April 7, 2014 (HealthDay News) -- Persons newly eligible for expanded Medicaid coverage under the Affordable Care Act (ACA) are not sicker than pre-ACA enrollees, according to research published online March 26 in Health Affairs.

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Complications for One in Five Adults Undergoing Tonsillectomy

MONDAY, April 7, 2014 (HealthDay News) -- About 20 percent of adults undergoing tonsillectomy experience complications, according to a study published in the April issue of Otolaryngology-Head and Neck Surgery.

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Patients Select Fewer New Docs at Bottom of Tiered Ranking

MONDAY, April 7, 2014 (HealthDay News) -- Patients are less likely to select a new physician ranked in the bottom of a tiered network, but often don't switch if their current physician is ranked at the bottom, according to research published online March 11 in Health Services Research.

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AMA Provides Resources to Aid Physicians' Collections

FRIDAY, April 4, 2014 (HealthDay News) -- The American Medical Association (AMA) has released resources to help doctors confront policy jumpers who may pose a financial risk to physicians during the Affordable Care Act's 90-day premium grace period, according to an article published March 25 in Medical Economics.

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Pending Malpractice Litigation May Bias Parents' Reports

FRIDAY, April 4, 2014 (HealthDay News) -- Following neonatal brachial plexus palsy, medical malpractice litigation is associated with worse parent reports of their child's function and pain, according to a study published in the March 5 issue of The Journal of Bone & Joint Surgery.

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Transplant Drugs Cut Persistent HIV Levels

THURSDAY, April 3, 2014 (HealthDay News) -- Immunosuppressant therapy taken following kidney transplantation may help reduce persistent HIV burdens in infected patients, according to a study published online April 3 in the American Journal of Transplantation.

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Minority of Spine Surgeons Conduct Pre-Op Psych Screen

THURSDAY, April 3, 2014 (HealthDay News) -- Less than 40 percent of U.S. spine surgeons report use of presurgical psychological screening (PPS), according to a study published online in the April issue of the Journal of Spinal Disorders & Techniques.

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Review: Bariatric Surgery Cuts Cardiovascular Disease, Death

THURSDAY, April 3, 2014 (HealthDay News) -- Bariatric surgery is associated with reduced risk of mortality and cardiovascular events, including myocardial infarction and stroke, according to a review and meta-analysis published in the April 15 issue of the International Journal of Cardiology.

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Half of Uninsured Don't Intend to Sign Up for Health Coverage

WEDNESDAY, April 2, 2014 (HealthDay News) -- About 50 percent of uninsured adults do not intend to sign up for coverage through the Affordable Care Act's health care exchanges, according to an article published March 26 in Medical Economics.

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Excellent Long-Term Outcomes Seen Following Esophagectomy

WEDNESDAY, April 2, 2014 (HealthDay News) -- Patients undergoing esophagectomy with gastric pull-up report excellent long-term nutritional status, quality of life, and satisfaction with eating, according to research published in the March issue of The Journal of Thoracic and Cardiovascular Surgery.

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CMS: Medicare Beneficiaries Saved $3.9B on Meds in 2013

TUESDAY, April 1, 2014 (HealthDay News) -- In 2013, 4.3 million seniors and people with disabilities saved an estimated $3.9 billion on prescription drugs, an increase from the 2012 savings, according to a report published by the U.S. Department of Health and Human Services.

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