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April 2015 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for April 2015. 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.

Collaborative Program Reduces Unnecessary C-Section Rates

THURSDAY, April 30, 2015 (HealthDay News) -- Fewer pregnant women had cesarean section births in Canadian hospitals that took part in a C-section review program, a new study reports. The findings were published in the April 30 issue of the New England Journal of Medicine.

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Racial/Ethnic Disparities in Arteriovenous Fistula Use

THURSDAY, April 30, 2015 (HealthDay News) -- Black and Hispanic patients are significantly less likely to initiate hemodialysis with arteriovenous fistula (AVF), compared with white patients, according to a study published online April 29 in JAMA Surgery.

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Long-Term Post-CABG Mortality Increased With Diabetes

WEDNESDAY, April 29, 2015 (HealthDay News) -- Patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) have increased long-term risk of death after coronary artery bypass grafting (CABG), with higher risk among those with T1DM, according to a study published in the April 28 issue of the Journal of the American College of Cardiology.

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Physician Compensation Up for Most Specialties

TUESDAY, April 28, 2015 (HealthDay News) -- Physician compensation has gone up for almost all specialties, according to a 2015 report published by Medscape.

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CDC: Surveillance System Can Help Reduce Health Care Injuries

TUESDAY, April 28, 2015 (HealthDay News) -- A surveillance system for health care facilities can be used to identify and help reduce the number of preventable injuries among health care personnel, according to research published in the April 24 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Global Variation in Antibiotic Rx Practices After Eyelid Sx

FRIDAY, April 24, 2015 (HealthDay News) -- There is considerable worldwide variation in antibiotic prescribing practices following eyelid surgery, according to a study published online April 23 in JAMA Ophthalmology.

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Antibiotic Choice Affects Infection Rate After Head and Neck Sx

FRIDAY, April 24, 2015 (HealthDay News) -- For patients undergoing head and neck free flap reconstruction, the choice of antibiotic impacts postoperative infection rate, according to a study published online April 23 in JAMA Otolaryngology-Head & Neck Surgery.

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More Evidence Needed to Assess Impact of Duty Hour Policies

FRIDAY, April 24, 2015 (HealthDay News) -- Evidence is necessary to assess the safety of duty hour limit policies for surgical residents, according to a viewpoint piece published online April 22 in JAMA Surgery.

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Less Urinary Incontinence After Total Abdominal Hysterectomy

FRIDAY, April 24, 2015 (HealthDay News) -- At five years after surgery, women undergoing subtotal abdominal hysterectomy (SAH) were more likely to have urinary incontinence (UI) than those undergoing total abdominal hysterectomy (TAH), according to a study published in the May issue of BJOG: An International Journal of Obstetrics and Gynaecology.

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Oophorectomy Linked to Better Survival in BRCA1 Breast Cancer

THURSDAY, April 23, 2015 (HealthDay News) -- Oophorectomy is associated with a decrease in mortality in women with breast cancer and a BRCA1 mutation, and women with estrogen receptor-negative breast cancer and a BRCA1 mutation should undergo the procedure shortly after diagnosis, according to research published online April 23 in JAMA Oncology.

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EHR Data Mining Helps With Quality Improvement

WEDNESDAY, April 22, 2015 (HealthDay News) -- Electronic health records (EHRs) are a valuable source of data that can be mined to help practices with quality improvement performance, according to a study published in Medical Economics.

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30-Day Unplanned Readmit Rate Low but Costly in Head, Neck Sx

WEDNESDAY, April 22, 2015 (HealthDay News) -- For patients undergoing head and neck surgery, 30-day unplanned readmission rates are low, but costly, according to a review published online March 9 in Head & Neck.

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Review Examines Salpingectomy Alone for Cutting Ovarian CA Risk

WEDNESDAY, April 22, 2015 (HealthDay News) -- Salpingectomy alone may be a risk management option for women at hereditary risk of ovarian cancer, according to a review published in the May issue of Cancer Prevention Research.

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Drug-Eluting Beat Bare Stents in Older Patients Undergoing PCI

TUESDAY, April 21, 2015 (HealthDay News) -- For older patients undergoing percutaneous coronary intervention (PCI), drug-eluting stents (DES) offer clinical benefit over bare metal stents (BMS), according to a study published in the May 1 issue of The American Journal of Cardiology.

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EHR Decision Support Ups Radiologic Test Appropriateness

TUESDAY, April 21, 2015 (HealthDay News) -- Computerized clinical decision-support (CCDS) capabilities of electronic health records may improve appropriate use of diagnostic radiologic test ordering and reduce test use, according to a review published in the April 21 issue of the Annals of Internal Medicine.

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Age, Creatinine, Ejection Fraction Predict Post-MI Survival

MONDAY, April 20, 2015 (HealthDay News) -- A simple age, creatinine, and ejection fraction (ACEF) score can predict one-year mortality risk in myocardial infarction 30-day survivors who underwent percutaneous coronary intervention, according to a study published in the May 1 issue of The American Journal of Cardiology.

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Suboptimal Prescribing Attitudes Could Signal Personal Distress

FRIDAY, April 17, 2015 (HealthDay News) -- Medical students in personal distress may be more likely to have suboptimal attitudes about self-prescribing and personal responsibility for reporting impaired colleagues, according to a study published in the April issue of Academic Medicine.

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Medicare Spending Down in Year One of Pioneer ACO

THURSDAY, April 16, 2015 (HealthDay News) -- Medicare spending is down in year one of the Pioneer accountable care organization (ACO) program, according to a study published online April 15 in the New England Journal of Medicine.

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Many Cataract Patients Undergo Unnecessary Pre-Op Testing

THURSDAY, April 16, 2015 (HealthDay News) -- Many patients still undergo routine preoperative testing before cataract surgery despite recommendations against it, according to a study published in the April 16 issue of the New England Journal of Medicine.

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Ethical Implications for Looking Up Applicants on Facebook

THURSDAY, April 16, 2015 (HealthDay News) -- Looking up students on Facebook and other social networking sites (SNS) is associated with ethical concerns, according to a perspective piece published in the March issue of the Journal of Graduate Medical Education.

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AMA Announces End of Sustainable Growth Rate Formula

WEDNESDAY, April 15, 2015 (HealthDay News) -- Recently adopted legislation has repealed the sustainable growth rate (SGR) formula, according to a report published by the American Medical Association (AMA).

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Cervical Disc Arthroplasty Tops ACDF for Single-Level Cervical Dz

WEDNESDAY, April 15, 2015 (HealthDay News) -- For patients with single-level symptomatic cervical disc disease, cervical disc arthroplasty (CDA) is associated with lower readmission rates, lower reoperation rates, and reduced costs compared with anterior cervical discectomy and fusion (ACDF), according to research published in the April 15 issue of Spine.

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Longevity of Bioprosthetic Valve Replacement Assessed

WEDNESDAY, April 15, 2015 (HealthDay News) -- Fifteen-year survival is comparable for bioprosthetic and mechanical prosthetic valve replacement, according to a study published in the April 14 issue of the Journal of the American Medical Association.

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Survey Looks at Patient Attitudes Regarding Informed Consent

WEDNESDAY, April 15, 2015 (HealthDay News) -- Most U.S. adults would prefer to be asked for permission to participate in studies assessing usual medical practices, according to a study published online April 14 in the Annals of Internal Medicine.

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Security Breaches of Health Records Up Over Past Decade

TUESDAY, April 14, 2015 (HealthDay News) -- Breaches in data security exposed more than 29 million health records to potential criminal misuse between 2010 and 2013, according to a new study. Security breaches involving hacking have nearly doubled in recent years, rising to 8.7 percent in 2013 compared with 4.7 percent in 2010, according to the study, published as a research letter in the April 14 issue of the Journal of the American Medical Association.

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Placebo Response May Depend on Individual DNA

TUESDAY, April 14, 2015 (HealthDay News) -- The strength of the placebo effect may depend on particular DNA, according to a report published online April 13 in Trends in Molecular Medicine.

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Quality Improvement Intervention Cuts Lost OR Time

TUESDAY, April 14, 2015 (HealthDay News) -- Significant reductions can be made in operating room (OR) time lost due to cancellation on the day of surgery (DoSC), according to a study published online April 13 in Pediatrics.

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Peritoneal Drainage, Laparotomy Cuts Mortality in NEC

MONDAY, April 13, 2015 (HealthDay News) -- For infants with necrotizing enterocolitis (NEC), peritoneal drainage followed by laparotomy is associated with reduced mortality but increased costs compared with peritoneal drainage alone, according to a study published online April 13 in Pediatrics.

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Many Doctors Haven't Started Dealing With ICD-10 Revision

FRIDAY, April 10, 2015 (HealthDay News) -- Most physicians have barely begun to deal with issues relating to documentation associated with the transition to the International Classification of Diseases, 10th Revision (ICD-10), according to an article published in Medical Economics.

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Medical Debt Burden Higher in Texas, Florida

FRIDAY, April 10, 2015 (HealthDay News) -- Significantly more adults in Florida and Texas struggle to pay medical bills or pay off medical debt over time compared with residents of New York and California, according to a new Commonwealth Fund report released Friday.

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Art Program Hones Med Students' Visual Observation Skills

FRIDAY, April 10, 2015 (HealthDay News) -- An innovative interdisciplinary program, Art Rounds, is effective for improving medical and nursing students' physical observation skills, according to a study published in the April issue of the Journal of Nursing Education.

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Almost One in 10 Readmitted After Carotid Revascularization

FRIDAY, April 10, 2015 (HealthDay News) -- Almost one in 10 Medicare patients undergoing carotid revascularization are readmitted within 30 days, according to a study published in the April 14 issue of the Journal of the American College of Cardiology.

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Periocular Basal Cell Carcinomas Can Grow Rapidly

THURSDAY, April 9, 2015 (HealthDay News) -- Periocular basal cell carcinomas (pBCCs) have a mean growth rate of 11.2 mm² every 30 days, according to a study published in the April issue of the British Journal of Dermatology.

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Older Blood May Be an Option for Cardiac Surgery Patients

THURSDAY, April 9, 2015 (HealthDay News) -- For patients undergoing cardiac surgery, using transfused red blood cells stored for 21 days or more is as good as using blood cells stored for 10 days or less, according to research findings reported in the April 9 issue of the New England Journal of Medicine.

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Medicare Beneficiaries With Melanoma May Face Tx Delay

WEDNESDAY, April 8, 2015 (HealthDay News) -- Approximately 20 percent of Medicare patients with melanoma face delays in getting surgical treatment, according to a new study published online April 8 in JAMA Dermatology.

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MRI Could Be Useful Pancreatic Cancer Screen for High-Risk

WEDNESDAY, April 8, 2015 (HealthDay News) -- Using magnetic resonance imaging (MRI) to screen people at high genetic risk for pancreatic cancer might help spot tumors early, according to new research. The findings were published online April 8 in JAMA Surgery.

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Limited Time Available to Review Sunshine Act Data

WEDNESDAY, April 8, 2015 (HealthDay News) -- Physicians have only 45 days to review and dispute reports regarding their financial ties to drug and medical device manufacturers reported under the Physician Payments Sunshine Act, according to the American Medical Association (AMA).

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Model Predicts Cardiac Death After Life Support Withdrawal

WEDNESDAY, April 8, 2015 (HealthDay News) -- A new model accurately identifies potential organ donors following cardiac death in neurocritical patients removed from life support. The findings were published online March 21 in the American Journal of Transplantation.

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Comparable Benefits for PT, Surgery in Lumbar Spinal Stenosis

TUESDAY, April 7, 2015 (HealthDay News) -- Physical therapy may be just as good as surgery for older adults with lower back pain due to lumbar spinal stenosis, according to new research published in the April 7 issue of the Annals of Internal Medicine.

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Med Students, Residents Rarely Perform Stethoscope Hygiene

TUESDAY, April 7, 2015 (HealthDay News) -- Stethoscope hygiene is rarely performed by trainee physicians, according to a research letter published online April 2 in the Journal of Hospital Medicine.

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Lower Extremity Revascularization in Elderly Found Lacking

MONDAY, April 6, 2015 (HealthDay News) -- Lower extremity revascularization in frail nursing home residents rarely improves their ambulatory status, according to a study published online April 6 in JAMA Internal Medicine.

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Clinical Practice Changing for Node Lymph Mgmt in Breast CA

FRIDAY, April 3, 2015 (HealthDay News) -- Women with breast cancer undergoing lumpectomy and sentinel node biopsy (SNB) may now be less likely to then have completion axillary lymph node dissection (ALND), according to research published online March 25 in the Journal of the American College of Surgeons.

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Article Highlights Legal Issues Linked to Physician Extenders

FRIDAY, April 3, 2015 (HealthDay News) -- The use of physician extenders (PEs; mainly physician assistants and nurse practitioners) may bring added legal risks to a practice, according to an article published in Medical Economics.

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Patients May Be Modifying Meds Due to Trouble Swallowing

THURSDAY, April 2, 2015 (HealthDay News) -- Some patients experience difficulties swallowing and modify medication dosage forms, without necessarily consulting health professionals, according to research published in the March issue of the Journal of Pharmacy Practice and Research.

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Review Indicates Benefits for Bilateral Cataract Surgery

THURSDAY, April 2, 2015 (HealthDay News) -- Immediately sequential bilateral cataract surgery seems beneficial, with faster rehabilitation, improved visual outcome, and savings in time and costs, according to a review published online March 30 in Clinical & Experimental Ophthalmology.

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Laparoscopic Sx Achieves Similar Survival Rates in Rectal Cancer

THURSDAY, April 2, 2015 (HealthDay News) -- Patients with localized rectal cancer may achieve similar survival rates by having minimally invasive laparoscopic surgery, instead of more invasive open surgery, according to new research published in the April 2 issue of the New England Journal of Medicine.

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Legal Issues of Removing Patient From Practice Explored

WEDNESDAY, April 1, 2015 (HealthDay News) -- The legal and ethical responsibilities of removing a patient from practice are discussed in an article published March 16 in Medical Economics.

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Obesity Ups Respiratory Events in Peds Procedural Sedation

WEDNESDAY, April 1, 2015 (HealthDay News) -- Obesity is associated with increased odds of respiratory events and more frequent need for airway intervention in patients undergoing pediatric procedural sedation, according to a study published online March 27 in Pediatric Anesthesia.

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FDA Approves New Miniature Blood Pump System

TUESDAY, March 24, 2015 (HealthDay News) -- The Impella 2.5 System has been approved by the U.S. Food and Drug Administration to maintain stable heart function and blood circulation during high-risk cardiac operations, the agency said in a news release.

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