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August 2014 Briefing - Surgery

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

Report Highlights Progress, Challenges in Health IT

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Progress has been made toward widespread adoption of electronic health records (EHRs), although there are still barriers to adoption of advanced use of EHRs, according to a report published by the Robert Wood Johnson Foundation.

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Cleft Lip, Palate Don't Increase Ear Tube Complications

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Cleft lip and/or palate (CLP) does not appear to affect complication rates for ventilation tube (VT) placement among pediatric patients, according to a study published online Aug. 28 in JAMA Otolaryngology-Head & Neck Surgery.

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Surgery for Spinal Metastasis Up From 2000 to 2009 in U.S.

FRIDAY, Aug. 29, 2014 (HealthDay News) -- From 2000 to 2009 there was an increase in surgical treatment for spinal metastasis in the United States, which was accompanied by increased complication rates and costs, according to a study published in the Sept. 1 issue of The Spine Journal.

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AMGA: Physician Turnover Still High in 2013

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For the second year running, physician turnover remains at the highest rate since 2005, according to a report published by the American Medical Group Association (AMGA).

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Doctors Frequently Experience Ethical Dilemmas

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For physicians trying to balance various financial and time pressures, ethical dilemmas are common, according to an article published Aug. 7 in Medical Economics.

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Cancer Patients With Depression Often Untreated

THURSDAY, Aug. 28, 2014 (HealthDay News) -- Patients with cancer and depression frequently do not receive effective treatment; however, an integrated program is effective in patients with cancer, and specifically lung cancer, according to three studies published online Aug. 28 in The Lancet Psychiatry, The Lancet, and The Lancet Oncology.

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African-Americans Have Worse Cervical Spine Surgery Outcomes

THURSDAY, Aug. 28, 2014 (HealthDay News) -- African-American patients have significantly higher rates of in-hospital complications and mortality associated with cervical spine surgery than Caucasian patients, according to a study published in the Aug. 15 issue of Spine.

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Preventive Bundle Cuts Colorectal Surgical Site Infections

THURSDAY, Aug. 28, 2014 (HealthDay News) -- Implementation of a preventive surgical site infection (SSI) bundle is associated with a reduction in SSI rates after colorectal surgery, according to a study published online Aug. 27 in JAMA Surgery.

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Pay-for-Performance Not Found to Impact Access to CABG

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- For patients with acute myocardial infarction (AMI), treatment at pay-for-performance (P4P) hospitals is not associated with a change in the rate of coronary artery bypass graft (CABG) surgery, according to a study published online Aug. 26 in Circulation: Cardiovascular Quality and Outcomes.

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Review: Surgery Doesn't Benefit Age-Related Meniscal Tears

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Evidence suggests that arthroscopic surgery does not benefit middle-aged patients with degenerative meniscal tears, according to research published online Aug. 25 in CMAJ, the journal of the Canadian Medical Association.

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Restrictive, Non-Solicitation Covenants Are Valid

MONDAY, Aug. 25, 2014 (HealthDay News) -- Restrictive and non-solicitation covenants are valid and can be enforced, according to an article published Aug. 5 in Medical Economics.

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U.S. to Tighten Access to Certain Narcotic Painkillers

FRIDAY, Aug. 22, 2014 (HealthDay News) -- The U.S. Drug Enforcement Administration (DEA) is going ahead with tough new controls on painkillers containing hydrocodone, which has been tied to a surge in dangerous addictions across the United States.

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Futile Care Linked to Delays in Care for Other Patients

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Futile care, which is used to prolong life without achieving a meaningful benefit for the patient, can cause delays in care for other patients waiting to be admitted to the intensive care unit (ICU), according to a study published in the September issue of Critical Care Medicine.

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Study IDs Risk Factors for Severe Hidradenitis Suppurativa

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Risk factors associated with severity of the disease may help guide therapy for hidradenitis suppurativa, according to research published in the September issue of the Journal of the American Academy of Dermatology.

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Abdominal Acoustic Monitoring Can Identify Post-Op Ileus

FRIDAY, Aug. 22, 2014 (HealthDay News) -- A noninvasive, abdominal acoustic monitoring device can distinguish postoperative ileus (POI) from patients and controls without POI, according to a proof-of-concept study published online Aug. 5 in the Journal of Gastrointestinal Surgery.

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Factors Identified for Reconstruction Post-Mastectomy

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- More than 40 percent of women undergo breast reconstruction following mastectomy and most patients are satisfied with the reconstruction decision-making process, according to a study published online Aug. 20 in JAMA Surgery.

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Organized Processes Help Practices Hire Well

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- A defined process is necessary to help physicians hire the right staff for their practice, according to an article published July 24 in Medical Economics.

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CRT, ICD Therapies Benefit Heart Failure Patients of All Races

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- For patients with heart failure with reduced ejection fraction, cardiac resynchronization therapy (CRT) and implantable cardioverter-defibrillator (ICD) therapies are associated with clinical benefit, irrespective of patient race/ethnicity, according to a study published in the Aug. 26 issue of the Journal of the American College of Cardiology.

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More Preventable Deaths With Outpatient Urology Surgery

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- There has been a shift from inpatient to outpatient surgery for commonly performed urological procedures, which has coincided with increasing rates of failure to rescue (FTR) mortality, according to a study published online Aug. 19 in BJU International.

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Fluid Restrictions May Cut Post-Op Complications

TUESDAY, Aug. 19, 2014 (HealthDay News) -- For patients undergoing pancreaticoduodenectomy (PD), fluid restrictions with 3 percent hypertonic saline can significantly cut complication rates, according to a study published in the September issue of the Annals of Surgery.

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Docs Must Consider Liability When Ordering Screening Tests

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Physicians and health care providers must be aware of their potential liability when ordering screening tests, according to an article published July 24 in Medical Economics.

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Boxed Warnings Are Common in Novel Therapeutics

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Boxed warnings are common on recent drug approvals, and many occur years after approval, according to a research letter published online Aug. 15 in JAMA Internal Medicine.

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Gender Gap Seen in Desire for Living Kidney Transplant

MONDAY, Aug. 18, 2014 (HealthDay News) -- Black women undergoing hemodialysis are less likely to want a living donor kidney transplantation (LDKT), despite being more likely to receive unsolicited offers for kidney transplant, compared with black men, according to a study published online Aug. 14 in the Clinical Journal of the American Society of Nephrology.

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Low Complication Rate for Peds Laparoscopic Cholecystectomy

FRIDAY, Aug. 15, 2014 (HealthDay News) -- For pediatric patients, laparoscopic cholecystectomy is associated with low complication rates and short postoperative hospital stays, according to research published in the June issue of Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.

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Extra Time Spent Counseling, Coordinating Care Billable

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Extra time spent counseling patients and coordinating care can be billed using evaluation and management (E/M) and prolonged service codes, according to an article published July 24 in Medical Economics.

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Cesareans for Term Breech Deliveries Improve Outcomes

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Increased rates of elective cesareans have improved the neonatal outcomes for singleton term breech deliveries, according to a study published online Aug. 11 in ACTA Obstetricia et Gynecologica Scandinavica.

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FDA Approves Donor-Lung Preservation Device

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- The XVIVO Perfusion System has been approved by the U.S. Food and Drug Administration to help preserve donor lungs that ultimately may be used for transplant, the agency said Tuesday in a news release.

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Meta-Analysis Strategy Impacts Estimation of Tx Outcome

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Estimation of treatment outcome varies with the meta-analysis strategy, according to a study published in the Aug. 13 issue of the Journal of the American Medical Association.

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Perioperative A-Fib Ups Long-Term Stroke Risk

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Perioperative atrial fibrillation is associated with an increased risk of subsequent stroke, especially after noncardiac surgery, according to a study published in the Aug. 13 issue of the Journal of the American Medical Association.

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10-Year Survival 61 Percent for Adult Primary Scoliosis Surgery

TUESDAY, Aug. 12, 2014 (HealthDay News) -- In adult middle-aged patients undergoing primary scoliosis surgery, the 10-year survival rate is 61 percent, according to a study published in the Aug. 1 issue of The Spine Journal.

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EHR Adoption Increasing, But Stage 2 Criteria Often Not Met

MONDAY, Aug. 11, 2014 (HealthDay News) -- Most U.S. hospitals and office-based physicians have adopted electronic health records (EHR), according to two studies published in the August issue of Health Affairs.

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Use of Medical Consults for Surgical Patients Varies Widely

MONDAY, Aug. 11, 2014 (HealthDay News) -- Use of medical consultations for surgical patients varies widely among hospitals, according to a study published online Aug. 4 in JAMA Internal Medicine.

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Issues to Consider With Integration of Telemedicine

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Integrating telemedicine raises various considerations, including operational and legal issues, according to an article published July 24 in Medical Economics.

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No Difference in Laparoscopic, Open Partial Hepatectomy

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Patients who undergo laparoscopic partial hepatic resection (LH) have similar short-term outcomes compared to those who undergo open partial hepatic resection (OH), according to a study published online July 30 in JAMA Surgery.

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Diagnostic Algorithm for Appendicitis Cuts Pediatric CT Use

THURSDAY, Aug. 7, 2014 (HealthDay News) -- For pediatric patients, implementation of a diagnostic algorithm for appendicitis correlates with a significant reduction in computed tomography (CT) use without impacting diagnostic accuracy, according to a study published in the August issue of Surgery.

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VA Health Care Reform Bill Signed Into Law

THURSDAY, Aug. 7, 2014 (HealthDay News) -- A bill signed into law Thursday by President Barack Obama is meant to provide veterans with easier access to government-paid health care.

Health Highlights: Aug. 7, 2014

Hospital Risk-Adjusted Margin Positivity Rate Is Quality Metric

THURSDAY, Aug. 7, 2014 (HealthDay News) -- Hospital risk-adjusted margin positivity rate (RAMP) can identify performance-based outliers and represents a rectal cancer surgery quality metric, according to a study published online Aug. 4 in the Journal of Clinical Oncology.

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Pain Reduction Tied to One-Year Spine Surgery Outcomes

THURSDAY, Aug. 7, 2014 (HealthDay News) -- For patients undergoing elective surgery for degenerative lumbar spine conditions, postoperative improvement in pain intensity is associated with improvements in physical function and reductions in disability in the year following surgery, according to a study published in the Aug. 1 issue of Spine.

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Statins May Improve Wound Healing

THURSDAY, Aug. 7, 2014 (HealthDay News) -- Statin therapy can improve wound healing, according to a review published in the August issue of the Annals of Thoracic Surgery.

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Lasting Clinical Results for Total Lumbar Disc Replacement

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Total lumbar disc replacement (TDR) yields mid- to long-term clinical efficacy and patient satisfaction, according to a study published in the Aug. 1 issue of The Spine Journal.

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Many Physicians Have Secondary Income

MONDAY, Aug. 4, 2014 (HealthDay News) -- Many physicians report earning income from sources other than their primary practice/employer, according to an article published July 24 in Medical Economics.

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CT Effective in Detection of Significant Cervical Spine Injury

MONDAY, Aug. 4, 2014 (HealthDay News) -- Computed tomography (CT) is effective in detecting clinically significant cervical spine (CS) injuries in patients with neurologic deficit or CS pain, according to a study published online July 30 in JAMA Surgery.

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Coflex Interspinous Device No Extra Benefit in Spinal Stenosis

MONDAY, Aug. 4, 2014 (HealthDay News) -- The use of a Coflex interspinous device does not further improve outcomes beyond decompressive surgery for the treatment of symptomatic lumbar spinal stenosis (LSS), according to a study published online in the August issue of the Journal of Spinal Disorders & Techniques.

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New Onset, Post-Op Atrial Fibrillation Ups Mortality

MONDAY, Aug. 4, 2014 (HealthDay News) -- New onset postoperative atrial fibrillation (POAF) is associated with worse patient outcomes, including increased risk-adjusted mortality, according to a study published in the August issue of The Annals of Thoracic Surgery.

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Review: Ketamine Does Not Adversely Affect Outcomes

MONDAY, Aug. 4, 2014 (HealthDay News) -- For intubated patients, ketamine is unlikely to adversely affect patient outcomes compared with other intravenous sedatives, according to a review published online July 22 in the Annals of Emergency Medicine.

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Guidelines Issued for Cardiac Management of Noncardiac Sx

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Recommendations have been developed for perioperative cardiovascular management of patients undergoing noncardiac surgery. These revised guidelines were published online Aug. 1 in the Journal of the American College of Cardiology.

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CMS Recognizes Telehealth in New Physician Fee Schedule

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Earlier this month, the Centers for Medicare & Medicaid Services issued proposed rules for updates to the Physician Fee Schedule and will accept comments until Sept. 2, according to an article published July 7 in Medical Economics.

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More Than Half of General Surgery Residents Want to Quit

FRIDAY, Aug. 1, 2014 (HealthDay News) -- A majority of categorical general surgery residents seriously consider leaving residency, according to a study published online July 30 in JAMA Surgery.

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Two New Radiographic Signs of Gastric Band Slippage ID'd

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Two radiographic signs have been identified that have high sensitivity and specificity for gastric band slippage, according to a study published in the July issue of the American Journal of Roentgenology.

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