December 2015 Briefing - Surgery

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

AMA: Burnout Is Top Issue for Physicians in 2015

WEDNESDAY, Dec. 30, 2015 (HealthDay News) -- Physician burnout is the top issue for physicians in 2015, according to a report published by the American Medical Association (AMA).

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Regional System of Care May Improve Outcomes for TAVR

WEDNESDAY, Dec. 30, 2015 (HealthDay News) -- A regional system of care seems beneficial for patients undergoing transcatheter aortic valve replacement (TAVR), according to a study published in the Dec. 28 issue of JACC: Cardiovascular Interventions.

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Patient Age at Initial Cataract Surgery Varies by Location

WEDNESDAY, Dec. 30, 2015 (HealthDay News) -- There is considerable geographic variation in patient age at initial cataract surgery across the United States, according to a study published online Dec. 30 in JAMA Ophthalmology.

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Pre-Op VTE Prophylaxis Safe in Major Cancer Surgery

TUESDAY, Dec. 29, 2015 (HealthDay News) -- Preoperative anticoagulation can safely be given to certain patients before major cancer surgery, according to a study published online Dec. 14 in the Journal of the American College of Surgeons.

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More Adverse Effects for Medical Castration in Prostate Cancer

TUESDAY, Dec. 29, 2015 (HealthDay News) -- For men with metastatic prostate cancer, gonadotropin-releasing hormone agonist (GnRHa) treatment is associated with more adverse effects than orchiectomy, according to a study published online Dec. 23 in JAMA Oncology.

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Surgery, Chemo Best for Elderly With Advanced Ovarian Cancer

TUESDAY, Dec. 29, 2015 (HealthDay News) -- Primary debulking surgery and chemotherapy in an optimal timeframe is associated with the longest survival time for elderly women with advanced ovarian cancer, according to a study published in the January issue of Obstetrics & Gynecology.

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History of CABG Linked to Reperfusion Delays in STEMI

MONDAY, Dec. 28, 2015 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI), those with a history of coronary artery bypass graft surgery (CABG) are more likely to have reperfusion delays, according to a study published in the Dec. 28 issue of JACC: Cardiovascular Interventions.

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Higher Hospital Prices in U.S. 'Monopoly Markets'

MONDAY, Dec. 28, 2015 (HealthDay News) -- Prices at hospitals in monopoly markets are 15 percent higher than those at hospitals in areas with at least four providers, according to research published recently at the Health Care Pricing Project website.

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Pre-Op Testing Over, Under Used in Mid Urethral Sling Surgery

MONDAY, Dec. 28, 2015 (HealthDay News) -- For patients undergoing mid urethral sling surgery, preoperative testing frequently does not adhere to national guidelines, according to a study published in the January issue of The Journal of Urology.

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Clinical Pathway Leads to Drop in Total Abdominal Hysterectomies

MONDAY, Dec. 28, 2015 (HealthDay News) -- Following implementation of a hysterectomy pathway there has been a decrease in the proportion of total abdominal hysterectomy (TAH) procedures performed between 2012 and 2014, according to research published online Dec. 7 in Obstetrics & Gynecology.

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Daily INR Measurement Best for Hospitalized Patients on Warfarin

WEDNESDAY, Dec. 23, 2015 (HealthDay News) -- For hospitalized patients, international normalized ratio (INR) monitoring less frequently than daily is associated with increased odds of warfarin-associated adverse events, according to a study published online Dec. 14 in the Journal of Hospital Medicine.

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FDA Lifts Ban on Blood Donations by Men Who Have Sex With Men

TUESDAY, Dec. 22, 2015 (HealthDay News) -- Men who have sex with men who have abstained from sex for one year will now be allowed to donate blood in the United States. The new policy, announced Monday by the U.S. Food and Drug Administration, reverses a three-decades-old ban on donations from this group of men that traces back to the start of the AIDS epidemic.

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Specific, Consistent ICD-10 Coding Key to Timely Payments

TUESDAY, Dec. 22, 2015 (HealthDay News) -- In order to prevent denials, it is important to code correctly within the International Classification of Diseases, Tenth Revision (ICD-10), with specificity matching documentation, according to an article published in Medical Economics.

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Affordable Care Act Has Improved Access to Care, Affordability

MONDAY, Dec. 21, 2015 (HealthDay News) -- Implementation of the Affordable Care Act has improved access to care and affordability of care for many adults, according to a study published in the December issue of Health Affairs.

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Use of Minimally Invasive Sx for Endometrial Cancer Varies

MONDAY, Dec. 21, 2015 (HealthDay News) -- There is considerable variation in hospital utilization of minimally invasive surgery for the treatment of early-stage endometrial cancer, according to a study published in the January issue of Obstetrics & Gynecology.

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Feedback to Surgical Residents Improves Use of VTE Prophylaxis

MONDAY, Dec. 21, 2015 (HealthDay News) -- For surgical residents, providing personal clinical effectiveness performance feedback regarding prescription of appropriate venous thromboembolism (VTE) prophylaxis improves performance, according to a study published online Nov. 25 in the Annals of Surgery.

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Risk of Unsatisfactory Spine Sx Outcome Up With Workers' Comp

MONDAY, Dec. 21, 2015 (HealthDay News) -- Patients undergoing spine surgery with workers' compensation (WC) have increased risk of an unsatisfactory outcome, according to a meta-analysis published in the Dec. 1 issue of The Spine Journal.

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Intra-Pancreatic Triacylglycerol Drops With Weight Loss in T2DM

MONDAY, Dec. 21, 2015 (HealthDay News) -- The weight loss-associated decrease in intra-pancreatic triacylglycerol which occurs after gastric bypass is specific to type 2 diabetes mellitus (T2DM), according to a study published online Dec. 1 in Diabetes Care.

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Implantable Collamer Lens Effective for Correcting Myopia

FRIDAY, Dec. 18, 2015 (HealthDay News) -- Implantable collamer lens (ICL) implantation is effective for correcting myopia, according to a study published online Dec. 12 in Clinical & Experimental Ophthalmology.

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FDA Approves New Device for Fecal Incontinence

FRIDAY, Dec. 18, 2015 (HealthDay News) -- The Fenix Continence Restoration System has been approved by the U.S. Food and Drug Administration to treat an inability to control bowel movements for patients who can't tolerate or use other approved methods.

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Nursing Conditions Tied to Hospital Cardiac Arrest Survival

FRIDAY, Dec. 18, 2015 (HealthDay News) -- Better work environments and decreased patient-to-nurse ratios on medical-surgical units are associated with higher odds of patient survival after an in-hospital cardiac arrest (IHCA), according to a study published in the January issue of Medical Care.

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Surgery May Beat Radiotherapy for Localized Prostate Cancer

THURSDAY, Dec. 17, 2015 (HealthDay News) -- Men with localized prostate cancer are more likely to survive if they have surgery rather than radiation therapy, according to findings published online Dec. 14 in European Urology.

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Nonoperative Management Feasible for Pediatric Appendicitis

THURSDAY, Dec. 17, 2015 (HealthDay News) -- For children with uncomplicated acute appendicitis, choosing nonoperative management is an effective treatment strategy, according to a study published online Dec. 16 in JAMA Surgery.

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Effect of Availability of TAVR on Clinical Practice Evaluated

THURSDAY, Dec. 17, 2015 (HealthDay News) -- The use of transcatheter aortic-valve replacement (TAVR) increased in Germany from 2007 to 2013, with a moderate concomitant reduction in surgical aortic-valve replacement, according to a study published in the Dec. 17 issue of the New England Journal of Medicine.

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Lack of Sleep Affects Mood, Cognition in Anesthesiologists

THURSDAY, Dec. 17, 2015 (HealthDay News) -- Partial sleep deprivation following a night-call shift affects anesthesiologists' total mood status and their cognitive skills, according to a study published in the January issue of Pediatric Anesthesia.

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Industry Outpacing NIH in Funding Research

WEDNESDAY, Dec. 16, 2015 (HealthDay News) -- There's been a sharp rise in the number of industry-funded clinical trials and a significant decline in those financed by the U.S. government in recent years, according to findings published in the Dec. 15 issue of the Journal of the American Medical Association.

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FDA Approves Bridion to Reverse Neuromuscular Blockade

WEDNESDAY, Dec. 16, 2015 (HealthDay News) -- Bridion (sugammadex) has been approved by the U.S. Food and Drug Administration to reverse the effects of neuromuscular blockade induced by rocuronium bromide and vecuronium bromide.

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PT Beats Surgery for Quick Relief of Carpal Tunnel Pain

WEDNESDAY, Dec. 16, 2015 (HealthDay News) -- For women with carpal tunnel syndrome (CTS), physical manual therapies are similarly effective to surgery in the medium and long term, and may be more effective in the short term, according to a study published in the November issue of The Journal of Pain.

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No Lasting Benefit for Early Tx of Patent Ductus Arteriosus

WEDNESDAY, Dec. 16, 2015 (HealthDay News) -- Early treatment to induce closure of the patent ductus arteriosus (PDA) in preterm infants does not improve long-term outcomes, according to a clinical report published online Dec. 15 in Pediatrics.

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Ovarian Conservation Safe in Endometrial Cancer, but Use Low

TUESDAY, Dec. 15, 2015 (HealthDay News) -- Despite the safety of ovarian conservation, the majority of young women with endometrial cancer still undergo oophorectomy, according to a study published in the January issue of Obstetrics & Gynecology.

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Neurotoxicity of Anesthesia in Children Needs to Be Addressed

TUESDAY, Dec. 15, 2015 (HealthDay News) -- A recent survey of pediatric anesthesia programs at teaching institutions in the United States highlights the need for improvements in training, clinical practice, and communication related to neurotoxicity associated with general anesthesia in young children, according to research published in the January issue of Pediatric Anesthesia.

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Improvements in RA Disease Activity With Bariatric Sx

MONDAY, Dec. 14, 2015 (HealthDay News) -- For patients with rheumatoid arthritis (RA), bariatric surgery-associated weight loss correlates with lower disease activity, decreased serum inflammatory markers, and less RA-related medication use, according to a study published in the December issue of Arthritis Care & Research.

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New Model of Inpatient Care Can Improve Outcomes

MONDAY, Dec. 14, 2015 (HealthDay News) -- Implementation of a new model of care can improve outcomes of care in medical and surgical units, according to a study published in the December issue of the Journal of Hospital Medicine.

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Paracentesis Underutilized in Patients With Cirrhosis, Ascites

FRIDAY, Dec. 11, 2015 (HealthDay News) -- For patients admitted with diagnoses of cirrhosis and ascites, paracentesis is associated with decreased in-hospital mortality but is underutilized, according to a study published online Dec. 8 in the Journal of Gastroenterology and Hepatology.

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Seven Behaviors Suggested to Improve 'Art of Medicine'

FRIDAY, Dec. 11, 2015 (HealthDay News) -- Seven behaviors should be implemented to improve the art of medicine, which can help improve relationships with patients, according to an article published in Family Practice Management.

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Timing May Be Key to Success for Early Breast CA Treatment

THURSDAY, Dec. 10, 2015 (HealthDay News) -- The sooner early-stage breast cancer patients have surgery following their diagnosis, and chemotherapy after their surgery, the better their chances of survival, according to two studies published online Dec. 10 in JAMA Oncology.

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Interlobar Collateral Ventilation Impacts EB Valve Outcomes

THURSDAY, Dec. 10, 2015 (HealthDay News) -- A more careful selection of patients could help improve the success rate of bronchoscopic lung-volume reduction with the use of one-way endobronchial valves in patients with emphysema, according to a study published in the Dec. 10 issue of the New England Journal of Medicine.

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Percentage of Graduates Entering GME Stable Over Past Decade

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- Despite an increase in the number of U.S. medical school graduates, over the past decade the percentage entering graduate medical education (GME) training has remained stable, according to a research letter published in the Dec. 8 issue of the Journal of the American Medical Association, a theme issue on medical education.

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Doctors Rally in Support of Morcellator Use Curbed by FDA

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- Dozens of gynecologists, oncologists, and women's health experts are challenging a U.S. Food and Drug Administration warning on power morcellator use for the removal of uterine fibroids.

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Depression Not Uncommon Among Resident Physicians

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- More than one in four doctors-in-training may be depressed, which could put their patients at risk, according to a study published in the Dec. 8 issue of the Journal of the American Medical Association, a theme issue on medical education.

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Guidelines Formulated for Arterial Conduits in CABG

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- Guidelines have been formulated for arterial conduits for coronary artery bypass graft (CABG) surgery, and published online Dec. 8 in the Annals of Thoracic Surgery.

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Staged Surgical Excision Superior for Treatment of Lentigo Maligna

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- For patients with lentigo maligna, staged surgical excision is associated with a low rate of recurrence, according to research published online Nov. 30 in the British Journal of Dermatology.

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Med Ed Can Be Improved for High-Value, Cost-Conscious Care

TUESDAY, Dec. 8, 2015 (HealthDay News) -- The combination of effective transmission of knowledge, facilitation of reflective practice, and a supportive environment can educate physicians to deliver high-value, cost-conscious care, according to a review published in the Dec. 8 issue of the Journal of the American Medical Association, a theme issue on medical education.

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CDC: Fewer Americans Struggling With Medical Bills

TUESDAY, Dec. 8, 2015 (HealthDay News) -- Fewer American families are struggling to pay medical bills, according to a report from the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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U.S. Health Care Spending Increased in 2014

TUESDAY, Dec. 8, 2015 (HealthDay News) -- The expansion of insurance coverage and increases in retail prescription drug spending contributed to an increase in total national health care expenditures in 2014, according to a report published online Dec. 2 in Health Affairs.

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Transgender Transition Treatment Deemed Cost-Effective

MONDAY, Dec. 7, 2015 (HealthDay News) -- Providing sex reassignment surgery and hormone treatment for transgender men and women is cost-effective, according to a study published online recently in the Journal of General Internal Medicine.

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Guidelines Developed for Perinatal Hematologic Cancers

MONDAY, Dec. 7, 2015 (HealthDay News) -- Consensus guidelines have been developed for clinical management of hematologic malignancies during the perinatal period, according to a special article published online Nov. 30 in the Journal of Clinical Oncology.

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Bariatric Surgery Beats Medical Control for Diabetes Remission

MONDAY, Dec. 7, 2015 (HealthDay News) -- Surgery is more effective than medical control for diabetes remission, with predictors including lower baseline glycemia and shorter diabetes duration, according to research published online Dec. 1 in Diabetes Care.

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Glove-Related Hand Urticaria May Be Rising in Health Care Workers

FRIDAY, Dec. 4, 2015 (HealthDay News) -- Health care workers are at high risk of glove-related hand urticaria, an occupational issue that may be increasing, according to a research letter published online Nov. 27 in the British Journal of Dermatology.

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AMA: Case Before Supreme Court Threatens Patient Privacy

THURSDAY, Dec. 3, 2015 (HealthDay News) -- A case before the Supreme Court is potentially threatening patient confidentiality, according to the American Medical Association (AMA).

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Survival Up for Patients With Stage IV Breast Cancer

WEDNESDAY, Dec. 2, 2015 (HealthDay News) -- American women diagnosed with advanced, stage IV breast cancer have a better chance of survival, and are surviving longer, compared to two decades ago, according to a study published online Dec. 2 in JAMA Surgery.

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Burnout Rates on the Rise for Physicians

WEDNESDAY, Dec. 2, 2015 (HealthDay News) -- Burnout is a growing problem among American doctors, according to research published in the December issue of the Mayo Clinic Proceedings.

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Benefits for Intra-, Extracapsular Tonsillectomy in Peds OSA

WEDNESDAY, Dec. 2, 2015 (HealthDay News) -- For children with obstructive sleep apnea syndrome (OSAS), both extracapsular tonsillectomy and adenoidectomy (ETA) and intracapsular tonsillectomy and adenoidectomy (ITA) are effective, according to a study published online Nov. 19 in JAMA Otolaryngology-Head & Neck Surgery.

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Recovery Pattern Is Useful Tool After CPA Tumor Resection

WEDNESDAY, Dec. 2, 2015 (HealthDay News) -- For patients who develop facial paralysis after cerebellopontine angle (CPA) tumor resection, the recovery pattern in the early postoperative period is useful for selecting patients for facial reanimation surgery, according to a study published online Nov. 19 in JAMA Facial Plastic Surgery.

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Physician's Briefing