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March 2017 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for March 2017. 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.

90 Percent of U.S. Physicians Satisfied With Career Choice

FRIDAY, March 31, 2017 (HealthDay News) -- Nine out of 10 American doctors are happy with their choice of profession, even though they have some challenges, according to an American Medical Association (AMA) survey of 1,200 doctors, residents, and medical students, conducted in February.

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Vertical Integration Insurance Products of Higher Quality

FRIDAY, March 31, 2017 (HealthDay News) -- Insurance products offered by hospitals and health systems, known as vertical integration, are generally of higher quality than other contracts, according to a study published in the March issue of Health Affairs.

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Donor-Recipient Weight and Sex Mismatch Ups Kidney Graft Loss

FRIDAY, March 31, 2017 (HealthDay News) -- For kidney transplantation, mismatch in donor-recipient sex, and in donor-recipient weight, where the recipient is much larger than the donor, is associated with increased risk of graft loss, according to a study published online March 30 in the Clinical Journal of the American Society of Nephrology.

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Estriol Gel Aids Vaginal Health Pre, Post Genital Prolapse Sx

FRIDAY, March 31, 2017 (HealthDay News) -- For postmenopausal women undergoing surgical treatment for pelvic organ prolapse, vaginal estriol gel is associated with improvement in vaginal health, according to a study published online March 27 in Menopause.

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Contralateral Prophylactic Mastectomy Rates Up Nationwide

THURSDAY, March 30, 2017 (HealthDay News) -- For women with early-stage unilateral breast cancer treated with surgery, there was an increase in the proportion undergoing contralateral prophylactic mastectomy (CPM) from 2004 to 2012, with considerable variation across states, according to a study published online March 29 in JAMA Surgery.

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Total Knee Replacement Typically Has Minimal Impact on QoL

WEDNESDAY, March 29, 2017 (HealthDay News) -- Total knee replacement has minimal effects on quality of life, but the effectiveness could increase if the procedure were restricted to more severely affected patients, according to a study published online March 28 in The BMJ.

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Arm, Hand Function Restored in Tetraplegic Patient

WEDNESDAY, March 29, 2017 (HealthDay News) -- For patients with high-cervical spinal cord injury, reaching and grasping using the paralyzed arm, reanimated through functional electrical stimulation (FES) + commanded using cortical signals through an intracortical brain-computer interface (iBCI), is feasible, according to a proof-of-concept demonstration study published online March 28 in The Lancet.

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Lap, Abdominal Hysterectomy Equal for Early Endometrial CA

TUESDAY, March 28, 2017 (HealthDay News) -- For women with stage I endometrial cancer, total laparoscopic hysterectomy (TLH) is equivalent to total abdominal hysterectomy (TAH) for disease-free survival at 4.5 years, according to a study published in the March 28 issue of the Journal of the American Medical Association.

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TV Ads for ACA Enrollment Linked to Decline in Uninsured Rates

TUESDAY, March 28, 2017 (HealthDay News) -- The volume of insurance advertisements during the first Affordable Care Act enrollment period correlated with change in uninsurance rates, with a higher volume of television advertisements linked to declines in uninsurance, according to a study published online March 15 in Health Affairs.

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ACP Issues Challenge to Cut Task Burden and Put Patients First

TUESDAY, March 28, 2017 (HealthDay News) -- In a position paper published online March 28 in the Annals of Internal Medicine, recommendations are presented to address the impact of administrative tasks and reduce the administrative burden on clinicians.

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Post-Op Urinary Retention Common After Spinal Stenosis Sx

TUESDAY, March 28, 2017 (HealthDay News) -- Postoperative urinary retention (POUR) is a common morbidity after surgery for degenerative lumbar spinal stenosis, according to research published in the April issue of The Spine Journal.

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Paid Malpractice Claims Cut in Half From 1992 to 2014 in U.S.

MONDAY, March 27, 2017 (HealthDay News) -- From 1992 to 2014 there was a decrease in the rate of malpractice claims paid on behalf of physicians in the United States, but mean compensation amounts increased, according to a study published online March 27 in JAMA Internal Medicine.

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Surgical Glue Reinforcement OK for Lap Sleeve Gastrectomy

MONDAY, March 27, 2017 (HealthDay News) -- Surgical glue is safe and cost-effective, compared to standard stapling, during laparoscopic sleeve gastrectomy, according to a study published online March 21 in the Journal of Evaluation in Clinical Practice.

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Advanced Age Need Not Deter Surgery for Cutaneous Tumors

MONDAY, March 27, 2017 (HealthDay News) -- Surgery for cutaneous tumors under local anesthesia is as well tolerated in elderly patients 90 years and older as it is in patients aged 75 to 80 years old, according to a study published online March 21 in the International Journal of Dermatology.

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Mobile App Cuts In-Person Visits After Breast Reconstruction

THURSDAY, March 23, 2017 (HealthDay News) -- Follow-up care delivered via a mobile app can reduce in-person visits for ambulatory patients undergoing breast reconstruction, according to a study published online March 22 in JAMA Surgery.

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30-Day Mortality Down During Joint Commission Survey Weeks

THURSDAY, March 23, 2017 (HealthDay News) -- Patients admitted to the hospital during The Joint Commission on-site inspections (surveys) have reduced mortality compared to that seen during non-survey weeks, according to research published online March 20 in JAMA Internal Medicine.

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Adenotonsillotomy Noninferior to Adenotonsillectomy in Peds OSA

WEDNESDAY, March 22, 2017 (HealthDay News) -- Adenotonsillotomy (ATT) is noninferior to adenotonsillectomy (ATE) for children aged 2 to 6 years with obstructive sleep apnea (OSA), according to a study published online March 20 in Pediatrics.

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AHA/ACC Update Guidelines for Valvular Heart Disease in Adults

WEDNESDAY, March 22, 2017 (HealthDay News) -- The American Heart Association and American College of Cardiology have updated guidelines for the management of patients with valvular heart disease, according to a report published online March 15 in Circulation.

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Opioid Users Incur Higher Costs After Elective Abdominal Surgery

WEDNESDAY, March 22, 2017 (HealthDay News) -- Preoperative opioid use is associated with increased health care utilization and costs after elective abdominal surgery, according to a study published in the April issue of the Annals of Surgery.

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Multiple Dosing Mitigates ASA Hyporesponsiveness After CABG

WEDNESDAY, March 22, 2017 (HealthDay News) -- Acetylsalicylic acid (ASA) hyporesponsiveness after coronary artery bypass graft (CABG) surgery can be overcome by multiple dosing, according to a study published online March 7 in the Journal of Thrombosis and Haemostasis.

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Black, Asian Medical Students Less Likely to Be AΩA Members

TUESDAY, March 21, 2017 (HealthDay News) -- Black and Asian medical students are less likely to be members of the Alpha Omega Alpha (AΩA) honor society than white students, according to a study published online March 6 in JAMA Internal Medicine.

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Radical Prostatectomy Linked to Greater Drop in Sexual Function

TUESDAY, March 21, 2017 (HealthDay News) -- For men with localized prostate cancer, radical prostatectomy is associated with a greater decrease in sexual domain scores, while different treatment strategies are associated with distinct patterns of adverse effects, according to two studies published in the March 21 issue of the Journal of the American Medical Association.

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Los Angeles eConsult Program Can Reduce Wait Times

FRIDAY, March 17, 2017 (HealthDay News) -- Implementation of an electronic system for provision of specialty care was rapidly adopted in Los Angeles, and it can reduce wait times to see specialists, according to a study published in the March issue of Health Affairs.

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Initial Rx Can Affect Likelihood of Long-Term Opioid Use

FRIDAY, March 17, 2017 (HealthDay News) -- Doctors who limit the supply of opioids they prescribe to three days or less may help patients reduce their risk of dependence and addiction, according to research published in the March 17 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Glaucoma Surgery Risk Up With 7+ Injections of Bevacizumab

FRIDAY, March 17, 2017 (HealthDay News) -- Seven or more injections of bevacizumab annually is associated with increased risk of glaucoma surgery, according to a study published online March 16 in JAMA Ophthalmology.

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Continuing Statins Up to Surgery May Improve CABG Outcomes

FRIDAY, March 17, 2017 (HealthDay News) -- Coronary artery bypass graft (CABG) surgery patients taking statins may improve their survival odds if the medication is continued up to the day of surgery, according to a study published online March 16 in the Annals of Thoracic Surgery.

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Shorter Length of Stay Tied to Earlier Readmission for Seniors

FRIDAY, March 17, 2017 (HealthDay News) -- For older patients discharged from the hospital to post-acute care (PAC) facilities, shorter length of hospital stay is associated with earlier readmission, according to a study published online March 3 in the Journal of the American Geriatrics Society.

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Patients Have High Confidence in Self-Testing INR

FRIDAY, March 17, 2017 (HealthDay News) -- Most patients have high confidence in self-testing their international normalized ratio (INR), according to a study published online Feb. 23 in the Journal of Clinical Nursing.

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Hyperbaric Oxygen Tx Beneficial for Systemic Sclerosis Ulcers

THURSDAY, March 16, 2017 (HealthDay News) -- Adjunctive hyperbaric oxygen therapy (HBOT) may be beneficial for treatment of systemic sclerosis (SSc) ulcers, according to a report published online Feb. 23 in the International Journal of Dermatology.

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Catastrophic Neonatal Outcome Ups Unscheduled C-Section Rates

THURSDAY, March 16, 2017 (HealthDay News) -- Catastrophic neonatal outcome is associated with a transient increase in the rate of unscheduled cesarean deliveries, according to research published in the April issue of Obstetrics & Gynecology.

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Clinical Decision Support System Use Tied to Fewer VTE Events

THURSDAY, March 16, 2017 (HealthDay News) -- Use of computerized clinical decision support systems (CCDSSs) among surgical patients is associated with an increase in the rate of appropriate ordering of venous thromboembolism (VTE) prophylaxis and a decrease in the risk of VTE events, according to a review published online March 15 in JAMA Surgery.

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Concurrent Benzodiazepine, Opioid Use Up Significantly

WEDNESDAY, March 15, 2017 (HealthDay News) -- From 2001 to 2013, concurrent benzodiazepine/opioid use significantly increased in privately-insured patients in the United States, according to a report published online March 14 in The BMJ.

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Women Underrepresented Among Grand Rounds Speakers

WEDNESDAY, March 15, 2017 (HealthDay News) -- Women seem to be underrepresented among academic grand rounds (GR) speakers, according to a research letter published online March 6 in JAMA Internal Medicine.

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Inpatient Rehab Doesn't Up Total Knee Arthroplasty Outcomes

WEDNESDAY, March 15, 2017 (HealthDay News) -- The use of inpatient rehabilitation in addition to home-based rehabilitation does not improve mobility at 26 weeks after total knee arthroplasty, according to a study published in the March 14 issue of the Journal of the American Medical Association.

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No Benefit for Activity Restriction Post Prolapse Surgery

WEDNESDAY, March 15, 2017 (HealthDay News) -- For women undergoing reconstructive prolapse surgery, satisfaction is similarly high three months after surgery for those instructed to liberally resume activities and for those instructed to restrict their activities, according to a study published in the April issue of Obstetrics & Gynecology.

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Support for Health Law Up to 48 Percent in February

TUESDAY, March 14, 2017 (HealthDay News) -- Support for the health law is increasing, with most Americans feeling that Medicaid should continue as it is today, according to a report published by Kaiser Health News.

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Higher Spending by Physicians Not Tied to Better Outcomes

MONDAY, March 13, 2017 (HealthDay News) -- Medicare patients treated by higher-spending physicians are just as likely to be readmitted or die within 30 days of being admitted to the hospital as patients treated by doctors who order fewer or less-expensive tests and treatments, according to a study published online March 13 in JAMA Internal Medicine.

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Patients With Thyroid CA Who Choose No Rx Report Isolation

FRIDAY, March 10, 2017 (HealthDay News) -- Patients with thyroid cancer who decide not to intervene experience anxiety, may feel isolated, and are at risk of disengaging from health care, according to a study published online March 9 in JAMA Otolaryngology-Head and Neck Surgery.

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Aromatherapy Massage Helpful for Female Cancer Patients

FRIDAY, March 10, 2017 (HealthDay News) -- Female cancer patients report positive experiences with aromatherapy massage (ATM), according to a study published online March 2 in the Journal of Clinical Nursing.

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ACA's Medicaid Expansion May Pose Challenges to Timely Care

THURSDAY, March 9, 2017 (HealthDay News) -- People living in states that expanded Medicaid under the Affordable Care Act (ACA) are less likely to be uninsured or struggling with the strain of unpaid medical bills, but they also seem to have increased difficulty receiving timely care, according to research published in the March 9 issue of the New England Journal of Medicine.

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Republicans Introduce Affordable Care Act Replacement

TUESDAY, March 7, 2017 (HealthDay News) -- An initial Republican replacement for the Affordable Care Act was formally introduced in the House of Representatives on Monday.

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Increased Nonvertebral Fracture Risk After Roux-en-Y Bypass

TUESDAY, March 7, 2017 (HealthDay News) -- Roux-en-Y gastric bypass (RYGB) is associated with increased nonvertebral fracture risk compared with adjustable gastric banding (AGB), according to a study published online March 2 in the Journal of Bone and Mineral Research.

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Most Health Care Providers Can Offer Cost Estimate

MONDAY, March 6, 2017 (HealthDay News) -- Most provider organizations can offer a cost estimate, although few patients request one, according to a report published by Becker's Hospital CFO.

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Judgement Bias in Medical Device Recall Decisions

FRIDAY, March 3, 2017 (HealthDay News) -- The characteristics of the signal in user feedback of adverse events associated with medical devices and the situated context of decision makers correlate with judgement bias in reacting to these adverse events, according to research published online Jan. 29 in Production and Operations Management.

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ASPS Releases New Plastic Surgery Statistics

FRIDAY, March 3, 2017 (HealthDay News) -- The number of cosmetic procedures in the United States rose 3 percent last year from 2015, according to the American Society of Plastic Surgeons.

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Exercise Treatments Best for Reducing Cancer-Related Fatigue

FRIDAY, March 3, 2017 (HealthDay News) -- Exercise and/or behavioral and educational therapy may be more effective than prescription drugs for dealing with cancer-related fatigue, according to a meta-analysis published online March 2 in JAMA Oncology.

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Overall, 8.8 Percent of U.S. Population Uninsured in 2016

THURSDAY, March 2, 2017 (HealthDay News) -- Overall, 8.8 percent of individuals of all ages were uninsured in the first nine months of 2016, which marked a nonsignificant reduction from 2015, according to a Feb. 14 report from the National Center for Health Statistics.

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Care Setting Affects Management of Carotid Artery Stenosis

THURSDAY, March 2, 2017 (HealthDay News) -- For individuals with a diagnosis of carotid artery stenosis, the likelihood of undergoing procedural management is increased for those treated in a fee-for-service system compared with a salary-based setting, according to a study published online March 1 in JAMA Surgery.

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Pre-Op Phone Consult Doesn't Cut Anxiety Before Mohs Surgery

THURSDAY, March 2, 2017 (HealthDay News) -- Receiving a preoperative educational telephone call does not reduce anxiety or improve satisfaction for patients undergoing same-day office consultation and Mohs micrographic surgery (MMS), according to a study published in the March issue of the Journal of the American Academy of Dermatology.

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Colorectal Cancer Rates, Mortality Down in Americans Aged ≥50

WEDNESDAY, March 1, 2017 (HealthDay News) -- Colorectal cancer (CRC) rates among those aged 50 and older have fallen 32 percent since 2000, while deaths from the disease fell by 34 percent, according to a report published online March 1 in CA: A Cancer Journal for Clinicians.

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Colorectal Cancer Facts & Figures 2017-2019

Hospitals May Be Overcharging for Hip, Knee Replacements

WEDNESDAY, March 1, 2017 (HealthDay News) -- Some U.S. hospitals might be charging private insurers twice as much for knee and hip replacements as the implants typically cost, according to a research letter published in the Feb. 28 issue of the Journal of the American Medical Association.

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Physician's Briefing
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