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May 2015 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for May 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: Physicians Driving the Slowing of Health Care Costs

FRIDAY, May 29, 2015 (HealthDay News) -- Low physician spending is contributing to an overall slowing of health care costs, according to a viewpoint piece published by the American Medical Association (AMA).

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Outpatient Uterine Polypectomy More Cost-Effective

FRIDAY, May 29, 2015 (HealthDay News) -- For women with abnormal uterine bleeding and hysteroscopically diagnosed endometrial polyps, outpatient treatment is more cost-effective than inpatient treatment, according to research published online May 25 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Teens More Satisfied Than Adults With Lumbar Disc Herniation Sx

FRIDAY, May 29, 2015 (HealthDay News) -- Adolescent patients are more satisfied with surgery for lumbar disc herniation than younger or older adults, according to a study published in the June 1 issue of The Spine Journal.

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RYGB Cuts Markers of Oxidative Stress in Subcutaneous Tissue

FRIDAY, May 29, 2015 (HealthDay News) -- Roux-en-Y gastric bypass (RYGB) surgery attenuates markers of oxidative stress in subcutaneous adipose tissue, according to a study published online May 22 in Diabetes.

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Weight-Based Enoxoparin Dosing Best for Obese After C-Section

FRIDAY, May 29, 2015 (HealthDay News) -- Weight-based dosing of enoxaparin is more effective than body mass index (BMI)-based dosing for venous thromboembolism prophylaxis among morbidly obese women after cesarean delivery, according to a study published in the June issue of Obstetrics & Gynecology.

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U.S. Organ Donation Rates Highest in Midwest

THURSDAY, May 28, 2015 (HealthDay News) -- In the United States, organ donor rates are highest in the Midwest and lowest in New York state, according to a report published online May 28 in the American Journal of Transplantation.

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14.9 Million New Cancer Cases Worldwide in 2013

THURSDAY, May 28, 2015 (HealthDay News) -- Between 1990 and 2013, the proportion of deaths worldwide caused by cancer rose from 12 to 15 percent. During that time, years of healthy life lost to cancer increased 29 percent, according to data on 28 types of cancer in 188 countries published online May 28 in JAMA Oncology.

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Post-CABG Predictors of Stroke Identified for Diabetes Patients

THURSDAY, May 28, 2015 (HealthDay News) -- For patients with diabetes mellitus undergoing multivessel coronary artery bypass grafting (CABG), predictors of stroke include previous stroke, warfarin use, and surgery outside the United States or Canada, according to research published in the May 15 issue of The American Journal of Cardiology.

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Pre-Op β-Blockers May Work Against Heart-Healthy Patients

WEDNESDAY, May 27, 2015 (HealthDay News) -- While patients with three or four heart risk factors should still be given a β-blocker before surgery, those with no risk for heart disease shouldn't get the medication as it might lower the odds of a good outcome, according to a report published online May 27 in JAMA Surgery.

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Return to Sports Starts at Three Months Post Scoliosis Surgery

TUESDAY, May 26, 2015 (HealthDay News) -- For patients with adolescent idiopathic scoliosis (AIS), surgeons are allowing return to sports starting at three months after corrective surgery, according to research published in the May 1 issue of The Spine Journal.

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Caution Urged When Using EHR Shortcut Features

TUESDAY, May 26, 2015 (HealthDay News) -- Caution should be exercised with use of electronic health record (EHR) documentation short cuts, according to a report published in Medical Economics.

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Large Practices Focused on Small Selection of EHR Products

FRIDAY, May 22, 2015 (HealthDay News) -- Sixty percent of clinicians in practices with 26 or more clinicians report use of one of 10 electronic health record (EHR) products, according to a report published by AmericanEHR Partners.

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Front Desk Staff Has Key Role in Managing Practice Cash Flow

FRIDAY, May 22, 2015 (HealthDay News) -- Three steps that can be implemented by front desk staff can help increase practices' cash flow, according to an article published in Medical Economics.

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Lean Six Sigma Approach Ups Quality of Hip Replacement Sx

FRIDAY, May 22, 2015 (HealthDay News) -- The Lean Six Sigma approach can be implemented to improve quality of care and reduce costs in prosthetic hip replacement surgery, according to a study published online May 11 in the Journal of Evaluation in Clinical Practice.

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AMA: Avoiding Distress in Medical School

FRIDAY, May 22, 2015 (HealthDay News) -- Understanding the key drivers underlying medical students' distress can help address the issues and enhance student well-being, according to an article published by the American Medical Association.

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Complication Rate Relatively Low for Anterior Lumbar Surgery

THURSDAY, May 21, 2015 (HealthDay News) -- For patients undergoing anterior lumbar surgery (ALS), complications occur relatively infrequently, with a complication rate of 14.1 percent overall, according to a review published in the May 1 issue of The Spine Journal.

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Optimal Mechanical Ventilation Strategy Identified for Obese

THURSDAY, May 21, 2015 (HealthDay News) -- For obese patients, the optimal mechanical ventilation strategy may be volume-controlled ventilation (VCV) with higher positive end-expiratory pressure (PEEP) and single recruitment maneuvers (RMs), according to a meta-analysis published in the June issue of Obesity Reviews.

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Benefits for Surgery Before Chemo in Advanced Ovarian CA

WEDNESDAY, May 20, 2015 (HealthDay News) -- Undergoing chemotherapy before surgery may help women battling advanced ovarian cancer, according to new research published online May 19 in The Lancet.

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Family Hx Alone Doesn't Appear to Affect Breast CA Tx Outcomes

WEDNESDAY, May 20, 2015 (HealthDay News) -- A positive family history is not a significant independent risk factor for breast cancer outcome, according to a study published online May 20 in the British Journal of Surgery.

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More Evidence That C-Sections Should Be Avoided When Possible

WEDNESDAY, May 20, 2015 (HealthDay News) -- Women who deliver their first baby by cesarean section are more likely to need blood transfusions and be admitted to intensive care units than women who opt for a vaginal delivery, U.S. health officials reported Wednesday.

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Bleeding Complications Up With Multicompartment Mesh Removal

WEDNESDAY, May 20, 2015 (HealthDay News) -- For women undergoing vaginal mesh removal, bleeding complications are higher for removal from multiple vaginal compartments versus a single vaginal compartment, according to research published May 6 in Obstetrics & Gynecology.

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Regional Anesthesia May Be Best in Infant Hernia Surgeries

WEDNESDAY, May 20, 2015 (HealthDay News) -- Infants undergoing herniorrhaphy may fare better with use of awake regional anesthesia (RA) over general anesthesia (GA), according to research published online May 14 in Anesthesiology.

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Tips Provided for Doctors Who Want to Move to Private Practice

MONDAY, May 18, 2015 (HealthDay News) -- For physicians who want to transition to private practice, several factors need consideration, including finances, legal matters, and insurance, according to an article published in Medical Economics.

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Histopathologic Features Not Linked to Clinical Rhinophyma

MONDAY, May 18, 2015 (HealthDay News) -- For patients with rhinophyma, histopathologic features are not associated with different clinical expression, according to a study published online May 6 in the Journal of Cutaneous Pathology.

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Study IDs Factors Linked to Improved Survival in OCSCC

FRIDAY, May 15, 2015 (HealthDay News) -- Factors associated with improved survival in oral cavity squamous cell cancer (OCSCC) include neck dissection and treatment at academic or research institutions, according to a study published online May 14 in JAMA Otolaryngology-Head & Neck Surgery.

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Health Care Justice Could Help End Wait for Tubal Sterilization

FRIDAY, May 15, 2015 (HealthDay News) -- Health care justice should be invoked as the basis for advocacy for needed change to eliminate the mandatory waiting period for elective tubal sterilization, according to an article published online April 30 in the American Journal of Obstetrics & Gynecology.

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Nearly 400 HIV-Positive Potential Organ Donors in U.S.

THURSDAY, May 14, 2015 (HealthDay News) -- Nearly 400 HIV-positive potential organ donors in the United States could donate organs each year to HIV-positive people waiting for transplants, according to a new study published online May 14 in the American Journal of Transplantation.

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Study Considers Antibiotics-First Approach to Appendicitis

THURSDAY, May 14, 2015 (HealthDay News) -- An antibiotics-first approach could be considered for specific patients with appendicitis, according to a case vignette published in the May 14 issue of the New England Journal of Medicine.

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Pregnancy Not Linked to Higher Mortality in Surgery

WEDNESDAY, May 13, 2015 (HealthDay News) -- Pregnancy does not raise a woman's risk for death or complications after undergoing general surgery, according to research published online May 13 in JAMA Surgery.

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Small Bowel Volvulus Should Be Considered in Surgical Evaluation

WEDNESDAY, May 13, 2015 (HealthDay News) -- Among U.S. adults, small bowel volvulus cases account for 1 percent of hospitalizations for bowel obstruction, according to research published online April 29 in the American Journal of Surgery.

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New Health Care Index Reports Increases in Consumer Costs

TUESDAY, May 12, 2015 (HealthDay News) -- A new Health Care Index shows increases in consumer costs, according to a report published by U.S. News & World Report.

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Guidance Offered to Help Doctors Deal With 'Dr. Google'

TUESDAY, May 12, 2015 (HealthDay News) -- Good communication is the key to resolving conflicts between the tests and treatment a patient may want based on online searches and those a physician believes are necessary, according to an article published online in Medical Economics.

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Survival Improving for Women With Ovarian Cancer

TUESDAY, May 12, 2015 (HealthDay News) -- Women diagnosed with ovarian cancer are now much more likely to survive the disease than they were several decades ago, according to research published online May 6 in Obstetrics & Gynecology.

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Nondisclosure Clauses Often Used in Malpractice Settlements

TUESDAY, May 12, 2015 (HealthDay News) -- Nondisclosure clauses are frequently used in malpractice settlement agreements, according to research published online May 11 in JAMA Internal Medicine.

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FDA: Senza Device Relieves Spinal Pain Without Paresthesia

MONDAY, May 11, 2015 (HealthDay News) -- The Senza spinal cord stimulation system has been approved by the U.S. Food and Drug Administration to treat chronic intractable pain of the trunk and/or limbs, including pain associated with failed back surgery syndrome, low back pain, and leg pain. The device can reduce pain without the paresthesia that characterizes more traditional pain-relieving methods, according to a news release issued by the agency.

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AMA: Six Traits of Financially Prepared Female Physicians

MONDAY, May 11, 2015 (HealthDay News) -- The traits of a financially prepared female physician include having a retirement portfolio that is on track or ahead of schedule for age and career stage, having a liquid emergency fund, and feeling adequately protected in the event of a disability, according to a report published by the American Medical Association (AMA).

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Moderate Costs Incurred by Living Kidney Donors

MONDAY, May 11, 2015 (HealthDay News) -- Living kidney donors (LKDs) incur moderate costs related to the completion of donation evaluation, according to a study published online May 5 in the American Journal of Transplantation.

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Shortened Fasting Feasible for Children Undergoing Surgery

MONDAY, May 11, 2015 (HealthDay News) -- The incidence of pulmonary aspiration is low in children undergoing elective surgery, even when allowed free clear fluids until called to the operating suite, according to research published online May 4 in Pediatric Anesthesia.

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Medical Students Want to Focus Learning on Preparing for Future

THURSDAY, May 7, 2015 (HealthDay News) -- Medical students report wanting to learn more about topics that are not currently being taught, including leadership training, health policy, health economics, and experiential learning, according to a report from the American Medical Association (AMA).

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High-Value Research of 2014 Presented for Peri-Op Medicine

THURSDAY, May 7, 2015 (HealthDay News) -- Articles relating to perioperative cardiac medicine, perioperative β-blocker use, perioperative pulmonary medicine, venous thromboembolism prophylaxis, and perioperative medication management are included in a special update summary published online April 30 in the Annals of Internal Medicine.

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Health Care Reform in Mass. Affects Survival in Trauma Patients

THURSDAY, May 7, 2015 (HealthDay News) -- Implementation of health care reform in Massachusetts did not seem to affect health insurance coverage for patients hospitalized following injury, but was associated with increased mortality rates, according to a study published online May 6 in JAMA Surgery.

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ACA Tied to Nearly 17 Million Gaining Health Coverage

THURSDAY, May 7, 2015 (HealthDay News) -- As a result of the Affordable Care Act (ACA), nearly 17 million previously uninsured Americans now have health coverage, according to a 2013 to 2015 report from the Rand Corporation.

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Strategies Provided for Maximizing Payment

WEDNESDAY, May 6, 2015 (HealthDay News) -- Physicians should use standard billing practices, including regular statements, to maximize accounts, and know that collection agencies and lawyers can help collect payment when necessary, according to an article published in Medical Economics.

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Acupuncture Effective for Post-Tonsillectomy Pain in Children

WEDNESDAY, May 6, 2015 (HealthDay News) -- Acupuncture, in addition to conventional analgesic treatment, is an effective treatment for post-tonsillectomy pain in children, according to a study published in the June issue of Pediatric Anesthesia.

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Texting Cuts Patients' Need for Pain Meds During Surgery

WEDNESDAY, May 6, 2015 (HealthDay News) -- Texting during minor surgery cuts the need for pain relievers among patients receiving regional anesthesia, according to a brief research report published in the April issue of Pain Medicine.

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Spotlight on Off-Label Use of Suturing Device

TUESDAY, May 5, 2015 (HealthDay News) -- Heart surgeons are making regular, and potentially dangerous, off-label use of a suturing device in patients with atrial fibrillation, according to a report published online May 4 in JAMA Internal Medicine.

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Five 'Top Issues' to Be Discussed at AMA Medical Student Forum

MONDAY, May 4, 2015 (HealthDay News) -- Issues that will be at the forefront of the National Medical Student Meeting include vaccinations, health care economics, Medicaid expansion, medical education loans, and the nationwide opioid epidemic, according to a report from the American Medical Association (AMA).

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Cuts in Epilepsy Drugs Boost Children's Post-Op IQ

MONDAY, May 4, 2015 (HealthDay News) -- Withdrawal of antiepileptic drugs (AEDs) in children is tied to higher IQ post-epilepsy surgery, according to a study published online April 21 in the Annals of Neurology.

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FDA Approves Raplixa to Help Control Surgical Bleeding

FRIDAY, May 1, 2015 (HealthDay News) -- Raplixa (human fibrin sealant) has been approved by the U.S. Food and Drug Administration to help control bleeding during surgery, the agency said in a news release.

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