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November 2013 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for November 2013. 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.

Pump Thrombosis Rates Up With Left Ventricular Assist Device

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- For patients who received the HeartMate II left ventricular assist device, the rates of pump thrombosis increased from about March 2011 to Jan. 1, 2013, according to a study published online Nov. 27 in the New England Journal of Medicine.

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Gabapentin Doesn't Cut Use of Morphine Post-Knee Arthroplasty

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- The addition of gabapentin to patient-controlled analgesia (PCA) protocol does not reduce morphine consumption, pain, or opioid-related side effects in patients undergoing total knee arthroplasty, according to a study published in the Nov. 20 issue of The Journal of Bone & Joint Surgery.

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Practices Should Start Preparing for Transition to ICD-10

TUESDAY, Nov. 26, 2013 (HealthDay News) -- Practices should start preparing for the transition to International Classification of Diseases, 10th Revision (ICD-10), according to an article published Nov. 10 in Medical Economics.

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Longer Wait to Surgery Worsens Survival in Uterine Cancer

TUESDAY, Nov. 26, 2013 (HealthDay News) -- Women who have longer wait times from diagnosis of uterine cancer to definitive surgery have reduced overall survival, according to research published online Nov. 25 in the Journal of Clinical Oncology.

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Pediatric Surgeries Often Performed in General Hospitals

TUESDAY, Nov. 26, 2013 (HealthDay News) -- The volume of general pediatric surgery performed in the United States is high, and these procedures are divided between specialized pediatric institutions and general hospitals, according to a study published online Nov. 25 in Pediatrics.

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Thyroid Shield Deemed Essential During Use of C-Arm Fluoroscopy

TUESDAY, Nov. 26, 2013 (HealthDay News) -- The best way for surgeons to reduce scattered radiation exposure to the thyroid is by wearing a shield tightly or wearing it loosely in combination with a bismuth masking reagent, according to a study published in the Nov. 15 issue of Spine.

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Spending on Vascular Care Not Tied to Amputation Reduction

MONDAY, Nov. 25, 2013 (HealthDay News) -- There are significant regional differences in spending on vascular care in patients who ultimately need amputation for severe peripheral arterial disease, according to a study published online Nov. 20 in JAMA Surgery.

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Symptoms Cluster After Esophageal Cancer Surgery

MONDAY, Nov. 25, 2013 (HealthDay News) -- For surgically treated patients with esophageal cancer, symptoms appear to cluster together, and these clusters are strongly associated with mortality, according to a study published online Nov. 25 in Cancer.

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American Medical Groups Protesting Physician Cuts

MONDAY, Nov. 25, 2013 (HealthDay News) -- Medical societies are taking action against the mass cancellations of physicians in Medicare Advantage plans in many states, according to an article published online Nov. 22 in Medical Economics.

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Family Doc Finds Mid-Level Providers Increase Revenue

MONDAY, Nov. 25, 2013 (HealthDay News) -- Hiring mid-levels -- physicians assistants and nurse practitioners -- can improve productivity, resulting in increased physician take-home pay, according to an article published Nov. 10 in Medical Economics.

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White House Extends Enrollment Deadline for Health Insurance

FRIDAY, Nov. 22, 2013 (HealthDay News) -- Consumers who want to enroll in a health insurance plan through HealthCare.gov will get a few extra days to sign up for coverage that will take effect on Jan. 1. The deadline for buying insurance through the federal health insurance exchange will be pushed from Dec. 15 to Dec. 23, a spokeswoman for the Centers for Medicare and Medicaid Services (CMS) said during a Friday news conference.

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CDC Report: Health Disparities Persist in America

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Despite progress in some areas, health disparities remain for many Americans, health officials reported Thursday. These inequalities are related to income, education, sex, race, ethnicity, employment and sexual orientation, and they all affect Americans' health and well-being, according to the U.S. Centers for Disease Control and Prevention.

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Many Women With Pelvic Prolapse Prefer to Keep Uterus

THURSDAY, Nov. 21, 2013 (HealthDay News) -- More women may prefer uterine preservation to hysterectomy for the treatment of pelvic organ prolapse symptoms, according to research published in the November issue of the American Journal of Obstetrics & Gynecology.

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Younger Age Is Significant QoL Predictor Post-Breast Biopsy

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- For women undergoing percutaneous breast biopsy procedures, younger age is a significant predictor of decreased short-term quality of life, according to a study published online Nov. 19 in Radiology.

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Surgeons Emotionally Affected by Surgical Complications

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Many surgeons are profoundly emotionally affected by surgical complications, according to a study published in the December issue of the British Journal of Surgery.

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More Mastectomy, Less Radiation in Male Breast CA Management

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Surgical management of male breast cancer (MBC) is considerably different from that of female breast cancer (FBC), according to a study published in the Nov. 15 issue of the International Journal of Radiation Oncology • Biology • Physics.

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Health Care Frustration Higher in U.S. Than Other Countries

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Compared to 10 other high-income industrialized nations, adults in the United States are more likely to go without health care because of costs, experience difficulty paying medical bills, and deal with frustrating health insurance paperwork or disputes such as unpaid claims, according to a report published by The Commonwealth Fund.

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FDA Requests Safety Measures for Topical Antiseptics

FRIDAY, Nov. 15, 2013 (HealthDay News) -- The U.S. Food and Drug Administration is requesting manufacturers of certain topical antiseptics make changes to their labeling and packaging that will enhance product safety, according to a Drug Safety Communication issued by the agency.

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Obama Nominates Health Care Law Backer to Be Surgeon General

FRIDAY, Nov. 15, 2013 (HealthDay News) -- An early supporter and advocate for the Affordable Care Act has been nominated by President Barack Obama to be the country's next surgeon general.

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Bariatric Surgery Linked to Increased Pregnancy Risks

FRIDAY, Nov. 15, 2013 (HealthDay News) -- Women with a history of bariatric surgery are at increased risk for preterm or small-for-gestational-age babies, according to a study published online Nov. 12 in BMJ.

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Obama: You Can Keep Your Health Plan (for a Year)

THURSDAY, Nov. 14 (HealthDay News) -- Bending to political pressure, President Barack Obama on Thursday announced a plan to allow Americans to keep their health insurance plans for another year, even if that coverage would have been cancelled because it fails to meet new rules under the Affordable Care Act.

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Health Care Enrollments Fall Far Short of White House Estimates

THURSDAY, Nov. 14 (HealthDay News) -- The Obama administration late Wednesday released a report revealing a disappointing number of health plan enrollments through the new federal and state insurance exchanges. Just over 106,000 Americans enrolled in health plans through the new marketplaces from Oct. 1 through Nov. 2, U.S. Health and Human Services Secretary Kathleen Sebelius said during a news conference.

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No Promises on Nov. 30 ACA Website Fix: U.S. Tech Chief

THURSDAY, Nov. 14 (HealthDay News) -- The nation's chief of information technology would not confirm on Wednesday whether the hobbled HealthCare.gov insurance exchange website would be fixed by month's end.

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Many Would Give Health Plans Private Info to Save Money: Poll

WEDNESDAY, Nov. 13 (HealthDay News) -- Many Americans say they'd submit to insurance company medical tests and lifestyle monitoring in exchange for lower-cost premiums, a new Harris/HealthDay poll finds.

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Population Aging Crisis May Have Been Overestimated

WEDNESDAY, Nov. 13 (HealthDay News) -- Use of an alternative measure for assessing the number of dependent older people suggests that the population aging crisis may have been overestimated, according to an analysis published online Nov. 12 in BMJ.

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Initial Health-Plan Enrollment Falls Below Expectations

TUESDAY, Nov. 12 (HealthDay News) -- Fewer than 50,000 people have enrolled in health insurance through the federal HealthCare.gov website, according to published reports. The tally represents enrollment in the troubled federal health insurance exchange from its launch date on Oct. 1 through last week, the Wall Street Journal reported Monday. HealthCare.gov serves as the insurance exchange for people in 36 states.

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Many Americans Want Docs to Help Explain Genetic Tests

TUESDAY, Nov. 12 (HealthDay News) -- When it comes to genetic testing, Americans support more research, laws to protect against discrimination, and involving medical professionals in offering guidance, according to research published online Nov. 7 in Genetics in Medicine.

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Analysis Describes Economic Anatomy of U.S. Health Care

TUESDAY, Nov. 12 (HealthDay News) -- Despite the increases in resources devoted to health care in the United States, multiple health care metrics show that the United States is trailing peer nations, according to a special communication published in the Nov. 13 issue of the Journal of the American Medical Association, a theme issue on critical issues in U.S. health care.

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Thromboembolism Prophylaxis Underused After C-Section

TUESDAY, Nov. 12 (HealthDay News) -- Thromboembolism prophylaxis is underused among women who undergo cesarean delivery in the United States, according to a study published online Nov. 6 in Obstetrics & Gynecology.

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Receiving Biosketch of Doctor Improves Patient Satisfaction

MONDAY, Nov. 11 (HealthDay News) -- Receiving a biosketch of an attending orthopedic trauma surgeon significantly improves patient satisfaction with the quality of care, according to a study published online Oct. 28 in the Journal of Orthopaedic Trauma.

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Post-Op Prophylactic Heparin Poses Very Low Bleed Risk

MONDAY, Nov. 11 (HealthDay News) -- The risk of hemorrhage seems to be very low when prophylactic low-molecular-weight heparin (LMWH) is initiated 24 to 36 hours after degenerative spine surgery but the associated venous thromboembolism (VTE) risk is considerable, according to research published in the Nov. 1 issue of Spine.

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Obama 'Sorry' Some People Losing Health Coverage

FRIDAY, Nov. 8 (HealthDay News) -- President Barack Obama said he's "sorry" some Americans are losing their insurance coverage as a result of his signature health-reform law, but his administration is pressing ahead with the law's implementation. It's estimated that 5 percent of Americans have individual health insurance policies, and many of these people are receiving cancellation notices as insurers switch to plans that comply with new health-reform requirements.

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Misuse of Antibiotics Prevalent in Gynecologic Surgery

FRIDAY, Nov. 8 (HealthDay News) -- Most women who undergo antibiotic-appropriate gynecologic procedures receive appropriate antibiotic prophylaxis, while antibiotics are administered to more than 40 percent of those undergoing antibiotic-inappropriate procedures, according to a study published online Nov. 6 in Obstetrics & Gynecology.

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FDA to Ban Trans Fats in Foods

THURSDAY, Nov. 7 (HealthDay News) -- U.S. health officials announced Thursday a plan to phase out heart-harmful trans fats in processed foods and restaurant fare. U.S. Food and Drug Administration Commissioner Margaret Hamburg, M.D., said the proposed restrictions on the use of trans fats could prevent 20,000 heart attacks a year and 7,000 deaths.

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Telemedicine Represents Enhanced Care Model

THURSDAY, Nov. 7 (HealthDay News) -- Telemedicine may represent an effective care model but there are associated concerns, specifically relating to reimbursement and legal issues, according to an article published Oct. 25 in Medical Economics.

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Amount of Care Similar for Rural, Urban Medicare Users

THURSDAY, Nov. 7 (HealthDay News) -- Although there may be a limited supply of physicians in some rural areas, little difference is found in the amount of health care received by Medicare beneficiaries for rural versus urban areas within the same region, according to research published in the November issue of Health Affairs.

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Intra-Articular, Systemic Steroids Beneficial in Back Pain

THURSDAY, Nov. 7 (HealthDay News) -- Intra-articular injection of steroids is slightly better than intramuscular injection for the treatment of facet joint syndrome, although both are effective, according to a study published in the Nov. 1 issue of Spine.

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Aspiring Doctors Are Optimistic About the Future of Medicine

THURSDAY, Nov. 7 (HealthDay News) -- Aspiring doctors are optimistic about the future of medicine, according to a report published by the National Academy of Future Physicians and Medical Scientists.

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Sebelius on Exchange Website: 'Delay Is Not an Option'

WEDNESDAY, Nov. 6 (HealthDay News) -- U.S. Health and Human Services Secretary Kathleen Sebelius said Wednesday that the Obama administration will not consider delaying implementation of health reform. Nor will it take down HealthCare.gov -- the troubled health insurance marketplace website -- while it's being fixed. "For millions of Americans, delay is not an option," Sebelius told the Senate Finance Committee during a hearing on the new health insurance marketplace. "People's lives depend on this," she said.

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Operating Night Before Surgery Doesn't Impact Complication Rate

TUESDAY, Nov. 5 (HealthDay News) -- For patients undergoing elective laparoscopic cholecystectomy, there is no significant difference in complication rates for surgeons who operate or do not operate the night before, according to a study published in the Nov. 6 issue of the Journal of the American Medical Association.

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Senators Seek Answers on Health Marketplace Woes

TUESDAY, Nov. 5 (HealthDay News) -- A top Obama administration health official said Tuesday that HealthCare.gov -- the troubled federal website used to sign up for insurance -- is improving, and insisted that private information provided during the online application process is safe and secure.

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In the Doctor's Lounge With Dr. Cindy Haines

FRIDAY, Nov. 1 (HealthDay News) -- This is the second issue of a monthly letter from me, HealthDay's chief medical officer and the managing editor of Physician's Briefing, HealthDay's news service for health care professionals. The intention of this letter (and the intention of what we do at HealthDay) is to provide tools of communication. At Physician's Briefing, this is by providing you, the busy and buried health care professional, news and information that matters to you in a way that won't slow you down. The intention is to provide news that can help you stay abreast of changing clinical guidelines, cutting-edge technologies, and novel treatment options. And now, we offer free Continuing Medical Education (CME) credits for you on select clinical articles, enabling you to get (at least) two birds with one stone.

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In the Doctor's Lounge With Dr. Cindy Haines

TUESDAY, Oct. 1 (HealthDay News) -- Please allow me to introduce myself: I am HealthDay's chief medical officer and the managing editor of Physician's Briefing, HealthDay's news service for health care professionals. This service is intended to provide busy physicians, nurses, and pharmacists with easily accessible, digestible health news that can keep them up-to-date and not missing a beat in their busy days providing care for those in need (and navigating the headaches and heartaches the business of medicine can too often bring). In short, this service is intended to make your professional life flow more smoothly in the way that helpful, useable, relevant, and timely information can.

Exchanges Will Be Cornerstone for Coverage Choices
Young Adults May Be Key to Making It All Work
Expect Pluses, Minuses for Those With Job-Based Coverage
If You're an Uninsured Worker, It's Your Chance to Get Covered
Medicaid Expansion Will Allow More to Get More
Many on Medicare Already Enjoying Benefits
AMA Presents: The National Journal
editors@healthday.com

Worse Outcomes for Early Post-Lumbar Spinal Fusion Rehab

TUESDAY, Nov. 5 (HealthDay News) -- Beginning rehabilitation at six weeks as opposed to 12 weeks post-lumbar spinal fusion is associated with higher costs and poorer outcomes, according to a study published in the Nov. 1 issue of Spine.

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Weight-Loss Surgery for Severely Obese Teens Safe

MONDAY, Nov. 4 (HealthDay News) -- Half of severely obese adolescents who undergo weight-loss surgery have several major comorbid conditions, but the short-term safety profile of the surgery is positive, according to a study published online Nov. 4 in JAMA Pediatrics.

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Considerable Weight Loss for Severely Obese Post-Bariatric Sx

MONDAY, Nov. 4 (HealthDay News) -- For severely obese adults undergoing bariatric surgery, there is considerable weight loss after surgery, and self-reported weight loss seems to be a valid measure of weight loss following bariatric surgery, according to a study and research letter published online Nov. 4 in the Journal of the American Medical Association.

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Bariatric Surgery May Improve Sexual Function in Women

MONDAY, Nov. 4 (HealthDay News) -- Women who undergo bariatric surgery to achieve weight loss have significant improvements in sexual function, according to research published online Nov. 4 in JAMA Surgery.

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Six People Signed Up on Day One of Federal Exchange Website

FRIDAY, Nov. 1 (HealthDay News) -- Just six people enrolled for health insurance through the federal HealthCare.gov website the first day of operation on Oct. 1, just-released Obama administration documents show.

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Physician Buy-In Key to Reducing Health Care Costs

FRIDAY, Nov. 1 (HealthDay News) -- Physician buy-in is essential for creation of any new payment system aimed at reducing health care costs, according to an article published Oct. 21 in Medical Economics.

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Etanercept Cuts Sciatic Pain From Lumbar Disc Herniation

FRIDAY, Nov. 1 (HealthDay News) -- Compared with placebo, transforaminal injections of etanercept provide relief from leg and back pain in patients with symptomatic lumbar disc herniation (LDH), according to research published in the Nov. 1 issue of Spine.

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Physician's Briefing

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