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April 2016 Briefing – Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for April 2016. 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.

FDA Reconsidering Training for Doctors Prescribing Opioids

FRIDAY, April 29, 2016 (HealthDay News) — Mandatory safety training for doctors who prescribe opioids is being reconsidered by the U.S. Food and Drug Administration.

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Wide Variation in Health Care Costs Across the U.S.

FRIDAY, April 29, 2016 (HealthDay News) — Health care prices vary widely across the United States, even within the same state, according to a study published in the April issue of Health Affairs.

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Article Discusses Workplace Violence in Health Care

THURSDAY, April 28, 2016 (HealthDay News) — There is a lack of data relating to the prevalence of workplace violence in health care and how to address it, according to a review article published in the April 28 issue of the New England Journal of Medicine.

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Sleep May Impact Mortality in Lung Transplant Recipients

THURSDAY, April 28, 2016 (HealthDay News) — For lung transplant recipients, sleep should be assessed in order to better clarify the predictors of post-transplant mortality, according to a letter to the editor published online April 18 in the American Journal of Transplantation.

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Doctors Have a Only a Few Weeks Left to Review Financial Data

WEDNESDAY, April 27, 2016 (HealthDay News) — Under the Physician Payments Sunshine Act, physicians have only a few weeks left to review and report disputes relating to their financial ties to drug and medical device manufacturers, according to the American Medical Association.

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U.S. Health Report Card Finds Racial, Ethnic Disparities Persist

WEDNESDAY, April 27, 2016 (HealthDay News) — An update on Americans’ health finds that racial and ethnic disparities persist, with significant gaps in obesity, cesarean births, and dental care. But advances have been made in some important areas, including infant mortality rates, women smokers, and numbers of uninsured, according to the new report from the U.S. Department of Health and Human Services.

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Seven Most Risky Emergency General Surgeries Identified

WEDNESDAY, April 27, 2016 (HealthDay News) — Seven types of surgeries, including appendectomy and cholecystectomy, account for four out of five emergency general-surgery deaths in the United States, according to research published online April 27 in JAMA Surgery.

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Interactions for HIV Drug Combos, Immunosuppressants

WEDNESDAY, April 27, 2016 (HealthDay News) — HIV-positive transplant recipients and their physicians should be aware of potential interactions between fixed dose combination products used for HIV treatment and immunosuppressant metabolism, according to a case report published online April 18 in the American Journal of Transplantation.

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Optimally Timed Follow-Up Cuts Readmissions After Cystectomy

WEDNESDAY, April 27, 2016 (HealthDay News) — Detection of concerning symptoms after radical cystectomy can be improved by optimizing the timing and number of outpatient encounters, according to a study published in the May issue of The Journal of Urology.

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Sixteen Percent of Live Kidney Donors Uninsured

TUESDAY, April 26, 2016 (HealthDay News) — Sixteen percent of living kidney donors (LKDs) are uninsured at the time of donation, according to a study published online April 18 in the American Journal of Transplantation.

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Femtosecond Laser Capsulotomy Limited in Mature Cataracts

MONDAY, April 25, 2016 (HealthDay News) — Femtosecond (FS) laser capsulotomy efficacy is decreased in mature cataracts, with higher occurrence rates of tags, according to a study published online April 22 in Lasers in Surgery and Medicine.

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First-Degree Relative Grafts Don’t Up Liver Disease Recurrence

MONDAY, April 25, 2016 (HealthDay News) — In liver transplantation (LT), patients who receive living donor grafts from first-degree relatives due to autoimmune liver diseases are not prone to increased disease recurrence, compared to those who receive grafts from distant/unrelated donors and deceased donors, according to a study published online April 18 in the American Journal of Transplantation.

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Continued Aspirin Treatment Safe With Partial Nephrectomy

MONDAY, April 25, 2016 (HealthDay News) — Continuing aspirin for chronic antiplatelet therapy is safe in patients undergoing laparoscopic partial nephrectomy, according to a study published in the April issue of The Journal of Urology.

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Physicians Can Get Involved in Developing Payment Models

FRIDAY, April 22, 2016 (HealthDay News) — Doctors can be involved in developing new payment models for their practices, according to the American Medical Association.

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Antimicrobial Treatment No Benefit After Kidney Transplant

FRIDAY, April 22, 2016 (HealthDay News) — For patients undergoing kidney transplantation (KT), systematic antimicrobial treatment of asymptomatic bacteriuria (AB) beyond the second month post-transplant is not beneficial, according to a study published online April 18 in the American Journal of Transplantation.

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Comorbidity Tied to Prostate Cancer Upgrading, Up Staging

FRIDAY, April 22, 2016 (HealthDay News) — Comorbidity burden is strongly and independently associated with pathological upgrading/up staging in men with clinically low-risk prostate cancer, according to a study published in the April issue of The Journal of Urology.

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Medical Expulsive Therapy Underused for Ureteral Stones

THURSDAY, April 21, 2016 (HealthDay News) — For patients with ureteral stones, medical expulsive therapy remains underused, according to a study published in the April issue of The Journal of Urology.

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Costs Linked to Center Volume for Lung Transplant Recipients

THURSDAY, April 21, 2016 (HealthDay News) — Admission costs and early readmission rates are lower for lung transplant recipients at high-volume centers, according to a study published online April 11 in the Annals of the American Thoracic Society.

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Relative Lens Vault Predicts Post-Op Refractory Error

THURSDAY, April 21, 2016 (HealthDay News) — For patients with primary angle-closure (PAC) and primary angle-closure glaucoma (PACG), relative lens vault (rLV; the ratio of lens vault [LV] to anterior vault [AV]) predicts postoperative refractive error, according to a study published online April 15 in Clinical & Experimental Ophthalmology.

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Improved Survival for Certain Cancers With Low-Dose Aspirin

THURSDAY, April 21, 2016 (HealthDay News) — Patients with colorectal, breast, or prostate cancers may have better survival odds if they are on a low-dose aspirin regimen, according to a review published online April 20 in PLOS ONE.

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DiaRem Score Predicts Who Will Be Cured by RYGB Surgery

WEDNESDAY, April 20, 2016 (HealthDay News) — For patients with type 2 diabetes, the DiaRem score can identify those who are likely to be cured by Roux-en-Y gastric bypass (RYGB) surgery, according to a research letter published online April 20 in JAMA Surgery.

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Better Functional Outcome With Stent Retrievers in Acute Stroke

WEDNESDAY, April 20, 2016 (HealthDay News) — For patients with acute ischemic stroke, treatment with stent retrievers with quick reperfusion time is associated with improved outcomes, according to a study published online April 19 in Radiology.

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Metal Up in Blood With Titanium Growth Guidance Sliding Device

TUESDAY, April 19, 2016 (HealthDay News) — Implantation of sliding growth guidance instrumentation LSZ-4D, made from titanium alloy Ti6A14V, is associated with increased content of Ti and V ions in the blood and in the tissues around the device, according to a study published in the March issue of The Spine Journal.

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Oral Nicotinamide Safe for Renal Transplant Recipients

MONDAY, April 18, 2016 (HealthDay News) — For renal transplant recipients, oral nicotinamide seems safe and is associated with nonsignificant reductions in new non-melanoma skin cancers (NMSCs), according to a study published online April 8 in the British Journal of Dermatology.

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Post-Op Gouty Arthritis Described in Patient Taking Thiazide

TUESDAY, April 19, 2016 (HealthDay News) — A case of postoperative acute gouty arthritis following laparoscopic cholecystectomy with umbilical hernioplasty, secondary to hydrochlorothiazide use, has been documented in a case report published in the March issue in the Journal of Pharmacy Practice and Research.

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Only Half of Rectal CA Patients Receiving Standard of Care

FRIDAY, April 15, 2016 (HealthDay News) — Use of chemoradiation followed by surgery among rectal cancer patients rose from 42.9 percent in 2004-2006, to 50 percent in 2007-2009, and to 55 percent in 2010-2012 in the United States, according to a report published online April 13 in Cancer.

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2016 Match Marks Record Highs for Registrants, Matching

FRIDAY, April 15, 2016 (HealthDay News) — The 2016 Match was the largest ever recorded by the National Resident Matching Program, with a higher match rate that 2015, according to a report from the American Medical Association.

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Decrease in Medicare Spending for 2012 ACO Entrants

FRIDAY, April 15, 2016 (HealthDay News) — Early reductions in Medicare spending were seen for the first full year of Medicare Shared Savings Program (MSSP) contracts for 2012 Accountable Care Organization (ACO) entrants, according to a study published online April 13 in the New England Journal of Medicine.

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Telephone Follow-Up Effective for Stage I Endometrial Cancer

FRIDAY, April 15, 2016 (HealthDay News) — For women treated for stage I endometrial cancer, telephone follow-up (TFU) is noninferior to hospital-based follow-up (HFU), according to a study published online April 7 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Abdominal Aortic Aneurysm Odds Up for Patients With Psoriasis

FRIDAY, April 15, 2016 (HealthDay News) — Psoriasis patients may face a higher risk of an abdominal aortic aneurysm, according to a study published online April 14 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Health Care Workers Skip Hand Washing One-Third of the Time

THURSDAY, April 14, 2016 (HealthDay News) — Staff at many outpatient health care facilities in New Mexico failed to follow recommendations for hand hygiene more than one-third of the time, according to findings published in the April 1 issue of the American Journal of Infection Control.

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Fusion Not Always Necessary for Back Pain From Stenosis

THURSDAY, April 14, 2016 (HealthDay News) — Spinal fusion surgery is too often used to treat lower back pain caused by stenosis when decompression would suffice, but is still beneficial for select patients, according to a pair of new clinical trials published in the April 14 issue of the New England Journal of Medicine.

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Surveillance Seems Safe for Some Intermediate Risk Prostate CA

THURSDAY, April 14, 2016 (HealthDay News) — For men with prostate cancer, active surveillance seems safe for those at low risk and for select patients at intermediate risk, according to a study published in The Journal of Urology.

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Coalition Calls for Changes to Hospital Pain Assessments

WEDNESDAY, April 13, 2016 (HealthDay News) — U.S. hospital procedures and questionnaires used to manage patient pain lead to overprescribing of addictive opioids and need to be changed, critics say.

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Bariatric Surgical Skill Doesn’t Appear to Weigh on Outcomes

WEDNESDAY, April 13, 2016 (HealthDay News) — Surgical skill does not appear to affect postoperative weight loss or resolution of medical conditions at one year after laparoscopic gastric bypass, according to a study published online April 13 in JAMA Surgery.

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Optimized Tx Linked to Lasting Pain Relief in Chronic Pancreatitis

WEDNESDAY, April 13, 2016 (HealthDay News) — For most patients with chronic pancreatitis (CP), optimized medical and interventional therapy is associated with lasting pain relief, according to a study published online April 7 in the Journal of Gastroenterology and Hepatology.

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Clinical Decision Support Tool Cuts CT Use for Appendicitis

WEDNESDAY, April 13, 2016 (HealthDay News) — The implementation of a multicomponent electronic clinical decision support tool reduces computed tomography (CT) use for pediatric patients with possible appendicitis, according to a study published online April 13 in Pediatrics.

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Doctors Can Be Misled About FDA ‘Breakthrough’ Drug Designation

TUESDAY, April 12, 2016 (HealthDay News) — Use of the word “breakthrough” in the U.S. Food and Drug Administration’s expedited approval process could mislead doctors about the new drugs’ actual benefits, according to a research letter published in the April 12 issue of the Journal of the American Medical Association.

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VA Commission on Care: Eliminate VA Medical Centers

MONDAY, April 11, 2016 (HealthDay News) — A radical proposal has been suggested for eliminating all Veterans Affairs (VA) medical centers and outpatient facilities in the next 20 years, floated by seven of 15 members of the VA Commission on Care, according to an article published in the Military Times.

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Doctors Report on Success of Throat Reconstruction

MONDAY, April 11, 2016 (HealthDay News) — An American man who underwent throat reconstruction seven years ago has no dysphagia and can eat normal food, according to a report published online April 8 in The Lancet.

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Steatosis in More Than Half of Liver Transplant Recipients

FRIDAY, April 8, 2016 (HealthDay News) — Steatosis affects more than half of liver transplant (LT) recipients, although it is not associated with worse patient survival, according to a study published online April 5 in Liver Transplantation.

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FDA OKs System for Certain Lap Power Morcellator Procedures

THURSDAY, April 7, 2016 (HealthDay News) — The U.S. Food and Drug Administration on Thursday said it would permit limited use of a “tissue containment system” in conjunction with laparoscopic power morcellators.

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Surgery Cuts Fracture Risk in Primary Hyperparathyroidism

WEDNESDAY, April 6, 2016 (HealthDay News) — For patients with primary hyperparathyroidism (PHPT), parathyroidectomy is associated with reduced fracture risk, whereas bisphosphonate treatment is not superior to observation, according to a study published online April 5 in the Annals of Internal Medicine.

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Are Guidelines Needed to Assess Competence of Aging Physicians?

FRIDAY, April 1, 2016 (HealthDay News) — The question of whether national guidelines need to be developed for assessing the competence of aging physicians was discussed during a recent meeting of key stakeholders, according to a news release from the American Medical Association (AMA).

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Medicare Tests New Payment System for Joint Replacements

FRIDAY, April 1, 2016 (HealthDay News) — A new way of paying for hip and knee replacements is being tested by Medicare with the goal of improving quality and cutting costs.

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