Here are what the editors at HealthDay consider to be the most important developments in Surgery for August 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.
CABG Plus Optimal Medical Therapy Best in T2DM and CAD
TUESDAY, Aug. 30, 2016 (HealthDay News) — For patients with type 2 diabetes and coronary artery disease (CAD), coronary artery bypass grafting (CABG) plus optimal medical therapy (OMT) is superior to percutaneous coronary intervention (PCI) plus OMT, according to a study published in the Sept. 6 issue of the Journal of the American College of Cardiology.
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No Impact of Medicaid Expansion on Hospital LOS, Mortality
FRIDAY, Aug. 26, 2016 (HealthDay News) — State Medicaid expansion as part of the Affordable Care Act (ACA) is not associated with length of stay (LOS) or in-hospital mortality among general medicine patients, according to a study published online Aug. 18 in the Journal of Hospital Medicine.
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Survival Benefit for Bronchoscopic Lung Volume Reduction
FRIDAY, Aug. 26, 2016 (HealthDay News) — For patients with heterogeneous emphysema, bronchoscopic lung volume reduction with endobronchial valves (BLVR) is associated with similar survival benefit as lung volume reduction surgery (LVRS), according to a research letter published in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.
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In-Hospital Mortality Up With Weekend Admission in NSTEMI
FRIDAY, Aug. 26, 2016 (HealthDay News) — For patients with non-ST-segment elevation myocardial infarction (NSTEMI), weekend admission is associated with increased in-hospital mortality, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.
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Bariatric Surgery May Increase Odds of Premature Birth
THURSDAY, Aug. 25, 2016 (HealthDay News) — Pregnant women who’ve had bariatric surgery may have increased odds for premature delivery, according to a research letter published in the Aug. 25 issue of the New England Journal of Medicine.
Trans-Obturator Tape Cost-Effective for Urinary Incontinence
THURSDAY, Aug. 25, 2016 (HealthDay News) — For women with stress urinary incontinence, use of trans-obturator tape (TOT) is cost-effective compared with tension-free vaginal tape (TVT), according to a study published online Aug. 10 in BJOG: An International Journal of Obstetrics and Gynaecology.
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Decision Support Tools Cut CT Use in Pediatric Appendicitis Workup
THURSDAY, Aug. 25, 2016 (HealthDay News) — For pediatric patients, passive and active decision support tools can reduce unnecessary computed tomography (CT) imaging among pediatric patients undergoing workup for appendicitis, according to a study published online Aug. 23 in Pediatrics.
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Steep Rise in U.S. Drug Prices Tied to Patent Monopolies
WEDNESDAY, Aug. 24, 2016 (HealthDay News) — Prescription drug prices are skyrocketing in the United States due in large part to government regulations, according to a study published in the Aug. 23/30 issue of the Journal of the American Medical Association.
CDC Urges Prevention, Early Recognition of Sepsis
WEDNESDAY, Aug. 24, 2016 (HealthDay News) — Many cases of life-threatening sepsis could be recognized and treated long before they cause severe illness or death, according to an Aug. 23 Vital Signs report from the U.S. Centers for Disease Control and Prevention.
Review: Frailty Status May Predict Outcome After Cardiac Surgery
WEDNESDAY, Aug. 24, 2016 (HealthDay News) — Frailty status may be able to predict outcome in older adults undergoing cardiac surgical procedures, although the quality of evidence is variable, according to a review published online Aug. 23 in the Annals of Internal Medicine.
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A-Fib Tied to Adverse Outcomes in Patients Undergoing PCI
WEDNESDAY, Aug. 24, 2016 (HealthDay News) — For patients undergoing percutaneous coronary intervention (PCI), atrial fibrillation (AF) is associated with in-hospital adverse outcomes, according to a study published in the Aug. 30 issue of the Journal of the American College of Cardiology.
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Electric Power Morcellation Use Down Following FDA Warning
WEDNESDAY, Aug. 24, 2016 (HealthDay News) — The use of power morcellators has dropped significantly for hysterectomies since the U.S. Food and Drug Administration warned against their use two years ago, according to a research letter published in the Aug. 23/30 issue of the Journal of the American Medical Association.
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Pudendal Nerve Entrapment Can Lead to Eating Disorder
TUESDAY, Aug. 23, 2016 (HealthDay News) — Pudendal nerve entrapment (PNE) leading to avoidant/restrictive food intake disorder (ARFID) has been described in a case report published online Aug. 19 in the International Journal of Eating Disorders.
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Elective Neck Dissection Cost-Effective in Oral Cavity Cancer
TUESDAY, Aug. 23, 2016 (HealthDay News) — For patients with clinically node-negative oral cavity squamous cell carcinoma, the addition of elective neck dissection to primary surgery is associated with a reduction in overall costs, according to a study published online Aug. 22 in the Journal of Clinical Oncology.
Decision Regret Uncommon After Radical Prostatectomy, IMRT
MONDAY, Aug. 22, 2016 (HealthDay News) — For patients with prostate cancer treated with radical prostatectomy (RP) and post-prostatectomy image-guided intensity-modulated radiotherapy (IG-IMRT), decision regret (DR) is uncommon and occurs more often after RP, according to research published online Aug. 16 in the Journal of Medical Imaging and Radiation Oncology.
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Coronary Heart Disease Risk Up in Patients With Gallstones
FRIDAY, Aug. 19, 2016 (HealthDay News) — Patients with history of gallstone disease may have a slightly increased risk of developing coronary heart disease (CHD), according to research published online Aug. 18 in Arteriosclerosis, Thrombosis, and Vascular Biology.
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USPSTF Ruling Followed by Fall in Early Prostate Cancer Diagnoses
FRIDAY, Aug. 19, 2016 (HealthDay News) — Diagnoses of early prostate cancer continue to decline in the United States, following the U.S. Preventive Services Task Force recommendation against routine screening, according to a research letter published online Aug. 18 in JAMA Oncology.
Legal Issues Impact Delivery of Telehealth
THURSDAY, Aug. 18, 2016 (HealthDay News) — Telehealth technologies can allow delivery of high-quality care at a lower cost, especially in underserved areas, but there is currently no uniform legal approach to telehealth, hampering its provision, according to a Health Policy Brief published online Aug. 15 in Health Affairs.
Revascularization Tops Medical Rx for Intermittent Claudication
THURSDAY, Aug. 18, 2016 (HealthDay News) — For patients with intermittent claudication (IC), revascularization interventions are more effective than medical interventions, according to a study published online Aug. 17 in JAMA Surgery.
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Sociodemographic Factors Affect Prostate CA Treatment Initiation
THURSDAY, Aug. 18, 2016 (HealthDay News) — For men with low-risk prostate cancer undergoing active surveillance, sociodemographic factors are associated with initiation of active treatment, according to a study published in the September issue of The Journal of Urology.
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Minority of Surgical Studies Include Men, Women Equally
WEDNESDAY, Aug. 17, 2016 (HealthDay News) — Few surgical studies include men and women equally, and only about one-third perform data analysis by sex, according to research published online Aug. 17 in JAMA Surgery.
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Residents Often Order Perceived Unnecessary Lab Tests
WEDNESDAY, Aug. 17, 2016 (HealthDay News) — Residents frequently order perceived unnecessary inpatient laboratory tests, according to a study published online Aug. 13 in the Journal of Hospital Medicine.
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U.S. Female Doctors Reimbursed Significantly Less Than Males
TUESDAY, Aug. 16, 2016 (HealthDay News) — Female doctors in the United States make much less than their male colleagues, according to a study published online Aug. 15 in the Postgraduate Medical Journal.
Proposed Change Could Improve Liver Transplant Access
TUESDAY, Aug. 16, 2016 (HealthDay News) — A new proposal would mean where Americans live will no longer affect how long they have to wait for a liver transplant.
New Guidelines Set Safe Surgery Margins for DCIS
TUESDAY, Aug. 16, 2016 (HealthDay News) — New surgery guidelines for treatment of women with ductal carcinoma in situ (DCIS) who undergo breast-conserving surgery with whole breast radiation could reduce both unnecessary surgeries and recurrence rates, three U.S. cancer groups say. The consensus guideline was published in the three groups’ journals, the Annals of Surgical Oncology, Practical Radiation Oncology, and the Journal of Clinical Oncology.
Liver Steatosis Ups New-Onset Diabetes After Transplantation
TUESDAY, Aug. 16, 2016 (HealthDay News) — For liver transplant recipients, donor liver steatosis is associated with increased incidence of new-onset diabetes after transplantation (NODAT), according to a study published online Aug. 10 in the Journal of Diabetes Investigation.
Pre-Op Urine Culture Doesn’t Predict Stone Culture
MONDAY, Aug. 15, 2016 (HealthDay News) — For patients undergoing percutaneous stone removal, preoperative urine culture does not predict intraoperative stone culture results, according to a study published in the September issue of The Journal of Urology.
Unstable Vital Signs for About One in Five Hospital Discharges
MONDAY, Aug. 15, 2016 (HealthDay News) — Among adults with a hospitalization, vital sign instability on discharge is associated with increased risk of 30-day mortality and readmission, according to a study published online Aug. 8 in the Journal of General Internal Medicine.
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Female Oncologists Report More Grief Responses, Burnout
MONDAY, Aug. 15, 2016 (HealthDay News) — Female oncologists report more grief responses to patient death, more emotional distress, and more burnout than male oncologists, according to a study published online Aug. 10 in Cancer.
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Thymectomy Improves Outcomes in Myasthenia Gravis
THURSDAY, Aug. 11, 2016 (HealthDay News) — Thymectomy improves clinical outcomes over a three-year period in patients with nonthymomatous myasthenia gravis, according to research published in the Aug. 11 issue of the New England Journal of Medicine.
Polyethylene Glycol 3350 Doesn’t Cut Time to Bowel Movement
THURSDAY, Aug. 11, 2016 (HealthDay News) — For women undergoing urogynecologic surgery, addition of polyethylene glycol 3350 (PEG3350) to docusate sodium does not reduce the time to first bowel movement, according to a study published in the September issue of Obstetrics & Gynecology.
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Risk of Post-Op Opioid Abuse Deemed Low for Elderly Patients
WEDNESDAY, Aug. 10, 2016 (HealthDay News) — Opioid abuse arises in only a very small fraction — less than half of 1 percent — of cases involving surgical patients aged 65 or older, according to a research letter published online Aug. 10 in JAMA Surgery.
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Many U.S. Hospitals Offer Language Services
WEDNESDAY, Aug. 10, 2016 (HealthDay News) — Overall, 68.8 percent of hospitals offer language services, with the proportion increasing with level of need, according to research published in the August issue of Health Affairs.
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Cerebral Protection Device Aids Patients Undergoing TAVI
WEDNESDAY, Aug. 10, 2016 (HealthDay News) — For patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), use of a cerebral protection device is associated with a reduction in the frequency of ischemic cerebral lesions, according to a study published in the Aug. 9 issue of the Journal of the American Medical Association.
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Antifibrotics Up Outcomes After Ahmed Glaucoma Valve Implant
WEDNESDAY, Aug. 10, 2016 (HealthDay News) — Mitomycin C (MMC) and 5-flurouracil (5-FU) improve outcomes following Ahmed glaucoma valve (AGV) implantation, according to a study published online Aug. 4 in Clinical & Experimental Ophthalmology.
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Western Diet May Contribute to Dense Breasts
TUESDAY, Aug. 9, 2016 (HealthDay News) — Overweight and obese women who eat a Western diet may develop more dense breast tissue, possibly increasing their risk for breast cancer, according to research published in the September issue of Obstetrics and Gynecology.
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Low Initial Dose, No Refills Can Help Prevent Opioid Dependency
TUESDAY, Aug. 9, 2016 (HealthDay News) — Patients who are first-time users of opioids should be prescribed a small dose without refills to reduce the risk of long-term use and possible addiction, according to a study published online Aug. 2 in the Journal of General Internal Medicine.
Review IDs Predictors of Post-TAVR Cerebrovascular Events
TUESDAY, Aug. 9, 2016 (HealthDay News) — For patients undergoing transcatheter aortic valve replacement (TAVR), predictors of cerebrovascular events (CVEs) include female sex, chronic kidney disease, new-onset atrial fibrillation, and enrollment date, according to a review published in the Aug. 16 issue of the Journal of the American College of Cardiology.
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Recs Developed for Neoadjuvant Chemo in Ovarian Cancer
TUESDAY, Aug. 9, 2016 (HealthDay News) — Guidelines have been developed for neoadjuvant chemotherapy use for newly diagnosed, advanced ovarian cancer. The clinical practice guideline was published online Aug. 8 in the Journal of Clinical Oncology.
Nonsterile Gloves Don’t Up Risk of Infection in Minor Skin Sx
FRIDAY, Aug. 5, 2016 (HealthDay News) — For patients undergoing outpatient cutaneous surgical procedures, use of nonsterile gloves is not associated with increased risk for surgical site infection (SSI), according to a review and meta-analysis published online Aug. 3 in JAMA Dermatology.
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‘Microhospitals’ Can Provide Quicker Access to Care
THURSDAY, Aug. 4, 2016 (HealthDay News) — Some health care systems are opening tiny hospitals which provide comprehensive emergency services but may have fewer than a dozen inpatient beds, according to a report published by Kaiser Health News.
Proinflammatory Response in Women With Vaginal Mesh
WEDNESDAY, Aug. 3, 2016 (HealthDay News) — Women with vaginal mesh with complications have a significantly increased proinflammatory response, according to a study published in the August issue of the American Journal of Obstetrics & Gynecology.
Opioid-Related Insurance Claims Rise 3,000 Percent
WEDNESDAY, Aug. 3, 2016 (HealthDay News) — The number of private health insurance claims for Americans addicted to opioids and heroin rose 3,203 percent from 2007 to 2014, according to a Fair Health report.
BRAF Inhibitors May Accelerate Wound Healing
WEDNESDAY, Aug. 3, 2016 (HealthDay News) — Topical application of BRAF inhibitors may accelerate healing of skin wounds, according to a study published online Aug. 1 in Nature Communications.
Good 20-Year Patency for Radial Artery Grafts in CABG
TUESDAY, Aug. 2, 2016 (HealthDay News) — The 20-year patency rate is good for patients who use the radial artery (RA) as a coronary bypass conduit, according to research published in the Aug. 9 issue of the Journal of the American College of Cardiology.
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Predictors ID’d for Switching to Active Tx in Prostate Cancer
TUESDAY, Aug. 2, 2016 (HealthDay News) — For men with low-risk prostate cancer, factors such as ethnicity influence patient decision to pursue active treatment during active surveillance, according to a study published online in The Journal of Urology.
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Surgical Trainee Involvement Tied to Peri-Op Complications
TUESDAY, Aug. 2, 2016 (HealthDay News) — The correlation between trainee participation in benign hysterectomy and perioperative complications is influenced by surgical approach, according to a study published in the August issue of the American Journal of Obstetrics & Gynecology.
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ASBS: Contralateral Prophylactic Mastectomy Discouraged
MONDAY, Aug. 1, 2016 (HealthDay News) — Contralateral prophylactic mastectomy should generally be discouraged in average-risk women, whose chances of developing breast cancer in the healthy breast are only 0.1 to 0.6 percent a year, according to a new American Society of Breast Surgeons position statement published online July 28 in the Annals of Surgical Oncology.
Review: Propofol Relatively Safe in Endoscopic Procedures
MONDAY, Aug. 1, 2016 (HealthDay News) — The risks of cardiopulmonary adverse events are similar for propofol sedation versus traditional agents in gastrointestinal endoscopic procedures, with fewer complications associated with use in simple endoscopic procedures, according to a review published online July 20 in Clinical Gastroenterology and Hepatology.
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European Countries Implementing Cost-Sharing
MONDAY, Aug. 1, 2016 (HealthDay News) — European health systems are requiring an increase in cost-sharing measures for patients 50 years of age and older, according to research published in the July issue of Health Affairs.
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