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June 2018 Briefing – Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for June 2018. 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.

Practice Management Can Improve Efficiency

FRIDAY, June 29, 2018 (HealthDay News) — Providers can take practical steps to improve practice efficiency and increase insurance reimbursement, according to an article published in Dermatology Times.

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Nitric Oxide Cuts Kidney Injury After Long Cardiac Surgery

FRIDAY, June 29, 2018 (HealthDay News) — Nitric oxide gas may lead to a reduction in the incidence of acute kidney injury and an improvement in long-term kidney function in patients undergoing multiple valve replacement and prolonged cardiopulmonary bypass, according to a study published in the American Journal of Respiratory and Critical Care Medicine.

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Prehabilitation May Improve Post Cardiac Surgery Outcomes

FRIDAY, June 29, 2018 (HealthDay News) — A three-pronged approach to prehabilitation, which includes improving nutritional status, exercise capacity, and worry reduction, may improve outcomes after cardiac surgery, according to a study published online June 27 in the Canadian Journal of Cardiology.

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AMA Calls for Electronic Health Record Training

FRIDAY, June 29, 2018 (HealthDay News) — The American Medical Association (AMA) is calling on medical schools and residency programs to incorporate electronic health record (EHR) training into their curricula.

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Initial Outcomes No Worse for Surgical ICU Patients With CA

FRIDAY, June 29, 2018 (HealthDay News) — Surgical patients who are admitted to the intensive care unit (ICU) and have cancer do not have worse initial outcomes than those without cancer, according to a study published online June 27 in JAMA Surgery.

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Penicillin Allergy Linked to MRSA, C. Difficile Risk

THURSDAY, June 28, 2018 (HealthDay News) — There is a correlation for documented penicillin allergy with increased risk of methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile, which is mediated by increased use of β-lactam alternative antibiotics, according to a study published online June 27 in the BMJ.

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Health Care Technology Impacts Younger Patient Satisfaction

THURSDAY, June 28, 2018 (HealthDay News) — Health care communication technology is a determinant of patient satisfaction in younger patients, according to a report published by Black Book Market Research LLC.

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Abortion Complication Rates Similar Between Facility Type

WEDNESDAY, June 27, 2018 (HealthDay News) There is no significant difference in abortion-related morbidities and adverse events following induced abortions, whether the procedure is performed in an ambulatory surgical center (ASC) or an office-based setting, according to a study published online June 26 in the Journal of the American Medical Association.

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AMA Adopts Ethical Guidance on Medical Tourism

TUESDAY, June 26, 2018 (HealthDay News) — The American Medical Association (AMA) recently adopted new ethical guidelines on medical tourism to help physicians understand their responsibilities when interacting with patients who seek or have received medical care outside the United States.

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Study Compares Treatment Options for T1a Renal Cancer

TUESDAY, June 26, 2018 (HealthDay News) — Percutaneous ablation (PA) is associated with oncologic outcomes that are similar to those of radical nephrectomy (RN) and may be associated with fewer complications than nephron-sparing partial nephrectomy (PN) for patients with stage T1a renal cell carcinoma (RCC), according to a study published online June 25 in the Annals of Internal Medicine.

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AMA: Docs Declare Drug Shortages Public Health Emergency

MONDAY, June 25, 2018 (HealthDay News) — At the annual meeting of the American Medical Association (AMA), physicians adopted policy declaring drug shortages an urgent public health crisis.

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Long-Term Risk of Anastomotic Ulceration After RYGB

FRIDAY, June 22, 2018 (HealthDay News) — There is a significant long-term risk of anastomotic ulceration (AU) after Roux-en-Y gastric bypass (RYGB), which increases over time and with history of tobacco use, according to a research letter published online June 20 in JAMA Surgery.

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Medicaid Expansion Ups Preemptive Listing for Kidney Transplant

THURSDAY, June 21, 2018 (HealthDay News) — The proportion of new preemptive listings for kidney transplantation with Medicaid coverage increased in states with Medicaid expansion in the post-expansion era, according to a study published online June 21 in the Clinical Journal of the American Society of Nephrology.

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More Cash-Pay Patients Means Docs Need Billing Strategies

THURSDAY, June 21, 2018 (HealthDay News) — More patients are paying for health care services with cash, and this means physician practices need a comprehensive billing policy, according to an article published in Medical Economics.

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Greater Satisfaction With Autologous Breast Reconstruction

THURSDAY, June 21, 2018 (HealthDay News) — Patients undergoing autologous post-mastectomy breast reconstruction have greater satisfaction than those undergoing implant reconstruction, and the odds of developing complications are significantly higher for autologous reconstruction types versus expander-implant techniques, according to two studies published online June 20 in JAMA Surgery.

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Gender Difference in Survival Seen After Radical Cystectomy

WEDNESDAY, June 20, 2018 (HealthDay News) — Compared with males, females who undergo radical cystectomy for bladder cancer have worse disease-free, cancer-specific, and overall survival, according to a review published in the July issue of The Journal of Urology.

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Considerable Costs Associated With Switching EHR

TUESDAY, June 19, 2018 (HealthDay News) — Switching electronic health record (EHR) systems can result in increased efficiency and productivity gains, but there are significant costs associated with the switch, according to an article published in Medical Economics.

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High Success Rates for Mitral Valve Repair With Robotic Surgery

TUESDAY, June 19, 2018 (HealthDay News) — Robotic and minimally invasive (mini) approaches to mitral surgery are associated with high rates of mitral repair, although robotic patients have longer procedural time, according to a study published online June 18 in Heart.

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Algorithm Predicts Very Low Blood Pressure During Surgery

TUESDAY, June 19, 2018 (HealthDay News) — A machine-learning algorithm can predict hypotension during surgery based on high-fidelity arterial pressure waveform analysis, according to a study published online June 11 in Anesthesiology.

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AMA Vows to Improve Access for Docs Seeking Mental Health Care

MONDAY, June 18, 2018 (HealthDay News) — The American Medical Association (AMA) recently adopted a policy aimed at improving physician access to mental health care in response to physician depression, burnout, and suicide.

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Screen Does Not Cut Abdominal Aortic Aneurysm Mortality in Men

FRIDAY, June 15, 2018 (HealthDay News) — Screening men for abdominal aortic aneurysm (AAA) does not reduce AAA-related mortality, according to a study published in the June 16 issue of The Lancet.

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Walk Test IDs Risk of Cognitive Dysfunction Post Cardiac Surgery

FRIDAY, June 15, 2018 (HealthDay News) — The six-minute walk distance (6MWD) test is useful in identifying patients with a higher likelihood of developing postoperative cognitive dysfunction (POCD) following cardiac surgery, according to a study published online May 9 in the Annals of Thoracic Surgery.

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Pediatric Kidney Recipients Often Have Subclinical Inflammation

FRIDAY, June 15, 2018 (HealthDay News) — For pediatric kidney recipients, subclinical inflammation is associated with increased risk for acute rejection and allograft failure, according to a study published online May 15 in the American Journal of Transplantation.

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AMA President Calls Physicians to Lead in Addressing Gun Violence

THURSDAY, June 14, 2018 (HealthDay News) — The issue of gun violence must be addressed by the physician leadership scientifically, in an evidence-based manner, according to remarks issued by the president of the American Medical Association (AMA) at the organization’s annual meeting.

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Children Can Drink Clear Fluids Until One Hour Before Anesthesia

THURSDAY, June 14, 2018 (HealthDay News) — On the day of surgery it is practical to allow children to drink until one hour before anesthesia, according to a special interest article published online April 27 in Pediatric Anesthesia.

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Peri-Op RBC Transfusions Linked to Postoperative VTE

THURSDAY, June 14, 2018 (HealthDay News) — Perioperative red blood cell (RBC) transfusions are associated with the development of new or progressive postoperative venous thromboembolism (VTE), according to a study published online June 13 in JAMA Surgery.

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Sun Defenses Up in Transplant Patients After Skin Cancer Study

WEDNESDAY, June 13, 2018 (HealthDay News) — For organ transplant recipients, participation in a skin cancer research study is associated with increased use of multiple sun protection behaviors, according to a research letter published online June 6 in JAMA Dermatology.

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Pre-Op Psychiatric Dx Not Tied to Bariatric Sx Outcomes in Teens

WEDNESDAY, June 13, 2018 (HealthDay News) — Preoperative psychiatric diagnoses are not associated with weight loss outcomes in severely obese adolescents receiving bariatric surgery, according to a study published online June 1 in Pediatrics.

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Negative Pressure Wound Tx No Benefit for Lower Limb Open Fx

WEDNESDAY, June 13, 2018 (HealthDay News) — Use of a negative pressure wound therapy (NPWT) for severe open fracture of the lower limb is not associated with improved self-rated disability at 12 months, compared with standard wound dressing, according to a study published in the June 12 issue of the Journal of the American Medical Association.

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How Do Business Partner Data Breaches Affect Your Practice?

TUESDAY, June 12, 2018 (HealthDay News) — Data breaches affecting health care systems or their partners need to be addressed quickly, according to an article published in Medical Economics.

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Older Age, ICU, Poor Renal Fcn Up Risk of Opioid OD in Hospital

TUESDAY, June 12, 2018 (HealthDay News) — Risk factors for opioid overdose among hospitalized patients include being age 65 years or older, being in an intensive care unit (ICU), and having renal impairment, according to a study published online May 23 in the Journal of Clinical Pharmacy and Therapeutics.

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Active Failures Seen in Proper Use of Personal Protective Equipment

TUESDAY, June 12, 2018 (HealthDay News) — Active failures frequently occur in infectious agent transmission-based precautions, including personal protective equipment (PPE) use, according to a study published online June 11 in JAMA Internal Medicine.

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APAGBI: Teens 13+ Should Be Assessed for VTE Prophylaxis

TUESDAY, June 12, 2018 (HealthDay News) — In the perioperative period, post-pubertal adolescents should be assessed for venous thromboembolism (VTE) prophylaxis because of their slightly elevated risk, according to a special article from the Association of Paediatric Anaesthetists of Great Britain and Ireland, published online April 27 in Pediatric Anesthesia.

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Medicaid Expansion Ups Access to Rehab in Young Adults With Injury

FRIDAY, June 8, 2018 (HealthDay News) — For young adults hospitalized for injury, the first year of implementation of Medicaid expansion under the Affordable Care Act correlated with significant increases in Medicaid coverage, reductions in lack of insurance, and increases in discharge to rehabilitation, according to a study published online June 6 in JAMA Surgery.

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Adenoid, Tonsil Removal May Affect Later Respiratory Risks

FRIDAY, June 8, 2018 (HealthDay News) — Adenoidectomy and tonsillectomy in children are associated with increased long-term risks of respiratory, infectious, and allergic diseases, according to a study published online June 7 in JAMA Otolaryngology-Head & Neck Surgery.

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Case Volume Affects Mortality for Immunosuppressed With Sepsis

FRIDAY, June 8, 2018 (HealthDay News) — At hospitals with the lowest volume of immunosuppressed patients with sepsis, the risk of death from sepsis due to a suppressed immune state is highest, according to a study published online June 1 in the Annals of the American Thoracic Society.

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Prostate Cancer Treatment Side Effects Linked to Distress

FRIDAY, June 8, 2018 (HealthDay News) — For prostate cancer survivors, dysfunction due to treatment side effects has a bidirectional association with emotional distress, according to a study published in the June issue of The Journal of Urology.

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Compression + Early Ablation Tied to Faster Leg Ulcer Healing

THURSDAY, June 7, 2018 (HealthDay News) — Early endovenous ablation of superficial venous reflux results in faster healing of venous leg ulcers and more time free from ulcers, compared with deferring endovenous ablation until after ulcer healing, according to a study published in the May 31 issue of the New England Journal of Medicine.

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Factors ID’d for Persistent Opioid Use After Pediatric Surgery

THURSDAY, June 7, 2018 (HealthDay News) — Higher daily average inpatient pain scores and higher postoperative opioid consumption are associated with a subsequent persistent opioid use of up to six months among pediatric patients undergoing major oncologic surgery, according to a study published online April 17 in Pediatric Anesthesia.

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Post-Transplant Tx Reduces Wait for Kidney in Hep C+ Patients

WEDNESDAY, June 6, 2018 (HealthDay News) — Post-transplant hepatitis C treatment increases access to transplant and reduces waitlist time among hepatitis C-positive patients awaiting kidney transplantation, according to a study published online May 14 in the American Journal of Transplantation.

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Online Consumer Ratings of Physicians Tend to Be Skewed

WEDNESDAY, June 6, 2018 (HealthDay News) — Online physician reviews tend to be skewed positively, according to a study published in the May issue of the Journal of Medical Internet Research.

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CDC: Prevalence of No Insurance Varies by Occupational Groups

WEDNESDAY, June 6, 2018 (HealthDay News) — The prevalence of being uninsured varies by occupational groups, according to research published in the June 1 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

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Radial-Artery Grafts Better Than Saphenous-Vein Grafts in CABG

WEDNESDAY, June 6, 2018 (HealthDay News) — Compared to saphenous-vein grafts, radial-artery grafts are associated with a lower rate of adverse cardiac events at five-year follow-up in coronary-artery bypass grafting (CABG) patients, according to research published in the May 31 issue of the New England Journal of Medicine.

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Post-Hurricane Deaths in Puerto Rico Underestimated

TUESDAY, June 5, 2018 (HealthDay News) — The actual number of deaths related to Hurricane Maria in Puerto Rico in 2016 is likely more than 70 times the official government estimate of 64, according to a study published online May 29 in the New England Journal of Medicine.

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Many Breast Cancer Survivors Do Not Undergo Annual Surveillance

MONDAY, June 4, 2018 (HealthDay News) — A considerable proportion of breast cancer survivors do not undergo annual surveillance breast imaging, according to a study published in the May issue of the Journal of the National Comprehensive Cancer Network.

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Benefit of Liposomal Bupivacaine for Pain in TKA Questioned

MONDAY, June 4, 2018 (HealthDay News) — Liposomal bupivacaine use in patients undergoing total knee arthroplasty is not associated with clinically meaningful reductions in inpatient opioid use, resource utilization, or opioid-related complications, according to a study published online May 21 in Anesthesiology.

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Remaining Kidney Health Most Important Concern for Donors

FRIDAY, June 1, 2018 (HealthDay News) — Concerns expressed by living kidney donors include kidney failure and function, as well as the surgical, lifestyle, and psychosocial impact of donation, according to a study published online May 31 in the Clinical Journal of the American Society of Nephrology.

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