Here are what the editors at HealthDay consider to be the most important developments in Surgery for September 2019. 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.
Adverse Outcomes Up for Vaginal Birth After Previous C-Section
MONDAY, Sept. 30, 2019 (HealthDay News) — Women undergoing vaginal birth after cesarean (VBAC) are more likely to have adverse maternal birth-related complications and perinatal outcomes, according to a study published online Sept. 24 in PLOS Medicine.
Mental Health Service Use Up After Bariatric Surgery
FRIDAY, Sept. 27, 2019 (HealthDay News) — There is an increase in mental health service presentations after bariatric surgery, according to a study published online Sept. 25 in JAMA Psychiatry.
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Preemptive Kidney Transplants Up After KAS Implementation
FRIDAY, Sept. 27, 2019 (HealthDay News) — Disparities persist in preemptive kidney transplantation, where a patient does not receive dialysis before transplant, despite introduction of the new Kidney Allocation System (KAS) in 2014, according to a study published online Sept. 26 in the Clinical Journal of the American Society of Nephrology.
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Average Annual Premium for Workers Increased in 2019
THURSDAY, Sept. 26, 2019 (HealthDay News) — In 2019, the average annual health insurance premium for workers increased slightly for single coverage and family coverage, according to a report published online Sept. 25 in Health Affairs.
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Mohs Micrographic Surgery May Up Survival in Stage I Melanoma
THURSDAY, Sept. 26, 2019 (HealthDay News) — Mohs micrographic surgery (MMS) is associated with improved survival compared with traditional surgery with wide margin excision (WME) for stage I melanoma, according to a study published online Sept. 25 in JAMA Dermatology.
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Pediatric Heart Allocation Policy No Better for Waitlist Mortality
THURSDAY, Sept. 26, 2019 (HealthDay News) — The current pediatric heart allocation policy has increased congenital heart disease (CHD) status 1A representation but has not improved waitlist mortality, according to a study published online Sept. 23 in the American Journal of Transplantation.
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Racial/Ethnic Disparities in Mortality Persist in the U.S.
WEDNESDAY, Sept. 25, 2019 (HealthDay News) — There are still racial and ethnic disparities in mortality, and these disparities are widening for some age groups, according to a study published online Sept. 24 in the American Journal of Preventive Medicine.
Woman’s Face Transplant Failing After Six Years
WEDNESDAY, Sept. 25, 2019 (HealthDay News) — Six years after having a face transplant, Carmen Blandin Tarleton’s doctors have found tissue damage that will most likely lead to loss of the face.
Guideline Updated for Prevention, Management of Hep C in CKD
MONDAY, Sept. 23, 2019 (HealthDay News) — In a synopsis of the 2018 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline, published online Sept. 24 in the Annals of Internal Medicine, updated recommendations are presented for the prevention, diagnosis, treatment, and management of hepatitis C virus (HCV) infection in adults with chronic kidney disease (CKD).
Protected Health Info Breaches Compromise Sensitive Data
MONDAY, Sept. 23, 2019 (HealthDay News) — Most protected health information (PHI) breaches compromise sensitive demographic and/or financial information, according to a research letter published online Sept. 23 in the Annals of Internal Medicine.
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Polysomnographic Thresholds of Limited Use in Pediatric OSA
MONDAY, Sept. 23, 2019 (HealthDay News) — Polysomnographic resolution of obstructive sleep apnea (OSA) and changes in polysomnographic severity of OSA in children account for a small but significant proportion of changes in symptoms and disease-specific quality of life, according to a study published online Sept. 18 in Pediatrics.
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Liver Transplants Rarely Performed for Unauthorized Immigrants
FRIDAY, Sept. 20, 2019 (HealthDay News) — Liver transplantation (LT) is rarely performed for unauthorized immigrants in the United States, according to a study published online Sept. 20 in Hepatology.
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Rate of Opioid Rx Increasing for Incisional Ocular Surgery
FRIDAY, Sept. 20, 2019 (HealthDay News) — The rate of filled opioid prescriptions is increasing for all types of incisional ocular surgery, according to a study published online Sept. 19 in JAMA Ophthalmology.
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Multifaceted Home-Based PT Does Not Aid Walking After Hip Fracture
FRIDAY, Sept. 20, 2019 (HealthDay News) — A multicomponent home-based physical therapy intervention does not improve the ability of older patients recovering from hip fracture to walk again, according to a study published in the Sept. 10 issue of the Journal of the American Medical Association.
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Kidney Donation Linked to Increased Hypertension Risk
FRIDAY, Sept. 20, 2019 (HealthDay News) — Kidney donation is associated with an increased risk for hypertension, according to a study published online Sept. 19 in the Clinical Journal of the American Society of Nephrology.
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Vaginal Mesh Hysteropexy No Better for Uterovaginal Prolapse
THURSDAY, Sept. 19, 2019 (HealthDay News) — Among women with symptomatic uterovaginal prolapse, prolapse outcomes are similar after three years for vaginal mesh hysteropexy compared with vaginal hysterectomy with uterosacral ligament suspension, according to a study published online Sept. 17 in the Journal of the American Medical Association.
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Frailty Assessment May Aid Liver Transplant Evaluation
THURSDAY, Sept. 19, 2019 (HealthDay News) — A frailty assessment as part of liver transplant evaluation may help identify transplant candidates at higher risk for death, according to a study published online Sept. 11 in JAMA Surgery.
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Medical Students Not Ready to Provide Nutritional Care
THURSDAY, Sept. 19, 2019 (HealthDay News) — Medical education does not equip students to provide high-quality, effective nutrition care, according to a review published in the September issue of The Lancet Planetary Health.
Physical Therapy and Surgery Reduce Mixed Urinary Incontinence Symptoms
TUESDAY, Sept. 17, 2019 (HealthDay News) — In women with mixed urinary incontinence, symptom reduction is significantly greater when behavioral and pelvic floor muscle therapy is combined with midurethral sling surgery compared with surgery alone, but the difference may not be clinically important, according to a study published in the Sept. 17 issue of the Journal of the American Medical Association.
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Hysterectomy Tied to Long-Term Risk for Depression, Anxiety
WEDNESDAY, Sept. 18, 2019 (HealthDay News) — Hysterectomy, even with ovarian conservation, is associated with an increased long-term risk for de novo depression, according to a study published online Aug. 30 in Menopause.
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Delaying Treatment Worsens Head, Neck Cancer Outcomes
MONDAY, Sept. 16, 2019 (HealthDay News) — Delaying time to treatment initiation (TTI) beyond 60 days is associated with decreased overall survival and increased head and neck cancer recurrence, according to a study published online Sept. 12 in JAMA Otolaryngology-Head & Neck Surgery.
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MCI Linked to Lower Use of Cardiac Catheterization in AMI
FRIDAY, Sept. 13, 2019 (HealthDay News) — Preexisting mild cognitive impairment (MCI) is associated with a lower use of cardiac catheterization and coronary revascularization after acute myocardial infarction (AMI), according to a study published online Aug. 13 in the Journal of General Internal Medicine.
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Medicaid Expansion Increases Access to Kidney Transplants
FRIDAY, Sept. 13, 2019 (HealthDay News) — There was an increase in Medicaid-covered preemptive kidney transplants (KT) among patients with end-stage renal disease (ESRD) living in Medicaid expansion states versus nonexpansion states, according to a study published online Aug. 19 in the Journal of General Internal Medicine.
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2011 FDA Safety Message Tied to Drop in Transvaginal Mesh Use
FRIDAY, Sept. 13, 2019 (HealthDay News) — A 2011 U.S. Food and Drug Administration safety communication correlated with a significant decline in transvaginal mesh use for treatment of apical prolapse, according to a study published online Sept. 10 in Obstetrics & Gynecology.
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Patient Factors May Predict Opioid Use After Discharge
FRIDAY, Sept. 13, 2019 (HealthDay News) — Certain factors may help clinicians identify which patients are more likely to have greater opioid use in the first month after major surgery, according to a study published online Aug. 5 in the Annals of Surgery.
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Hep C-Viremic Kidneys Increasingly Used for Transplant
THURSDAY, Sept. 12, 2019 (HealthDay News) — Hepatitis C virus (HCV)-viremic kidneys are increasingly being used for transplants and seem to have good one-year outcomes, according to a study published online Sept. 12 in the Journal of the American Society of Nephrology.
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Cancer Survival Increasing in High-Income Countries
THURSDAY, Sept. 12, 2019 (HealthDay News) — Cancer survival is continuing to increase across high-income countries, although there are international disparities, according to a study published online Sept. 11 in The Lancet Oncology.
Risk for Long-Term Opioid Use Up in Hidradenitis Suppurativa
WEDNESDAY, Sept. 11, 2019 (HealthDay News) — Patients with hidradenitis suppurativa (HS) have an increased risk for long-term opioid use, according to a study published online Sept. 11 in JAMA Dermatology.
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EPA to Phase Out Chemical Testing on Mammals
WEDNESDAY, Sept. 11, 2019 (HealthDay News) — The eventual elimination of chemical testing on mammals was announced Tuesday by the U.S. Environmental Protection Agency.
The New York Times Article
More Information: EPA
Psychiatric Disorders May Up Risk for Bilateral Oophorectomy
FRIDAY, Sept. 6, 2019 (HealthDay News) — Certain mental health conditions are associated with an increased risk for unnecessary bilateral oophorectomy for nonmalignant indications, according to a study published online Aug. 30 in Menopause.
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Spending Up With Treatment in Hospital-Owned Practices
WEDNESDAY, Sept. 11, 2019 (HealthDay News) — Financial integration between physicians and hospitals raises patient spending but does not impact care quality, according to a study published online Sept. 3 in the Journal of General Internal Medicine.
Poverty Rate Drops, but Fewer Americans Have Health Insurance
TUESDAY, Sept. 10, 2019 (HealthDay News) — The percentage of Americans living in poverty declined in 2018, but the rate of those without health insurance increased, according to a U.S. Census Bureau report.
The New York Times Article
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Gun Owners, Nonowners Support Strengthening U.S. Gun Laws
TUESDAY, Sept. 10, 2019 (HealthDay News) — Most gun owners and individuals who do not own guns support measures to strengthen U.S. gun laws, according to a report published online Sept. 9 in Health Affairs.
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Age Modifies Effects of Estrogen Therapy in Women Without Ovaries
TUESDAY, Sept. 10, 2019 (HealthDay News) — For women aged 50 to 79 years, the effects of conjugated equine estrogens (CEE) do not differ according to bilateral salpingo-oophorectomy (BSO) status; however, age modifies the effect of CEE in women with prior BSO, according to a study published online Sept. 10 in the Annals of Internal Medicine.
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Use of Pain Reliever Tramadol May Up Risk for Hypoglycemia
MONDAY, Sept. 9, 2019 (HealthDay News) — Use of the widely prescribed opioid tramadol is associated with a greater risk for developing hypoglycemia compared with almost every other opioid, according to a study published online Aug. 28 in Scientific Reports.
Racial, Ethnic Underrepresentation Found in Med School Matriculants
FRIDAY, Sept. 6, 2019 (HealthDay News) — Among medical school matriculants, black, Hispanic, and American Indian or Alaska Native (AIAN) students are underrepresented, according to a study published online Sept. 4 in JAMA Network Open.
Majority of U.S. Doctors Believe ACA Has Improved Access to Care
THURSDAY, Sept. 5, 2019 (HealthDay News) — Sixty percent of U.S. physicians believe that the Affordable Care Act (ACA) has improved access to care and insurance after five years of implementation, according to a report published in the September issue of Health Affairs.
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Underused Drug Combo May Up Survival in Lung Transplant
THURSDAY, Sept. 5, 2019 (HealthDay News) — A little used immunosuppression regimen may substantially improve survival following lung transplant, according to a study published online Aug. 28 in JAMA Network Open.
Algorithm Based on Response, Biology Guides Neuroblastoma Tx
THURSDAY, Sept. 5, 2019 (HealthDay News) — Use of a response- and biology-based treatment algorithm for intermediate-risk neuroblastoma is associated with excellent survival and reduces treatment for some patients, according to a study published online Aug. 6 in the Journal of Clinical Oncology.
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Drinking More Coffee Tied to Lower Risk for Gallstone Disease
THURSDAY, Sept. 5, 2019 (HealthDay News) — Individuals who drink more than six cups of coffee per day have a reduced risk for developing symptomatic gallstone disease (GSD), according to a study published online Sept. 5 in the Journal of Internal Medicine.
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QoL Better With Laser Ablation, Surgery for Varicose Veins
THURSDAY, Sept. 5, 2019 (HealthDay News) — For patients with varicose veins, disease-specific quality of life is better after laser ablation or surgery than after foam sclerotherapy at five years after treatment, according to a study published in the Sept. 5 issue of the New England Journal of Medicine.
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Cesarean Section Quality Initiative Cuts Opioid Use
WEDNESDAY, Sept. 4, 2019 (HealthDay News) — The enhanced recovery after surgery (ERAS) program, a quality improvement initiative that made changes to preoperative and postoperative processes, leads to reductions in opioid use without increased pain and with faster recovery, according to a study published in the September issue of Obstetrics & Gynecology.
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Exercise Physiologists Aid Early Mobilization in ICU Patients
WEDNESDAY, Sept. 4, 2019 (HealthDay News) — Exercise physiologists can provide safe and effective early mobilization in intensive care units (ICUs), according to a study published in the September issue of the American Journal of Critical Care.
Evidence Says Antipsychotics Do Not Prevent Delirium in Adults
TUESDAY, Sept. 3, 2019 (HealthDay News) — Current evidence does not support routine use of haloperidol or second-generation antipsychotics for prevention or treatment of delirium in hospitalized adults, according to two reviews published online Sept. 3 in the Annals of Internal Medicine.
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Some Hospital-Acquired Pressure Injuries Are Unavoidable
TUESDAY, Sept. 3, 2019 (HealthDay News) — About 40 percent of hospital-acquired pressure injuries (HAPIs) are unavoidable, according to a study published in the September issue of the American Journal of Critical Care.
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