April 2018 Briefing - Surgery

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

3-D-Printed Templates Aid Mandibular Fracture Repair

MONDAY, April 30, 2018 (HealthDay News) -- A three-dimensional (3-D)-printed short-segment template prototype is feasible for management of complex mandibular fractures, according to a study published online April 26 in JAMA Facial Plastic Surgery.

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Liver-Kidney Recipients Have Donor-Specific Hypo-Responses

MONDAY, April 30, 2018 (HealthDay News) -- Simultaneous liver-kidney transplant recipients' peripheral blood cells have unique phenotypic and functional characteristics that are associated with donor-specific hypo-alloresponsiveness, according to a study published online April 12 in Kidney International.

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New Clinic Satisfaction Tool Provides Real-Time Feedback

THURSDAY, April 26, 2018 (HealthDay News) -- A new clinic satisfaction tool improves communication and provides real-time feedback, according to a study published online April 14 in Neurosurgery.

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High Risk of Death After Major Diabetes-Related Amputations

FRIDAY, April 27, 2018 (HealthDay News) -- There is a high risk of postoperative mortality among patients undergoing lower-limb amputation, according to a study published online April 5 in Diabetes Care.

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ALS by Physician May Improve Traumatic Arrest Outcomes

FRIDAY, April 27, 2018 (HealthDay News) -- For patients with traumatic out-of-hospital cardiac arrest (OHCA), pre-hospital advanced life support (ALS) provided by a physician is associated with increased likelihood of one-month survival, according to a study published online April 25 in JAMA Surgery.

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Previous Stroke Tied to Higher Risks in Aortic Valve Replacement

FRIDAY, April 27, 2018 (HealthDay News) -- For patients undergoing surgical aortic valve replacement (SAVR), previous stroke is a risk factor for recurrent ischemic stroke and major adverse cardiovascular events (MACE), according to a study published online April 25 in JAMA Cardiology.

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Inadequate Functional Health Literacy Mars Post-Op Recovery

THURSDAY, April 26, 2018 (HealthDay News) -- For patients undergoing day surgery, inadequate functional health literacy (FHL) is associated with poorer postoperative recovery and lower health-related quality of life, according to a study published online April 25 in JAMA Surgery.

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Patient Mortality Lower for Older Versus Young Surgeons

THURSDAY, April 26, 2018 (HealthDay News) -- For patients undergoing non-elective surgery, patient mortality is lower for older versus younger surgeons, according to a study published online April 25 in The BMJ.

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Saturday Is National Prescription Drug Take Back Day

THURSDAY, April 26, 2017 (HealthDay News) -- The U.S. Drug Enforcement Administration and local agencies are holding the 15th National Prescription Drug Take Back Day across the country this Saturday, April 28.

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Medicare Requiring Hospitals to Post Prices Online

WEDNESDAY, April 25, 2018 (HealthDay News) -- U.S. hospitals will have to post their standard prices online and make it easier for patients to access their electronic medical records, Medicare officials said Tuesday.

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Ticagrelor + Aspirin Beneficial After Elective CABG

TUESDAY, April 24, 2018 (HealthDay News) -- For patients undergoing elective coronary artery bypass grafting (CABG), ticagrelor + aspirin is associated with significantly increased saphenous vein graft patency rates compared with aspirin alone, according to a study published in the April 24 issue of the Journal of the American Medical Association.

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Black Men More Likely to Die From Firearm Homicide

TUESDAY, April 24, 2018 (HealthDay News) -- Firearm homicides are much more common among black men compared to white men, particularly in rust belt states, according to a study published online April 24 in the Annals of Internal Medicine.

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Celecoxib Lowers Opioid Use Post Head & Neck Cancer Surgery

MONDAY, April 23, 2018 (HealthDay News) -- For patients undergoing head and neck cancer (HNC) surgery, perioperative use of celecoxib is associated with reduced use of opioids after surgery, according to a study published online April 18 in JAMA Otolaryngology-Head & Neck Surgery.

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Colon Cancer Survival Varies by Insurance Type

FRIDAY, April 20, 2018 (HealthDay News) -- Compared to patients with private insurance, colon cancer survival is lower for patients with no insurance or with Medicaid, according to a study published in the May issue of Diseases of the Colon & Rectum.

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Mortality Down With Spinal Anesthesia for Hip Fx Surgery

FRIDAY, April 20, 2018 (HealthDay News) -- For patients undergoing hip fracture fixation, general anesthesia (GA) is associated with increased 90-day mortality compared with spinal anesthesia (SA), according to a study presented at the 2018 World Congress on Regional Anesthesia and Pain Medicine, held from April 19 to 21 in New York City.

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Lasting Outcome Similar for ULS, SSLF for Pelvic Organ Prolapse

TUESDAY, April 17, 2018 (HealthDay News) -- For women with pelvic organ prolapse, there is no significant difference in five-year outcomes with uterosacral ligament suspension (ULS) and sacrospinous ligament fixation (SSLF) surgeries, and no difference in the success of perioperative behavioral therapy and pelvic floor muscle training (BPMT) or usual care, according to a study published in the April 17 issue of the Journal of the American Medical Association.

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Delayed Coronary Obstruction Rare After TAVR

THURSDAY, April 19, 2018 (HealthDay News) -- Delayed coronary obstruction (DCO) after transcatheter aortic valve replacement (TAVR) is a rare phenomenon but is associated with a high in-hospital mortality rate, according to a study published in the April 10 issue the Journal of the American College of Cardiology.

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C. Difficile Risk Higher With Stoma Reversal Versus Colectomy

WEDNESDAY, April 18, 2018 (HealthDay News) -- Patients who undergo elective stoma reversal have a higher incidence of postoperative Clostridium difficile infection versus patients who undergo elective colectomy, according to a study published in the May issue of Diseases of the Colon & Rectum.

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Neuroscience Education, Motor Control Training Ease Spinal Pain

TUESDAY, April 17, 2018 (HealthDay News) -- For individuals with chronic spinal pain, pain neuroscience education combined with cognition-targeted motor control training seems more effective than current best-evidence physical therapy, according to a study published online April 16 in JAMA Neurology.

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Similar Outcomes for Transplant With Overdose-Death Donors

MONDAY, April 16, 2018 (HealthDay News) -- Transplantation of organs from overdose-death donors (ODDs) is associated with similar five-year patient survival and graft survival as organs from trauma-death donors (TDDs) and medical-death donors (MDDs), according to a study published online April 17 in the Annals of Internal Medicine.

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Recommendations Developed on Gender Equity in Medicine

MONDAY, April 16, 2018 (HealthDay News) -- In a position paper published online April 17 in the Annals of Internal Medicine, recommendations are provided aimed at addressing gender equity in physician compensation and career advancement opportunities.

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Nonoptimized Drug Therapy Costs More Than $500 Billion Annually

MONDAY, April 16, 2018 (HealthDay News) -- The estimated annual cost of drug-related morbidity and mortality resulting from nonoptimized medication therapy is more than half a trillion dollars in the United States, according to a study published online March 26 in the Annals of Pharmacotherapy.

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Rapid Deployment Valve for Aortic Stenosis Ups Stroke Risk

FRIDAY, April 13, 2018 (HealthDay News) -- For patients with aortic valve stenosis, treatment with a rapid deployment valve (RDV) is associated with increased rates of new-onset pacemaker implantation and disabling stroke, compared with conventional biological valves (CBVs), according to a study published in the April 3 issue of the Journal of the American College of Cardiology.

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Recent Years Saw Increase in Burden of Prior Authorization

THURSDAY, April 12, 2018 (HealthDay News) -- The burden of prior authorization (PA) has increased over the past five years, and 92 percent of physicians report associated delays in access to care, according to the results of a survey published by the American Medical Association (AMA).

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Many Providers Unaware of Racial Disparities in Kidney Transplants

THURSDAY, April 12, 2018 (HealthDay News) -- Health care provider awareness of racial disparities in kidney transplant waitlisting is low, especially among nurse managers and white providers, according to a study published online April 12 in the Clinical Journal of the American Society of Nephrology.

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FDA Warning Ups Hysterectomy Complications for Uterine Fibroids

THURSDAY, April 12, 2018 (HealthDay News) -- For women undergoing hysterectomy for uterine fibroids, there was an increase in major and minor 30-day complication rates following the issuing of a U.S. Food and Drug Administration black box warning against the use of power morcellation for excision of uterine fibroids, according to a study published online April 11 in JAMA Surgery.

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About Half of Pregnant Women With HIV Have C-Sections

WEDNESDAY, April 11, 2018 (HealthDay News) -- About half of pregnant women with HIV infection underwent cesarean delivery between 1998 and 2013, according to a study published online April 6 in Obstetrics & Gynecology.

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Civilian Prehospital Tourniquets Linked to Reduction in Mortality

WEDNESDAY, April 11, 2018 (HealthDay News) -- Civilian prehospital tourniquet application is associated with a six-fold mortality reduction in patients with peripheral vascular injuries, according to a study published in the Journal of the American College of Surgeons.

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Considerable Differences in Burden of Disease at State Level

TUESDAY, April 10, 2018 (HealthDay News) -- There are considerable differences in the burden of disease at the state level, according to a study published in the April 10 issue of the Journal of the American Medical Association.

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Suggestions Offered to Reduce Physician Frustration With EHRs

TUESDAY, April 10, 2018 (HealthDay News) -- Changes can be implemented to help reduce physician frustration with electronic health records (EHRs), according to an article published in Medical Economics.

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Scoliosis Surgery Found Beneficial for Cerebral Palsy Patients

TUESDAY, April 10, 2018 (HealthDay News) -- Scoliosis surgery in patients with cerebral palsy (CP) leads to a significant improvement in health-related quality of life (HRQoL), which is maintained five years following surgery, according to a study published in the April 4 issue of The Journal of Bone & Joint Surgery.

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Sirolimus May Be Beneficial in DIPNECH Syndrome

MONDAY, April 9, 2018 (HealthDay News) -- Sirolimus may be beneficial for patients with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH), according to a research letter published online April 10 in the Annals of Internal Medicine.

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Interns' Schedule Takes Toll on Sleep, Physical Activity, Mood

FRIDAY, April 6, 2018 (HealthDay News) -- New interns' intense and changing schedules take a toll on sleep, activity, and mood, according to a study published online March 14 in the Journal of General Internal Medicine.

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Large Drop Seen in Infection-Related Post-Transplant Deaths

THURSDAY, April 5, 2018 (HealthDay News) -- There has been a large drop in infection-related deaths following kidney transplantation since the 1990s, according to a study published online April 5 in the Clinical Journal of the American Society of Nephrology.

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ACA Marketplaces Expand Coverage for Chronically Ill

THURSDAY, April 5, 2018 (HealthDay News) -- The Affordable Care Act's Marketplaces covered a disproportionate share of non-elderly adults with high health care risks in the 2014 to 2015 time period, according to a study published in the April issue of Health Affairs.

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Online Doc Reviews Don't Reflect Patient Satisfaction Surveys

THURSDAY, April 5, 2018 (HealthDay News) -- Online physician reviews do not reflect patient satisfaction surveys (PSSs), according to a study published in the April issue of the Mayo Clinic Proceedings.

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Variations Identified in Free-Text Directions in E-Prescriptions

WEDNESDAY, April 4, 2018 (HealthDay News) -- There is considerable variation in the quality of free-text patient directions (Sig) in electronic prescriptions (e-prescriptions), according to a study published online April 2 in the Journal of Managed Care & Specialty Pharmacy.

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Diabetes, HbA1c Linked to Adverse Outcomes After Surgery

TUESDAY, April 3, 2018 (HealthDay News) -- For surgical inpatients aged ≥54 years, diabetes and increased hemoglobin A1c (HbA1c) are associated with increased risk of adverse outcomes, according to a study published online March 26 in Diabetes Care.

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Early Alcohol Use in Pregnancy Tied to Gastroschisis

TUESDAY, April 3, 2018 (HealthDay News) -- Alcohol consumption early in pregnancy may be a risk factor for the development of gastroschisis in neonates, according to a study published recently in the Journal of Maternal-Fetal & Neonatal Medicine.

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Grief Symptoms Similar in Donor vs Non-Donor Decision Families

MONDAY, April 2, 2018 (HealthDay News) -- Perceptions of the organ donation experience vary between relatives who decide to donate their relative's organs and those who do not, but the decision does not appear to be associated with subsequent grief symptoms, according to a study published online March 19 in the American Journal of Respiratory and Critical Care Medicine.

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Pre-Op Chronic Opioid Use Ups Poor Outcomes Post Spinal Fusion

MONDAY, April 2, 2018 (HealthDay News) -- Preoperative chronic opioid use is associated with poor outcomes and continued dependence after posterior lumbar fusion, according to a study published online March 20 in Spine.

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Transfusion Outcomes Differ by Race for Peds Scoliosis Surgery

MONDAY, April 2, 2018 (HealthDay News) -- In the surgical correction of pediatric scoliosis, black race is independently associated with increased estimated blood loss, increased rate of blood transfusion, and increased amount of blood transfused, according to a study published online March 9 in Pediatric Anesthesia.

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Thyroidectomy Rates Lower After Guideline Implementation

MONDAY, April 2, 2018 (HealthDay News) -- Implementation of the 2015 American Thyroid Association guidelines on surgery for well-differentiated thyroid carcinoma was associated with a significant decrease in the rates of both up-front total thyroidectomy and completion thyroidectomy, according to a study published online March 29 in JAMA Otolaryngology-Head & Neck Surgery.

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