July 2019 Briefing - Surgery

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

Burnout Symptoms May Up Racial Bias Among Resident Physicians

WEDNESDAY, July 31, 2019 (HealthDay News) -- Symptoms of burnout seem to be associated with greater explicit and implicit racial bias among resident physicians, according to a study published online July 26 in JAMA Network Open.

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$70 Million Settlement Reached in Generic Drug Delay Case

TUESDAY, July 30, 2019 (HealthDay News) -- Three drug companies will pay a total of nearly $70 million to California to settle charges of delaying the sale of generic drugs to keep brand-name drug prices high, the state's attorney general said Monday.

AP News Article

National Norms Developed for Assessing Medical School Empathy

TUESDAY, July 30, 2019 (HealthDay News) -- National norms have been developed for assessing empathy among men and women at different levels of medical school education, according to a study published in the August issue of the Journal of the American Osteopathic Association.

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CIED Complication Rates Vary Considerably Among Hospitals

TUESDAY, July 30, 2019 (HealthDay News) -- Cardiovascular implantable electronic device (CIED) complication rates vary considerably among hospitals, according to a study published online July 30 in the Annals of Internal Medicine.

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First Surgery for Ischemic Leg Ulcer May Affect Amputation Risk

TUESDAY, July 30, 2019 (HealthDay News) -- For patients with critical limb ischemia, open surgery first is associated with worse amputation-free survival but not with increased mortality compared with endovascular surgery first, according to a study published online July 30 in Circulation: Cardiovascular Quality and Outcomes.

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Opioid Prescribing, New Persistent Use Down After Childbirth

MONDAY, July 29, 2019 (HealthDay News) -- Since 2008, there has been a decrease in opioid prescribing and new persistent use after vaginal or cesarean delivery, according to a study published online July 26 in JAMA Network Open.

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Half of Deaths After Noncardiac Surgery Due to 3 Complications

MONDAY, July 29, 2019 (HealthDay News) -- Three complications account for almost 45 percent of deaths occurring after noncardiac surgery, according to a study published in the July 29 issue of CMAJ, the journal of the Canadian Medical Association.

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Sling, PT May Be OK for Two-Part Proximal Humerus Fractures

FRIDAY, July 26, 2019 (HealthDay News) -- Functional results may be the same for operative and nonoperative treatment of displaced two-part proximal humerus fractures in patients over 60 years of age, according to a study published online July 18 in PLOS Medicine.

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Thyroidectomy Complication Rate Down When Surgeon Volume Up

FRIDAY, July 26, 2019 (HealthDay News) -- For patients undergoing total thyroidectomy, the occurrence rate of complications decreases as annual surgeon volumes increase, according to a study published online July 25 in JAMA Otolaryngology-Head & Neck Surgery.

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Bariatric Surgery Up in Patients With End-Stage Kidney Disease

THURSDAY, July 25, 2019 (HealthDay News) -- For patients with end-stage kidney disease (ESKD), there has been an increase in bariatric surgery, with proportional use of laparoscopic sleeve gastrectomy increasing, according to a study published online July 25 in the Clinical Journal of the American Society of Nephrology.

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No Indication of 'July Effect' in Context of Cardiac Surgery

THURSDAY, July 25, 2019 (HealthDay News) -- In the context of cardiac surgery, there is no indication of a "July effect," describing worse outcomes in the first month of training, according to a study published online July 25 in the Annals of Thoracic Surgery.

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Allergan Recalls Textured Breast Implants Linked to Lymphoma

WEDNESDAY, July 24, 2019 (HealthDay News) -- Allergan's textured breast implants will be recalled due to their link to a rare cancer, the U.S. Food and Drug Administration announced Wednesday.

FDA Press Release
FDA Safety Communication
Allergan Press Release

Periop Diabetic Ketoacidosis Seen in Patients on SGLT2 Inhibitors

WEDNESDAY, July 24, 2019 (HealthDay News) -- Sodium-glucose cotransporter-2 inhibitor (SGLT2i)-associated diabetic ketoacidosis (DKA) may occur after surgery even in patients with normal or near-normal blood glucose levels, according to a review published in the July issue of the British Journal of Anaesthesia.

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Tissue Adhesive, Sterile Strips Similar After Cesarean Section

WEDNESDAY, July 24, 2019 (HealthDay News) -- With cesarean deliveries, wound complications are similar for tissue adhesive and sterile strips when used after closure of a Pfannenstiel skin incision, according to a study published online July 9 in Obstetrics & Gynecology.

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Reoperation Rate Down With Retropubic Sling for Incontinence

TUESDAY, July 23, 2019 (HealthDay News) -- For women with recurrent stress urinary incontinence (SUI), the cumulative incidence of reoperation is significantly lower with treatment with a retropubic sling versus a transobturator sling, according to a study published online July 9 in Obstetrics & Gynecology.

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State-Level Firearm Ownership Linked to Domestic Firearm Homicide

MONDAY, July 22, 2019 (HealthDay News) -- There is an association for state-level firearm ownership rates with domestic, but not nondomestic, firearm homicide, according to a study published online July 22 in the American Journal of Preventive Medicine.

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Rates of Anal Cancer Precursors High in Women Living With HIV

MONDAY, July 22, 2019 (HealthDay News) -- The prevalence of anal high-grade squamous intraepithelial lesions (HSILs), which precede anal cancer, is high among women living with HIV (WLHIV) in the United States, according to a study published online July 11 in Clinical Infectious Diseases.

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Female Ophthalmology Residents Perform Fewer Procedures

FRIDAY, July 19, 2019 (HealthDay News) -- Female residents perform fewer cataract operations and total procedures than male residents, according to a study published online July 18 in JAMA Ophthalmology.

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Current Antibiotic Stewardship Program Practices Characterized

FRIDAY, July 19, 2019 (HealthDay News) -- Current infection prevention and antibiotic stewardship program practices continue to include a main focus on surveillance for multidrug-resistant organisms, according to a report published online July 17 in Infection Control & Hospital Epidemiology.

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Music Relieves Preop Anxiety Before Peripheral Nerve Block

FRIDAY, July 19, 2019 (HealthDay News) -- Patients undergoing preoperative peripheral nerve block placement have a similar change in anxiolytic scores when they receive music medicine versus midazolam, according to a study published online July 18 in Regional Anesthesia & Pain Medicine.

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Factors Associated With Thyroid Cancer Overtreatment Identified

FRIDAY, July 19, 2019 (HealthDay News) -- One-fourth of patients receive unnecessary treatment with radioactive iodine after surgery for low-risk papillary thyroid cancer, according to a study published in the June issue of Surgical Oncology.

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About One in 20 Patients Exposed to Preventable Harm

THURSDAY, July 18, 2019 (HealthDay News) -- The pooled prevalence of preventable patient harm is 6 percent across a range of medical settings globally, according to a review published online July 17 in The BMJ.

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Novel Test Accurately Identifies Precancerous Pancreatic Cysts

THURSDAY, July 18, 2019 (HealthDay News) -- A comprehensive test is more accurate than conventional clinical and imaging criteria for identifying precancerous pancreatic cysts, according to a study published online July 17 in Science Translational Medicine.

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Superior Outcomes Seen for Living Donor Liver Transplant

TUESDAY, July 16, 2019 (HealthDay News) -- Living donor liver transplant (LDLT) offers superior outcomes and less resource utilization over deceased donor liver transplant (DDLT), according to research published online July 10 in the Annals of Surgery.

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MS Relapse Risk Not Increased in Postoperative Period

TUESDAY, July 16, 2019 (HealthDay News) -- Exposure to a surgical procedure requiring anesthesia does not seem to increase the risk for postoperative multiple sclerosis (MS) relapse, according to a study published online June 25 in the Multiple Sclerosis Journal.

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Firearm-Related Pediatric Mortality Down With Stricter Laws

MONDAY, July 15, 2019 (HealthDay News) -- States with stricter firearm legislation have lower rates of firearm-related pediatric mortality, according to a study published online July 15 in Pediatrics.

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Prepregnancy Surgery Linked to Risk for Neonatal Abstinence Syndrome

MONDAY, July 15, 2019 (HealthDay News) -- Prepregnancy surgery is associated with elevated neonatal abstinence syndrome risk in future pregnancies, according to a study published in the July 15 issue of CMAJ, the journal of the Canadian Medical Association.

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Risk for Leg Amputation Higher With Microvascular Disease

FRIDAY, July 12, 2019 (HealthDay News) -- Microvascular disease (MVD) increases the risk for amputation alone and in combination with peripheral artery disease (PAD), according to a study published online July 8 in Circulation.

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Prescribing Fewer Tablets Can Cut Post-ACL Surgery Opioid Use

FRIDAY, July 12, 2019 (HealthDay News) -- For patients undergoing anterior cruciate ligament reconstruction, prescribing fewer tablets is associated with lower postoperative opioid consumption, according to a research letter published in the June 25 issue of the Journal of the American Medical Association.

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Serious Misdiagnosis-Related Harms Mostly Due to 'Big Three'

FRIDAY, July 12, 2019 (HealthDay News) -- Vascular events, infections, and cancers account for about three-quarters of serious misdiagnosis-related harms, according to a study published online July 11 in Diagnosis.

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Feeding Examination Can Avert Surgical Frenotomy Procedures

FRIDAY, July 12, 2019 (HealthDay News) -- Most patients referred for ankyloglossia can benefit from intervention strategies other than surgical procedures, according to a study published online July 11 in JAMA Otolaryngology-Head & Neck Surgery.

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Capping Work Hours in Residency Does Not Impact Outcomes Later

THURSDAY, July 11, 2019 (HealthDay News) -- Exposure of U.S. physicians to work-hour reforms during residency training is not associated with post-training differences in patient mortality, readmissions, or costs of care, according to a study published online July 11 in The BMJ.

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PE, Death Not Reduced With Early Vena Cava Filter Placement

THURSDAY, July 11, 2019 (HealthDay News) -- Early prophylactic placement of a vena cava filter compared with no placement of a filter after major trauma does not result in a reduced incidence of symptomatic pulmonary embolism or death at 90 days, according to a study published online July 7 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the International Society on Thrombosis and Haemostasis, held from July 6 to 10 in Melbourne, Australia.

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Oliceridine Studied for IV Pain Relief After Abdominoplasty

THURSDAY, July 11, 2019 (HealthDay News) -- Oliceridine is being proposed as an analgesic option for the relief of moderate-to-severe acute postoperative pain, according to a study recently published in Pain Practice.

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Health Care Professionals Exhibit Gender Bias

THURSDAY, July 11, 2019 (HealthDay News) -- Survey results show that health care professionals have implicit and explicit gender bias, according to a study published online July 5 in JAMA Network Open.

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President to Sign Order to Improve Kidney Disease Care

WEDNESDAY, July 10, 2019 (HealthDay News) -- Significant changes in how kidney disease is treated in the United States are outlined in an executive order that was signed Wednesday by President Donald Trump.

AP News Article

Focus on Ovarian Cancer Surgical Volume May Not Be Best Metric

WEDNESDAY, July 10, 2019 (HealthDay News) -- Limiting ovarian cancer surgery to high-volume surgeons and hospitals to improve survival could restrict care at many low-volume centers with better-than-expected outcomes, according to a study published in the June issue of Obstetrics & Gynecology.

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Risk for Cancer Higher in Those With Congenital Heart Disease

WEDNESDAY, July 10, 2019 (HealthDay News) -- Children and young adult patients with congenital heart disease (CHD) have an increased risk for developing cancer, according to a study published online July 5 in JAMA Network Open.

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Osteoporosis Undertreated in Joint Replacement Patients

WEDNESDAY, July 10, 2019 (HealthDay News) -- Osteoporosis is common in patients undergoing total joint arthroplasty (TJA), yet the condition is often undertreated, according to a study published in the July issue of the Journal of Arthroplasty.

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Rule Requiring Drug Prices in TV Ads Blocked by Judge

TUESDAY, July 9, 2019 (HealthDay News) -- A Trump administration rule to force pharmaceutical companies to disclose the list prices of their drugs in television ads was blocked Monday by a federal judge.

The New York Times Article

EHR System-Generated In-Basket Messages Linked to Burnout

TUESDAY, July 9, 2019 (HealthDay News) -- Receipt of more than the average number of electronic health record (EHR) system-generated in-basket messages is associated with an increased probability of physician burnout, according to a study published in the July 1 issue of Health Affairs.

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Operating Time for Hip, Knee Replacement Overestimated

MONDAY, July 8, 2019 (HealthDay News) -- The Medicare Physician Fee Schedule and most recent Relative Value Scale Update Committee recommendations overestimate the operating time for original and revision hip and knee replacements, according to a study published in the July issue of Health Affairs.

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Early Nerve Transfer Enables Hand Function After Spinal Cord Injury

MONDAY, July 8, 2019 (HealthDay News) -- Early nerve transfer surgery results in improvements in upper-limb function after spinal cord injury, according to a study published online July 4 in The Lancet.

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Survey Reveals Gaps in Opioid Rx Patterns of Orthopedic Surgeons

MONDAY, July 8, 2019 (HealthDay News) -- The vast majority of orthopedic surgeons recommend prescribing a nine-day supply of around-the-clock oxycodone doses following commonly performed orthopedic surgeries, according to a study published in the May/June issue of the Journal of Opioid Management.

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Adding Clinical Variables Aids in Lung Allocation for Transplants

WEDNESDAY, July 3, 2019 (HealthDay News) -- Adding clinical variables improves the accuracy of lung allocation score (LAS) for transplant candidates, according to a study published online June 14 in the American Journal of Respiratory and Critical Care Medicine.

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Most U.S. Adults Are Concerned About Antibiotic Resistance

WEDNESDAY, July 3, 2019 (HealthDay News) -- Most U.S. adults have heard of and are concerned about antibiotic resistance, but 45 percent report having not taken antibiotics as prescribed, according to a report published online June 21 by the Kaiser Family Foundation.

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Guidance Issued for Management of Fontan Circulation

TUESDAY, July 2, 2019 (HealthDay News) -- A scientific statement with recommendations for follow-up care in patients with Fontan circulation surviving into adulthood was published online July 1 in Circulation.

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Guide Addresses Medical Issues Relevant to Transgender Persons

TUESDAY, July 2, 2019 (HealthDay News) -- A guide to help clinicians understand the medical issues relevant to transgender persons, based on a review of current evidence, was published online July 2 in the Annals of Internal Medicine.

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Considerable Number of Patients Receive Surprise Hospital Charges

TUESDAY, July 2, 2019 (HealthDay News) -- Eighteen percent of all emergency department visits and 16 percent of in-network hospital stays have at least one out-of-network charge, according to a report published June 20 by the Kaiser Family Foundation.

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Model Can Predict Lung Cancer in Patient With Visible Nodule on CT

MONDAY, July 1, 2019 (HealthDay News) -- For patients with visible lung nodules, a model combining clinical and radiologic factors can predict risk for incident lung cancer, according to a study published online June 27 in Cancer Prevention Research.

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