October 2018 Briefing - Surgery

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

Greater Weight Loss With Gastric Bypass Than Other Bariatric Sx

WEDNESDAY, Oct. 31, 2018 (HealthDay News) -- Roux-en-Y gastric bypass (RYGB) is associated with greater weight loss at one, three, and five years than sleeve gastrectomy (SG) or adjustable gastric banding (AGB), though it also has the highest rate of 30-day adverse events, according to a study published Oct. 29 in the Annals of Internal Medicine.

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Discharge Day Does Not Impact Readmission After Cardiac Sx

WEDNESDAY, Oct. 31, 2018 (HealthDay News) -- For cardiac surgical patients, the likelihood of readmission has no association with day of discharge, according to a study published online Oct. 11 in the Annals of Thoracic Surgery.

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AMA Announces Initiative to Reinvent Physician Training

TUESDAY, Oct. 30, 2018 (HealthDay News) -- The American Medical Association (AMA) today announced a new $15 million competitive grant initiative, the "Reimagining Residency" initiative, aimed at improving residency training.

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Accepting Increased-Risk Donor Heart Tied to Higher Survival

TUESDAY, Oct. 30, 2018 (HealthDay News) -- Acceptance of a heart from an increased-risk donor (IRD) is associated with a significant survival benefit, according to a research letter published in the November issue of the Journal of the American College of Cardiology.

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Many Hospitals Noncompliant With Record Request Regulations

MONDAY, Oct. 29, 2018 (HealthDay News) -- Among top-ranked U.S. hospitals, data reveal discrepancies in information provided to patients regarding medical records release processes as well as noncompliance with state and federal regulations, according to a study published online Oct. 5 in JAMA Network Open.

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Smoking Associated With Head, Neck Surgery Complications

MONDAY, Oct. 29, 2018 (HealthDay News) -- Smoking is associated with increased rates of postoperative wound disruption and subsequent reoperation among patients undergoing free flap reconstruction of the head and neck, according to a study published online Oct. 18 in JAMA Facial Plastic Surgery.

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Cardiac Implant Prices Higher in U.S. Than EU Countries

FRIDAY, Oct. 26, 2018 (HealthDay News) -- Cardiac implant prices are two to six times higher in the United States than in Germany, according to a study published in the October issue of Health Affairs.

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Trump Administration Announces Plan to Cut Drug Prices

FRIDAY, Oct. 26, 2018 (HealthDay News) -- In an effort to cut high drug costs, the prices paid by Medicare for certain prescription drugs would be based on those in other advanced industrial nations, according to a proposal announced Oct. 25 by the Trump administration.

HHS Study
New York Times Article

Alcohol Disorder Screening in Women Post-RYGB Inadequate

FRIDAY, Oct. 26, 2018 (HealthDay News) -- Assessing the frequency and quantity of alcohol consumption may be inadequate for identifying alcohol-related problems in women who have undergone Roux-en-Y gastric bypass (RYGB) surgery, according to a study published online Oct. 11 in the Annals of Surgery.

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Pace of Change Has Accelerated in Alternative Payment Models

THURSDAY, Oct. 25, 2018 (HealthDay News) -- The impact of alternative payment models (APMs) on physician practices has been described in a study published by the RAND Corp. and the American Medical Association.

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Open Surgery for Early Lung CA Tied to Long-Term Opioid Use

THURSDAY, Oct. 25, 2018 (HealthDay News) -- Surgical invasiveness might play a role in the odds of becoming a long-term opioid user after early-stage lung cancer surgery, according to a research letter published online Sept. 24 in JAMA Oncology.

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Outcomes Studied for Surgical Tx of Stress Urinary Incontinence

THURSDAY, Oct. 25, 2018 (HealthDay News) -- Among women undergoing midurethral mesh sling insertion, the rate of mesh sling removal at nine years is estimated to be 3.3 percent, according to a study published online Oct. 23 in the Journal of the American Medical Association.

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Almost One in 10 Treated in Hospital for Non-Fatal Injury

WEDNESDAY, Oct. 24, 2018 (HealthDay News) -- In 2013, 9.8 per 100 people were treated in the hospital for a non-fatal injury, with costs estimated at $1.853 trillion, according to a study published online Oct. 8 in Injury Epidemiology.

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Prevalence of Pediatric Metabolic, Bariatric Surgery Examined

WEDNESDAY, Oct. 24, 2018 (HealthDay News) -- From 2005 through 2014, an estimated 14,178 metabolic and bariatric surgery (MBS) procedures were performed among pediatric patients aged 20 years and younger with severe obesity, according to a research letter published online Oct. 22 in JAMA Pediatrics.

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White House Unveils New Insurance Option for Small Firms

TUESDAY, Oct. 23, 2018 (HealthDay News) -- A plan to allow small businesses to use tax-free accounts to provide health coverage for employees was announced today by the Trump administration.

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Percent Weight Regain Predicts Health Risks Post-Bariatric Surgery

MONDAY, Oct. 22, 2018 (HealthDay News) -- Measuring the percentage of weight regained following the maximum amount of weight lost after Roux-en-Y gastric bypass (RYGB) surgery best predicts a patient's risk for several serious health problems, according to a study published in the Oct. 16 issue of the Journal of the American Medical Association.

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Changes in Nomenclature for Perioperative Cognitive Disorders

MONDAY, Oct. 22, 2018 (HealthDay News) -- Recommendations have been developed for nomenclature of cognitive changes associated with anesthesia and surgery; the recommendations were published in the November issue of Anesthesiology.

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Physical Therapy an Option for Nonobstructive Meniscal Tears

FRIDAY, Oct. 19, 2018 (HealthDay News) -- Physical therapy (PT) is non-inferior to arthroscopic partial meniscectomy (APM) for patients with nonobstructive meniscal tears, according to a study published in the Oct. 2 issue of the Journal of the American Medical Association.

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Aspirin, Anticoagulants Similarly Prevent VTE After TKA

FRIDAY, Oct. 19, 2018 (HealthDay News) -- Among patients undergoing total knee arthroplasty (TKA), aspirin alone may provide protection against postoperative venous thromboembolism (VTE) that is similar to that of other anticoagulants, according to a study published online Oct. 17 in JAMA Surgery.

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Transcatheter Mitral Valve Repair Benefits Some With Heart Failure

FRIDAY, Oct. 19, 2018 (HealthDay News) -- Transcatheter mitral-valve repair results in a lower rate of hospitalization and lower all-cause mortality than medical therapy alone among patients with heart failure and moderate-to-severe secondary mitral regurgitation who remain symptomatic despite the use of guideline-directed medical therapy, according to a study published online Sept. 23 in the New England Journal of Medicine.

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Clostridium difficile Spores Survive Laundering of Sheets

WEDNESDAY, Oct. 17, 2018 (HealthDay News) -- Clostridium difficile spores are able to survive laundering through a commercial washer extractor, according to a study published online Oct. 16 in Infection Control & Hospital Epidemiology.

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Procurement Requirements Drive Interoperability in Health Care IT

THURSDAY, Oct. 18, 2018 (HealthDay News) -- Interoperability of health care information technology (IT) must be improved to facilitate creation of a fully integrated health care system that can improve health and health care at lower cost, according to a report published by the National Academy of Medicine.

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Hologram-Guided External Ventricular Drain Insertion Feasible

WEDNESDAY, Oct. 17, 2018 (HealthDay News) -- Hologram-guided external ventricular drain (EVD) insertion yields greater accuracy and no adverse events, according to a study published online Oct. 16 in the Journal of Neurosurgery.

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Treatment Tied to Survival Benefit in Complex Bladder Cancer

WEDNESDAY, Oct. 17, 2018 (HealthDay News) -- Cancer treatment is associated with a clinically meaningful survival benefit in older, medically complex patients with superficial bladder cancer (SBC), according to a study published online Oct. 5 in Cancer.

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Bariatric Sx Cuts Macrovascular Complications in Obesity, T2DM

TUESDAY, Oct. 15, 2018 (HealthDay News) -- For patients with severe obesity and type 2 diabetes, bariatric surgery is associated with a lower risk for macrovascular outcomes compared with not undergoing surgery, according to a study published in the Oct. 16 issue of the Journal of the American Medical Association.

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Gastric Banding, Metformin Similar for Improving Glycemia

TUESDAY, Oct. 16, 2018 (HealthDay News) -- In adults with moderate obesity and either impaired glucose tolerance (IGT) or recently diagnosed mild type 2 diabetes (T2D), gastric banding and metformin are similarly effective for slowing disease progression over a two-year period, according to a study published online Oct. 3 in Diabetes Care.

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Without Medicaid Expansion, Poor Patients Forgo Medical Care

MONDAY, Oct. 15, 2018 (HealthDay News) -- Doing without medical care is much more common among low-income residents of states that have not expanded Medicaid than among low-income people in other states, according to a Government Accountability Office report.

AP News Article

Cataract Surgery Tied to Drop in Cognitive Decline in Seniors

MONDAY, Oct. 15, 2018 (HealthDay News) -- Cataract surgery is associated with a reduction in the rate of cognitive decline among older adults, according to a study published online Oct. 11 in PLOS ONE.

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Ultrasound Can Predict Success of AV Fistula for Hemodialysis

FRIDAY, Oct. 12, 2018 (HealthDay News) -- Detection of arteriovenous fistula (AVF) blood flow, diameter, and depth on ultrasound can predict AVF clinical maturation, according to a study published online Oct. 11 in the Journal of the American Society of Nephrology.

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Global Rates of Cesarean Section on the Rise Since 2000

FRIDAY, Oct. 12, 2018 (HealthDay News) -- Global cesarean section (CS) rates are increasing, according to one in a series of three papers published online Oct. 11 in The Lancet.

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Poor Outcomes for Hispanic Infants With Congenital Heart Dz

THURSDAY, Oct. 11, 2018 (HealthDay News) -- For live-born infants with hypoplastic left heart syndrome (HLHS) and d-transposition of the great arteries (TGA), Hispanic ethnicity is associated with poor outcome, according to a study published online Oct. 10 in the Journal of the American Heart Association.

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Sleeve Gastrectomy, Gastric Bypass May Be Better for Teens

THURSDAY, Oct. 11, 2018 (HealthDay News) -- Adolescents with severe obesity achieve substantial and sustainable weight loss with sleeve gastrectomy (SG) and gastric bypass procedures but not with gastric banding, according to a study published in the September issue of Surgery for Obesity and Related Diseases.

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Aetna-CVS Merger Approved

WEDNESDAY, Oct. 10, 2018 (HealthDay News) -- A $69 billion merger between health insurer Aetna and pharmacy manager CVS Health has been approved, according to the U.S. Justice Department.

The New York Times Article

Minority Residents Experience Burdens Linked to Race/Ethnicity

TUESDAY, Oct. 9 2018 (HealthDay News) -- Minority residents describe burdens associated with race/ethnicity, including microaggressions and bias on a daily basis, according to a study published online Sept. 28 in JAMA Network Open.

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Industry-Funded Trials Often Involve Employees in Studies

FRIDAY, Oct. 5, 2018 (HealthDay News) -- Industry employees are often involved in the design, conduct, and reporting of industry-funded trials in high-impact journals, according to a study published online Oct. 3 in The BMJ.

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No Increase in In-Hospital, Post-Discharge Death With HRRP

FRIDAY, Oct. 5, 2018 (HealthDay News) -- Announcement and implementation of the Hospital Readmissions Reduction Program (HRRP) was not associated with increases in in-hospital or post-discharge mortality after acute myocardial infarction (AMI), heart failure, or pneumonia, according to a study published online Sept. 28 in JAMA Network Open.

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Clinical Comorbidities Up After Arthroscopic Hip Surgery

FRIDAY, Oct. 5, 2018 (HealthDay News) -- Following elective arthroscopic hip surgery, the rate of seven major clinical comorbidities increases significantly, according to a study published online Sept. 27 in the British Journal of Sports Medicine.

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Three-Quarters of Health Care Workers Got Flu Shot Last Year

THURSDAY, Oct. 4, 2018 (HealthDay News) -- Just over three-quarters of health care personnel received a flu vaccine last season, according to research published in the Sept. 28 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Price Hikes Noted in Small Subset of Generic Drugs

THURSDAY, Oct. 4, 2018 (HealthDay News) -- A small but growing subset of generic drugs experienced sudden large price increases from 2007 to 2013, according to a study published in the October issue of Health Affairs.

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Tips Provided for Budgeting in Medical Residency

THURSDAY, Oct. 4, 2018 (HealthDay News) -- Medical residents should start budgeting and save for the future, according to an article published in the American Medical Association AMA Wire.

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Opioid Use Down With 'Enhanced Recovery After Surgery' Program

THURSDAY, Oct. 4, 2018 (HealthDay News) -- An "enhanced recovery after surgery" (ERAS) program is associated with a significant reduction in opioid consumption after gynecologic surgery with no increase in pain scores, according to a study published in the August issue of Obstetrics & Gynecology.

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Medicare Patient Readmit Rates Higher in Proprietary Hospitals

WEDNESDAY, Oct. 3, 2018 (HealthDay News) -- Among Medicare patients with six major diseases, readmission rates are higher for those receiving care in proprietary hospitals compared with government or nonprofit hospitals, according to a study published online Sept. 18 in PLOS ONE.

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Uninsured Rate at 8.8 Percent in First Quarter of 2018

WEDNESDAY, Oct. 3, 2018 (HealthDay News) -- In the first quarter of 2018, the uninsured rate was 8.8 percent, not significantly different from a year earlier, according to a report released Aug. 29 by the National Center for Health Statistics (NCHS).

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Preventable Cardiovascular Events Are Big Economic Burden

TUESDAY, Oct. 2, 2018 (HealthDay News) -- Preventable cardiovascular events place a considerable health and economic burden on the United States, according to research published in the Sept. 7 issue of the U.S. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report.

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For Employer-Based Plans, Spending Across Services Steady

TUESDAY, Oct. 2, 2018 (HealthDay News) -- Despite large health policy changes, the distribution of spending across service areas has remained fairly consistent over the past 10 years for those enrolled in employer-sponsored insurance, according to a study published in the October issue of Health Affairs.

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Second Opinion at NCI Center Valuable for Breast CA Patients

TUESDAY, Oct. 2, 2018 (HealthDay News) -- Almost 43 percent of patients diagnosed with breast cancer presenting to a National Cancer Institute (NCI)-designated cancer center for a second opinion have a change in diagnosis, according to a study published in the October issue of the Annals of Surgical Oncology.

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Interviews Can Help Ensure Physician Candidates Fit Culture

TUESDAY, Oct. 2, 2018 (HealthDay News) -- In preparing to interview to hire a new physician, practices must understand their own cultures, according to an article published in Medical Economics.

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Number of Health-Related Data Breaches Increasing

TUESDAY, Oct. 2, 2018 (HealthDay News) -- The number of health data breaches has steadily increased since 2010, according to a research letter published in the Sept. 25 issue of the Journal of the American Medical Association.

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Hospital Privacy Curtains Become Increasingly Contaminated

MONDAY, Oct. 1, 2018 (HealthDay News) -- Curtains surrounding patient beds become progressively contaminated with bacteria, according to a study published in the September issue of the American Journal of Infection Control.

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Risk of Venous Thromboembolism Recurrence High

MONDAY, Oct. 1, 2018 (HealthDay News) -- The risk of recurrence after incident venous thromboembolism is high, particularly among patients with cancer-related venous thromboembolism, according to a study published in the September issue of The American Journal of Medicine.

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Anti-Reflux Surgery Promising in Idiopathic Pulmonary Fibrosis

MONDAY, Oct. 1, 2018 (HealthDay News) -- Laparoscopic antireflux surgery is safe and well-tolerated in patients with idiopathic pulmonary fibrosis (IPF) and abnormal acid gastroesophageal reflux (GER), according to a phase 2 study published in the Sept. 1 issue of The Lancet Respiratory Medicine.

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More Non-Elderly Americans Uninsured in 2017 Versus 2016

MONDAY, Oct. 1, 2018 (HealthDay News) -- From 2016 to 2017, there was an increase in the number of uninsured non-elderly Americans, according to a report published by the Robert Wood Johnson Foundation.

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