October 2019 Briefing - Surgery

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

Bariatric Surgery Linked to Reduced Risk for Skin Cancer

THURSDAY, Oct. 31, 2019 (HealthDay News) -- For individuals with obesity, bariatric surgery is associated with a reduced risk for skin cancer, including melanoma, according to a study published online Oct. 30 in JAMA Dermatology.

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No Benefit Seen for SLNB in BCS for DCIS in Older Women

THURSDAY, Oct. 31, 2019 (HealthDay News) -- For older patients with ductal carcinoma in situ (DCIS) who undergo breast-conserving surgery (BCS), sentinel lymph node biopsy (SLNB) is not associated with improvements in long-term outcomes, according to a study published in the December issue of JNCI Cancer Spectrum.

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Rate of Surgical Bailout Low for TAVR

THURSDAY, Oct. 31, 2019 (HealthDay News) -- The need for surgical bailout in patients undergoing transcatheter aortic valve replacement (TAVR) is low, according to a study recently published in JACC: Cardiovascular Interventions.

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CDC: U.S. Life Expectancy Up Slightly, Mortality Lower in 2017

WEDNESDAY, Oct. 30, 2019 (HealthDay News) -- Life expectancy has increased slightly in the United States, and mortality is lower than in 2007, according to a report published Oct. 30 by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

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Facebook Launches Preventive Health Tool

TUESDAY, Oct. 29, 2019 (HealthDay News) -- A new tool designed to help guide preventive care for heart disease, cancer, and seasonal flu was launched in the United States Monday by Facebook.

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Aspirin May Slow Growth of Multiple Intracranial Aneurysms

TUESDAY, Oct. 29, 2019 (HealthDay News) -- Aspirin is associated with a reduced rate of aneurysm growth for patients with multiple intracranial aneurysms, according to a review published online Oct. 29 in the Journal of Neurosurgery.

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Readmissions Up for Preexisting HAIs With Home Discharge

TUESDAY, Oct. 29, 2019 (HealthDay News) -- Discharge to a skilled nursing facility (SNF) is associated with fewer avoidable readmissions for preexisting health care-associated infections (HAIs) compared with home discharges, according to a study published online Oct. 23 in the Journal of the American Geriatrics Society.

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Outcomes Poor With Medical Care From Fraud, Abuse Perpetrators

MONDAY, Oct. 28, 2019 (HealthDay News) -- Receiving medical care from fraud and abuse perpetrators (FAPs), subsequently excluded from Medicare, is associated with higher rates of all-cause mortality and emergency hospitalization, according to a study published online Oct. 28 in JAMA Internal Medicine.

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Doctors Mostly Dissatisfied With Electronic Health Record Systems

MONDAY, Oct. 28, 2019 (HealthDay News) -- The majority of physicians are dissatisfied with their current electronic health record (EHR) systems, according to survey results released Oct. 16 by Medical Economics.

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Delay of Surgery for DCIS Ups Risk for Invasive Breast Cancer

FRIDAY, Oct. 25, 2019 (HealthDay News) -- For each month of delay between diagnosis and surgery for ductal carcinoma in situ (DCIS), there is slightly worse survival and an increase in risk for invasive disease, according to a study published online Sept. 27 in the Annals of Surgical Oncology.

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Family Involvement Cuts Postop Delirium in Older Patients

FRIDAY, Oct. 25, 2019 (HealthDay News) -- The Tailored, Family-Involved Hospital Elder Life Program (t-HELP) is effective in reducing postoperative delirium (POD) for older patients, according to a Chinese study published online Oct. 21 in JAMA Internal Medicine.

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CDC: Drugs Involved in Overdose Deaths Varied Regionally in 2017

FRIDAY, Oct. 25, 2019 (HealthDay News) -- The drugs most frequently involved in drug overdose deaths in 2017 varied regionally in the United States, according to a study published online Oct. 25 in the National Health Statistics Reports, a publication from the U.S. Centers for Disease Control and Prevention.

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Fewer Women Than Men Receive Kidney Replacement Therapy

THURSDAY, Oct. 24, 2019 (HealthDay News) -- Fewer women than men receive kidney replacement therapy (KRT), according to a large European study published online Oct. 24 in the Clinical Journal of the American Society of Nephrology.

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One in Five Receive Opioid Rx After Cardiac Implant Procedure

THURSDAY, Oct. 24, 2019 (HealthDay News) -- One in five patients received opioid prescriptions for management of pain following cardiac implantable electronic device (CIED) procedures, according to a study published online Oct. 20 in HeartRhythm.

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Overweight, Obese Patients Rate Tummy Tuck Results Highly

THURSDAY, Oct. 24, 2019 (HealthDay News) -- Overweight and obese patients are overwhelmingly pleased with the results of tummy tuck procedures, according to a study published in the October issue of Plastic and Reconstructive Surgery.

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Poor Health Literacy Tied to More Hardships Among Cancer Survivors

WEDNESDAY, Oct. 23, 2019 (HealthDay News) -- Health insurance literacy may be an important intervention for addressing financial problems associated with cancer, according to a study published online Oct. 21 in JNCI Cancer Spectrum.

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Lung Transplant With Ex Vivo Lung Perfusion Feasible

WEDNESDAY, Oct. 23, 2019 (HealthDay News) -- Use of ex vivo lung perfusion (EVLP)-treated lungs increases the number of patients undergoing transplantation with comparable long-term outcomes, according to a study published online Oct. 9 in JAMA Surgery.

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Prophylactic Melatonin Does Not Cut Delirium After Major Cardiac Surgery

WEDNESDAY, Oct. 23, 2019 (HealthDay News) -- Prophylactic use of melatonin does not prevent delirium after major cardiac surgery, according to a study published online Oct. 8 in the Journal of the American Geriatrics Society.

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Outcomes Across Nonmelanoma Skin Cancer Treatments Similar

WEDNESDAY, Oct. 23, 2019 (HealthDay News) -- Outcomes for nonmelanoma skin cancers are similar at one year, regardless of treatment type, although cosmetic results vary, according to a review published in the Oct. 15 issue of Cancer.

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More Choices, Lower Premiums for ACA Consumers Next Year

TUESDAY, Oct. 22, 2019 (HealthDay News) -- There will be more health insurance choices and a slight decrease in premiums for many consumers next year under the Affordable Care Act, according to the Trump administration.

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Substance Use Disorder Ups Risk for Death After IE Valve Surgery

TUESDAY, Oct. 22, 2019 (HealthDay News) -- Patients with infective endocarditis (IE) and substance use disorder (SUD) have a more than twofold risk for dying following valve surgery compared with patients without SUD, according to a study published online Oct. 16 in the Annals of Thoracic Surgery.

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Recommendations Updated for Nonvariceal Upper GI Bleeding

MONDAY, Oct. 21, 2019 (HealthDay News) -- In clinical guidelines published online Oct. 22 in the Annals of Internal Medicine, updated recommendations are presented for the management of nonvariceal upper gastrointestinal bleeding.

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Trainee Demographics Tied to Passage of U.S. Surgical Boards

MONDAY, Oct. 21, 2019 (HealthDay News) -- Resident race, ethnicity, sex, and family status at internship are associated with surgical board passage rates in the United States, according to a study published online Oct. 16 in JAMA Surgery.

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Public Outcomes Reporting Tied to Drop in Valve Replacements

MONDAY, Oct. 21, 2019 (HealthDay News) -- Initiating public reporting was associated with a significant decrease in valve surgery for all infective endocarditis (IE) cases, regardless of injection drug use (IDU) status, according to a study published Oct. 10 in Clinical Infectious Diseases.

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Tranexamic Acid Within Three Hours Cuts Some TBI Deaths

MONDAY, Oct. 21, 2019 (HealthDay News) -- Among patients with mild-to-moderate acute traumatic brain injury (TBI), the risk for head injury-related death is reduced in those receiving tranexamic acid within three hours compared with placebo, according to a study published online Oct. 14 in The Lancet.

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Patient Cost Responsibility Up for Guideline-Discordant Care

FRIDAY, Oct. 18, 2019 (HealthDay News) -- For patients with metastatic breast cancer (MBC), receipt of National Comprehensive Cancer Network Guideline-discordant care is associated with higher patient cost responsibility, according to a study published in the October issue of the Journal of the National Comprehensive Cancer Network.

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Use of Deceased Donor Kidneys Varies by Center

THURSDAY, Oct. 17, 2019 (HealthDay News) -- There is center-level variation in the use of deceased donor kidneys, according to a study published online Oct. 17 in the Clinical Journal of the American Society of Nephrology.

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Study Looks at Pediatric Firearm-Related Eye Injuries in the U.S.

THURSDAY, Oct. 17, 2019 (HealthDay News) -- A quarter of all U.S. ocular firearm injuries occur within the pediatric population, according to a study published online Oct. 10 in JAMA Ophthalmology.

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Insurance Plans Vary in Policies for Gender-Affirming Surgeries

THURSDAY, Oct. 17, 2019 (HealthDay News) -- There is great variability in coverage and medical necessity criteria for gender-affirming top surgery across insurance companies, according to a study published in the October issue of Plastic and Reconstructive Surgery.

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Opioid Crisis Cost United States $631 Billion Over Four Years

WEDNESDAY, Oct. 16, 2019 (HealthDay News) -- The U.S. opioid epidemic cost the nation's economy $631 billion from 2015 through 2018, a new study says.

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Surgery May Be Best Option for Some With Refractory Heartburn

WEDNESDAY, Oct. 16, 2019 (HealthDay News) -- In patients who truly have proton pump inhibitor (PPI)-refractory heartburn, including those with reflux hypersensitivity, surgery may be the best treatment option, according to a study published in the Oct. 16 issue of the New England Journal of Medicine.

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Postop Opioid Rx Sevenfold Higher in U.S., Canada Versus Sweden

WEDNESDAY, Oct. 16, 2019 (HealthDay News) -- Patients in the United States and Canada receive prescription opioids after surgeries at a rate that is approximately seven times higher than the rate in Sweden, according to a study published online Sept. 4 in JAMA Network Open.

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Opioids May Not Be Needed for Acute Pain Control After Vasectomy

WEDNESDAY, Oct. 16, 2019 (HealthDay News) -- Opioids do not provide improved pain control following a vasectomy and may be tied to a higher risk for persistent use, according to a study published in the October issue of The Journal of Urology.

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Gastric Bypass Linked to Lower Risk for Major Birth Defects

TUESDAY, Oct. 15, 2019 (HealthDay News) -- Infants born to women who have undergone Roux-en-Y gastric bypass surgery have a lower risk for major birth defects than those born to matched control women, according to a study published in the Oct. 15 issue of the Journal of the American Medical Association.

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Likelihood of Transplant Lower at Profit-Driven Dialysis Facilities

TUESDAY, Oct. 15, 2019 (HealthDay News) -- Patients with end-stage kidney disease who undergo dialysis at for-profit institutions are less likely to receive a kidney transplant, according to a study published online Sept. 10 in the Journal of the American Medical Association.

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Pulmonary Embolism Risk Elevated for More Than Six Weeks Postop

TUESDAY, Oct. 15, 2019 (HealthDay News) -- The postoperative risk for pulmonary embolism extends more than six weeks for six types of surgery, according to a study published online Oct. 9 in JAMA Surgery.

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Reconstructive Surgery International Trips Are Cost-Effective and Sustainable

TUESDAY, Oct. 15, 2019 (HealthDay News) -- International trips for specialty plastic surgeries can be cost-effective or very cost-effective for several conditions, according to a study published in the September issue of Plastic and Reconstructive Surgery.

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No Increased Mortality Seen With Paclitaxel Drug-Eluting Devices

THURSDAY, Oct. 9, 2019 (HealthDay News) -- Paclitaxel drug-eluting devices used for endovascular revascularization (EVR) of peripheral vessels do not appear to be associated with increased mortality over 11 years compared with uncoated devices, according to a study published online Oct. 9 in the European Heart Journal.

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Medicare Fraud-Prevention Rules to Be Revised

WEDNESDAY, Oct. 9, 2019 (HealthDay News) -- Revision of decades-old Medicare rules meant to prevent fraud has been proposed by the Trump administration.

AP News Article

2000 to 2015 Saw Increase in Medicare GME Payments

WEDNESDAY, Oct. 9, 2019 (HealthDay News) -- Medicare graduate medical education (GME) payments increased significantly from 2000 to 2015, according to a study published online Oct. 7 in JAMA Internal Medicine.

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Gender-Affirming Surgery May Aid Long-Term Mental Health

WEDNESDAY, Oct. 9, 2019 (HealthDay News) -- For transgender individuals with a diagnosis of gender incongruence, increased time since last gender-affirming surgery is associated with reduced mental health treatment, according to a study published online Oct. 4 in The American Journal of Psychiatry.

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Review: E-Stim Devices May Increase Spinal Fusion Rates

WEDNESDAY, Oct. 9, 2019 (HealthDay News) -- Electrical stimulation technologies (ESTs) appear to be effective for increasing spinal fusion, according to a review of preclinical and clinical literature published online Oct. 8 in the Journal of Neurosurgery: Spine.

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Pediatric Firearm Injury Prevention Research Underfunded

TUESDAY, Oct. 8, 2019 (HealthDay News) -- Funding for pediatric firearm injury prevention research is only 3.3 percent of that predicted according to the mortality burden, say the authors of a report published in the October issue of Health Affairs.

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Cost of Waste in U.S. Health System Estimated

TUESDAY, Oct. 8, 2019 (HealthDay News) -- The estimated cost of waste in the U.S. health care system varies from $760 to $935 billion, according to a special communication published online Oct. 7 in the Journal of the American Medical Association.

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Burnout Linked to Poor Quality Care in Published Literature

TUESDAY, Oct. 8, 2019 (HealthDay News) -- In the published literature, burnout in health care professionals is frequently associated with poor-quality care, but the effect size may be smaller than reported, according to data from a systematic review published online Oct. 8 in the Annals of Internal Medicine.

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Hysterectomy Technique Tied to Poorer Uterine Cancer Outcomes

MONDAY, Oct. 7, 2019 (HealthDay News) -- Uncontained power morcellation is associated with a higher mortality risk in women with occult uterine sarcoma, especially in those with occult leiomyosarcoma, according to a study published online Sept. 16 in the Journal of Clinical Oncology.

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Medicaid Pays 75 Percent of What Medicare Pays for Spine Surgeries

FRIDAY, Oct. 4, 2019 (HealthDay News) -- There are large disparities between Medicaid and Medicare reimbursement rates for eight spine procedures, according to a study published online Sept. 26 in Spine.

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PCI, CABG for Left Main CAD Have Similar Five-Year Outcomes

FRIDAY, Oct. 4, 2019 (HealthDay News) -- Five-year rates of a composite outcome of death, stroke, and myocardial infarction are similar for patients with left main coronary artery disease following either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), according to a study published online Sept. 28 in the New England Journal of Medicine. The research was published to coincide with Transcatheter Cardiovascular Therapeutics 2019, the annual meeting of the Cardiovascular Research Foundation, held from Sept. 25 to 29 in San Francisco.

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Enhanced Recovery Program Aids Bariatric Surgery Outcomes

THURSDAY, Oct. 3, 2019 (HealthDay News) -- Implementation of a large-scale, enhanced recovery project for bariatric surgery is feasible and results in a decrease in extended length of stay (ELOS), according to a study published online Sept. 23 in Surgery for Obesity and Related Diseases.

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Urinary Catheters Not Needed for Joint Replacement Surgery

WEDNESDAY, Oct. 2, 2019 (HealthDay News) -- Patients undergoing joint replacement under epidural anesthesia have no increased risk for postoperative adverse genitourinary (GU) complications by skipping preoperative indwelling urinary catheters, according to a study published in the October issue of the Journal of Arthroplasty.

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