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November 2014 Briefing - Surgery

Last Updated: December 01, 2014.

Here are what the editors at HealthDay consider to be the most important developments in Surgery for November 2014. 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.

Hospital Volume Not Linked to Costs of Cancer Surgery

WEDNESDAY, Nov. 26, 2014 (HealthDay News) -- Hospital surgical volume does not appear to correlate with Medicare payments for cancer surgery, according to research published online Nov. 24 in the Journal of Clinical Oncology.

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FDA Adds Boxed Warning to Laparoscopic Power Morcellators

MONDAY, Nov. 24, 2014 (HealthDay News) -- The U.S. Food and Drug Administration on Monday announced that new boxed warning labels will be added to laparoscopic power morcellators used in hysterectomy or uterine fibroid removal.

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Newly Insured Under ACA May Have Trouble Finding Doctors

MONDAY, Nov. 24, 2014 (HealthDay News) -- Millions of Americans bought health insurance coverage through the Affordable Care Act in the past year and physicians may be reluctant to accept these patients.

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AMA: Gender Inequality Still Exists in Medicine

FRIDAY, Nov. 21, 2014 (HealthDay News) -- Gender inequality still exists in medicine, according to an article published by the American Medical Association (AMA).

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Mastectomy Rates Rising Among Women Eligible for Lumpectomy

THURSDAY, Nov. 20, 2014 (HealthDay News) -- A rising number of early-stage breast cancer patients who are eligible for lumpectomy are nonetheless undergoing mastectomy, according to a study published online Nov. 19 in JAMA Surgery.

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Risk of Adverse Outcomes Up With PCI In Adults With Diabetes

THURSDAY, Nov. 20, 2014 (HealthDay News) -- For adults with diabetes and multivessel or left main coronary artery disease, percutaneous coronary intervention (PCI) is associated with increased likelihood of a composite outcome compared with coronary artery bypass grafting (CABG), according to a review and meta-analysis published in the Nov. 18 issue of the Annals of Internal Medicine.

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Early Nasoenteric Tube Feeding Doesn't Benefit Acute Pancreatitis

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- For patients with acute pancreatitis at high risk of complications, early nasoenteric tube feeding does not improve outcomes compared with an oral diet after 72 hours, according to a study published in the Nov. 20 issue of the New England Journal of Medicine.

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Malpractice Premiums Vary With Work Hours, Practice Size

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- There have been significant fluctuations in medical malpractice premiums, based on doctor's age, location, workload, and practice size, according to a report published Nov. 6 in Medical Economics.

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Measuring HbA1c at Admission Helps Tailor Treatment Regimen

MONDAY, Nov. 17, 2014 (HealthDay News) -- Measurement of hemoglobin A1c (HbA1c) at hospital admission can tailor treatment regimens at discharge, according to a study published in the November issue of Diabetes Care.

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New Rx Regimen Produces HCV SVR in Liver Transplant Patients

FRIDAY, Nov. 14, 2014 (HealthDay News) -- A new drug regimen produced high sustained virologic response (SVR) rates in a small group of liver transplant patients with recurrent hepatitis C virus genotype 1 infection. The report was published online Nov. 12 in the New England Journal of Medicine.

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Triple Aim Should Be Expanded to Address Physician Burnout

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Expanding the Triple Aim approach -- which includes enhancing patient experience, improving population health, and reducing costs -- to the Quadruple Aim by adding the goal of improving health care provider work life is recommended, according to the authors of an article published in the November/December issue of the Annals of Family Medicine.

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U.S. Prices Soaring for Some Generic Drugs

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Market forces are dramatically driving up the cost of some generic drugs, prompting U.S. investigations into the pricing of what should be cheap alternatives to brand-name medications.

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Guidelines Aim to Reduce 2nd Surgeries Post-Lumpectomy

THURSDAY, Nov. 13, 2014 (HealthDay News) -- In a study of 241 ,597 women who had breast conservation surgery for breast cancer, 23.6 percent needed a second operation. The report was published online Nov. 12 in JAMA Surgery.

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Tubouterine Implantation Can Undo Hysteroscopic Sterilization

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Tubouterine implantation is feasible for hysteroscopic sterilization reversal and results in promising rates of pregnancy and live birth, according to a study published online Nov. 5 in Obstetrics & Gynecology.

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Cost-Effectiveness Evidence for Minimal Access Surgery Lacking

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- There is insufficient evidence to assess the cost-effectiveness of minimal access surgery (MAS) compared with conventional open procedures for the cervical and lumbar spine, according to a review published in a supplement to the Oct. 15 issue of Spine, focusing on value-based spine care.

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Patient Preference for Anticoagulant Tx Outcome Varies

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Patients' preferences for outcomes of anticoagulation therapy vary and are affected by previous stroke or myocardial infarction experience, according to a study published online Nov. 11 in Circulation: Cardiovascular Quality and Outcomes.

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Pain, Depression Tied to Delirium Risk Post-Surgery

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Pain and depression before an operation may increase seniors' risk for delirium after surgery, according to a study published in the November issue of The Lancet Psychiatry.

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Few Studies Assess Value of Cervical Degenerative Disc Sx

MONDAY, Nov. 10, 2014 (HealthDay News) -- Few studies examine the cost-effectiveness of surgery for patients with cervical degenerative disc disease (DDD), according to a review published in a supplement to the Oct. 15 issue of Spine, focusing on value-based spine care.

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Guideline Developed for Management of Acromegaly

MONDAY, Nov. 10, 2014 (HealthDay News) -- Recommendations have been developed for the diagnosis and management of acromegaly. The new clinical practice guideline was published in the November issue of the Journal of Clinical Endocrinology & Metabolism.

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Want to Be a Leader? Cultivate a Healthy Look

FRIDAY, Nov. 7, 2014 (HealthDay News) -- It's more important for potential business or political leaders to look healthy than intelligent, according to a study published online Nov. 5 in Frontiers in Human Neuroscience.

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Resident Trainees Up Operative Times for Hysterectomy

FRIDAY, Nov. 7, 2014 (HealthDay News) -- Resident participation in laparoscopic hysterectomy procedures for benign disease is associated with longer surgical time and small increases in the rates of postoperative reoperation and readmission, according to a study published in the November issue of the American Journal of Obstetrics & Gynecology.

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Better Physician Communication at Shift Change Reduces Errors

FRIDAY, Nov. 7, 2014 (HealthDay News) -- Changing how doctors communicate during shift changes in hospitals reduces the risk of adverse events in patients by 30 percent, according to a study published in the Nov. 6 issue of the New England Journal of Medicine.

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Docs Spend ~16.6 Percent of Their Time on Administration

FRIDAY, Nov. 7, 2014 (HealthDay News) -- About 16.6 percent of doctors' working hours are spent on administrative work, according to a study published recently in the International Journal of Health Services.

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Colorectal Cancer on the Rise for U.S. Adults Under 50

THURSDAY, Nov. 6, 2014 (HealthDay News) -- While rates of colorectal cancer (CRC) have fallen among older Americans, cases among adults aged 20 to 49 are rising and expected to continue to do so, according to research published online Nov. 5 in JAMA Surgery.

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Bone Health After Fracture May Be Overlooked in Men

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Older men are much less likely than women to receive osteoporosis screening and treatment after suffering a wrist fracture, according to a study published in the Nov. 1 issue of The Journal of Bone & Joint Surgery.

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ASCO Endorses Guideline for Radiation After Prostatectomy

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- The American Society for Clinical Oncology (ASCO) has endorsed a recent guideline for adjuvant and salvage radiotherapy after prostatectomy. The endorsement was published online Nov. 3 in the Journal of Clinical Oncology.

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Urinary Retention Seen in ~5% of Posterior Lumbar Surgeries

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- The risk of developing postoperative urinary retention (POUR) after posterior lumbar spine surgery is approximately 5 percent, with certain patient factors associated with higher risk, according to a study published in the Oct. 15 issue of Spine.

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AMA: New Mapping Tool IDs Areas in Need of Physicians

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- A new interactive mapping tool can help physicians and their staff determine locations to establish or expand their practice, according to a report published by the American Medical Association (AMA).

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Opening Visitation Access Boosts Patient, Family Experience

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Opening visitation access across all facilities can improve patient and family experience, according to research published in the July/August issue of the Journal of Nursing Administration.

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Long-Term Shift Work May Drain the Brain

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Working non-standard hours -- "shift work" -- for many years is not only hard on the body, but may also dull the mind, new research suggests. According to the study, published online Nov. 3 in Occupational & Environmental Medicine, those who do shift work for more than 10 years seem to have the equivalent of an extra 6.5 years of age-related decline in memory and thinking skills.

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Ebola Elimination Possible With Early Patient Isolation

MONDAY, Nov. 3, 2014 (HealthDay News) -- Isolation of patients with Ebola in critical condition within days of symptom onset is likely to have a high chance of eliminating the disease, according to a study published online Oct. 28 in the Annals of Internal Medicine.

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Bariatric Surgery Substantially Reduces T2DM Risk in Obese

MONDAY, Nov. 3, 2014 (HealthDay News) -- Bariatric surgery in obese patients significantly lowers risk of developing type 2 diabetes, independent of other factors such as smoking, hypertension, and high cholesterol, according to a study published online Nov. 3 in The Lancet Diabetes & Endocrinology.

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Rate of PCI for Coronary Artery Disease Drops in the U.S.

MONDAY, Nov. 3, 2014 (HealthDay News) -- In the past several years, the rate of percutaneous coronary intervention (PCI) for coronary artery disease (CAD) has decreased in the United States, according to research published in the Oct. 1 issue of The American Journal of Cardiology.

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CT Findings ID Tx Effectiveness in Small-Bowel Obstruction

MONDAY, Nov. 3, 2014 (HealthDay News) -- Computed tomographic (CT) findings can predict the effectiveness of nonsurgical treatment in patients with adhesive small-bowel obstruction (SBO), according to a study published in the November issue of Radiology.

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AMA: Absence of Health Insurer Competition in Many Areas

MONDAY, Nov. 3, 2014 (HealthDay News) -- In most metropolitan areas, there is a significant absence of health insurer competition, according to a report published by the American Medical Association (AMA).

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Preterm, Low Birth-Weight Babies May Need New Hips As Adults

MONDAY, Nov. 3, 2014 (HealthDay News) -- Adults who were born preterm or at a low birth weight may have an increased risk of needing a hip replacement due to osteoarthritis, according to a study published online Nov. 3 in Arthritis Care & Research.

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