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November 2017 Briefing - Surgery

Last Updated: December 01, 2017.

Here are what the editors at HealthDay consider to be the most important developments in Surgery for November 2017. 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.

Mortality Up for Some Cancers in Urban-Dwelling Native Americans

THURSDAY, Nov. 30, 2017 (HealthDay News) -- Urban American Indians and Alaskan Natives (AIAN) with cancer have a significantly higher comorbidity burden, and have higher mortality for some cancers, according to a study published online Nov. 29 in Cancer Research.

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Recent Increase in Cataract Sx at Ambulatory Surgical Centers

WEDNESDAY, Nov. 29, 2017 (HealthDay News) -- From 2001 to 2014 there was a transition in the site of cataract surgery from hospital outpatient departments (HOPDs) to ambulatory surgical centers (ASCs), according to a study published online Nov. 22 in JAMA Ophthalmology.

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Over 5 Percent of Incident Cancer Due to Diabetes, High BMI

WEDNESDAY, Nov. 29, 2017 (HealthDay News) -- More than 5 percent of all incident cancers in 2012 were attributable to diabetes and high body mass index (BMI), according to a study published online Nov. 28 in The Lancet Diabetes & Endocrinology.

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Wait Time Linked to Worse Outcomes in Hip Fracture Surgery

WEDNESDAY, Nov. 29, 2017 (HealthDay News) -- Increased wait time is associated with an increased risk of complications and 30-day mortality among adults undergoing hip fracture surgery, according to a study published in the Nov. 28 issue of the Journal of the American Medical Association.

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Patients Often Uncomfortable With Overlapping Surgeries

WEDNESDAY, Nov. 29, 2017 (HealthDay News) -- On average, patients are neutral toward or uncomfortable with concurrent or overlapping surgical procedures, according to a study published in the Nov. 15 issue of The Journal of Bone & Joint Surgery.

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Clinician Denial of Patient Requests Impacts Satisfaction

TUESDAY, Nov. 28, 2017 (HealthDay News) -- Clinician denial of some types of tests requested by patients is associated with worse patient satisfaction with the clinician, according to a study published online Nov. 27 in JAMA Internal Medicine.

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New Workflows Have Potential to Address Provider Burnout

MONDAY, Nov. 27, 2017 (HealthDay News) -- New solutions are needed to address burnout among health care team members, yet, in a catch-22 situation for health industry leaders, change fatigue contributes to burnout, according to a Vocera Communications report entitled In Pursuit of Resilience, Well-Being, and Joy in Healthcare.

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Essay Adds to Discourse on Impact of Suggestive Jokes

MONDAY, Nov. 27, 2017 (HealthDay News) -- Seemingly benign, recurring patterns of joking around a single theme (joke cycles) can contribute to humorizing and legitimizing sexual misconduct, according to an essay published online Nov. 12 in Communication and Critical/Cultural Studies.

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History of Prior Cancer Common in Newly Diagnosed Patients

MONDAY, Nov. 27, 2017 (HealthDay News) -- A substantial number of patients diagnosed with incident cancer in the United States have a prior history of cancer, according to a brief report published online Nov. 22 in JAMA Oncology.

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Percutaneous Transluminal Angioplasty Ineffective in MS

MONDAY, Nov. 27, 2017 (HealthDay News) -- Percutaneous transluminal angioplasty (PTA) seems to be safe but ineffective for patients with multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency (CCSVI), according to a study published online Nov. 18 in JAMA Neurology.

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Female Physicians' Spouses More Likely to Work

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Spouses of female physicians are on average more educated and work more hours outside the home than spouses of male physicians, according to a research letter published online Nov. 21 in the Annals of Internal Medicine.

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Monoclonal Antibodies Cut Ischemia-Reperfusion Injury

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Anti-CD47 monoclonal antibody (CD47mAb) therapy reduces ischemia-reperfusion injury of renal allografts in an animal transplantation model, according to a study published online Oct. 31 in the American Journal of Transplantation.

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Child Behavior Associated With Clinician Sevoflurane Exposure

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Negative behavior among children undergoing elective ear, nose, and throat surgery is associated with higher mean and maximum sevoflurane concentrations in the anesthesiologist's breathing zone, according to a study published online Oct. 25 in Pediatric Anesthesia.

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Baby Boomers Have Increased Risk of Rx Opioid Overdose Death

WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Individuals born between 1947 and 1964 have a significantly increased risk of prescription opioid overdose death and heroin overdose death, and those born from 1979 to 1992 also have an increased risk of heroin overdose death, according to a study published online Nov. 21 in the American Journal of Public Health.

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High Costs Associated With Physician Burnout, Attrition

TUESDAY, Nov. 21, 2017 (HealthDay News) -- Physicians who are experiencing burnout are more than twice as likely to leave their organization within two years, and this is associated with significant economic costs, according to a report from the American Medical Association.

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Surgery of Limited Clinical Benefit for Subacromial Shoulder Pain

TUESDAY, Nov. 21, 2017 (HealthDay News) -- For patients with subacromial shoulder pain, outcomes are better with arthroscopic subacromial decompression and investigational arthroscopy only, although the difference versus no treatment is not clinically important, according to a study published online Nov. 20 in The Lancet.

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Certain Traits Tied to More HIV Tests in Transgender Individuals

MONDAY, Nov. 20, 2017 (HealthDay News) -- Transgender individuals with certain characteristics, including a history of incarceration and self-referral, have more HIV tests, according to a short report published in Transgender Health.

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Simple Checklist Can Identify Useful Clinical Practice Guidelines

FRIDAY, Nov. 17, 2017 (HealthDay News) -- A simple, easy-to-use checklist, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST), can identify useful clinical practice guidelines, according to a study published in the September/October issue of the Annals of Family Medicine.

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Many Health Care Providers Work While Sick

FRIDAY, Nov. 17, 2017 (HealthDay News) -- More than 40 percent of health care personnel (HCP) with influenza-like illness (ILI) work while ill, according to a study published in the November issue of the American Journal of Infection Control.

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Force Analysis May Help Distinguish Surgeon Skill Level

FRIDAY, Nov. 17, 2017 (HealthDay News) -- Force-sensing bipolar forceps and force analysis may help differentiate surgeon skill level, according to a study published online Nov. 15 in JAMA Surgery.

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Attributes of High-Value Oncology Practices Identified

FRIDAY, Nov. 17, 2017 (HealthDay News) -- Attributes that distinguish high-value oncology practices have been identified, according to a study published online Nov. 16 in JAMA Oncology.

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FDA Investigation Linked to Drop in Codeine Rx for Children

THURSDAY, Nov. 16, 2017 (HealthDay News) -- The U.S. Food and Drug Administration (FDA) investigation into the safety of codeine use by children, which culminated in a black box warning in February 2013, led to substantially decreased codeine prescribing to children after tonsillectomy and/or adenoidectomy, according to a study published online Nov. 16 in Pediatrics.

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High Levels of Burnout, Stress for U.S. Surgical Residents

THURSDAY, Nov. 16, 2017 (HealthDay News) -- Surgical residents have high levels of burnout, which is associated with high stress, depression, and suicidal ideation, according to a study published online in the Journal of the American College of Surgeons.

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Sentinel Lymph Node Biopsy Underused in High-Risk SCC

THURSDAY, Nov. 16, 2017 (HealthDay News) -- Sentinel lymph node biopsy (SLNB) is underused for high-risk squamous cell carcinoma (SCC) of the skin, according to a research letter published online Nov. 15 in JAMA Dermatology.

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Insurance Underlies Black-White Survival Disparity in CRC

WEDNESDAY, Nov. 15, 2017 (HealthDay News) -- Insurance coverage differences account for about half of the disparity in survival rates between black and white patients aged 18 to 64 years with colorectal cancer (CRC), according to a study published online Nov. 14 in Gastroenterology.

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Findings Support Endovascular Repair of Aortic Aneurysm

WEDNESDAY, Nov. 15, 2017 (HealthDay News) -- For patients with suspected ruptured abdominal aortic aneurysm, endovascular repair is associated with a survival advantage at three years compared with open repair, according to a study published online Nov. 14 in the BMJ.

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Perioperative Aspirin May Benefit Patients With Prior PCI

TUESDAY, Nov. 14, 2017 (HealthDay News) -- For patients with prior percutaneous coronary intervention (PCI), perioperative aspirin seems to be beneficial, according to a study published online Nov. 13 in the Annals of Internal Medicine.

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Drug Combination Cost-Effective for Cesarean Prophylaxis

TUESDAY, Nov. 14, 2017 (HealthDay News) -- The addition of azithromycin to cephalosporin for cesarean delivery infection prophylaxis is cost-effective and leads to better maternal outcomes, according to a study published online Nov. 7 in Obstetrics & Gynecology.

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Oral Chemotherapy Parity Laws Offer Some Financial Protection

MONDAY, Nov. 13, 2017 (HealthDay News) -- The adoption of state oral chemotherapy parity laws has improved financial protection for many patients, according to a study published online Nov. 9 in JAMA Oncology.

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Surgeons Often Prescribing Too Many Opioids After Rhinoplasty

MONDAY, Nov. 13, 2017 (HealthDay News) -- Patients use a mean of 8.7 of the initially prescribed 20 to 30 hydrocodone-acetaminophen combination tablets after rhinoplasty, according to a study published online Nov. 9 in JAMA Facial Plastic Surgery.

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Use of MMR Deficiency Testing in Younger CRC Patients Is Low

MONDAY, Nov. 13, 2017 (HealthDay News) -- Fewer than half of younger adults with colorectal cancer (CRC) undergo mismatch repair (MMR) deficiency of DNA testing, according to a study published online Nov. 9 in JAMA Oncology.

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Breast Cancer Recurrences Steady After Therapy Cessation

THURSDAY, Nov. 9, 2017 (HealthDay News) -- When adjuvant endocrine therapy for estrogen receptor-positive breast cancer is stopped after five years, recurrences occur at a steady rate into the future, according to a meta-analysis published online Nov. 8 in the New England Journal of Medicine.

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Patients Use ~Half of Opioids Prescribed After Hysterectomy

THURSDAY, Nov. 9, 2017 (HealthDay News) -- Gynecologists prescribe about twice the amount of opioids than patients use after hysterectomy for benign, nonobstetric indications, according to a study published online Nov. 7 in Obstetrics & Gynecology.

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CPAP May Be Superior to Gastric Banding for Severe Sleep Apnea

THURSDAY, Nov. 9, 2017 (HealthDay News) -- Continuous positive airway pressure (CPAP) may be a more effective treatment than laparoscopic gastric banding (LGB) for control of severe obstructive sleep apnea (OSA), according to a study published online Oct. 16 in the American Journal of Respiratory and Critical Care Medicine.

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Adding Exercise to Compression Therapy Promising for Leg Ulcers

THURSDAY, Nov. 9, 2017 (HealthDay News) -- Supervised exercise training in conjunction with compression may improve outcomes for patients with venous leg ulcers (VLUs), according to a study published online Oct. 27 in the British Journal of Dermatology.

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Overlapping Surgery Appears Safe in Neurosurgical Procedures

THURSDAY, Nov. 9, 2017 (HealthDay News) -- For patients undergoing neurosurgical procedures, overlapping surgery (OS) is not associated with morbidity, mortality, or worsened functional status, according to a study published online Nov. 8 in JAMA Surgery.

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Average Cost of Care in Year After Ovarian Cancer Surgery ~$100K

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- For women with ovarian cancer who underwent both surgery and adjuvant chemotherapy, the average medical expenditures are about $100,000 in the first year after surgery, according to a study published online Nov. 7 in Obstetrics & Gynecology.

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Doctors Have Extra Two Weeks to Preview Performance Data

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- Physicians have two extra weeks to preview their 2016 performance information as a result of a mistake related to the Centers for Medicare & Medicaid Services' Physician Compare online resource, according to a report published by the American Academy of Family Physicians.

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ASCO Issues Statement Regarding Alcohol and Cancer

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- Alcohol use is associated with certain types of cancer, and the risk of cancer can be reduced by strategies to prevent excessive use of alcohol, according to a statement published online Nov. 7 in the Journal of Clinical Oncology.

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In ER, Combination of Ibuprofen, Acetaminophen Relieves Pain

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- For patients presenting to the emergency department with acute extremity pain, the combination of ibuprofen and acetaminophen does not differ in terms of pain reduction from three different opioid and acetaminophen combination analgesics, according to a study published online Nov. 7 in the Journal of the American Medical Association.

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Increases in U.S. Health Spending Tied to Health Service Price

WEDNESDAY, Nov. 8, 2017 (HealthDay News) -- Factors including increases in health care service price and intensity are associated with increases in U.S. health care spending from 1996 to 2013, according to a study published online Nov. 7 in the Journal of the American Medical Association.

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Rates of IVC Filter Placement Decreased from 2010 to 2014

TUESDAY, Nov. 7, 2017 (HealthDay News) -- The rates of inferior vena cava (IVC) filter placement increased from 2005 until 2010 and then decreased through 2014, according to a research letter published online Nov. 6 in JAMA Internal Medicine.

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Steroid-Releasing Sinus Implant Deemed Effective, Safe

MONDAY, Nov. 6, 2017 (HealthDay News) -- For patients with chronic rhinosinusitis (CRS), placement of an hourglass-shaped bioabsorbable, steroid-releasing sinus implant improves postoperative outcomes when placed in the frontal sinus ostia (FSO) after endoscopic sinus surgery (ESS), according to a study published online Nov. 2 in JAMA Otolaryngology -- Head & Neck Surgery.

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Facility Volume Found to Impact Nasopharyngeal CA Survival

MONDAY, Nov. 6, 2017 (HealthDay News) -- Treatment at a high-volume facility (HVF) is a significant predictor of improved overall survival in nasopharyngeal cancer (NPC), according to a research letter published online Nov. 2 in JAMA Otolaryngology -- Head & Neck Surgery.

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Incidence of Early-Stage Breast CA, CRC Up With ACA Adoption

MONDAY, Nov. 6, 2017 (HealthDay News) -- After adoption of the Affordable Care Act (ACA), there was an increase in the incidence of early-stage breast and colorectal cancer, according to a research letter published online Nov. 2 in JAMA Oncology.

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Current Practice Not Cost-Effective for Air Medical Triage

FRIDAY, Nov. 3, 2017 (HealthDay News) -- Current practice is not cost-effective compared with the Air Medical Prehospital Triage (AMPT) score for trauma patients, and the field triage system undertriage rate for patients with severe injuries exceeds 20 percent, according to two studies published online Nov. 1 in JAMA Surgery.

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Abstract/Full Text (subscription or payment may be required) -- Voskens
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'09 to '15 Saw Increase in Transradial Access for STEMI PCI

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Use of transradial access (TRA) for ST-elevation myocardial infarction (STEMI) percutaneous coronary intervention (PCI) increased from 2009 to 2015, with considerable geographic, operator, and institutional variation, according to a study published online Nov. 1 in JACC: Cardiovascular Interventions.

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GLP-1 May Mediate Effects of Gastric Bypass on CNS Activation

THURSDAY, Nov. 2, 2017 (HealthDay News) -- The central effects of glucagon-like peptide-1 (GLP-1) may mediate the effects of Roux-en-Y gastric bypass (RYGB) on central nervous system (CNS) activation in response to visual and gustatory food cues, according to a study published online Oct. 12 in Diabetes Care.

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Driving Impairment Warnings Often Not Given With Rx Meds

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Not all prescription drug users report receiving warnings about driving impairment, according to a study published online Nov. 1 in the Journal of Studies on Alcohol and Drugs.

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Connective Tissue Disease May Raise Post-Abdominoplasty Risks

THURSDAY, Nov. 2, 2017 (HealthDay News) -- Patients with autoimmune connective tissue diseases (CTDs) undergoing abdominoplasty have increased risk of venous thromboembolism (VTE) events and need for blood transfusions compared to those without CTDs, according to a research letter published online Nov. 1 in JAMA Surgery.

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CMS Launches Initiative to Examine Impact of Regulations

WEDNESDAY, Nov. 1, 2017 (HealthDay News) -- The Centers for Medicare & Medicaid Services (CMS) has launched an initiative to examine which provider regulations should be discarded or revamped amid concerns that the regulations are reducing the amount of time that physicians spend with patients, according to an article published in Modern Healthcare.

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Updated Guidelines Released for Ventricular Arrhythmias

WEDNESDAY, Nov. 1, 2017 (HealthDay News) -- The American College of Cardiology, the American Heart Association, and the Heart Rhythm Society have released updated guidelines for the management of adults who have ventricular arrhythmias (VAs) or who are at risk for sudden cardiac death (SCD). The guidelines were published online Oct. 30 in the Journal of the American College of Cardiology.

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