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August 2018 Briefing - Surgery

Last Updated: September 04, 2018.

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

Preemptive Analgesia May Cut Post-Op Pain in Anorectal Surgery

FRIDAY, Aug. 31, 2018 (HealthDay News) -- Preemptive pain medication is safe and reduces pain in the early postoperative period for patients undergoing anorectal surgery, according to a study published in the July issue of Diseases of the Colon & Rectum.

Abstract/Full Text (subscription or payment may be required)

Medical Bills in Collections Decrease With Patient Age

FRIDAY, Aug. 31, 2018 (HealthDay News) -- Medical collections decrease substantially with age, possibly because of increased health insurance coverage and incomes, according to a study published in the August issue of Health Affairs.

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Mindfulness Training Acceptable Among Surgical Interns

FRIDAY, Aug. 31, 2018 (HealthDay News) -- Formal mindfulness-based stress reduction (MBSR) appears to be both feasible and acceptable to surgical interns, according to a pilot study published online Aug. 29 in JAMA Surgery.

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Editorial (subscription or payment may be required)

No Meaningful Increase in Physician Compensation Last Year

THURSDAY, Aug. 30, 2018 (HealthDay News) -- There was no meaningful increase in physician compensation in 2017, and a decline in productivity was noted, according to the results of a survey conducted by AMGA Consulting.

Press Release
Survey (subscription or payment may be required)

U.S. Opioid Use Not Declining, Despite Focus on Abuse

WEDNESDAY, Aug. 29, 2018 (HealthDay News) -- Rates of opioid use in the United States do not appear to be declining, according to a study published online Aug. 1 in The BMJ.

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Marketplace Premiums Increase More With Monopolist Insurers

WEDNESDAY, Aug. 29, 2018 (HealthDay News) -- Affordable Care Act Marketplace premiums increase more in areas with monopolist insurers, according to a study published in the August issue of Health Affairs.

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PT Better After Hip Surgery Than Opioids in Younger Adults

WEDNESDAY, Aug. 29, 2018 (HealthDay News) -- Physical therapy management is associated with better outcomes for young patients undergoing arthroscopic hip surgery, compared to primary or exclusive opioid treatment, according to a study recently published in Physical Therapy.

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Wording Used May Affect Thyroid Cancer Patients' Anxiety, Choices

WEDNESDAY, Aug. 29, 2018 (HealthDay News) -- The terminology used to describe small papillary thyroid cancers (PTCs) may affect patients' anxiety levels and treatment choices, according to a study published online Aug. 23 in JAMA Otolaryngology-Head & Neck Surgery.

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Editorial

Medical Practices Should Address Negative Online Reviews

TUESDAY, Aug. 28, 2018 (HealthDay News) -- Medical practice staff can effectively handle negative online reviews by staying calm and positive, looking for solutions, apologizing, and thanking the reviewers, according to an article published in Physicians Practice.

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Skin Microbiota Differ for Obese, Non-Obese Undergoing C-Section

TUESDAY, Aug. 28, 2018 (HealthDay News) -- After cesarean delivery (CD), the incision site harbors a higher bacterial biomass in obese women than in non-obese women, according to a study recently published in Scientific Reports.

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Artificial Intelligence Holds Promise in Medicine

TUESDAY, Aug. 28, 2018 (HealthDay News) -- Artificial intelligence (AI) in health care offers opportunities for early detection and triage, diagnostics and personalized medicine, and medical decision-making, according to an article published in Managed Healthcare Executive.

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Alcohol Is Leading Risk Factor for Global Disease Burden

TUESDAY, Aug. 28, 2018 (HealthDay News) -- Globally, alcohol use is a leading risk factor for disease burden, according to research published online Aug. 23 in The Lancet.

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Editorial

Experts Address Loss of the National Guideline Clearinghouse

TUESDAY, Aug. 28, 2018 (HealthDay News) -- The demise of the National Guideline Clearinghouse (NGC) in July 2018 is likely to impact evidence-based health care around the world, according to an Ideas and Opinions piece published online Aug. 28 in the Annals of Internal Medicine.

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Bigger Drop in Opioid Prescribing After CDC Guideline Release

MONDAY, Aug. 27, 2018 (HealthDay News) -- Release of the U.S. Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain in March 2016 corresponded to greater increases in several opioid prescribing patterns, according to a study published online Aug. 28 in the Annals of Internal Medicine.

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Most Research Participants Not Concerned About Data Sharing

MONDAY, Aug. 27, 2018 (HealthDay News) -- Few participants in clinical trials have strong concerns about the risks of data sharing, according to a special article recently published in the New England Journal of Medicine.

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Prescription Drug Monitoring Program May Not Cut Opioid Use

MONDAY, Aug. 27, 2018 (HealthDay News) -- Implementation of a mandatory prescription drug monitoring program (PDMP) does not necessarily reduce the overall rate of opioid prescribing or the mean number of pills prescribed for patients undergoing general surgical procedures, according to a study published online Aug. 22 in JAMA Surgery.

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AMA Adopts Policy Promoting Health Equity As a Goal

FRIDAY, Aug. 24, 2018 (HealthDay News) -- The American Medical Association (AMA) House of Delegates has adopted a policy that sets health equity as a goal for the U.S. health care system, according to a report published in the organization's AMA Wire.

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Decline in Hospital-Acquired Conditions Continues

FRIDAY, Aug. 24, 2018 (HealthDay News) -- The rate of hospital-acquired conditions (HACs) continued its decline from 2014 to 2016, according to the Agency for Healthcare Research and Quality (AHRQ) National Scorecard on Hospital-Acquired Conditions.

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Hydrocodone Schedule Change Affected Post-Op Opioid Rx

FRIDAY, Aug. 24, 2018 (HealthDay News) -- Hydrocodone's change from schedule III to schedule II in 2014 was associated with an increase in the amount of opioids filled in the initial prescription after surgery, according to a study published online Aug. 22 in JAMA Surgery.

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Lower Post-Op Mortality With Hip Fx Surgery on Day of Admission

FRIDAY, Aug. 24, 2018 (HealthDay News) -- Postoperative mortality is lower for medically stable older patients who undergo surgery for hip fracture on the day of admission or the following day, according to a study published in the Aug. 7 issue of CMAJ, the journal of the Canadian Medical Association.

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Most Surgical Residents Want Financial Education

THURSDAY, Aug. 23, 2018 (HealthDay News) -- Surgical residents feel strongly that personal financial education should be offered during medical training, according to a study published in the August issue of the Journal of the American College of Surgeons.

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Small Practices Also at Risk for Data Breaches

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- Data breaches can happen to small medical practices, but staff can take steps to prevent them, according to an article published in Medical Economics.

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Strategy Outlined for Shooter Incident in Health Care Facility

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- Adhering to a "secure, preserve, fight" strategy is recommended for health care professionals working with a vulnerable patient population, according to a Medicine and Society piece published in the Aug. 9 issue of the New England Journal of Medicine.

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National Provider Identifiers Are Vulnerable to Theft

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- National Provider Identifiers (NPIs) are vulnerable to identity theft, according to an article published in Physicians Practice.

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Advantages for HDHP Enrollees in Large Versus Small Firms

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- Workers in small firms are more likely to have higher deductible levels and lack employer contributions to help pay for out-of-pocket expenses compared to workers in larger firms, according to a study published in the August issue of Health Affairs.

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Similar Outcomes for Rural, Urban Cancer Patients in SWOG Trials

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- Rural and urban cancer patients with uniform care access through participation in a SWOG (formerly the Southwest Oncology Group) treatment trial have similar outcomes, according to a study published online Aug. 17 in JAMA Network Open.

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Editorial

Doctors Often Not Discussing Risk Factors With Patients

TUESDAY, Aug. 21, 2018 (HealthDay News) -- Patients report that doctors are routinely not discussing known risk factors for common causes of death, according to a survey conducted by ImagineMD.

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Pennsylvania Case Could Affect Evidence for Malpractice Defense

TUESDAY, Aug. 21, 2018 (HealthDay News) -- The Pennsylvania Supreme Court has agreed to hear a case that could affect what evidence physicians may present in defense during medical malpractice suits, according to an article published in the American Medical Association's AMA Wire.

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Hypnosis Doesn't Cut Post-Op Pain in Breast Cancer Surgery

TUESDAY, Aug. 21, 2018 (HealthDay News) -- Hypnosis before general anesthesia does not reduce postoperative breast pain among patients undergoing minor breast cancer surgery, according to a study published online Aug. 17 in JAMA Network Open.

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Sentinel Lymph Node Mapping Most Cost-Effective for Uterine CA

TUESDAY, Aug. 21, 2018 (HealthDay News) -- Sentinel lymph node mapping has the lowest costs and highest quality-adjusted survival compared to both routine and selective lymphadenectomy for managing low-risk endometrial carcinoma, according to a study published in the July issue of Obstetrics & Gynecology.

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Experts Offer Tips for Provider Appeal of Denied Medical Claims

MONDAY, Aug.20, 2018 (HealthDay News) -- Knowing payer policies and regulatory requirements is critical to appealing denials, according to an article published in Medical Economics.

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NYU Becomes First Medical School to Cover All Tuition

MONDAY, Aug. 20, 2018 (HealthDay News) -- The NYU School of Medicine has announced that it is offering full-tuition scholarships to all current and future students in its M.D. degree program, regardless of need or merit.

Press Release

Lumpectomy + Radiation May Cut Breast Cancer Mortality in DCIS

MONDAY, Aug. 20, 2018 (HealthDay News) -- Treatment with lumpectomy and radiotherapy is associated with a reduction in breast cancer mortality versus lumpectomy or mastectomy alone among patients with ductal carcinoma in situ (DCIS), according to a study published online Aug. 10 in JAMA Network Open.

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Editorial

Residents' Sleep Deteriorates During Training

FRIDAY, Aug. 17, 2018 (HealthDay News) -- First-year residents experience worsening sleep duration and quality as well as daytime sleepiness, according to a study published in the June issue of the Journal of General Internal Medicine.

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Editorial (subscription or payment may be required)

Practice Names, Logos Should Be Carefully Designed

THURSDAY, Aug. 16, 2018 (HealthDay News) -- Practice names and logos should be carefully designed to emphasize what is unique about a practice, according to a blog post published in Physicians Practice.

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Steps Provided for Discharging Patient From Practice

THURSDAY, Aug. 16, 2018 (HealthDay News) -- Certain steps should be taken when discharging a patient for failure or inability to meet financial obligations, according to an article published in Physicians Practice.

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Patient Portals Don't Appear to Have Much Traction

THURSDAY, Aug. 16, 2018 (HealthDay News) -- Patient portals have not taken off as expected, according to an article published in Medical Economics.

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ACA Coverage Gains Include Workers Without Insurance

THURSDAY, Aug. 16, 2018 (HealthDay News) -- After the expanded coverage provisions of the Affordable Care Act (ACA) were implemented in 2014, self-employed individuals and wage earners without employer-sponsored health coverage offers had coverage gains equal to or greater than those of people not employed, according to a report published in the August issue of Health Affairs.

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Opioid Dependence More Common Before Spine Surgery

THURSDAY, Aug. 16, 2018 (HealthDay News) -- Opioid dependence is more likely to occur in patients with degenerative spondylolisthesis (DS) before surgery than afterward, according to a study recently published in the Journal of Neurosurgery: Spine.

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Liposomal Bupivacaine Block No Aid for Cesarean Pain

THURSDAY, Aug. 16, 2018 (HealthDay News) -- A liposomal bupivacaine incisional block at the time of cesarean delivery does not improve pain scores in the first 48 hours postoperatively, according to a study published in the July issue of Obstetrics & Gynecology.

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Reasons for Undergoing Cosmetic Procedures Explored

WEDNESDAY, Aug. 15, 2018 (HealthDay News) -- As well as enhancing physical appearance, patients seek cosmetic procedures for emotional and psychosocial reasons, according to a study published online Aug. 15 in JAMA Dermatology.

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Trauma Surgery Association IDs Steps to Curb Firearm Violence

TUESDAY, Aug. 14, 2018 (HealthDay News) -- The American Association for the Surgery of Trauma (AAST) has set out a manifesto to halt "senseless" firearm violence and injury, according to a statement published online Aug. 8 in Trauma Surgery & Acute Care Open.

AAST Statement

6 Factors Related to Inclusion in Health Care Workplace ID'd

TUESDAY, Aug. 14, 2018 (HealthDay News) -- There are six broad factors that can affect inclusion within health care organizations, according to a study published online Aug. 3 in JAMA Network Open.

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Four Pros to Integrating EHR, Practice Management Software

MONDAY, Aug. 13, 2018 (HealthDay News) -- Consolidating electronic health records and practice management software allows practices to save time and money, make fewer mistakes, and reduce the risk of privacy breaches, according to an article published in Physicians Practice.

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Sedation Level Doesn't Impact Delirium Risk After Hip Fx Repair

MONDAY, Aug. 13, 2018 (HealthDay News) -- For older patients undergoing hip fracture repair, the level of sedation does not impact delirium risk overall, according to a study published online Aug. 8 in JAMA Surgery.

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Bariatric Surgery Lowers Microvascular Disease Risk

MONDAY, Aug. 13, 2018 (HealthDay News) -- Bariatric surgery is tied to lower overall incidence of microvascular disease in patients with type 2 diabetes mellitus (T2DM), according to a study published online Aug. 7 in the Annals of Internal Medicine.

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Editorial (subscription or payment may be required)

C. difficile Tied to Increased Graft Loss in Solid Organ Recipients

MONDAY, Aug. 13, 2018 (HealthDay News) -- For solid organ transplant (SOT) recipients, Clostridium difficile infection (CDI) is associated with increased graft loss, according to a study published in the July issue of the American Journal of Transplantation.

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Military-Civilian Trauma System Partnership Developed

FRIDAY, Aug. 10, 2018 (HealthDay News) -- A growing partnership between the Military Health System and permanent civilian trauma institutions is being fostered, according to an article published in the August issue of the Journal of the American College of Surgeons.

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ACS Briefing Discusses Use of Lessons From Combat Care

FRIDAY, Aug. 10, 2018 (HealthDay News) -- The American College of Surgeons (ACS) hosted a briefing on Capitol Hill to discuss the successes and challenges of combat casualty care in Iraq and Afghanistan by the U.S. military, and how an integrated military-civilian trauma system can help save the lives of both soldiers and civilians.

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Childbearing Surgical Residents Often Feel Career Dissatisfaction

FRIDAY, Aug. 10, 2018 (HealthDay News) -- More than half of women who have a baby during surgical residency express some type of career dissatisfaction, according to a study published online Aug. 1 in JAMA Surgery.

Abstract/Full Text (subscription or payment may be required)

AMA Adopts Policy on Augmented Intelligence

FRIDAY, Aug. 10, 2018 (HealthDay News) -- The American Medical Association (AMA) House of Delegates has adopted a policy on augmented intelligence, according to a report published in the association's AMA Wire.

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AMA Adopts Policy to Advance Gender Equity in Medicine

THURSDAY, Aug. 9, 2018 (HealthDay News) -- The American Medical Association (AMA) House of Delegates has adopted a new policy to study, act for, and advocate to advance gender equity in medicine, according to a report published in the association's AMA Wire.

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Infection Prevention Differs Between Small, Large Hospitals

THURSDAY, Aug. 9, 2018 (HealthDay News) -- Small and large hospitals differ in infection preventionist (IP) staffing and infection prevention and control (IPC) resources, according to a study published in the August issue of the American Journal of Infection Control.

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Revision Rates for Arthritis-Related Hip Replacement Down

THURSDAY, Aug. 9, 2018 (HealthDay News) -- Use of cross-linked polyethylene (XLPE) has significantly reduced the revision rate following total hip arthroplasty (THA) for osteoarthritis, according to a study published in the Aug. 1 issue of the Journal of Bone & Joint Surgery.

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Editorial

Inducing Labor at Term Appears to Reduce Cesarean Risk

WEDNESDAY, Aug. 8, 2018 (HealthDay News) -- Inducing labor at 39 weeks may decrease the risk of cesarean section, according to a study published in the Aug. 9 issue of the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Cyber Insurance Recommended for All Physician Practices

WEDNESDAY, Aug. 8, 2018 (HealthDay News) -- The growing threat of hacking is increasing the number of physicians buying cyber insurance, according to an article published in Medical Economics.

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Resource Use Greater for More Severe Pediatric Appendicitis

WEDNESDAY, Aug. 8, 2018 (HealthDay News) -- More severe presentations of complicated appendicitis are associated with worse outcomes and greater resource use among pediatric patients, according to a study published online July 25 in JAMA Surgery.

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Editorial (subscription or payment may be required)

One-Third of Canadian Patients Get Hip Fx Repair Within 24 Hours

WEDNESDAY, Aug. 8, 2018 (HealthDay News)-- Only one-third of Canadian patients received hip fracture repair surgery within the desired 24 hours, according to a Canadian study published in the June 11 issue of CMAJ, the journal of the Canadian Medical Association.

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Steps Taken to Increase Use of Electronic Tools in Medicine

WEDNESDAY, Aug. 8, 2018 (HealthDay News) -- Additional codes have been approved by the Current Procedural Terminology (CPT) Editorial Panel for chronic care remote physiologic monitoring and internet consultations, according to a report published by the American Medical Association (AMA).

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AMA Proposes Policy Opposing Medicaid 'Lockout' Provisions

TUESDAY, Aug. 7, 2018 (HealthDay News) -- A new policy opposing lockout provisions that block Medicaid patients from the program for lengthy periods and instead supporting allowing patients to reapply immediately for redetermination was adopted by the American Medical Association (AMA) House of Delegates during the AMA's annual meeting in Chicago, according to an article published in the association's AMA Wire.

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Overtreatment of Thyroid Cancers Seems Common

TUESDAY, Aug. 7, 2018 (HealthDay News) -- Overtreatment of thyroid cancers is common, according to a perspective article published in the July 25 issue of the New England Journal of Medicine.

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Routine X-Ray Not Needed After US-Guided Central Line Insertion

TUESDAY, Aug. 7, 2018 (HealthDay News) -- Pneumothorax and catheter misplacement after ultrasound-guided central venous catheter (CVC) insertion are rare and thus do not justify post-procedural chest X-ray (CXR), according to a study published in the July issue of CHEST.

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Most Online Reviews for Spine Surgeons Are Surgeon-Dependent

TUESDAY, Aug. 7, 2018 (HealthDay News) -- Spine surgeons are more likely to receive favorable online reviews for factors pertaining to outcomes and likeability/character and negative reviews based on ancillary staff interactions and office environment, according to a study published online July 2 in Spine.

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Death Records Estimate 1,139 Deaths Due to Hurricane Maria

TUESDAY, Aug. 7, 2018 (HealthDay News) -- Based on death records following Hurricane Maria, the hurricane-related mortality burden of excess deaths through December 2017 is estimated to be 1,139, higher than the official death toll of 64, according to a research letter published online Aug. 2 in the Journal of the American Medical Association.

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Many Youths Believe Gun Control Would Decrease Mass Shootings

MONDAY, Aug. 6, 2018 (HealthDay News) -- Most youths in a recent survey support the right to own guns, but the majority believe that gun control laws would reduce mass shootings, according to a research letter published online July 30 in JAMA Pediatrics.

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Good Outcomes for HCV-Negative Recipients of HCV Kidneys

MONDAY, Aug. 6, 2018 (HealthDay News) -- Hepatitis C virus (HCV)-negative recipients of HCV-infected kidneys experience HCV cure and good quality of life, according to research published online Aug. 7 in the Annals of Internal Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Fewer Cervical Spine Injuries Seen With Motorcycle Helmet Use

MONDAY, Aug. 6, 2018 (HealthDay News) -- Cervical spine injuries occur less frequently among motorcycle crash victims who were wearing a helmet versus those not wearing a helmet at the time of injury, according to a study published in the June issue of the Journal of Neurosurgery: Spine.

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Surgical Price Transparency Tied to Improved Volume, Revenue

MONDAY, Aug. 6, 2018 (HealthDay News) -- Ambulatory surgery centers experience increases in patient volume, patient satisfaction, and revenue after adopting price transparency, according to a study published recently in The American Surgeon.

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Increase in Proportion of TAVR Used From 2012 to 2015

MONDAY, Aug. 6, 2018 (HealthDay News) -- From 2012 to 2015, there was an increase in the number of patients overall and age 65 years and younger receiving transcatheter aortic valve replacement (TAVR), according to a research letter published online July 23 in the Journal of the American Medical Association.

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Variation in Specialty Drug Coverage Across Health Plans

FRIDAY, Aug. 3, 2018 (HealthDay News) -- There is considerable variation in specialty drug coverage across commercial health plans, according to a study published in the July issue of Health Affairs.

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Some Bacteria Now More Tolerant of Alcohol-Based Sanitizers

FRIDAY, Aug. 3, 2018 (HealthDay News) -- Some types of bacteria are developing tolerance of alcohol-based hand sanitizers used in hospitals, according to a study published in the Aug. 1 issue of Science Translational Medicine.

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Ciprofloxacin May Up Likelihood of Aortic Dissection, Rupture

FRIDAY, Aug. 3, 2018 (HealthDay News) -- In a mouse model of moderate, sporadic aortic aneurysm and dissection (AAD), ciprofloxacin increases susceptibility to aortic dissection and rupture, according to a study published online July 25 in JAMA Surgery.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Groups Urge CMS to Reconsider Suspending Risk Adjustment

FRIDAY, Aug. 3, 2018 (HealthDay News) -- In a letter sent to Administrator Seema Verma of the Centers for Medicare & Medicaid Services (CMS), medical organizations are urging reconsideration of the decision to suspend payments to insurers as required under the Affordable Care Act's risk-adjustment program.

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Health Affairs Announces Launch of New Three-Year Initiative

THURSDAY, Aug. 2, 2018 (HealthDay News) -- A council on health care spending and value has been established by the journal Health Affairs.

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Three Financial Metrics Can Improve Practice Performance

THURSDAY, Aug. 2, 2018 (HealthDay News) -- By understanding three indices and metrics, physicians can change the financial outcome of their medical practice, according to a report published in Medical Economics.

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TGFB1 Mutation Ups Radiation-Induced Breast Fibrosis Risk

THURSDAY, Aug. 2, 2018 (HealthDay News) -- The C-509T allele in the promoter region of transforming growth factor β (TGFB1) is associated with radiation-induced breast fibrosis risk among patients with early-stage breast cancer, according to study published online July 19 in JAMA Oncology.

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New Short-Term Health Plans Have Large Coverage Gaps

THURSDAY, Aug. 2, 2018 (HealthDay News) -- There are large coverage gaps in short-term health plans that were approved Wednesday by the Trump administration, and are described by critics as "junk insurance."

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How Doctors Receive Feedback Is Key for Antimicrobial Programs

THURSDAY, Aug. 2, 2018 (HealthDay News) -- Anticipation of how providers will receive feedback is important for antimicrobial stewardship programs to consider in informing educational messaging, according to a study published online June 7 in Infection Control & Hospital Epidemiology.

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National Guideline Clearinghouse Offline Due to Funding Cuts

WEDNESDAY, Aug. 1, 2018 (HealthDay News) -- The National Guideline Clearinghouse (NGC) and National Quality Measures Clearinghouse (NQMC) websites were taken down on July 16 when funding for these federal databases ended, according to an announcement by the Agency for Healthcare Research and Quality (AHRQ).

Announcement
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Dog's Saliva Caused Bacterial Infection Leading to Amputations

WEDNESDAY, Aug. 1, 2018 (HealthDay News) -- A Wisconsin man had his lower legs and hands amputated after developing a rare blood infection caused by bacteria in dog saliva.

Washington Post Article
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Steps Can Be Taken by Doctors to Minimize Risk of Lawsuits

WEDNESDAY, Aug. 1, 2018 (HealthDay News) -- Targeted steps can be taken to minimize future risks of lawsuits, according to an article published in Physicians Practice.

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