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February 2018 Briefing – Surgery

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

Alternatives to Whole Liver Transplants Feasible for Children

WEDNESDAY, Feb. 28, 2018 (HealthDay News) — Alternatives to whole liver transplants for children have become safer, according to a study published recently in The Journal of Pediatrics.

Sleeve Gastrectomy Linked to Improved Glycemia in Mice

WEDNESDAY, Feb. 28, 2018 (HealthDay News) — Sleeve gastrectomy (SG) is associated with an improvement in glycemia, via increased insulin sensitivity, according to a study published online Feb. 23 in Diabetes.

RBC, Plasma Transfusions Drop From 2011 to 2014

TUESDAY, Feb. 27, 2018 (HealthDay News) — From 2011 to 2014, there were decreases in red blood cell (RBC) and plasma transfusions among hospitalized patients, according to a research letter published in the Feb. 27 issue of the Journal of the American Medical Association.

Early Studies Often Show Exaggerated Treatment Effect

TUESDAY, Feb. 27, 2018 (HealthDay News) — Trials to evaluate drugs or devices used to treat chronic medical conditions that are published early in the chain of evidence often show an exaggerated treatment effect compared with subsequent trials, according to research published online Feb. 21 in the Mayo Clinical Proceedings.

Race, Insurance Status Affects Job Status After Breast Cancer

TUESDAY, Feb. 27, 2018 (HealthDay News) — Diminished employment two years after early-stage breast cancer diagnosis is associated with African-American race and uninsured or publicly insured status, according to a study published online Feb. 13 in Cancer.

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CABG May Be Best for Patients With DM, LV Dysfunction

TUESDAY, Feb. 27, 2018 (HealthDay News) — Coronary artery bypass grafting (CABG) is associated with a significant reduction in major adverse cardiac and cerebrovascular events and mortality compared with percutaneous coronary intervention (PCI) among patients with diabetes mellitus (DM), multivessel coronary artery disease (CAD), and left ventricular dysfunction (LVD), according to a study published in the Feb. 27 issue of the Journal of the American College of Cardiology.

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Understanding Rx Nonadherence Can Improve Adherence

MONDAY, Feb. 26, 2018 (HealthDay News) — Understanding nonadherence in patients and encouraging a change in attitude toward patients and their medication can improve medication adherence, according to a report published by the American Medical Association (AMA).

Recommendations for Optimizing Hidden Curriculum in Medicine

MONDAY, Feb. 26, 2018 (HealthDay News) — In a position paper published online Feb. 27 in the Annals of Internal Medicine, the American College of Physicians (ACP) presents recommendations for optimizing clinical learning environments by fostering a positive hidden curriculum in medicine.

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Factors for Poor HRQOL ID’d in Patients Treated for Glaucoma

MONDAY, Feb. 26, 2018 (HealthDay News) — Reduced health-related quality of life (HRQOL) in surgically and medically treated patients with glaucoma is associated with factors including worse diplopia, poorer visual acuity in either eye, and treatment type, according to a study published online Feb. 22 in JAMA Ophthalmology.

FDA Warns of Possible Heart Risks Linked to Clarithromycin

FRIDAY, Feb. 23, 2018 (HealthDay News) — The antibiotic clarithromycin (brand name: Biaxin) may increase the long-term risk of heart problems and death in patients with heart disease, according to U.S. health officials.

Artificial Intelligence May Help Prevent Physician Burnout

FRIDAY, Feb. 23, 2018 (HealthDay News) — Artificial intelligence (AI), in which computers can be trained to recognize patterns in large quantities of data, may be able to reduce physicians’ burdens, saving them time and energy, according to a report published in Medical Economics.

Peds Cardiac Surgery Outcomes Vary by Neighborhood Income

FRIDAY, Feb. 23, 2018 (HealthDay News) — Children undergoing cardiac surgery from the lowest-income neighborhoods have worse outcomes, according to a study published online Feb. 22 in Pediatrics.

Second-Gen Drug-Eluting Stents Similarly Effective for LMCAD

FRIDAY, Feb. 23, 2018 (HealthDay News) — There are few significant differences in target-vessel failure with different types of second-generation drug-eluting stents (DES) for obstructive left main coronary artery disease (LMCAD), according to a study published in the Feb. 27 issue of the Journal of the American College of Cardiology.

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Risk Factors for Recurrence of Acute Diverticulitis Identified

THURSDAY, Feb. 22, 2018 (HealthDay News) — Certain patient factors increase the risk of recurrent acute diverticulitis, according to a study published in the March issue of Diseases of the Colon & Rectum.

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Neurosurgery Residents Burned Out, but Satisfied With Career

THURSDAY, Feb. 22, 2018 (HealthDay News) — Rates of burnout and career satisfaction are both high among neurosurgery residents, according to a study published online Feb. 9 in the Journal of Neurosurgery.

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GI Surgical Site Infections Higher in Low-Income Countries

WEDNESDAY, Feb. 14, 2018 (HealthDay News) — The burden of surgical site infection (SSI) after gastrointestinal surgery is greater for countries with low income as classified by the U.N. Human Development Index (HDI), according to a study published online Feb. 13 in The Lancet Infectious Diseases.

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CDC: No Change in Percentage of Uninsured in U.S. From ’16 to ’17

THURSDAY, Feb. 22, 2018 (HealthDay News) — The percentage of uninsured U.S. persons of all ages did not change significantly from 2016 to the first nine months of 2017, according to a report published online Feb. 22 by the National Center for Health Statistics.

Odds of ARDS Up After Cardiac Surgery During Flu Season

WEDNESDAY, Feb. 21, 2018 (HealthDay News) — Undergoing cardiac surgery during the influenza season is associated with increased likelihood of development of acute respiratory distress syndrome (ARDS), according to a research letter published in the Feb. 21 issue of the New England Journal of Medicine.

Aspirin, Rivaroxaban Similar After Total Hip, Knee Arthroplasty

WEDNESDAY, Feb. 21, 2018 (HealthDay News) — For patients who have undergone total hip or knee arthroplasty, extended prophylaxis with aspirin does not differ significantly from rivaroxaban for venous thromboembolism prevention, according to a study published in the Feb. 21 issue of the New England Journal of Medicine.

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Perioperative Glucose but Not A1C Predicts Surgical Outcomes

WEDNESDAY, Feb. 21, 2018 (HealthDay News) — Perioperative glucose predicts 30-day mortality linearly in noncardiac surgical patients and nonlinearly in cardiac surgical patients, according to a study published online Feb. 13 in Diabetes Care.

Online Tool Aids Decision Making About Breast Cancer Treatment

WEDNESDAY, Feb. 21, 2018 (HealthDay News) — The interactive iCanDecide breast cancer treatment decision tool can improve high-quality decision making about breast cancer surgical treatment, according to a study published online Jan. 24 in the Journal of Clinical Oncology.

Burnout Found Prevalent Among Doctors in Single Health System

TUESDAY, Feb. 20, 2018 (HealthDay News) — Burnout is prevalent among physicians, affecting over one-third of physicians in a single health system, and is associated with health care delivery, according to a research letter published online Feb. 19 in JAMA Internal Medicine.

Bariatric Surgery Linked to Discontinuing Diabetes Meds

FRIDAY, Feb. 16, 2018 (HealthDay News) — Antidiabetes treatment discontinuation rates are higher for obese individuals undergoing bariatric surgery, according to a study published online Feb. 14 in JAMA Surgery.

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Patients Want Physicians to Have Greater Connectivity

THURSDAY, Feb. 15, 2018 (HealthDay News) — Most patients want greater connectivity, online tools and text messaging, as well as more time with their physicians, according to a report published in Medical Economics.

Patients Often Mispredict Well-Being After Mastectomy

THURSDAY, Feb. 15, 2018 (HealthDay News) — Adult women undergoing mastectomy underestimate future well-being after mastectomy alone and overestimate well-being after reconstruction, according to a study published online Feb. 7 in JAMA Surgery.

New Tool Measures Impact of Brachial Plexus Injury

THURSDAY, Feb. 15, 2018 (HealthDay News) — A new questionnaire can measure the impact of brachial plexus injury (BPI) and assess surgical outcomes, according to a study published in the Feb. 7 issue of the Journal of Bone & Joint Surgery.

Opioids Plus Acetaminophen, Ketorolac Cost-Effective Post-Sx

THURSDAY, Feb. 15, 2018 (HealthDay News) — Intravenous acetaminophen with or without ketorolac is associated with reduced opioid consumption and cost of care after scoliosis surgery in adolescents, compared with opioids alone, according to a study published online Jan. 29 in Pediatric Anesthesia.

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Greater Weight Loss With RYGB in Obese With T2DM at Three Years

WEDNESDAY, Feb. 14, 2018 (HealthDay News) — For obese adults with type 2 diabetes, Roux-en-Y gastric bypass (RYGB) surgery is associated with greater weight loss, lower hemoglobin A1c (HbA1c), and reduced cardiovascular risk compared with intensive medical diabetes and weight management (IMWM), according to a study published online Feb. 6 in Diabetes Care.

Four Best Practices Outlined to Prevent Health Care Cyberattacks

TUESDAY, Feb. 13, 2018 (HealthDay News) — Four best practices outlined that can help prevent health care cyberattacks, which increased from 2016 to 2017, according to a report published in Managed Healthcare Executive.

Risk Tool Predicts Pressure Injuries in Hospitalized Children

TUESDAY, Feb. 13, 2018 (HealthDay News) — The Braden QD Scale reliably predicts both immobility-related and device-related pressure injuries in hospitalized pediatric patients, according to a study published in the January issue of the Journal of Pediatrics.

Pre-Op Weight Loss Improves Outcomes of Bariatric Surgery

TUESDAY, Feb. 13, 2018 (HealthDay News) — Excess weight loss (EWL) immediately preceding bariatric surgery is associated with improved outcomes, according to a study published online Feb. 2 in the Journal of the American College of Surgeons.

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USPSTF Recommends Against Ovarian Cancer Screening

TUESDAY, Feb. 13, 2018 (HealthDay News) — The U.S. Preventive Services Task Force (USPSTF) recommends against screening for ovarian cancer in asymptomatic women. These findings form the basis of a final recommendation statement published in the Feb. 13 issue of the Journal of the American Medical Association.

Evidence Report

Final Recommendation Statement

EHRs Not Sufficient to Ensure Success in Value-Based Care

MONDAY, Feb. 12, 2018 (HealthDay News) — Electronic health records (EHRs) are not sufficient to ensure success in value-based care, according to an article published in Medical Economics.

Limited Opioid Prescribing Among Dermatologists

MONDAY, Feb. 12, 2018 (HealthDay News) — Opioid prescribing among dermatologists is limited, with most of the top prescribing dermatologists working in surgical practice, according to research published online Feb. 7 in JAMA Dermatology.

Injury Scene Characteristics Linked to Injury Mortality

FRIDAY, Feb. 9, 2018 (HealthDay News) — The characteristics of an injury scene are associated with injury mortality, with increased odds of death linked to increased distance to the nearest trauma center, according to a study published online Feb. 7 in JAMA Surgery.

Top Consumer Concerns Reported About Physicians

FRIDAY, Feb. 9, 2018 (HealthDay News) — Health care consumers have four major concerns regarding their physicians, according to a report published by Managed Healthcare Executive.

Approach Offers Regional Control of HPV-Related Head, Neck CA

FRIDAY, Feb. 9, 2018 (HealthDay News) — Good regional control can be achieved with up-front surgery and adjuvant therapy for patients with invasive nodal disease from oropharyngeal squamous cell carcinoma (SCC) related to human papillomavirus (HPV), according to a study published online Jan. 29 in Head & Neck.

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Poll: Personal Beliefs Shouldn’t Allow Doctors to Refuse to Treat

THURSDAY, Feb. 8, 2018 (HealthDay News) — Most people do not believe that professionals including health care providers should be allowed to refuse to provide services based on their conscience or beliefs, according to a recent HealthDay/The Harris Poll.

Active Surveillance OK for Non-Muscle Invasive Bladder Cancer

THURSDAY, Feb. 8, 2018 (HealthDay News) — For patients with non-muscle invasive bladder cancer, active surveillance seems reasonable and cost-effective, according to a study published in the February issue of The Journal of Urology.

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PFO Linked to Ischemic Stroke Risk After Non-Cardiac Surgery

TUESDAY, Feb. 6, 2018 (HealthDay News) — For adults undergoing non-cardiac surgery, having a preoperatively diagnosed patent foramen ovale (PFO) is associated with increased risk of perioperative ischemic stroke, according to a study published in the Feb. 6 issue of the Journal of the American Medical Association.

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Head, Neck Imaging Uncommon in Patients With Palate Trauma

TUESDAY, Feb. 6, 2018 (HealthDay News) — Patients presenting to the emergency department with a primary diagnosis of palate trauma often do not undergo head and neck imaging, according to a study published online Feb. 1 in JAMA Otolaryngology-Head and Neck Surgery.

Telementoring Becoming Practical for Robotic Urological Surgery

MONDAY, Feb. 5, 2018 (HealthDay News) — Telementoring and telesurgery for minimally invasive urological surgery are becoming more practical and cost-effective, according to a review published in the February issue of The Journal of Urology.

Opioid Prescribing Trends in the VA Similar to Other Settings

MONDAY, Feb. 5, 2018 (HealthDay News) — Opioid prescribing trends in the Veterans Health Administration (VHA) from 2010 to 2016 followed similar trajectories as non-VHA settings, peaking around 2012 then declining, according to a study published online Jan. 29 in the Journal of General Internal Medicine.

Distance From Advanced Cardiac Care Affects Odds of Survival

MONDAY, Feb. 5, 2018 (HealthDay News) — In patients with acute coronary syndromes (ACS) complicated by cardiogenic shock (CS) in Nova Scotia, Canada, access to cardiac catheterization independently predicts survival, but those farthest from the center offering cardiac catheterization are the least likely to be transferred, according to a study published recently in the Canadian Journal of Cardiology.

Humanities Exposure Positively Impacts Medical Students

MONDAY, Feb. 5, 2018 (HealthDay News) — Exposure to the humanities correlates with less burnout and higher levels of positive personal qualities among medical students, according to a study published online Jan. 29 in the Journal of General Internal Medicine.

Pre-Op Exercise in Lung Cancer Patients Halves Complications

FRIDAY, Feb. 2, 2018 (HealthDay News) — Preoperative exercise halves the rate of postoperative complications in patients with lung cancer, according to a review published Feb. 1 in the British Journal of Sports Medicine.

2010 to 2013 Saw Increase in Laparoscopic Hysterectomies

FRIDAY, Feb. 2, 2018 (HealthDay News) — Laparoscopy became the most common surgical approach for hysterectomy between 2010 and 2013, with associated changes in payments statistics for hysterectomy, according to a study published recently in the American Journal of Obstetrics and Gynecology.

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Factors Identified That Impact Physicians IT Adoption

FRIDAY, Feb. 2, 2018 (HealthDay News) — Physicians have considerable concerns about the efficacy and evidence base of health information technology (IT), according to a report published by the American Medical Association (AMA).

Depression Ups Mortality Risk Post Aortic Valve Replacement

FRIDAY, Feb. 2, 2018 (HealthDay News) — The presence of depressive symptoms among older adults undergoing transcatheter (TAVR) or surgical (SAVR) aortic valve replacement increases the risk of mortality, according to research published online Jan. 17 in JAMA Cardiology.

Estimated Biopsy Rate Varies After Breast Cancer Treatment

FRIDAY, Feb. 2, 2018 (HealthDay News) — The estimated biopsy rate after breast cancer treatment varies, according to a study published online Jan. 31 in JAMA Surgery.

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Patients, Doctors Often Disagree About Surgical Scar Evaluation

THURSDAY, Feb. 1, 2018 (HealthDay News) — Patients and physicians disagree about evaluation of surgical scars, according to a review published online Feb. 1 in JAMA Facial Plastic Surgery.

Medicaid Expansion Cuts Out-of-Pocket Spending

THURSDAY, Feb. 1, 2018 (HealthDay News) — States that expanded Medicaid cut the probability of non-elderly near-poor adults being uninsured and lowered average out-of-pocket spending, according to a study published online Jan. 24 in Health Affairs.

Persistent Pain Common 1 Month After Elective Pediatric Surgery

THURSDAY, Feb. 1, 2018 (HealthDay News) — Many pediatric patients have persistent pain after common ambulatory surgeries, according to a study published online Jan. 20 in Pediatric Anesthesia.

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