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MONTHLY BRIEFINGS - Dec 2017


December 2017 Briefing - Surgery

Tue, Jan 2, 2018

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

Tips Offered for Patient-Provider Opioid Tapering Talks

THURSDAY, Dec. 28, 2017 (HealthDay News) -- Helping patients understand individualized reasons for opioid tapering and encouraging them to provide input into the process are key for patient-provider communications, according to a study published in the November issue of the Journal of Pain.

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Out-of-Pocket Costs Correlate With Receipt of Cancer Care

THURSDAY, Dec. 28, 2017 (HealthDay News) -- Across cancers, higher out-of-pocket (OOP) costs are associated with higher rates of oral prescription abandonment and delayed initiation, according to a study published online Dec. 20 in the Journal of Clinical Oncology.

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Reducing Tx May Harm Safety in Early HPV+ Oropharyngeal Cancer

WEDNESDAY, Dec. 27, 2017 (HealthDay News) -- For patients with human papillomavirus (HPV)+ stage I or II oropharyngeal cancer, deintensification of treatment from chemoradiotherapy to one modality may compromise safety, according to a study published online Dec. 15 in Cancer.

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Intrauterine Balloon Tamponade May Cut Invasive Procedures

WEDNESDAY, Dec. 27, 2017 (HealthDay News) -- For women undergoing vaginal delivery, the use of intrauterine balloon tamponade is associated with a significantly lower use of invasive procedures for hemorrhage control, according to a study published online Dec. 4 in Obstetrics & Gynecology.

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Preoperative G-Tube Placement Associated With Cost Savings

TUESDAY, Dec. 26, 2017 (HealthDay News) -- Preoperative placement of gastrostomy tubes (G-tubes) in patients with head and neck cancer yields cost savings, according to a study published online Nov. 13 in Head & Neck.

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Survival Down With Ventricular Arrhythmia Early Post CF-LVAD

TUESDAY, Dec. 26, 2017 (HealthDay News) -- For patients post contemporary continuous flow left ventricular assist device (CF-LVAD) implantation, early ventricular arrhythmias (VAs) are associated with significantly reduced survival, according to a study published online Dec. 20 in JACC: Clinical Electrophysiology.

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Normalized Post-Op CEA May Help Predict Colon Cancer Prognosis

TUESDAY, Dec. 26, 2017 (HealthDay News) -- Colon cancer patients with elevated preoperative carcinoembryonic antigen (CEA) levels that normalize after resection are not at increased risk for poor prognosis, according to a study published online Dec. 21 in JAMA Oncology.

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Gene Polymorphisms Linked to Risk of Chronic Post-Op Pain

TUESDAY, Dec. 26, 2017 (HealthDay News) -- Genetics may be a factor in the experience of chronic pain post surgery, according to a study published online Dec. 14 in Anesthesiology.

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Good Long-Term Survival After Childhood Liver Transplant

TUESDAY, Dec. 26, 2017 (HealthDay News) -- Liver transplantation in childhood is associated with good long-term survival, according to a study published online Dec. 15 in the American Journal of Transplantation.

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Early-Stage Cancer Diagnoses Up With ACA's Medicaid Expansions

THURSDAY, Dec. 21, 2017 (HealthDay News) -- In their first year, the 2014 Medicaid expansions, facilitated by the Affordable Care Act, were associated with an increase in cancer diagnoses, particularly at the early stage, according to a study published online Dec. 21 in the American Journal of Public Health.

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Cancer Probability Documentation Lacking for Some at High Risk

THURSDAY, Dec. 21, 2017 (HealthDay News) -- For patients with high-risk indeterminate pulmonary nodes (IPNs), physicians rarely provide quantitative documentation of cancer probability, according to a study published online Dec. 20 in JAMA Surgery.

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Findings Support Comprehensive Approach for Seniors With Cancer

THURSDAY, Dec. 21, 2017 (HealthDay News) -- Addressing persistent symptoms, managing comorbidities, promoting leisure-time physical activity, and addressing financial challenges are key in optimizing health-related quality of life (HRQOL) in older adults with cancer, according to a study published online Dec. 18 in Cancer.

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Financial Strain, Stress High Among Colorectal CA Survivors

THURSDAY, Dec. 21, 2017 (HealthDay News) -- Four in 10 colorectal cancer survivors report cancer-related financial stress or strain, which is significantly associated with low health-related quality of life, according to a study published in the January issue of Diseases of the Colon & Rectum.

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C7 Nerve Transfer Improves Function in Spastic Arm Paralysis

WEDNESDAY, Dec. 20, 2017 (HealthDay News) -- C7 nerve transfer is beneficial for patients with unilateral arm paralysis for more than five years, according to a study published online Dec. 20 in the New England Journal of Medicine.

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Levonorgestrel IUD Feasible for Low-Risk, Early Uterine Cancer

WEDNESDAY, Dec. 20, 2017 (HealthDay News) -- A levonorgestrel-releasing intrauterine device (LNG-IUD) is effective in the majority of patients undergoing conservative treatment for low-risk endometrial cancer and complex atypical hyperplasia, according to a case-series study published online Dec. 4 in Obstetrics & Gynecology.

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Femtosecond Laser Safer for Post-Vitrectomy Cataract Surgery

WEDNESDAY, Dec. 20, 2017 (HealthDay News) -- Femtosecond laser-assisted cataract surgery demonstrates comparable visual outcomes to conventional phacoemulsification, with a trend toward better intraoperative and postoperative safety, according to a study published online Dec. 14 in Clinical & Experimental Ophthalmology.

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Oral Care Guidelines Can Improve Quality of Oral Health Care

WEDNESDAY, Dec. 20, 2017 (HealthDay News) -- Development and implementation of standardized oral care treatment and referral guidelines can improve the overall quality of oral health practice for older sub-acute patients, according to a study published online Dec. 13 in the Journal of Pharmacy Practice and Research.

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STEMI Patient Perceptions Impact Emergency Medical Services Use

TUESDAY, Dec. 19, 2017 (HealthDay News) -- ST-elevation myocardial infarction (STEMI) patient perceptions, including those involving the speed of transport and concerns about resource misuse, are an important factor in determining emergency medical services (EMS) use, according to a study published online Dec. 13 in the Journal of Evaluation in Clinical Practice.

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Pre-Op Liraglutide Cuts Post-Op Plasma Glucose in T2DM

TUESDAY, Dec. 19, 2017 (HealthDay News) -- For patients with type 2 diabetes mellitus undergoing non-cardiac surgery, premedication with liraglutide is associated with reduced median plasma glucose one hour postoperatively, according to a study published online Dec. 12 in Anaesthesia.

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DBS Safe But Not Beneficial in Parkinson's Dementia

TUESDAY, Dec. 19, 2017 (HealthDay News) -- Low-frequency deep brain stimulation of the nucleus basalis of Meynert (NBM DBS) can be safely conducted in patients with Parkinson's disease dementia, but it does not result in significant improvements in primary cognitive outcomes, according to a study published online Dec. 18 in JAMA Neurology.

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Equation Predicts Risk of End-Stage Renal Disease in Children

MONDAY, Dec. 18, 2017 (HealthDay News) -- The kidney failure risk equation (KFRE) is a simple tool that provides excellent discrimination of the risk of end-stage renal disease (ESRD) in children with chronic kidney disease (CKD), according to a study published online Dec. 18 in JAMA Pediatrics.

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Male U.S. Doctors Receive Higher Values of Industry Payments

MONDAY, Dec. 18, 2017 (HealthDay News) -- Male physicians in the United States received higher values of general payments from industry than females in 2015, according to a research letter published online Dec. 18 in JAMA Internal Medicine.

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Anaphylaxis Is Rare Complication of Pregnancy

MONDAY, Dec. 18, 2017 (HealthDay News) -- Anaphylaxis is a rare complication of pregnancy, with an estimated incidence of 1.6 per 100,000 maternities, according to a study published online Nov. 29 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Year One Results Out for Value-Based Payment Modifier Program

MONDAY, Dec. 18, 2017 (HealthDay News) -- Almost 30 percent of eligible practices failed to register and report data in the first year of the Physician Value-Based Payment Modifier program, according to a report published in the December issue of Health Affairs.

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Doctors Must Report on at Least 1 Patient, 1 Measure for MACRA

FRIDAY, Dec. 15, 2017 (HealthDay News) -- In order to meet the 2017 Medicare and CHIP Reauthorization Act (MACRA) participation reporting deadline and avoid a Medicare payment penalty in 2019, physicians must report on at least one patient and one measure by Dec. 31, and submit to Medicare no later than Feb. 28, 2018, according to a report from the American Medical Association (AMA).

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Recent Decrease in Excess Risk of All-Cause Mortality in ESRD

FRIDAY, Dec. 15, 2017 (HealthDay News) -- Among individuals with end-stage renal disease (ESRD), there was a decrease in the excess risk of all-cause mortality from 1995 to 2013, according to a study published online Dec. 14 in the Clinical Journal of the American Society of Nephrology.

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Contrast-Enhanced Ultrasound No Aid for Metastasis Detection

FRIDAY, Dec. 15, 2017 (HealthDay News) -- Contrast-enhanced laparoscopic ultrasonography (CE-LUS) does not appear to increase the detection rate of liver metastasis during robotic-assisted surgery for primary colorectal cancer (CRC), according to a study published online Nov. 13 in the Journal of Clinical Ultrasound.

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Making Insurers Participate in Marketplace Could Cut Volatility

THURSDAY, Dec. 14, 2017 (HealthDay News) -- Requiring insurers that participate in Medicare or Medicaid to also participate in Marketplaces in the same geographic area could improve access to insurance, according to a study published in the December issue of Health Affairs.

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Telemedicine Facilitates Diabetes Foot Ulcer Care

THURSDAY, Dec. 14, 2017 (HealthDay News) -- Telemedicine follow-up enables more comprehensive diabetes foot ulcer care, according to a study published online Nov. 29 in the Journal of Clinical Nursing.

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Gabapentin Doesn't Cut Time to Pain Cessation After Surgery

WEDNESDAY, Dec. 13, 2017 (HealthDay News) -- For patients undergoing surgery, gabapentin does not reduce the time to pain cessation, but can increase the rate of opioid cessation, according to a study published online Dec. 13 in JAMA Surgery.

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Amount of Opioids Prescribed After Hospital Discharge Varies

WEDNESDAY, Dec. 13, 2017 (HealthDay News) -- For postoperative patients there is considerable variation in the amount of opioids prescribed at hospital discharge, according to research published online Dec. 13 in JAMA Surgery.

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Urinary Tract Injury Incidence Low in Gynecologic Laparoscopy

WEDNESDAY, Dec. 13, 2017 (HealthDay News) -- The incidence of lower urinary tract injuries is 0.33 percent for patients undergoing gynecologic laparoscopy for benign indications, according to a review published online Dec. 4 in Obstetrics & Gynecology.

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No Link Between Pre-Op Cholesterol, Post-Op Pain

WEDNESDAY, Dec. 13, 2017 (HealthDay News) -- Preoperative levels of serum total cholesterol (TC) do not correlate with postoperative pain following laparoscopic surgery for gastric cancer, according to research published online Nov. 23 in PAIN Practice.

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CABG May Be Best Method to Revascularize in Diabetes

TUESDAY, Dec. 12, 2017 (HealthDay News) -- In patients with diabetes and multivessel coronary artery disease (MV-CAD), coronary artery bypass grafting (CABG) may be the preferred method of revascularization, with lower rates of major adverse cardiac or cerebrovascular events (MACCE), according to a study published in the Dec. 19 issue of the Journal of the American College of Cardiology.

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Pediatric Oncologists Willing to Consider Medical Marijuana

TUESDAY, Dec. 12, 2017 (HealthDay News) -- The absence of standards is an important barrier to pediatric oncologists recommending medical marijuana (MM), despite their willingness to do so, according to a study published online Dec. 12 in Pediatrics.

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β-Cell Sensitivity to Glucose Impaired After Gastric Bypass

MONDAY, Dec. 11, 2017 (HealthDay News) -- Individuals with prior Roux-en-Y gastric bypass (GB) have blunted β-cell sensitivity to changes in glycemia, according to a study published online Nov. 20 in Diabetes, Obesity and Metabolism.

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Deceleration in Health Care Spending Growth in 2016

MONDAY, Dec. 11, 2017 (HealthDay News) -- Health care spending growth slowed in 2016 following faster growth in 2014 and 2015, according to research published online Dec. 6 in Health Affairs.

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Telomere Fusions Predict Dysplasia, Invasive Pancreatic CA

FRIDAY, Dec. 8, 2017 (HealthDay News) -- Telomere fusions predict the presence of high-grade dysplasia (HGD) and/or invasive pancreatic cancer, according to a study published online Dec. 8 in the Journal of Molecular Diagnostics.

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Bariatric Surgery Alters Liver Fatty Acid Metabolism

FRIDAY, Dec. 8, 2017 (HealthDay News) -- Bariatric surgery seems to change fatty acid metabolism in the liver, according to a study published online Nov. 20 in Diabetes Care.

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Pharmacomechanical Thrombolysis No Benefit in DVT

THURSDAY, Dec. 7, 2017 (HealthDay News) -- The addition of pharmacomechanical thrombolysis does not reduce the risk of post-thrombotic syndrome among patients with acute proximal deep vein thrombosis, according to a study published in the Dec. 7 issue of the New England Journal of Medicine.

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Different Weight Loss Patterns Observed Following Bariatric Sx

WEDNESDAY, Dec. 6, 2017 (HealthDay News) -- Different weight loss patterns are observed following Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB), with much of the weight loss maintained over time, according to a study published online Dec. 6 in JAMA Surgery.

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Evidence-Based Guidelines Cut Postoperative Opioid Use

WEDNESDAY, Dec. 6, 2017 (HealthDay News) -- Implementation of evidence-based guidelines can reduce opioid prescribing after laparoscopic cholecystectomy, according to a research letter published online Dec. 6 in JAMA Surgery.

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Thyroidectomy-Specific Quality Improvement Measures ID'd

WEDNESDAY, Dec. 6, 2017 (HealthDay News) -- For patients undergoing thyroidectomy, hypocalcemia and recurrent laryngeal nerve (RLN) injury may be useful quality improvement measures, according to a study published online Nov. 29 in JAMA Surgery.

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Antithrombotics Deemed Safe in Carpal Tunnel Release Surgery

TUESDAY, Dec. 5, 2017 (HealthDay News) -- For patients undergoing wide-awake carpal tunnel release (CTR) surgery, antithrombotic (AT) agents may be safely continued, according to a research letter published online Nov. 29 in JAMA Surgery.

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About One in Six Readmitted Post-Revascularization for PAD

TUESDAY, Dec. 5, 2017 (HealthDay News) -- For patients with peripheral arterial disease who are discharged following peripheral arterial revascularization, 17.6 percent have 30-day nonelective readmission, according to a study published online Dec. 5 in the Annals of Internal Medicine.

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Lymph Node Density Predicts Thyroid Cancer Outcomes

TUESDAY, Dec. 5, 2017 (HealthDay News) -- Lymph node density (LND) can help predict outcomes in patients with papillary thyroid cancer, according to a study published online Nov. 30 in JAMA Otolaryngology -- Head & Neck Surgery .

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CVS-Aetna Merger Has Implications for Doctors' Offices

TUESDAY, Dec. 5, 2017 (HealthDay News) -- CVS Health's planned purchase of insurance giant Aetna, a $69 billion deal, was announced Sunday.

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Risk of Surgical Complications Up for Overlapping Hip Surgery

MONDAY, Dec. 4, 2017 (HealthDay News) -- For patients undergoing surgery for hip fracture or total hip arthroplasty (THA), overlapping surgery is associated with increased risk of surgical complications, according to a study published online Dec. 4 in JAMA Internal Medicine.

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Relevant Health Care Price Info Hard to Find Online

MONDAY, Dec. 4, 2017 (HealthDay News) -- Overall, 17 percent of websites provide geographically relevant health care price estimates relating to specific interventions, according to a research letter published online Dec. 4 in JAMA Internal Medicine.

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Risk of Persistent Opioid Use a Concern for Youth After Surgery

MONDAY, Dec. 4, 2017 (HealthDay News) -- Adolescents and young adults are at risk for persistent opioid use after surgery, and this represents an important pathway to consider in the epidemic of prescription opioid misuse, according to a study published online Dec. 4 in Pediatrics.

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Oral Microbiome Composition Linked to Esophageal Cancer Risk

MONDAY, Dec. 4, 2017 (HealthDay News) -- Oral microbiome composition is associated with the risk of esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), according to a study published online Dec. 1 in Cancer Research.

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Odds for Carotid Artery Stenting in Seniors Up Post-CREST Era

MONDAY, Dec. 4, 2017 (HealthDay News) -- The odds of carotid artery stenting (CAS) have increased in the post-Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) era, despite safety concerns for patients older than 70 years, according to a study published online Dec. 4 in JAMA Neurology.

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Targeting Ups Nanoparticle Delivery to Graft Endothelial Cells

FRIDAY, Dec. 1, 2017 (HealthDay News) -- Targeting can enhance accumulation of nanoparticles (NPs) to graft endothelial cells (ECs) of human kidneys undergoing ex vivo normothermic machine perfusion (NMP), according to research published online Nov. 29 in Science Translational Medicine.

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ACC Guides Treatment of Bleeding With Oral Anticoagulation

FRIDAY, Dec. 1, 2017 (HealthDay News) -- A decision pathway has been developed to guide management of acute bleeding in patients treated with oral anticoagulants (OACs); the decision pathway was published online Dec. 1 in the Journal of the American College of Cardiology.

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Differences in Cancer Survival by Type of Insurance

FRIDAY, Dec. 1, 2017 (HealthDay News) -- From 1997 to 2014, improvements in cancer survival were mainly limited to patients with private or Medicare insurance, according to a study published online Nov. 30 in JAMA Oncology.

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Lobectomy Beats SBRT Survival in Early-Stage NSCLC

FRIDAY, Dec. 1, 2017 (HealthDay News) -- For stage I non-small-cell lung cancer, survival is better with lobectomy than stereotactic body radiation therapy (SBRT), although there is no difference for sublobar resection and SBRT, according to a study published online Nov. 29 in the Annals of Thoracic Surgery.

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>40% of Cancers, Cancer Deaths Due to Modifiable Risk Factors

FRIDAY, Dec. 1, 2017 (HealthDay News) -- An estimated 42.0 percent of all incident cancers and 45.1 percent of cancer deaths in the United States are attributed to potentially modifiable risk factors, according to a study published online Nov. 21 in CA: A Cancer Journal for Clinicians.

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