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August 2020 Briefing – Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for August 2020. 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.

Follow-up Calls After Mohs Surgery Do Not Boost Satisfaction

MONDAY, Aug. 31, 2020 (HealthDay News) — Postoperative follow-up telephone calls (TFU) to patients after Mohs micrographic surgery (MMS) do not improve patient satisfaction, according to a research letter published online July 31 in the Journal of the American Academy of Dermatology.

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Most Shoulder Replacements Last More Than 10 Years

FRIDAY, Aug. 28, 2020 (HealthDay News) — About 90 percent of shoulder replacements last for longer than 10 years, and patient-reported outcome measures show sustained benefits, according to a review published online Aug. 26 in The Lancet Rheumatology.

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Recovery Protocol Cuts Opioid Use After Elective Neurosurgery

THURSDAY, Aug. 27, 2020 (HealthDay News) — Enhanced recovery after surgery (ERAS) protocols can reduce postoperative use of opioids in patients undergoing elective spine and peripheral nerve surgical procedures, according to a study published online Aug. 6 in Pain Medicine.

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AHA Details How to Lower Stroke Risk During, After Heart Surgery

WEDNESDAY, Aug. 26, 2020 (HealthDay News) — In a scientific statement issued by the American Heart Association and published online Aug. 26 in Circulation, recommendations are presented for reducing the risk for perioperative stroke in adults undergoing cardiac and thoracic aortic operations.

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Prevalence of SARS-CoV-2 in Asymptomatic Children Identified

TUESDAY, Aug. 25, 2020 (HealthDay News) — The pooled prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV02) in asymptomatic children is 0.65 percent and is significantly associated with the incidence of COVID-19 in the general population, according to a research letter published online Aug. 25 in JAMA Pediatrics.

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Nurse Understaffing Common in Hospitals Prior to COVID-19

TUESDAY, Aug. 25, 2020 (HealthDay News) — Many hospital nurses in Illinois and New York were burned out and working in understaffed conditions immediately prior to the first wave of COVID-19 patients, according to a study published online Aug. 18 in BMJ Quality & Safety.

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Care Delayed for Many U.S. Breast Cancer Patients Early in Pandemic

TUESDAY, Aug. 25, 2020 (HealthDay News) — Nearly half of breast cancer patients have experienced delays in care due to the COVID-19 pandemic, according to a study published online Aug. 9 in Breast Cancer Research and Treatment.

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Health, Economic Factors Tied to Outcomes of Emergency Surgery

TUESDAY, Aug. 25, 2020 (HealthDay News) — Increased levels of comorbidity and socioeconomic deprivation are associated with mortality, discharge destination, and length of hospital stay (LOS) following admission for emergency general surgery (EGS), according to a study published online Aug. 24 in Trauma Surgery & Acute Care Open.

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Transoral Robotic Surgery Ups Survival in Oropharyngeal Cancer

MONDAY, Aug. 24, 2020 (HealthDay News) — For patients with early-stage oropharyngeal cancer, transoral robotic surgery is associated with improved surgical outcomes and survival, according to a study published online Aug. 20 in JAMA Oncology.

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Targeted Intraoperative RT Is Effective Alternative to EBRT

FRIDAY, Aug. 21, 2020 (HealthDay News) — Single-dose targeted intraoperative radiotherapy (TARGIT-IORT) during lumpectomy is an effective alternative to external beam radiotherapy (EBRT), according to a study published online Aug. 19 in The BMJ.

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Nonopioid Pain Protocol Feasible After Sports Orthopedic Surgery

FRIDAY, Aug. 21, 2020 (HealthDay News) — For patients undergoing common orthopedic sports procedures, a multimodal, nonopioid pain protocol featuring little or no use of opioids is feasible for managing postoperative pain, according to a study published in the August issue of Arthroscopy.

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Longer Bisphosphonate Use May Up Atypical Femur Fracture Risk

THURSDAY, Aug. 20, 2020 (HealthDay News) — Longer duration of bisphosphonate use is associated with an increased risk for atypical femur fracture, according to a study published in the Aug. 20 issue of the New England Journal of Medicine.

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Drug-Coated Balloon Angioplasty Better for Hemodialysis Fistulas

THURSDAY, Aug. 20, 2020 (HealthDay News) — For the treatment of stenotic lesions in dysfunctional hemodialysis arteriovenous fistulas, drug-coated balloon angioplasty is superior to standard angioplasty during the six months after the procedure, according to a study published in the Aug. 20 issue of the New England Journal of Medicine.

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Poll: More Older Adults Using Telehealth During Pandemic

WEDNESDAY, Aug. 19, 2020 (HealthDay News) — More older adults have used telehealth to consult with a health care provider during the COVID-19 pandemic compared with that seen in the previous year, according to a report published online Aug. 17 based on the results of the University of Michigan National Poll on Healthy Aging.

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Bariatric Surgery Linked to Reduction in Mortality Rate

TUESDAY, Aug. 18, 2020 (HealthDay News) — Bariatric surgery is associated with a reduction in mortality, and Roux-en-Y gastric bypass (RYGB) is effective for blood pressure (BP) control in patients with hypertension and obesity, according to two studies published online Aug. 18 in the Annals of Internal Medicine.

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Mortality Down but Health Care Costs Up From Gun Violence

TUESDAY, Aug. 18, 2020 (HealthDay News) — From 2005 to 2016, there was a decrease in gunshot wound (GSW) mortality, accompanied by increasing mean costs, according to a study published online Aug. 10 in the Journal of the American College of Surgeons.

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Factors Tied to Hormone Therapy Use After Oophorectomy ID’d

MONDAY, Aug. 17, 2020 (HealthDay News) — Age at surgery, education level, and preventive mastectomy are associated with hormone therapy (HT) use after preventive oophorectomy in BRCA mutation carriers, according to a study published online Aug. 10 in Menopause.

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Some Doctors Endorse Thyroid Ultrasonography Unnecessarily

MONDAY, Aug. 17, 2020 (HealthDay News) — A considerable proportion of physicians endorse use of thyroid ultrasonography for clinically unsupported reasons, according to a research letter published online Aug. 12 in JAMA Surgery.

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Return-to-School Recommendations Issued for Organ Transplant Recipients

FRIDAY, Aug. 14, 2020 (HealthDay News) — For solid organ transplant (SOT) recipients, the decision of whether to return to school should be a shared decision between families, transplant professionals, and educators, according to an expert opinion article published online Aug. 4 in the Journal of the Pediatric Infectious Diseases Society.

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Outcomes Worse With No Surgery for Cholecystitis in Pregnancy

THURSDAY, Aug. 13, 2020 (HealthDay News) — Contrary to current guidelines, most pregnant women admitted to U.S. hospitals for acute cholecystitis are managed nonoperatively, according to a study published online July 14 in the Annals of Surgery.

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Women Have More Depression With Peripheral Artery Disease

THURSDAY, Aug. 13, 2020 (HealthDay News) — Women with peripheral artery disease (PAD) have a higher burden of depressive symptoms compared with men, according to a study published online Aug. 12 in the Journal of the American Hospital Association.

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GI Surgical Outcomes Worse With Preop Use of Opioids, Sedatives

THURSDAY, Aug. 13, 2020 (HealthDay News) — Preoperative opioid and sedative use are risk factors for morbidity and mortality following colorectal resections, according to a study published in the July issue of Diseases of the Colon & Rectum.

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Maternal Weight Tied to Early-Onset Neonatal Bacterial Sepsis

THURSDAY, Aug. 13, 2020 (HealthDay News) — Risk for early-onset neonatal bacterial sepsis (EOS) increases with maternal overweight and obesity, particularly in term infants, according to a study recently published in Clinical Infectious Diseases.

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Burnout Less Likely for Doctors in Minority Race/Ethnic Groups

WEDNESDAY, Aug. 12, 2020 (HealthDay News) — Compared with non-Hispanic White physicians, physicians in minority racial/ethnic groups are less likely to report burnout, according to a study published online Aug. 7 in JAMA Network Open.

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Guidelines Detail How to Manage Aneurysms of Visceral Arteries

WEDNESDAY, Aug. 12, 2020 (HealthDay News) — In evidence-based clinical practice guidelines, issued by the Society for Vascular Surgery and published in a supplement to the July issue of the Journal of Vascular Surgery, recommendations are presented for the care and treatment of aneurysms of the visceral arteries.

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Factors ID’d in Withdrawal of Life Support in Severe TBI Patients

WEDNESDAY, Aug. 12, 2020 (HealthDay News) — In addition to clinical factors, socioeconomic factors may play a role in the decision regarding withdrawal of life-supporting treatment (WLST) in patients with severe traumatic brain injury (sTBI), according to a study recently published in JAMA Surgery.

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Surgical Delays Not Life-Threatening in Early Breast Cancer

WEDNESDAY, Aug. 12, 2020 (HealthDay News) — Surgical delays do not seem to be life-threatening for women with ductal carcinoma in situ (DCIS) or with early-stage estrogen receptor-positive (ER+) breast cancer, according to a study published online Aug. 6 in the Journal of the American College of Surgeons.

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Guidance Helps Doctors Optimize Telemedicine for Seniors

TUESDAY, Aug. 11, 2020 (HealthDay News) — In an Ideas and Opinions article published online Aug. 11 in the Annals of Internal Medicine, guidance is provided for physicians to optimize telemedicine, which can be challenging for older patients.

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Persistent Opioid Use Seen in ~10 Percent of Patients After Cardiac Surgery

TUESDAY, Aug. 11, 2020 (HealthDay News) — Persistent opioid use is a common concern after cardiac surgery, according to a study published online June 17 in JAMA Cardiology.

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Expanding Medicaid in Holdout States Could Insure 3.9 Million

MONDAY, Aug. 10, 2020 (HealthDay News) — Expanding Medicaid to all states could reduce the number of uninsured by 28 percent based on pre-COVID-19 data, according to a report released by the Urban Institute and the Robert Wood Johnson Foundation.

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Cast Immobilization Recommended for Scaphoid Fractures

MONDAY, Aug. 10, 2020 (HealthDay News) — Initial cast immobilization is recommended for adults with scaphoid waist fractures displaced by 2 mm or less, with surgery recommended for confirmed nonunions of fracture, according to a study published in the Aug. 8 issue of The Lancet.

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Life Expectancy 78.60 Years for U.S. Population for 2009-2011

FRIDAY, Aug. 7, 2020 (HealthDay News) — Life expectancy for 2009 to 2011 was 78.60 years for the total U.S. population, with the highest life expectancy for Hispanic women, according to the Aug. 7 National Vital Statistics Reports, a publication from the U.S. Centers for Disease Control and Prevention.

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Short-Term Risk for Below-Knee Amputation Not Increased With SGLT2i

FRIDAY, Aug. 7, 2020 (HealthDay News) — For patients with type 2 diabetes, sodium glucose cotransporter 2 (SGLT2) inhibitors do not increase the risk for below-knee amputation compared with dipeptidyl peptidase 4 (DPP-4) inhibitors, according to a study published online Aug. 5 in Diabetes Care.

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ICU Beds Lacking in Low-Income Neighborhoods Across the U.S.

THURSDAY, Aug. 6, 2020 (HealthDay News) — There are greater shortages of intensive care unit (ICU) beds for critically ill patients in low-income neighborhoods compared with high-income neighborhoods, according to a report published in the August issue of Health Affairs.

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ASCRS Updates Guidelines on Surgery for Crohn Disease

THURSDAY, Aug. 6, 2020 (HealthDay News) — In clinical practice guidelines from the American Society of Colon and Rectal Surgeons, published in the August issue of Diseases of the Colon & Rectum, recommendations are presented for indications and considerations before, during, and after surgery for Crohn disease (CD).

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Diabetes-Related Lower-Limb Amputations Up in Older Adults

THURSDAY, Aug. 6, 2020 (HealthDay News) — Since 2009, diabetes-related nontraumatic lower-extremity amputation (NLEA) has been increasing among older adults, according to a study published online July 28 in Diabetes Care.

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Health Plans Not Implementing Prior Authorization Reforms

WEDNESDAY, Aug. 5, 2020 (HealthDay News) — Physicians say prior authorization (PA) continues to interfere with patient care and can lead to adverse clinical consequences, according to the results of a survey released by the American Medical Association.

Press Release

Physician Survey

President Says Medicare Should Expand Telehealth Services

TUESDAY, Aug. 4, 2020 (HealthDay News) — President Donald Trump signed an order on Monday that will broaden the role of telehealth for Medicare patients, the Associated Press reported.

AP News Article

Most Studies Still Fail to Analyze Data by Sex

TUESDAY, Aug. 4, 2020 (HealthDay News) — The effect of gender is still largely ignored in scientific studies, according to a study published online June 9 in eLife.

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Canakinumab Explored as Therapy for Large-Joint Osteoarthritis

MONDAY, Aug. 3, 2020 (HealthDay News) — Inhibition of interleukin-1β (IL-1β) with canakinumab seems to reduce the incidence of total hip replacement/total knee replacement (THR/TKR) compared with placebo, according to an exploratory analysis published online Aug. 4 in the Annals of Internal Medicine.

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Guidelines Indicate Breastfeeding Is Safe After Maternal Anesthesia

MONDAY, Aug. 3, 2020 (HealthDay News) — Breastfeeding is safe after anesthesia, according to guidelines issued by the Association of Anaesthetists and published online July 31 in Anaesthesia.

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38 Percent of Older Adults in U.S. Not Ready for Video Doctor Visits

MONDAY, Aug. 3, 2020 (HealthDay News) — An estimated 38 percent of all older adults in the United States are not ready for video visits with physicians, according to a research letter published online Aug. 3 in JAMA Internal Medicine.

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