Here are what the editors at HealthDay consider to be the most important developments in Surgery for November 2019. 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.

Rates of Postoperative Mortality High for Frail, Very Frail Patients

WEDNESDAY, Nov. 27, 2019 (HealthDay News) — Patients who are frail and very frail have high rates of postoperative mortality across all levels of operative stress, according to a study published online Nov. 13 in JAMA Surgery.

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Antimicrobial Resistance Patterns Examined for Adult, Peds HAIs

WEDNESDAY, Nov. 27, 2019 (HealthDay News) — In two reports published online Nov. 25 in Infection Control & Hospital Epidemiology, authors present updated summaries of common pathogens and antimicrobial resistance patterns among health care-associated infections (HAIs) in adult and pediatric patients.

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Outcomes Poorer With New U.S. Donor Heart Allocation System

WEDNESDAY, Nov. 27, 2019 (HealthDay News) — Change in the U.S. allocation system for donor hearts has reduced waitlist mortality, but posttransplantation outcomes may have been worsened, according to a research letter published online Nov. 20 in the Journal of Heart and Lung Transplantation.

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U.S. Life Expectancy Dropped Since 2014 for Working-Age Adults

TUESDAY, Nov. 26, 2019 (HealthDay News) — U.S. life expectancy increased from 1959 to 2016 but has been decreasing since 2014, according to research published in the Nov. 26 issue of the Journal of the American Medical Association.

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Dermatologists Issue Consensus Guideline for Opioid Prescribing

TUESDAY, Nov. 26, 2019 (HealthDay News) — In an expert panel consensus, published online Nov. 12 in the Journal of the American Academy of Dermatology, opioid-prescribing guidelines are presented for common dermatologic procedures.

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Peds Cardiac Surgical Outcomes Improved in Consortium

TUESDAY, Nov. 26, 2019 (HealthDay News) — Children’s hospitals participating in the Pediatric Cardiac Critical Care Consortium (PC4) have improved cardiac surgery outcomes, including a 24 percent reduction in in-hospital mortality, according to a study published in the Dec. 3 issue of the Journal of the American College of Cardiology.

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Nutritional Deficiencies ID’d in Teens After Bariatric Surgery

MONDAY, Nov. 25, 2019 (HealthDay News) — Teens who undergo bariatric surgery may be at increased risk for nutritional deficiencies years later, according to a study published online Nov. 6 in Clinical Gastroenterology and Hepatology.

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Overall Rate of Pediatric Nonpowder Firearm Injuries Down

MONDAY, Nov. 25, 2019 (HealthDay News) — From 1990 to 2016, there was a decrease in nonpowder firearm injuries treated in emergency departments among children but an increase in the rate of eye injuries, according to a study published online Nov. 25 in Pediatrics.

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Rates of Joint Surgery Higher With Psoriatic Arthritis

MONDAY, Nov. 25, 2019 (HealthDay News) — The five-year incidence rate of joint surgery in psoriatic arthritis (PsA) patients is twice as high as in the general population, and this rate has remained steady over time, according to a study published in the November issue of Annals of the Rheumatic Diseases.

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Treatment Beneficial for Nonagenarians With Lung Cancer

FRIDAY, Nov. 22, 2019 (HealthDay News) — Receiving treatment is associated with better survival for nonagenarians with non-small cell lung cancer (NSCLC), with the greatest survival benefit for stage I patients, according to a study published online Nov. 18 in the Annals of Thoracic Surgery.

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CDC: Nearly Half of TBI-Related Deaths Categorized as Intentional

FRIDAY, Nov. 22, 2019 (HealthDay News) — From 2015 to 2017, 44 percent of traumatic brain injury (TBI)-related deaths were categorized as intentional injuries, according to research published in the Nov. 22 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Policies Limit Medicaid Payment for Transplant in Alcoholic Liver Disease

FRIDAY, Nov. 22, 2019 (HealthDay News) — Restrictive Medicaid policies are associated with a reduced proportion of payment by Medicaid for liver transplantation (LT) for alcohol-related liver disease (ALD) since 2011, according to a study published online Nov. 8 in Hepatology.

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Negative Impact Persists for Survivors of Firearm Injury

THURSDAY, Nov. 21, 2019 (HealthDay News) — Firearm injury seems to have a lasting effect, with survivors of gunshot wounds (GSW) having negative outcomes for years, according to a study published online Nov. 20 in JAMA Surgery.

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Recommendations Developed for Multidrug-Resistant Tuberculosis

THURSDAY, Nov. 21, 2019 (HealthDay News) — In a new clinical practice guideline, published online Nov. 15 in the American Journal of Respiratory and Critical Care Medicine, recommendations are presented for the treatment of multidrug-resistant tuberculosis (MDR-TB).

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Employee Premiums, Deductibles Eating Larger Share of Income

THURSDAY, Nov. 21, 2019 (HealthDay News) — During the last decade, health care costs have eaten up a larger share of income for millions of middle-class Americans with employer coverage, according to Trends in Employer Health Care Coverage, 2008-2018, a Nov. 21 report from The Commonwealth Fund.

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More Appropriate Prostate Cancer Tx Seen at Multidisciplinary Clinic

WEDNESDAY, Nov. 20, 2019 (HealthDay News) — Receiving care at a multidisciplinary (MultiD) clinic facilitates adherence to evidence-based national treatment guidelines for prostate cancer, according to a study published online Nov. 19 in Cancer.

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Focused Ultrasound Thalamotomy May Reduce Essential Tremor

WEDNESDAY, Nov. 20, 2019 (HealthDay News) — Transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) thalamotomy shows continued benefit for suppression of medication-refractory essential tremor (ET) at three years, according to a study published online Nov. 20 in Neurology.

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Optic Nerve Ultrasound May ID Increased Intracranial Pressure

TUESDAY, Nov. 19, 2019 (HealthDay News) — Optic nerve ultrasonography can help diagnose increased intracranial pressure with high specificity and sensitivity for patients with traumatic and nontraumatic brain injury, according to a review published online Nov. 19 in Annals of Internal Medicine.

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White House Wants Hospitals, Insurers to Provide Actual Costs of Care

MONDAY, Nov. 18, 2019 (HealthDay News) — New rules requiring hospitals and insurers to disclose the actual prices for common tests and procedures before they are performed have been proposed by the Trump Administration.

AP News Article

Revision, Removal Risks Low for Synthetic Midurethral Slings

MONDAY, Nov. 18, 2019 (HealthDay News) — The long-term risk for women with stress urinary incontinence needing surgical revision or removal after initial placement of synthetic midurethral slings is low, according to a study published in the November issue of Obstetrics & Gynecology.

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Survey of U.S. Registered Nurses Points to Worsening Shortages

THURSDAY, Nov. 14, 2019 (HealthDay News) — The 2019 AMN Healthcare Survey of Registered Nurses raises concerns about the outlook for the nursing profession in the United States.

2019 Survey of Registered Nurses

Surgery for Congenital Heart Disease Tied to Kidney Disease

THURSDAY, Nov. 14, 2019 (HealthDay News) — The risk for mortality and end-stage kidney disease (ESKD) is high in children who undergo surgical repair for congenital heart disease compared with the general population, according to a study published in the October issue of the Clinical Journal of the American Society of Nephrology.

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Secondary Surgical Cytoreduction Not Superior in Ovarian Cancer

THURSDAY, Nov. 14, 2019 (HealthDay News) — For patients with platinum-sensitive recurrent ovarian cancer, secondary surgical cytoreduction followed by chemotherapy does not result in longer overall survival than chemotherapy alone, according to a study published in the Nov. 14 issue of the New England Journal of Medicine.

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Injecting Illegal Drugs Ups Risk for Death After Heart Surgery

WEDNESDAY, Nov. 13, 2019 (HealthDay News) — People who inject drugs (PWID) have shorter survival following cardiac surgery than non-PWID, according to a review published online Nov. 8 in BMC Infectious Diseases.

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High-Risk Surgical Patients Benefit From Teaching Hospitals

WEDNESDAY, Nov. 13, 2019 (HealthDay News) — High-risk patients benefit from having surgery at teaching hospitals, according to a study published online Oct. 15 in the Annals of Surgery.

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Imaging Rates Continue to Rise Despite Efforts to Reduce

WEDNESDAY, Nov. 13, 2019 (HealthDay News) — Despite initiatives to reduce the use of medical imaging, rates continue to rise in both the United States and Ontario, Canada, according to a study recently published in the Journal of the American Medical Association.

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Pediatric Liver Transplant Recipients Often Undervaccinated

TUESDAY, Nov. 12, 2019 (HealthDay News) — Many pediatric liver transplant recipients are undervaccinated, according to a research letter published in the Nov. 12 issue of the Journal of the American Medical Association.

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Double Lung Transplant Performed for Vaping-Related Illness

TUESDAY, Nov. 12, 2019 (HealthDay News) — What is believed to be the first double lung transplant in the United States for a patient whose lungs were irreparably damaged after vaping was performed by doctors at the Henry Ford Health System in Detroit.

CNN Article

Patient, Graft Survival Excellent for Twin Kidney Transplant

TUESDAY, Nov. 12, 2019 (HealthDay News) — Among identical-twin kidney transplants, patient and kidney graft survival rates are excellent, according to a study published online Oct. 9 in the American Journal of Transplantation.

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Plastic Surgery Trainees May Delay Plans to Have Children

FRIDAY, Nov. 8, 2019 (HealthDay News) — The demands of training may negatively affect family planning and reproductive health for both female and male plastic surgery residents and fellows, according to a study published in the November issue of Plastic and Reconstructive Surgery.

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Race, Poverty Not Tied to Knee Replacement Outcomes

THURSDAY, Nov. 7, 2019 (HealthDay News) — Race and poverty are not significantly tied to total knee replacement (TKR) failure or revision, according to a study published in the November issue of Arthritis Care & Research.

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Early Postop Infection Ups One-Year Infection, Mortality Risk

THURSDAY, Nov. 7, 2019 (HealthDay News) — Patients with 30-day postoperative infection have an increased risk for long-term infection and mortality, according to a study published online Nov. 6 in JAMA Surgery.

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Tx Choice for T2DM in Obese Teens Tied to Later Kidney Disease Risk

THURSDAY, Nov. 7, 2019 (HealthDay News) — For severely obese adolescents with type 2 diabetes (T2D), medical therapy is associated with increased odds of diabetic kidney disease (DKD) at five years compared with metabolic bariatric surgery, according to a study published online Nov. 4 in Diabetes Care.

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Medical Practices Burdened by Regulatory Requirements

TUESDAY, Nov. 5, 2019 (HealthDay News) — The vast majority of group medical practices report that regulatory requirements, including prior authorization and quality payment programs, are burdensome, according to a survey released by the Medical Group Management Association.

Annual Regulatory Burden Survey

Low-Intensity Warfarin Not Noninferior in Hip, Knee Surgery

TUESDAY, Nov. 5, 2019 (HealthDay News) — Among older patients undergoing hip or knee replacement, low-intensity compared with standard-intensity warfarin prophylaxis did not meet the noninferiority criterion for the composite outcome of risk for venous thromboembolism or death, according to a study recently published in the Journal of the American Medical Association.

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Seriously Ill Medicare Beneficiaries Face Financial Hardship

MONDAY, Nov. 4, 2019 (HealthDay News) — Seriously ill Medicare enrollees experience considerable financial distress, according to a report published in the November issue of Health Affairs.

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Dr. Stephen Hahn Nominated to Head FDA

MONDAY, Nov. 4, 2019 (HealthDay News) — Radiation oncology expert Stephen Hahn, M.D., has been nominated as the new U.S. Food and Drug Administration commissioner.

CNN Article

Women Satisfied With Breast Reductions Years Later

MONDAY, Nov. 4, 2019 (HealthDay News) — Women who undergo breast-reduction surgery before age 25 experience excellent breast-related quality of life decades after surgery, according to a study published in the November issue of Plastic and Reconstructive Surgery.

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Recommendations Developed to Address Clinician Burnout

FRIDAY, Nov. 1, 2019 (HealthDay News) — In Taking Action Against Clinician Burnout, a new report published online Oct. 23 by the National Academies of Sciences, Engineering, and Medicine, recommendations are presented to address clinician burnout.

Taking Action Against Clinician Burnout

Pain Control Adequate With Fewer Opioids After Corneal Surgery

FRIDAY, Nov. 1, 2019 (HealthDay News) — Patients undergoing corneal surgery and receiving fewer opioid tablets still have adequate pain control, according to a study published online Oct. 31 in JAMA Ophthalmology.

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Increase Seen in Opioid-, Synthetic Opioid-Involved OD Deaths

FRIDAY, Nov. 1, 2019 (HealthDay News) — From 2015 to 2017, there were increases in opioid-involved and synthetic opioid-involved overdose drug rates in nearly all racial/ethnic groups, according to research published in the Nov. 1 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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