Today’s Top Story
Election of Donald Trump to presidency, Republican control of Congress puts ACA repeal on the table.
Since passage of the Affordable Care Act (ACA), many Republican lawmakers have campaigned on a platform that includes repeal of that legislation. Combined with continued control by Republicans of both houses of the U.S. Congress, the election of Donald Trump to president of the United States places critics of the healthcare law in a position to act on those promises. Mr. Trump had previously promised to repeal the ACA “very, very quickly” if elected, and an article in Politico notes that Republican lawmakers have developed a road map to repeal significant parts of the ACA even with their narrow Senate majority. However, the writer notes that outlines for an ACA replacement remain vague. In general, Republican proposals have included health savings accounts, tax credits to help consumers purchase insurance, and provisions for allowing insurers to sell healthcare insurance across state lines.
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Other News
Study: Even mild pulmonary complications increase postoperative risks.
Results of a multicenter study revealed that even mild postoperative pulmonary complications (PPCs) are associated with increased early postoperative mortality, intensive care unit (ICU) admission, and hospital length of stay. The study, published online in JAMA Surgery, involved 1,202 patients with American Society of Anesthesiologists Classification 3 who underwent noncardiothoracic surgery requiring 2 hours or more of general anesthesia with mechanical ventilation between May and November 2014. At least 1 PPC occurred in 401 patients (33.4 percent). The most common complications were the need for prolonged therapy and atelectasis; severe complications were rare. The researchers found that even relatively mild complications were associated with significantly increased hospital stay, admission to the ICU, and mortality within the first week after surgery.
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Study: Possible benefit seen with liposomal bupivacaine following spine surgery.
A study of patients undergoing single-level lumbar spine surgery found that those who received liposomal bupivacaine (LB) following surgery required narcotic pain medication for a significantly decreased length of time (average decrease, 10.3 hours) compared with non-LB patients. The study, appearing in The Spine Journal, involved 80 total patients undergoing single-level microdiskectomy for lumbar or sacral compressive disk disease. The 40 patients receiving LB infiltration used intravenous narcotics postoperatively for an average of 13 hours versus 23.3 hours for non-LB patients. However, no significant difference was noted between visual analog scores for the patient groups at any point postoperatively, nor between total morphine-equivalent doses or 30-day emergency room visits for pain. “It is uncertain if the independent effect of LB may have been masked by the multimodal postoperative pain control protocol in use,” the authors write. They said further study is warranted, and that the impact of LB would likely be greater in more invasive procedures.
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Medtronic faces lawsuit regarding spinal device.
A former Medtronic sales representative has brought a federal false claims and misbranding lawsuit against the medical device company. As reported by The Star Tribune, the suit alleges that Medtronic designed a family of spinal devices for the neck but told the U.S. Food and Drug Administration that the devices were to be used only in the lower spine and chest, where the devices were nearly always too small to work. The suit alleges that Medtronic’s goal was to avoid the time and expense required for safety testing. Court documents show that Medtronic denied the allegations, asserting that the product was developed in different sizes to accommodate anatomical differences in patients. Medtronic has asked a federal judge to dismiss the suit.
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Study evaluates “return to learn” laws for reintegrating students into school after sustaining concussion.
Findings published online in the journal Pediatrics suggest that state-level rules may offer only vague legal guidance regarding student reintegration into school following concussion. The researchers assessed “return to learn” (RTL) laws across the eight states that had implemented such statutes. They found that 75 percent of RTL laws held schools responsible for RTL management, but only 25 percent of states had mandated RTL education for school personnel. Overall, none of the RTL laws provided guidance on support of students with persistent post-concussive symptoms, and only one law recommended an evidence-based standard for RTL guidelines. The researchers argue that the data reveal a need for improved integration between RTL laws and research, so that the laws may “reflect existing best-practice recommendations and remain current as the evidence base develops.”
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USBJI grant mentoring and career development program accepting applications from young investigators.
Jan. 15, 2017, is the deadline for young investigators to apply to take part in the United States Bone and Joint Initiative (USBJI) and Bone and Joint Canada grant mentoring program. The program is open to promising junior faculty, senior fellows, or postdoctoral researchers who have been nominated by their department or division chairs. It is also open to senior fellows or residents who are doing research and have a faculty appointment in place or confirmed. Basic and clinical investigators, without or with training awards (including K awards) are invited to apply. Investigators selected to take part in the program attend two workshops, 12–18 months apart, and work with faculty between workshops to develop their grant applications. Attendees are given the opportunity to maintain a relationship with a mentor until their application is funded. The next workshop will take place April 7–9, 2017, in Rosemont, Ill.
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Call for volunteers: Political Action Committee of the AAOS.
Dec. 21, 2016, is the last day to submit your application for treasurer of the Political Action Committee (PAC) of the American Association of Orthopaedic Surgeons (AAOS). The PAC oversees all AAOS activities relating to political fundraising and financial support for candidates for federal office. Applicants for this position must be active fellows and U.S. citizens with specific knowledge of the many research and health policy positions of the AAOS, and have experience interacting with federal officials.
Learn more and submit your application…
