Jeannette Y. Wick, RPh, MBA, FASCP

Generally, surgeons are gravitating toward shorter courses of antibiotics for surgical prophylaxis to reduce toxicity, selection of resistant organisms, Clostridium difficile infection, and cost.

Most oncologists recommend removing melanomas within 4 to 6 weeks of diagnostic biopsy. Researchers have analyzed Medicare's database to determine how quickly the highest risk population (elderly people) have melanomas removed. Their findings indicate 20 percent wait more than 1.5 months to have the malignancy removed, and roughly 8 percent wait longer than 3 months.

Acute compartment syndrome is a surgical emergency of increased pressure within one of the body's muscle- and nerve-containing compartments, usually in the leg or arm. It occurs when accumulation of necrotic debris and hemorrhage (especially after fracture) increases intra-compartmental pressure, and that pressure exceeds the interstitium's capillary perfusion pressure.

For inflammatory abdominal aortic aneurysm, is open surgery or endovascular repair a better choice?

The Choosing Wisely project offers specific, evidence-based recommendations providers and patients should discuss to make determine each individual patient's most appropriate care.

Patients with diabetes may need prompting and encouragement to meet recommended levels of eye care. Having health insurance coverage doesn't seem to increase adherence to this recommendation.

The American Diabetes Association recommends eating fewer calories of better quality to prevent diabetes. Researchers looked at the available evidence from studies that examined a variety of diets and found that any healthy diet reduces the risk of diabetes by about 20%.

With more than 40 million Americans either diagnosed or at high risk for osteoporosis as they age, researchers are scrambling to find ideal preventive and curative agents. One target that strengthens bones is excessive osteoclast activity. A team of researchers recently found that one biologic that targets excessive osteoclast activity may positively influence another problem of later life: insulin sensitivity.

Albumin -- the most abundant protein in the human body -- has many roles. It transports hormones, fatty acids, and other compounds. It buffers serum pH, and maintains osmotic pressure. Now, it appears that albumin may be a tool that could be used in diabetes management.

Study results show that adult patients with type 1 diabetes who used subcutaneous insulin pumps maintained lower HbA1c values over a 10-year period compared with baseline levels.

Patients at risk for stroke due to clinically significant carotid stenosis benefit from carotid endarterectomy (CEA), a procedure that prevents neurologic sequelae. The best surgical outcomes occur when patients undergo revascularization on diagnosis. Studies report that white patients are more likely to have CEA and experience good postoperative outcomes than black patients.

Researchers from a number of leading academic facilities across the United States have published a study that details post-surgical MACE prevalence and risk factors in patients with Williams syndrome.

Lack of sleep and chronic kidney disease (CKD) independently lead to hypertension, diabetes mellitus, lower quality of life, and shorter life expectancy. Severity of CKD and sleep disturbances may also worsen diabetes and hypertension synergistically.

Secondary hyperparathyroidism is common in dialysis patients due to impaired vitamin D activation. An article published in the 2015 issue of Seminars in Dialysis surveys the past decade's findings about use of calcium sensing receptor activators-also called calcimimetics-in this population.

In the 15 years since the Institute of Medicine published the ground-breaking report, "To Err is Human," the US healthcare system has zeroed in on safety and prevention of medical errors. Despite extensive and innovative efforts, the health care system's fragmentation is still a barrier to cost-effective quality care and patient satisfaction.

Splenectomy creates life-long risk for overwhelming infections, especially from encapsulated bacteria, and experts estimate that splenectomy patients are 50 times more likely to develop overwhelming infection than others.

Widespread uptake of Streptococcus pneumonia conjugate vaccine (PCV7) has changed the microbiological landscape of infectious disease in children. Many studies have demonstrated the expected shift away from S. pneumoniae as the leading cause of acute otitis media, and identify emerging organisms.

Levothyroxine is typically given before breakfast but interest is growing in recommending bedtime administration. Bedtime administration may reduce the likelihood of high gastric pH, food interference, or drug interactions.

Researchers investigating symptoms in people with self-reported aspartame sensitivity could find no substantive psychological or metabolic response to aspartame.

Neuroinflammatory and ischemic diseases including Alzheimer's disease, Parkinson's disease, and stroke are notoriously difficult to treat. Researchers have looked for ways to quantify, understand and reduce cerebral inflammation, and to date have been able to determine that microglia-driven inflammation destroys neuronal populations.

How do mutations associated with familial Alzheimer's disease (FAD)-a rare form of Alzheimer's disease that has an early and aggressive onset-produce the disorder's devastating effects? A new mouse study provides answers.

Mental disorders predispose patients to weight gain, regardless of age. Psychiatric patients are more likely to develop metabolic syndrome and the poor health consequences that follow. For the most part, older patients develop metabolic syndrome, but adolescents with mental illness do, too.

Approximately 14% of patients infected with human immunodeficiency virus (HIV) also have type 2 diabetes mellitus. That number is expected to rise as the population of HIV-infected patients ages and develop associated chronic comorbidities.

Controversy is no rarity in the field of reproductive endocrinology and infertility. Since its discovery and early clinical applications, everyone seemed to have (and still has) an opinion about in vitro fertilization (IVF) procedures.

Superficial fat necrosis is a rare complication of insulin injections that can manifest with severe, persistent, and well-localized pain.

Up to 65% of all thyroidectomies are now done as outpatient procedures, and high-volume surgeons have very low complication rate with these surgeries.

Most surgeons refer patients for postoperative physical rehabilitation, but there is little evidence supporting the decision by some to start physical therapy before surgery. An article in the February 2015 issue of Physical Therapy looked at employing physical therapy earlier to prevent complications.

Value-based insurance design (VBID) initiatives are starting to focus on surgery-especially procedures that fall into the "low value" bracket, like hysterectomies and low-back surgery.

Americans' low-fiber diets that tend to be rich in red meats put them at risk for diverticulosis, and by age 60, roughly half of Americans have or have had diverticulosis. It's not clear how many patients with diverticulosis go on to develop diverticulitis, but once diverticulitis develops, 10-25% of patients need surgery, often urgently.

An article in Newsweek highlights a growing trend: travelling to a foreign country to undergo major surgery. Americans are flocking to countries such as Costa Rica, Mexico, India, Thailand, and Mexico, as well as European destinations such as Germany, for affordable surgical procedures.