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Category: Surgery | Monthly Briefing

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April 2010 Briefing - Surgery

Last Updated: May 03, 2010.

 

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Here are what the editors at HealthDay consider to be the most important developments in Surgery for April 2010. 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.

Visits When Doctor Is Seated Seem Longer to Patients

THURSDAY, April 29 (HealthDay News) -- Hospitalized patients perceive brief bedside visits from a physician to be longer if the physician is seated rather than standing, according to research from the University of Kansas.

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In VBAC, Epidural Doses Linked to Uterine Rupture Risk

THURSDAY, April 29 (HealthDay News) -- Frequent epidural anesthesia doses needed by women who attempt vaginal delivery after cesarean delivery (VBAC) may indicate an increased risk for uterine rupture, according to research published in the April issue of the American Journal of Obstetrics & Gynecology.

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Lumbar Fusion Associated With Improved Quality of Life

THURSDAY, April 29 (HealthDay News) -- After patients undergo lumbar fusion for degenerative lumbar stenosis with spondylolisthesis, health-related quality of life outcome measures approach those of the age-matched normal population, and are similar to improvements observed in patients after total hip and knee joint replacement surgery, according to a study in the April issue of The Spine Journal.

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Risk Factors for Physician Misconduct Identified

WEDNESDAY, April 28 (HealthDay News) -- Doctors who are male, are from lower socioeconomic groups or had academic difficulties in medical school may be at increased risk of professional misconduct, according to a study published online April 27 in BMJ.

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Head-Mounted Device May Be Helpful for Anesthesiologists

WEDNESDAY, April 28 (HealthDay News) -- The use of a head-mounted display (HMD) that shows patients' vital signs in anesthesiologists' field of vision during a procedure is associated with more time spent monitoring the patient and surgical field, according to research published in the April issue of Anesthesia & Analgesia.

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FDA Changes Medical Device Advisory Committee Process

TUESDAY, April 27 (HealthDay News) -- Because of the increasing number of medical device advisory panel meetings in recent years, the U.S. Food and Drug Administration is changing the way expert panels review and discuss information during public hearings on devices that are being reviewed for premarket approval.

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Some Tracheostomy Tubes Made by Covidien Recalled

TUESDAY, April 27 (HealthDay News) -- Covidien and the U.S. Food and Drug Administration have initiated a voluntary recall of certain lots of cuffed Shiley tracheostomy tubes and custom/specialty tracheostomy tubes because pilot balloon inflation assembly leaks result in the cuffs not holding air.

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Device Found as Effective as Heparin for Clot Prevention

TUESDAY, April 27 (HealthDay News) -- The use of a mobile compression device for the prevention of thromboembolic disease after total hip arthroplasty is likely just as effective as low-molecular-weight heparin treatment but safer, according to a study in the March issue of the Journal of Bone & Joint Surgery.

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Interruptions Increase Medication Errors by Nurses

TUESDAY, April 27 (HealthDay News) -- Nurses who are interrupted in the process of preparing and administering medications are more likely to make an error, with error severity increasing with the number of interruptions, according to a study in the April 26 issue of the Archives of Internal Medicine.

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Financial Ties Negatively Affect Perceptions of Research Quality

TUESDAY, April 27 (HealthDay News) -- Disclosure of financial ties to industry influences patients', physicians', and research participants' beliefs about the quality of research evidence, according to a review published in the April 26 issue of the Archives of Internal Medicine.

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New Tool May Improve Organ Donation Rates

MONDAY, April 26 (HealthDay News) -- A new tool may help identify comatose patients with irreversible neurologic injury who are candidates for organ donation after cardiac death protocols, according to research published in the April 27 issue of Neurology.

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FDA Addresses External Infusion Pump Safety Issues

MONDAY, April 26 (HealthDay News) -- The U.S. Food and Drug Administration has announced a new initiative to address safety issues related to external infusion pumps, which are commonly used in hospitals, other clinical settings, and patient's homes.

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Panel Warns of Risks Posed by Female Genital Cutting

MONDAY, April 26 (HealthDay News) -- Immigrants from areas where female genital cutting (FGC) in infants, children and adolescents is common may request physicians in the United States to perform such procedures, but the American Academy of Pediatrics (AAP) opposes all types of FGC that pose physical or psychological risk, and counsels its members not to perform such procedures, according to a policy statement published online April 26 in Pediatrics.

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In Diabetes Patients, Modifiable Factors Up Risk of Cesarean

FRIDAY, April 23 (HealthDay News) -- Nulliparous women with type 1 diabetes mellitus have a high rate of cesarean delivery, and their potentially modifiable risk factors for cesarean delivery include pre-pregnancy body weight, gestational weight gain, and accuracy of the prediction of fetal macrosomia, according to a study published in the May issue of Obstetrics & Gynecology.

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Socioeconomic Status Affects Prostate Cancer Treatment

FRIDAY, April 23 (HealthDay News) -- In men with prostate cancer, lower socioeconomic status is associated with a significantly lower likelihood of undergoing radical prostatectomy or radiotherapy, according to a study published April 22 in BMJ.

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Urologist Presence Linked to Less Urologic Cancer Mortality

THURSDAY, April 22 (HealthDay News) -- The presence of a urologist in a county is linked to lower mortality for prostate, bladder and kidney cancer, though increasing urologist density beyond two urologists per 100,000 people does not result in further improvements, according to research published online April 20 in the Journal of Clinical Oncology.

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Gene-Expression Profiling for Rejection Monitoring Effective

THURSDAY, April 22 (HealthDay News) -- The use of gene-expression profiling to monitor for rejection in cardiac transplant recipients at low risk of rejection may be just as effective and safe, with fewer biopsies performed, as routine endomyocardial biopsy monitoring, according to a study published online April 22 in the New England Journal of Medicine to coincide with a presentation at the annual meeting of the International Society for Heart & Lung Transplantation, held from April 21 to 24 in Chicago.

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Sirolimus- and Probucol-Eluting Stent Effective at Two Years

THURSDAY, April 22 (HealthDay News) -- After two years of follow-up, a new-generation sirolimus- and probucol-eluting stent (Dual-DES) maintains an advantage over sirolimus-eluting stents (SES) and zotarolimus-eluting stents (ZES), though the safety profiles of the three types are similar, according to research published online April 21 in the Journal of the American College of Cardiology.

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Delaying CABG Surgery Does Not Benefit NSTEMI Patients

THURSDAY, April 22 (HealthDay News) -- Although most non-ST-segment elevation myocardial infarction (NSTEMI) patients undergo late coronary artery bypass graft (CABG) surgery after arriving at a hospital, they do not have improved outcomes compared with patients who undergo early CABG, despite having higher-risk clinical characteristics, according to research published in the April issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

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Step-Up Approach Beneficial in Necrotizing Pancreatitis

WEDNESDAY, April 21 (HealthDay News) -- Among patients with necrotizing pancreatitis and infected necrotic tissue, a minimally invasive step-up approach may effectively reduce the rate of major complications or death compared with open necrosectomy, according to a study published in the April 22 issue of the New England Journal of Medicine.

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Taped Consult Boosts Patient Knowledge, Sense of Control

WEDNESDAY, April 21 (HealthDay News) -- Audiotaping a cardiac surgery patient's pre-surgical consultation, and providing the patient with the tape to review, substantially increases his or her knowledge and sense of control, while reducing anxiety and depression, according to a study in the April issue of the Archives of Surgery.

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Non-Teaching Hospitals Found Superior for Colon Resection

WEDNESDAY, April 21 (HealthDay News) -- For colon resections across the spectrum of disease -- including benign disease -- the volume-outcome relationship favors non-teaching hospitals over teaching hospitals, according to research published in the April issue of the Archives of Surgery.

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Delaying Clopidogrel After Stent Placement May Be Deadly

TUESDAY, April 20 (HealthDay News) -- Many patients who have had a drug-eluting stent (DES) inserted delay filling a prescription for clopidogrel after discharge from the hospital, and, as a result, they face nearly double the risk of heart attack or death, according to research published online April 20 in Circulation: Cardiovascular Quality and Outcomes.

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Drug Ups Liver Cancer Patients' Survival After Transplant

MONDAY, April 19 (HealthDay News) -- In patients with hepatocellular carcinoma (HCC), sirolimus-based immunosuppression protocols are associated with significantly improved survival rates after liver transplantation, according to research published in the April issue of Hepatology.

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Surgery Helps Improve Sex Life in Lumbar Disc Herniation

FRIDAY, April 16 (HealthDay News) -- Patients with lumbar disc herniation may experience impairment to their sex lives, and while surgery can help improve sexual desire and activities, women may take longer than men to resume sexual activities, according to a study published in the March 15 issue of Spine.

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Recipient Diagnosis Associated With Corneal Graft Failure

FRIDAY, April 16 (HealthDay News) -- Recipient diagnosis is a risk factor for graft failure after penetrating keratoplasty, though length of corneal preservation is not associated with either graft failure or late endothelial failure (LEF), according to a study in the April issue of the Archives of Ophthalmology.

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Proximal Endovascular Occlusion Found Safe for Stenting

THURSDAY, April 15 (HealthDay News) -- Proximal endovascular occlusion (PEO) can be safely and effectively used during the placement of a carotid artery stent, according to a study in the April 20 issue of the Journal of the American College of Cardiology.

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Bariatric Surgery Linked to Lower Risk of Pregnancy Complications

WEDNESDAY, April 14 (HealthDay News) -- Obese women who undergo bariatric surgery before having a baby have a lower risk of hypertensive disorders in pregnancy than obese women who have a baby before undergoing bariatric surgery, according to a retrospective cohort study published online April 13 in BMJ.

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Advanced Age Affects Mortality Risk After Device Implantation

TUESDAY, April 13 (HealthDay News) -- In-hospital mortality is significantly higher for elderly patients who receive implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) compared with younger patients, according to a study in the April 12 issue of the Archives of Internal Medicine.

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Valve-in-Valve Implantation Is Effective Option

TUESDAY, April 13 (HealthDay News) -- Transcatheter valve-in-valve implantation is an effective option for the management of bioprosthetic valve failure, according to a study published online April 12 in Circulation.

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Study Compares Abdominal Aortic Aneurysm Repair Types

MONDAY, April 12 (HealthDay News) -- In patients with abdominal aortic aneurysm, endovascular repair is associated with significantly lower operative mortality than open surgical repair. In the long term, however, there are no significant differences in total mortality or aneurysm-related mortality, and endovascular repair is associated with complications resulting in higher costs, according to a study published online April 11 in the New England Journal of Medicine to coincide with a presentation at the Charing Cross International Symposium, held from April 10 to 13 in London.

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Regional Variations Seen in Radical Prostatectomy Cost

THURSDAY, April 8 (HealthDay News) -- Even after adjustment for medical case mix, local wages and other factors, there are wide variations from state to state in the total cost of radical prostatectomy, suggesting that inefficiencies exist in the health care market, according to research published in the April issue of The Journal of Urology.

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Physician Ownership Linked to Higher Surgery Volume

THURSDAY, April 8 (HealthDay News) -- Physicians with an ownership stake in an ambulatory surgery center (ASC) perform, on average, twice as many procedures as physicians without an ownership stake, according to research published in the April issue of Health Affairs.

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Drug-Eluting Stents Effective in Critical Leg Ischemia

THURSDAY, April 8 (HealthDay News) -- Balloon expandable drug-eluting stents (DES) are effective and safe in preventing major amputation and relieving symptoms in patients with below-the-knee critical leg ischemia, according to a study published in the April 13 issue of the Journal of the American College of Cardiology.

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Child's Post-Anesthesia Crying Unaffected by Parent Presence

WEDNESDAY, April 7 (HealthDay News) -- Young children coming out of anesthesia postoperatively in a post-anesthesia care unit (PACU) may cry whether or not their parents are present, though parental presence is associated with decreased negative behavior change two weeks later, according to a study in the April issue of Anesthesia & Analgesia.

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FDA Issues Warning Regarding 'Lipodissolve' Procedures

WEDNESDAY, April 7 (HealthDay News) -- The U.S. Food and Drug Administration has issued warning letters to six U.S.-based medical spas and a Brazilian company, saying they made false or misleading statements that "lipodissolve" procedures are safe and effective, or otherwise misbranded the products.

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Environment Affects Quality of Life in Adolescent Scoliosis

WEDNESDAY, April 7 (HealthDay News) -- Living environment may influence assessment results of the quality of life after surgery in adolescent idiopathic scoliosis patients, according to a study in the March 15 issue of Spine.

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Socioeconomic Position Affects Survival After Heart Surgery

WEDNESDAY, April 7 (HealthDay News) -- In patients who undergo cardiac surgery, lower socioeconomic position -- but not race -- is associated with a significantly increased risk of mortality, according to a study published online April 6 in Circulation: Cardiovascular Quality and Outcomes.

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Complex Spinal Surgeries Up Among Medicare Patients

TUESDAY, April 6 (HealthDay News) -- While the overall rate of spinal stenosis surgery among Medicare beneficiaries declined slightly during 2002 to 2007, the rate of complex fusions skyrocketed, and, compared with decompression, fusion was associated with higher risks of 30-day mortality and major complications in 2007, according to a study in the April 7 issue of the Journal of the American Medical Association.

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Editorial (subscription or payment may be required)

TachoSil Sealant Patch Approved for Cardiovascular Surgery

MONDAY, April 5 (HealthDay News) -- The TachoSil sealant patch has been approved by the U.S. Food and Drug Administration to prevent bleeding from small blood vessels in certain cardiovascular surgery cases, the agency said Monday.

this approval

Recurrence Unlikely for Many Biopsied Melanocytic Nevi

MONDAY, April 5 (HealthDay News) -- In patients who undergo biopsy of benign to moderately dysplastic melanocytic nevi, there is a low rate of clinical recurrence, so re-excision may not be necessary, according to a study in the April issue of the Journal of the American Academy of Dermatology.

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Many Transplant Patients Open to Possibly Infected Kidney

FRIDAY, April 2 (HealthDay News) -- The majority of renal transplant candidates are open to accepting a kidney from a donor at increased risk for blood-borne viral infections such as HIV under some circumstances, but many donor kidneys infected with hepatitis C are thrown away despite the need among hepatitis C patients awaiting transplants, according to two studies published, respectively, online March 25 in the Clinical Journal of the American Society of Nephrology and March 26 in the American Journal of Transplantation.

Abstract - Reese
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Abstract - Kucirka
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Revision Burden Higher for Disc Replacement Than Fusion

FRIDAY, April 2 (HealthDay News) -- In the United States, the national revision burden for lumbar total disc replacement is higher than that for lumbar fusion surgery, but comparable to that for total hip and knee replacements, according to research published in the March 15 issue of Spine.

Abstract
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Fusion Outcome Not Correlated With Symptom Duration

FRIDAY, April 2 (HealthDay News) -- Among a group of patients who underwent posterior lumbar interbody fusion (PLIF) for chronic low back pain, outcome wasn't related to the duration of symptoms (DOS), according to research published in the March 15 issue of Spine.

Abstract
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Appropriateness Criteria May Improve Surgical Outcomes

FRIDAY, April 2 (HealthDay News) -- In patients with low back pain and/or sciatica, application of appropriateness criteria for surgery can significantly improve patient outcomes, according to a study in the March 15 issue of Spine.

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Care Bundles May Decrease In-Hospital Mortality

FRIDAY, April 2 (HealthDay News) -- Implementing care bundles may significantly reduce in-hospital mortality, according to a report published online April 1 in BMJ.

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Decision Aids Not Used by Most Doctors With Cancer Patients

THURSDAY, April 1 (HealthDay News) -- Despite the benefits of decision aids in helping cancer patients make informed treatment decisions that often improve outcomes, many physicians are unaware of them and most are not currently using them, according to a study published online March 30 in the Journal of Clinical Oncology.

Abstract
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Radiotherapy Receipt After Breast-Conserving Surgery High

THURSDAY, April 1 (HealthDay News) -- In breast cancer patients, adjuvant radiotherapy receipt is consistently high after breast-conserving surgery but lower after mastectomy, even in patients for whom the treatment is strongly indicated, and surgeon involvement is a major influence on radiotherapy receipt, according to a study published online March 29 in the Journal of Clinical Oncology.

Abstract
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Perforated Polydioxanone Foil Useful in Nasal Septum Surgery

THURSDAY, April 1 (HealthDay News) -- Polydioxanone foil is useful in the reconstruction of the nasal septum, although unperforated foil is associated with a risk of saddling, according to a medical record review published in the March/April issue of the Archives of Facial Plastic Surgery.

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Almost One Million Safety Incidents in Medicare Patients

THURSDAY, April 1 (HealthDay News) -- There were almost a million safety incidents among more than 900,000 hospitalized Medicare patients from 2006 to 2008, leading to nearly 100,000 in-hospital deaths, according to the March 2010 HealthGrades Seventh Annual Patient Safety in American Hospitals Study.

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