Here are what the editors at HealthDay consider to be the most important developments in Surgery for June 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.
Consensus Formulation of CAV Nomenclature Issued
WEDNESDAY, June 30 (HealthDay News) -- The first international consensus formulation of a standardized nomenclature to define and describe post-heart-transplant cardiac allograft vasculopathy (CAV) has been issued by clinicians representing the International Society for Heart and Lung Transplantation Working Group on Classification of Cardiac Allograft Vasculopathy, and published in the July issue of the Journal of Heart and Lung Transplantation.
Cyclosporine After Transplant Tied to De Novo Cancer Risk
WEDNESDAY, June 30 (HealthDay News) -- Immunosuppressive treatment with cyclosporine A (CsA), rather than tacrolimus (TAC), with dose level monitoring two hours post-dosing (C2 monitoring) or in patients age 50 or younger appears to have a significant association with the development of de novo cancer after liver transplantation, according to research published in the July issue of Liver Transplantation.
Statins May Slow Post-Surgery Cancer Recurrence
TUESDAY, June 29 (HealthDay News) -- In men who undergo radical prostatectomy for prostate cancer, those who take statins have a decreased risk of biochemical recurrence, according to research published online June 28 in Cancer.
Doctors Agree Malpractice Fears Drive Overuse of Tests
MONDAY, June 28 (HealthDay News) -- A large majority of physicians agree that the practice of defensive medicine -- stemming from malpractice concerns -- is responsible for an overuse of medical tests and procedures, according to a research letter in the June 28 issue of the Archives of Internal Medicine.
Obesity May Not Complicate Spine Surgery
MONDAY, June 28 (HealthDay News) -- Though some studies have suggested higher body mass index (BMI) increases risk for complications after spine surgery, a new study published in the July issue of The Spine Journal did not find any such correlation.
Updated Recommendations for Endometriosis Released
FRIDAY, June 25 (HealthDay News) -- Women who suffer from endometriosis-related pain should be treated first with conservative, non-surgical approaches and then with more invasive options if pain does not resolve, and hysterectomy only as a last resort, according to a practice bulletin issued by the American College of Obstetricians and Gynecologists (ACOG) and published in the July issue of Obstetrics & Gynecology.
Surgery Provides Improved Outcomes in Spinal Stenosis
THURSDAY, June 24 (HealthDay News) -- Symptomatic spinal stenosis patients who undergo surgical treatment maintain substantially greater improvements in pain and function measures through four years compared to those treated nonoperatively, according to a study published in the June 15 issue of Spine.
Early Shunting Controls Bleeding in Cirrhotic Patients
WEDNESDAY, June 23 (HealthDay News) -- Typically reserved as a rescue therapy, the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) soon after hospital admittance for acute variceal bleeding in cirrhosis patients may reduce the likelihood of treatment failure and death, according to research published in the June 24 issue of the New England Journal of Medicine.
Surgical Infection-Prevention Program Has Mixed Results
TUESDAY, June 22 (HealthDay News) -- Adherence to Surgical Care Improvement Project (SCIP) infection-prevention measures is associated with a decreased risk of postoperative infections only when the measures are analyzed as a composite score instead of individually, according to research published in the June 23/30 issue of the Journal of the American Medical Association.
Spinal Surgical Site Infections Usually S. Aureus
TUESDAY, June 22 (HealthDay News) -- Both deep and superficial surgical site infections (SSIs) after spinal surgery are usually caused by Staphylococcus aureus; successful treatment of deep infections is possible with single stage debridement and intravenous antibiotics, and superficial infections can effectively be treated with local wound care and oral antibiotic therapy, according to research published in the June 1 issue of Spine.
Many Doctors Positive Toward Industry Gifts, Interactions
TUESDAY, June 22 (HealthDay News) -- Physicians from a wide array of specialties -- particularly surgeons, trainees, and those not familiar with their institutions' policies on industry interactions -- have positive attitudes toward the pharmaceutical and medical device industries' marketing-related activities, according to research published in the June issue of the Archives of Surgery.
Surgical Residents Critical of Work-Hour Restrictions
MONDAY, June 21 (HealthDay News) -- The 50-hour workweek limitation for residents that has been adopted in Switzerland may have improved residents' quality of life, but at a cost to their surgical training and patient care, according to research published in the June issue of the Archives of Surgery.
Laparoscopy May Be Safest Option for Diverticular Disease
FRIDAY, June 18 (HealthDay News) -- Laparoscopic colon resection for diverticular disease results in fewer complications, lower postoperative mortality, and shorter hospital stays than open surgery for the condition, according to research published in the June issue of Gastroenterology.
Alternative Approach to Valve Replacement Surgery Effective
FRIDAY, June 18 (HealthDay News) -- Transcatheter valve-in-valve implantation may be an effective option for high-risk elderly patients with degenerated bioprostheses in the aortic and mitral position, according to a study published online April 30 in Catheterization & Cardiovascular Interventions.
Nationally, Unilateral Mastectomy Rate Has Declined
TUESDAY, June 15 (HealthDay News) -- Although several single-institution studies have reported an increase in mastectomy rates in the past decade, unilateral mastectomy rates appear to have decreased from 2000 to 2006, according to a population-based analysis published online June 14 in the Journal of Clinical Oncology.
Enhancing Red Blood Cells in Prostatectomy Judged Safe
MONDAY, June 14 (HealthDay News) -- The use of erythropoietin stimulating proteins (ESPs) in men with normal hemoglobin levels undergoing open radical retropubic prostatectomy is not associated with an increase in cardiovascular or thromboembolic complications, according to a study in the June issue of Urology.
Arthroplasty Growth Rates Similar Across Hospitals
FRIDAY, June 11 (HealthDay News) -- The use of arthroplasty of lower extremity joints is rising at a similar rate in markets that have new arthroplasty programs and in those that don't, according to a study published in the June 1 issue of the Journal of Bone & Joint Surgery.
Medical and PCI Long-Term Outcomes Similar in CAD
FRIDAY, June 11 (HealthDay News) -- Coronary artery disease (CAD) patients who are either medically treated or treated with percutaneous coronary intervention (PCI) including stenting have similar long-term outcomes for mortality and nonfatal myocardial infarction, but the PCI group experiences less angina, according to a study in the June 1 issue of the American Journal of Cardiology.
Care Costs Substantial Before Lumbar Discectomy
FRIDAY, June 11 (HealthDay News) -- Patients with lumbar disc herniation incur substantial charges for preoperative care in the months before discectomy -- during a period of conservative management -- which are roughly equally divided between diagnostic charges and therapeutic charges, according to research published in the June issue of The Spine Journal.
Nurses and Surgeons Perceive Teamwork Differently
THURSDAY, June 10 (HealthDay News) -- They may be on the same team, but operating room nurses and surgeons have different perceptions of communication and teamwork effectiveness in the operating room, according to research published in the June issue of the AORN Journal.
Organ Sparing Surgery for Bladder Cancer Feasible
THURSDAY, June 10 (HealthDay News) -- Gynecologic organ sparing procedures for the surgical treatment of bladder cancer appear to be feasible, with acceptable oncologic outcomes and voiding function, according to research published in the June issue of Urology.
S. aureus Infections a Greater Risk After Certain Procedures
THURSDAY, June 10 (HealthDay News) -- The frequency and type of invasive Staphylococcus aureus infections following surgeries vary according to the type of procedure, with cardiothoracic and neurosurgical procedures linked to the highest risks, according to research published in the July issue of Infection Control & Hospital Epidemiology.
Abdominal Aortic Aneurysm Not Uncommon in CABG Patients
WEDNESDAY, June 9 (HealthDay News) -- Among patients who have undergone coronary artery bypass grafting (CABG), abdominal aortic aneurysms (AAAs) are particularly common in men with a history of smoking and other vascular problems, including peripheral arterial disease (PAD), according to research published in the June 1 issue of the American Journal of Cardiology.
Delaying Gallbladder Removal Ups Complications, Costs
WEDNESDAY, June 9 (HealthDay News) -- Delaying cholecystectomy in elderly adults hospitalized due to acute cholecystitis often results in hospital readmissions within two years and increased patient morbidity, mortality and costs, according to research published in the May issue of the Journal of the American College of Surgeons.
Hand Hygiene Practices Low Among Health Care Providers
WEDNESDAY, June 9 (HealthDay News) -- Nurses and other health care providers are often noncompliant with hand hygiene guidelines before and after procedures, though compliance is higher with high-risk procedures and when health care providers are exposed to blood, according to a study in the May issue of Applied Nursing Research.
Infection Control Lapses Common in Surgical Centers
TUESDAY, June 8 (HealthDay News) -- Two-thirds of Medicare-participating ambulatory surgical centers (ASCs) have at least one lapse in their infection control practices, and a substantial number have three or more lapses, according to research published in the June 9 issue of the Journal of the American Medical Association.
Fatal Medication Errors Rise in July at Teaching Hospitals
TUESDAY, June 8 (HealthDay News) -- In July there is a significant increase in fatal medication errors at medical institutions, and this spike is at least partly due to the arrival of new medical residents, according to a study published online May 29 in the Journal of General Internal Medicine.
Anesthesia During Cancer Surgery May Impact Outcomes
MONDAY, June 7 (HealthDay News) -- The use of anesthesia during cancer surgery may impact long-term outcomes and risk of cancer recurrence, according to two articles published in the June issue of Anesthesia & Analgesia.
Smoking Cessation Approach Reduces Surgery Complications
MONDAY, June 7 (HealthDay News) -- Initiating a smoking cessation intervention program after acute fracture surgery and carrying it out for six weeks may reduce the risk of post-surgical complications, according to a study in the June 1 issue of the Journal of Bone & Joint Surgery.
Antivirals in Compensated Cirrhosis Found Cost-Effective
FRIDAY, June 4 (HealthDay News) -- The antiviral treatment of patients with compensated cirrhosis may be the most cost-effective treatment option for patients with advanced liver disease caused by hepatitis C virus (HCV) infection, according to research published in the June issue of Liver Transplantation.
Low HDL Predicts Development of Abdominal Aortic Aneurysm
FRIDAY, June 4 (HealthDay News) -- There appears to be a consistent association between low levels of high-density lipoprotein (HDL) and the presence of abdominal aortic aneurysms (AAAs) in men aged 65 years or older, according to research published in the May 15 issue of the American Journal of Cardiology.
Stenting Safe Alternative to CABG in ULMCA Stenosis
THURSDAY, June 3 (HealthDay News) -- In patients with unprotected left main coronary artery (ULMCA) stenosis and additional vascular disease, coronary stenting is probably a safe alternative to coronary artery bypass graft (CABG), according to research published in the June 8 issue of the Journal of the American College of Cardiology.
Case Study Shows Poor Results of Back Pain Overtreatment
THURSDAY, June 3 (HealthDay News) -- For low back pain, overly aggressive surgical treatment and overtreatment with narcotics can result in severely adverse outcomes for the patient, including increased pain, loss of functionality and drug addiction, according to a case report in the May 20 issue of Spine.
Cost Varies by Region in Spinal Fusion for Scoliosis
THURSDAY, June 3 (HealthDay News) -- There is significant variation in the cost and hospital length of stay (LOS) for spinal fusion for idiopathic scoliosis in different regions of the United States, according to research published in the May 15 issue of Spine.
Ultrasound Identifies Patients at Higher Stroke Risk
WEDNESDAY, June 2 (HealthDay News) -- The detection of asymptomatic embolic signals using transcranial doppler (TCD) may help identify groups of patients with asymptomatic carotid stenosis who are at low or high risk of stroke, which could be useful in identifying those most likely to benefit from endarterectomy, according to a study published online May 28 in The Lancet Neurology to coincide with its presentation at the European Stroke Conference, held from May 25 to 28 in Barcelona, Spain.
Combination Strategy Best for Bleeding Prevention After PCI
TUESDAY, June 1 (HealthDay News) -- Patients undergoing percutaneous coronary intervention (PCI) who get bivalirudin in addition to a vascular closure device have the lowest bleeding risk, but patients with a high preprocedural bleeding risk are less likely to receive this treatment, according to research published in the June 2 issue of the Journal of the American Medical Association.
Microdebrider May Be Best Tonsillectomy Technique
TUESDAY, June 1 (HealthDay News) -- Microdebrider intracapsular tonsillectomy appears to have an edge over coblation and electrocautery when it comes to tonsillectomy complication rates, according to research published in the June issue of Otolaryngology -- Head and Neck Surgery.
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