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Category: Surgery | Monthly Briefing

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September 2010 Briefing - Surgery

Last Updated: October 01, 2010.

 

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

Watchful Waiting Shows Cost Advantage in Prostate Cancer

THURSDAY, Sept. 30 (HealthDay News) -- Watchful waiting with active surveillance (WWAS) may steeply reduce costs compared to radical prostatectomy in men with low-risk prostate cancer, according to research published in the September issue of Urology.

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Tissue Oxygenation Test Predicts Surgical Site Infection

THURSDAY, Sept. 30 (HealthDay News) -- Subcutaneous oxygen concentrations, measurable by a simple test, appear to be highly predictive of a patient's risk for developing postoperative surgical site infections (SSIs), according to research published in the October issue of Anesthesia & Analgesia.

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Comorbidities at Prostatectomy Tied to Other Causes of Death

THURSDAY, Sept. 30 (HealthDay News) -- Men undergoing radical prostatectomy who have greater comorbidity after surgery also have a higher risk of death from other causes than prostate cancer, so assessing patients' other conditions may be advisable when considering treatment, according to research published in the September issue of Urology.

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RA May Raise Complication Risk After Ankle Arthroplasty

MONDAY, Sept. 27 (HealthDay News) -- Underlying inflammatory connective-tissue disease, primarily rheumatoid arthritis, is associated with an increased risk for major incision complications and additional surgery for patients who have undergone total ankle arthroplasty, according to research published in the Sept. 15 issue of the Journal of Bone & Joint Surgery.

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Carotid Endarterectomy Tied to Long-Term Stroke Reduction

FRIDAY, Sept. 24 (HealthDay News) -- Carotid endarterectomy (CEA) performed in asymptomatic patients under 75 years of age appears to reduce 10-year stroke risks, with half this reduction in disabling or fatal strokes, according to a study published in the Sept. 25 issue of The Lancet.

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Low-Volume Hysterectomy Surgeons Tied to Higher Risk

FRIDAY, Sept. 24 (HealthDay News) -- Morbidity and mortality are higher after hysterectomies performed by surgeons who perform fewer than 10 of these procedures per year, and those who perform at least 10 per year are more likely to perform minimally invasive procedures, according to research published in the October issue of Obstetrics & Gynecology.

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Adverse Pathology Not Seen in Deferred Prostatectomy

FRIDAY, Sept. 24 (HealthDay News) -- Men with low- to intermediate-risk prostate cancer undergoing prostate-specific antigen surveillance who later have deferred radical prostatectomy do not have significantly worsened pathologic features after surgery than men undergoing primary radical prostatectomy, according to research published in the October issue of The Journal of Urology.

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More Than Quarter Readmitted in 90 Days After Cystectomy

FRIDAY, Sept. 24 (HealthDay News) -- Many patients are readmitted to the hospital in the three months after radical cystectomy, and several factors can offer guidance on which patients have a higher risk of requiring readmission, according to research published in the October issue of The Journal of Urology.

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Salpingo-Oophorectomy Recommendations Released

FRIDAY, Sept. 24 (HealthDay News) -- The Society of Gynecologic Oncologists has released recommendations for the performance of prophylactic bilateral salpingo-oophorectomy (BSO) based on a woman's risk of developing ovarian cancer. The recommendations have been published in the September issue of Obstetrics & Gynecology.

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Obstetric/Gynecologic Inpatient Procedures Declining

THURSDAY, Sept. 23 (HealthDay News) -- The number of inpatient obstetric and gynecologic surgical procedures has been trending downward, though they still make up a sizable proportion of inpatient procedures for U.S. women, according to research published in the October issue of Obstetrics & Gynecology.

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Venous Thromboembolism Seen After 1% of Hip Replacements

THURSDAY, Sept. 23 (HealthDay News) -- Venous thromboembolism following total hip replacement occurs in roughly 1 percent of patients who receive pharmacological thromboprophylaxis, and factors associated with increased risk of venous thromboembolism include osteoarthritis, a history of cardiovascular disease, and previous thromboembolism, according to research published in the Sept. 15 issue of the Journal of Bone & Joint Surgery.

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Ablation Therapy Effective for Atrial Fibrillation in Young

WEDNESDAY, Sept. 22 (HealthDay News) -- Atrial fibrillation (AF) patients under the age of 45 who undergo ablative therapy experience fewer major complications and similar efficacy as older patients, and have a higher chance of remaining AF free without the use of antiarrhythmic drugs (AADs), according to research published online Sept. 21 in Circulation: Arrhythmia and Electrophysiology.

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Depth of Melanoma Excision Varies by Physician Type

WEDNESDAY, Sept. 22 (HealthDay News) -- The depth of excision of invasive melanomas differs substantially among different types of physicians, according to a study in the September issue of the Archives of Dermatology.

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Disc Batteries Can Cause Severe Esophageal Damage

TUESDAY, Sept. 21 (HealthDay News) -- Ingestion of disc batteries can cause severe injury among pediatric patients and require emergency endoscopic retrieval, according to research published in the September issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Low-Dose Heparin May Not Be Better Than Standard-Dose

TUESDAY, Sept. 21 (HealthDay News) -- In high-risk patients with non-ST-segment elevation acute coronary syndromes initially treated with fondaparinux, low-dose heparin does not appear to reduce major peri-percutaneous coronary intervention (PCI) bleeding or vascular access site complications, according to research published in the Sept. 22/29 issue of the Journal of the American Medical Association.

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Elevated Post-Op Glucose Ups Risk of Surgical Site Infection

TUESDAY, Sept. 21 (HealthDay News) -- Postoperative hyperglycemia is an important risk factor for surgical site infection (SSI) in general surgical procedures, but only operative time and diabetes are associated with SSI after vascular procedures, according to research published in the September issue of the Archives of Surgery.

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Sentinel-Lymph-Node Surgery Safe, Effective Option

TUESDAY, Sept. 21 (HealthDay News) -- Outcomes for women with breast cancer with clinically negative lymph nodes who undergo sentinel-lymph-node (SLN) surgery are clinically equivalent to outcomes for those who undergo the more invasive axillary-lymph-node dissection (ALND), according to a study published online Sept. 21 in The Lancet Oncology.

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Studies Assess Immediate Breast Reconstruction Issues

MONDAY, Sept. 20 (HealthDay News) -- In breast cancer patients who undergo immediate breast reconstruction (IBR), post-mastectomy irradiation (PMRT) is linked to surgical complications and implant loss, but the risk of noninfectious postoperative complications isn't higher after mastectomy and IBR in women who receive chemotherapy, according to two studies published in the September issue of the Archives of Surgery.

Abstract - Christante
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Abstract - Peled
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Trends Noted in Adolescent Bariatric Surgery in California

MONDAY, Sept. 20 (HealthDay News) -- In California adolescents, whites and females are having bariatric surgery at rates disproportionate to the rates seen for boys and nonwhites, and laparoscopic adjustable gastric banding (LAGB) has increased dramatically among adolescents, according to research published online Sept. 20 in Pediatrics.

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Stenting in Aortic Coarctation at Least Equals Other Methods

FRIDAY, Sept. 17 (HealthDay News) -- The short- and long-term outcomes of stent implantation for aortic coarctation appear comparable or superior to those of other approaches, according to research published in the October issue of Catheterization & Cardiovascular Interventions.

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FDA Issues Label Change for Valganciclovir Hydrochloride

THURSDAY, Sept. 16 (HealthDay News) -- The U.S. Food and Drug Administration has alerted health care professionals of new pediatric dosing recommendations for valganciclovir hydrochloride (Valcyte) in an effort to prevent overdosing in children with low body weight, low body surface area, and below normal serum creatinine.

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Depression, Burnout Have Dire Impact on Medical Training

TUESDAY, Sept. 14 (HealthDay News) -- Depressed medical students are more likely to endorse depression stigma attitudes than nondepressed students, and those with burnout are more likely to engage in unprofessional conduct and less likely to hold altruistic views of physicians' social responsibilities than those without burnout, according to two articles published in the Sept. 15 issue of the Journal of the American Medical Association.

Abstract - Schwenk
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Abstract - Dyrbye
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Sacrifice Makes Industry Gifts Seem More Acceptable

TUESDAY, Sept. 14 (HealthDay News) -- Residents who are reminded of the sacrifices they made to attain their medical education tend to rate the acceptability of industry-sponsored gifts higher than those who are not reminded, according to research published in the Sept. 15 issue of the Journal of the American Medical Association.

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Researchers Identify Variables Tied to Med Student Outcomes

TUESDAY, Sept. 14 (HealthDay News) -- Race/ethnicity, debt load, and admissions test score all appear to have an impact on a medical student's likelihood of graduating from medical school and passing the licensing exams, according to research published in the Sept. 15 issue of the Journal of the American Medical Association.

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Women Adapt Differently to Myocardial Pressure Overload

TUESDAY, Sept. 14 (HealthDay News) -- A woman's physiology may result in faster regression of left ventricular (LV) hypertrophy after aortic valve replacement, according to research published in a supplement to the Sept. 14 issue of Circulation.

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Re-Consent Important Before Secondary Use of Genetic Data

MONDAY, Sept. 13 (HealthDay News) -- Most research participants want to be asked for secondary consent -- referred to as re-consent -- before their existing personal genetic data are added to the federal database of Genotypes and Phenotypes (dbGaP), according to research published in the September issue of the Journal of Empirical Research on Human Research Ethics.

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Stenting for Carotid Stenosis Unsafe for Older Adults

FRIDAY, Sept. 10 (HealthDay News) -- Stenting for treatment of carotid stenosis should be avoided in patients 70 years of age or older, but the approach appears to be as safe as endarterectomy in patients younger than 70, according to a meta-analysis published online Sept. 10 in The Lancet.

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Use of Bone Morphogenetic Protein Has Risen

FRIDAY, Sept. 10 (HealthDay News) -- Between 2002 and 2007, the use of bone morphogenetic protein (BMP) rose steeply, and the majority of procedures using BMP were for off-label applications, according to research published in the Sept. 1 issue of Spine.

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Little Between-Surgeon Variation Seen for Mastectomy

FRIDAY, Sept. 10 (HealthDay News) -- For breast cancer patients, between-surgeon variation is wider for patients' receipt of breast reconstruction than for receipt of mastectomy, according to research published online Sept. 8 in Medical Care.

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Inflammation Biomarkers ID Prosthetic Joint Infection

THURSDAY, Sept. 9 (HealthDay News) -- Several inflammation biomarkers, including interleukin-6, C-reactive protein level, erythrocyte sedimentation rate, and white blood-cell count, can effectively diagnose prosthetic joint infection at the time of total hip or knee arthroplasty, according to a meta-analysis published in the Sept. 1 issue of the Journal of Bone & Joint Surgery.

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Crohn's-Related Surgery Risk in Children Rarer Than Thought

THURSDAY, Sept. 9 (HealthDay News) -- The risk of bowel surgery in pediatric Crohn's disease (CD) patients appears to be lower than previously reported, and early initiation of immunomodulators does not appear to influence the risk of bowel surgery, according to research published in the September issue of Clinical Gastroenterology and Hepatology.

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Perioperative Stroke Rare but Deadly in Joint Replacement

THURSDAY, Sept. 9 (HealthDay News) -- Though rare, perioperative stroke following joint replacement has a high rate of both mortality and morbidity, according to a study in the Sept. 1 issue of the Journal of Bone & Joint Surgery.

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Minorities, Uninsured Struck by Cars Have Higher Death Risk

THURSDAY, Sept. 9 (HealthDay News) -- African-American, Hispanic, and uninsured pedestrians struck by vehicles have a greater mortality risk than white or privately insured pedestrians who are struck, according to research published in the August issue of Surgery.

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Annual Medical Liability Costs Surpass $50 Billion

THURSDAY, Sept. 9 (HealthDay News) -- The annual costs of the medical liability system in the United States total more than $50 billion, which accounts for a relatively small but non-trivial portion of total health care spending, according to an article in the September issue of Health Affairs.

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Novel Risk Score Predicts Long-Term Mortality After PCI

WEDNESDAY, Sept. 8 (HealthDay News) -- A risk scoring model that includes post-procedural complications predicts long-term mortality in patients undergoing percutaneous coronary intervention (PCI), according to research published in the Sept. 1 issue of the American Journal of Cardiology.

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Gemcitabine Not Superior for Resected Pancreatic Cancer

TUESDAY, Sept. 7 (HealthDay News) -- For patients who undergo complete resection of pancreatic cancer, treatment with gemcitabine does not result in improved overall survival compared to treatment with fluorouracil plus folinic acid, though it may lead to fewer adverse events, according to a study in the Sept. 8 issue of the Journal of the American Medical Association.

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Discrepancies Seen Between Docs, Patients on PCI Beliefs

TUESDAY, Sept. 7 (HealthDay News) -- Patients undergoing elective coronary catheterization and possible percutaneous coronary intervention (PCI) are generally much more likely than their physicians to believe the procedure will prevent a heart attack, according to research published in the Sept. 7 issue of the Annals of Internal Medicine.

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QRS Infarct Scoring Is Good Prognostic Indicator

FRIDAY, Sept. 3 (HealthDay News) -- Infarct size estimated by QRS scoring on discharge electrocardiogram is a prognostic indicator in patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI), according to a study published in the Sept. 1 issue of the American Journal of Cardiology.

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Predictors of Kidney Transplant Failure Identified

FRIDAY, Sept. 3 (HealthDay News) -- Kidney transplant recipients with interstitial fibrosis and subclinical inflammation after one year are at an increased risk of transplant failure, according to a study published online Sept. 2 in the Journal of the American Society of Nephrology.

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Protocol Guides Wound Closure Timing for Open Fractures

THURSDAY, Sept. 2 (HealthDay News) -- Use of a protocol based on wound culture results after irrigation and surgical debridement of open fractures appears to result in a low rate of infection and may help guide decisions on wound closure timing, according to research published in the Aug. 18 issue of the Journal of Bone & Joint Surgery.

Abstract
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Gender-Specific Knee Implants May Have No Benefits

THURSDAY, Sept. 2 (HealthDay News) -- Gender-specific posterior cruciate-substituting high-flexion knee prostheses don't appear to have any clinical advantages over standard models, at least in the short term, according to research published in the Aug. 18 issue of the Journal of Bone & Joint Surgery.

Abstract
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Coronary Collateral Flow Predicts Outcomes in STEMI

THURSDAY, Sept. 2 (HealthDay News) -- The extent of coronary collateral flow in ST-elevation myocardial infarction (STEMI) patients prior to mechanical reperfusion may predict their long-term clinical outcomes, according to research published in the Sept. 1 issue of the American Journal of Cardiology.

Abstract
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Bariatric Surgery Cost-Effective in Very Obese With Diabetes

THURSDAY, Sept. 2 (HealthDay News) -- Both gastric bypass and gastric banding are cost-effective ways to reduce diabetes-associated complications and mortality among severely obese individuals with diabetes, according to research published in the September issue of Diabetes Care.

Abstract
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Debulking of Ovarian Cancer Can Be Before or After Chemo

WEDNESDAY, Sept. 1 (HealthDay News) -- Debulking surgery for advanced ovarian cancer results in similar outcomes whether it is done before or after adjuvant chemotherapy, according to a study published in the Sept. 2 issue of the New England Journal of Medicine.

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Fontan Survivors Show Less IART Than Previously Reported

WEDNESDAY, Sept. 1 (HealthDay News) -- The prevalence of intra-atrial re-entrant tachycardia (IART) in a large group of survivors of the Fontan operation is lower than that reported in previous studies, and certain factors appear to be linked to development of this problem, according to research published in the Sept. 7 issue of the Journal of the American College of Cardiology.

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