Here are what the editors at HealthDay consider to be the most important developments in Surgery for July 2011. 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.
Traumatic Brain Injury Linked to Increased Stroke Risk
FRIDAY, July 29 (HealthDay News) -- Individuals who sustain a traumatic brain injury (TBI) are at an increased risk of stroke, with more than 10 times higher risk in the first three months, according to a study published online July 28 in Stroke.
New Policy Improves Kidney Transplant Rates for Minorities
FRIDAY, July 29 (HealthDay News) -- Changes to the U.S. kidney allocation system in 2003, which eliminated priority for human leukocyte antigen-B (HLA-B) similarity improved deceased-donor kidney transplantation among minorities without affecting the two-year graft survival during the first six years following the policy change, according to a study published online June 14 in the American Journal of Transplantation.
More Weight Loss in Bariatric Surgery Than Standard Care
THURSDAY, July 28 (HealthDay News) -- Bariatric surgery appears to have substantially higher efficacy than standard care for reducing weight in severely obese adults, according to a review published in the August issue of Obesity Reviews.
Kidney Transplantation After Desensitization Ups Survival
WEDNESDAY, July 27 (HealthDay News) -- For patients with human leukocyte antigen (HLA) sensitivity, performing live-donor kidney transplants after HLA desensitization gives a significant survival benefit over waiting for an HLA-compatible kidney, according to a study published in the July 28 issue of the New England Journal of Medicine.
AVI-4658 Safe and Effective for Duchenne Muscular Dystrophy
TUESDAY, July 26 (HealthDay News) -- The phosphorodiamidate morpholino oligomer AVI-4658 has been found to safely induce new dystrophin protein expression in a significant dose-dependent manner in patients with Duchenne muscular dystrophy (DMD), according to a study published online July 25 in The Lancet.
Lower In-Hospital Mortality for Obese Patients With RI/ARDS
MONDAY, July 25 (HealthDay News) -- Obesity is associated with a decreased incidence of in-hospital mortality in patients who develop postoperative respiratory insufficiency (RI)/adult respiratory distress syndrome (ARDS), according to a study published online July 21 in the Journal of Intensive Care Medicine.
Unexplained Higher Hemorrhage Risk in PAD, CVD Patients
MONDAY, July 25 (HealthDay News) -- Patients with peripheral arterial obstructive disease (PAD) or cerebrovascular disease (CVD) have a higher risk of hemorrhagic events than those with coronary artery disease (CAD), though this difference cannot be explained by known risk factors, use of antithrombotics, or genetic variations in hemostasis, according to a study published online July 13 in the Journal of Thrombosis and Haemostasis.
Hemolysis Products Impair Nitric Oxide Function on Infusion
MONDAY, July 25 (HealthDay News) -- The products of hemolysis, which accumulate in blood stored under standard conditions, interact with nitric oxide (NO) on infusion and impair its vascular function, according to an experimental study published online July 11 in Circulation.
HCC Surgery Depends on Race, Socioeconomics, Hospital Type
FRIDAY, July 22 (HealthDay News) -- Only a small proportion of patients with hepatocellular carcinoma (HCC) undergo surgical treatment, which varies significantly with race, socioeconomic status, and type of hospital, according to a study published in the July issue of the Archives of Surgery.
Best Performing Hospitals for Women in 19 U.S. States ID'd
THURSDAY, July 21 (HealthDay News) -- The best performing hospitals for maternity care and gynecologic surgery across 19 states have been identified, according to the HealthGrades 2011 Obstetrics and Gynecology in American Hospitals report published online July 19 by HealthGrades.
Medical Students Support Right to Conscientious Objection
THURSDAY, July 21 (HealthDay News) -- Nearly half of medical students in the United Kingdom, especially Muslims, believe in the right of doctors to conscientiously object to or refuse any procedure, according to a study published online July 18 in the Journal of Medical Ethics.
Decrease in Rate of Surgical Adverse Events in VHA Centers
THURSDAY, July 21 (HealthDay News) -- The rate of adverse events for surgical procedures and harm in the Veterans Health Administration (VHA) system decreased from 2006 to 2009 while reported close calls increased, according to a study published online July 18 in the Archives of Surgery.
Liver Resection Score IDs Susceptibility to Complications
THURSDAY, July 21 (HealthDay News) -- A score to predict morbidity in liver resections helps identify which patients are most susceptible to complications, according to a study published online July 18 in the Archives of Surgery.
Surgeons Constitute Risk Factor for Infection After Colon Surgery
WEDNESDAY, July 20 (HealthDay News) -- Surgeons are found to constitute a risk factor for surgical site infections (SSI) in patients undergoing colon surgery, independent of other factors linked to the patient, the procedure, or the hospital where the intervention took place, according to a study published online July 18 in the Archives of Surgery.
Chemo, Trastuzumab, Surgery Up Survival in HER2-Positive MBC
MONDAY, July 18 (HealthDay News) -- Patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) and central nervous system (CNS) metastases have improved survival with trastuzumab, chemotherapy, and surgical treatment, according to a study published in the July 15 issue of Clinical Cancer Research.
BetaPV Infection Tied to SCC in Transplant Recipients
MONDAY, July 18 (HealthDay News) -- There is a significant association between betapapillomavirus (betaPV) infection and squamous cell carcinoma (SCC) in patients who receive organ transplants, according to a study published in the July issue of the American Journal of Transplantation.
Post-Surgery VTE Prophylaxis Use Varies Among Hospitals
FRIDAY, July 15 (HealthDay News) -- The use of venous thromboembolism (VTE) prophylaxis after spinal fusion surgery varies widely in U.S. hospitals, according to a study published in the July issue of the Journal of Thrombosis and Haemostasis.
'Rule of Rescue' Trumps Societal Benefits in ICU
THURSDAY, July 14 (HealthDay News) -- More than one-third of intensive care unit (ICU) clinicians are willing to forego societal benefits to prioritize ICU allocation to a living, critically ill patient over a dead or dying patient who would be a potential organ donor, according to a study published in the July issue of Intensive Care Medicine.
Timely Surgery in Traumatic Brain Injury Halves Death Rate
THURSDAY, July 14 (HealthDay News) -- For patients with traumatic brain injury (TBI), shorter time from emergency department (ED) arrival to surgery significantly lowers mortality and length of hospital stay (LOS), according to a study published in the July issue of the Journal of Emergency Nursing.
FDA: Transvaginal Mesh Placement Tied to Adverse Events
WEDNESDAY, July 13 (HealthDay News) -- The U.S. Food and Drug Administration has warned health care providers and patients that transvaginal surgical placement of mesh to repair pelvic organ prolapse (POP) may be riskier than other surgical approaches, with no greater clinical benefit.
Occluded Artery Trial Results Have Minimal Impact
WEDNESDAY, July 13 (HealthDay News) -- The results of the Occluded Artery Trial (OAT) and subsequent guideline revisions have not, to date, been fully incorporated into clinical practice in many hospitals in the United States, according to a study published online July 11 in the Archives of Internal Medicine.
Large Bone Volume Harvested in Posterolateral Lumbar Fusion
WEDNESDAY, July 13 (HealthDay News) -- Large volumes of local bone can be harvested during posterolateral lumbar fusion surgery, according to a study published in the June issue of The Spine Journal.
High-Volume Exercise Feasible After Bariatric Surgery
TUESDAY, July 12 (HealthDay News) -- Following a high-volume exercise program (HVEP) is feasible for more than 50 percent of patients who have undergone Roux-en-Y gastric bypass and gastric banding, according to a study published in the June 16 issue of Obesity.
Year-End Changeovers Linked to Decreased Quality of Care
TUESDAY, July 12 (HealthDay News) -- Quality of health care tends to decrease at the time of academic year-end changeovers, with an increase in patient mortality and decrease in efficiency, according to a meta-analysis published online July 11 in the Annals of Internal Medicine.
Cardiac Transplants Tied to Increased Risk of Skin Cancer
MONDAY, July 11 (HealthDay News) -- Patients who have undergone cardiac transplants have an increased risk of developing skin cancer, in particular cutaneous squamous cell carcinoma (SCC), compared to the general population, according to a study published in the July issue of the American Journal of Transplantation.
Clinical Practice Guidelines Underused in Bladder Cancer
MONDAY, July 11 (HealthDay News) -- Clinical practice guidelines for management of patients with bladder cancer are not being followed, with provider-level factors contributing to this underuse, according to a study published online July 11 in Cancer.
Physical Therapy Doesn't Affect Male Urinary Incontinence
FRIDAY, July 8 (HealthDay News) -- One-to-one conservative physical therapy does not improve urinary incontinence in men compared to standard care after prostate surgery, according to a study published online July 8 in The Lancet.
Factors in Acinetobacter Infection Transmission ID'd
FRIDAY, July 8 (HealthDay News) -- The identification of themes involved in the transmission of multi-drug resistant (MDR) Acinetobacter infections, sources of transmission, and interventions to reduce infections offer new insight into MDR Acinetobacter infections in war injuries, according to a review published in the July issue of the AORN Journal.
Obesity Tied to Higher Risk of Breast Surgery Complications
THURSDAY, July 7 (HealthDay News) -- Obesity is associated with a significantly higher risk of complications following breast surgery, according to a study published online June 9 in Plastic and Reconstructive Surgery.
Nurses' Calls Decrease Day-of-Surgery Cancellations
THURSDAY, July 7 (HealthDay News) -- Nurse-to-patient telephone calls three days prior to scheduled surgery result in a significant decrease in the daily cancellation rate, increased patient satisfaction scores, and increased operating room use, according to a study published in the July issue of the AORN Journal.
PCIs Done for Acute Indications Almost Always Appropriate
WEDNESDAY, July 6 (HealthDay News) -- Most percutaneous coronary interventions (PCIs) performed for acute indications are appropriate, but for nonacute indications the proportion of inappropriate PCIs is higher, with substantial between-hospital variations, according to a study published in the July 6 issue of the Journal of the American Medical Association.
Fewer Clinical Capabilities in Critical Access Rural Hospitals
TUESDAY, July 5 (HealthDay News) -- Rural critical access hospitals (CAHs) have fewer clinical capabilities, significantly poorer performance on process measures, and higher 30-day mortality rates than non-CAHs for patients with acute myocardial infarction (AMI), congestive heart failure, and pneumonia, according to a study published in the July 6 issue of the Journal of the American Medical Association.
Invasive Strategies Tied to Lower NSTEMI Mortality in CKD
TUESDAY, July 5 (HealthDay News) -- The management of non-ST-segment elevation myocardial infarction (NSTEMI) with invasive strategies (early invasive [EI] and deferred invasive [DI]) in patients with chronic kidney disease (CKD) is associated with significantly decreased mortality compared to a conservative strategy, except for patients with severe CKD, according to a study published in the July 15 issue of The American Journal of Cardiology.
Transvaginal BNC Effective for Devastated Urethra
TUESDAY, July 5 (HealthDay News) -- Modified transvaginal bladder neck closure (TV BNC) with a urethral flap is effective for devastated urethra, minimizing the risk of upper tract injury and fistula formation, according to a study published in the July issue of Urology.
Priority Score Predicts Post-Op Survival and Dropout Risk
TUESDAY, July 5 (HealthDay News) -- A continuous hepatocellular carcinoma (HCC) priority score incorporating a model for end-stage liver disease (MELD), alpha-fetoprotein and tumor size can be used to predict dropout, post-transplantation survival, and recurrence rates after liver transplantation, according to a study published online June 10 in the American Journal of Transplantation.
PCI Safe and Feasible in End-Stage Liver Disease
MONDAY, July 4 (HealthDay News) -- Percutaneous coronary intervention (PCI) for coronary artery disease (CAD) is safe and feasible for liver transplant candidates with end-stage liver disease (ESLD), according to a study published in the July issue of Liver Transplantation.
Unprotected Left Main Coronary Artery PCI Safe, Effective
FRIDAY, July 1 (HealthDay News) -- For patients with normal left ventricular function, elective unprotected left main coronary artery (ULMCA) percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may be a safe and effective treatment, according to a study published in the June 1 issue of Catheterization & Cardiovascular Interventions.
Blood Pressure Variability Tied to Heart Surgery Mortality
FRIDAY, July 1 (HealthDay News) -- Variations in perioperative blood pressure are associated with 30-day mortality in cardiac surgical patients, with increased mortality risks for high-risk than low-risk patients, according to a study published in the July issue of Anesthesia & Analgesia.
Gastric Bypass Tied to Lower Pro-Inflammatory Proteins
FRIDAY, July 1 (HealthDay News) -- Laparoscopic Roux-en-Y gastric bypass surgery (RYGB) reduces pro-inflammatory biomarkers and increases the levels of anti-inflammatory proteins, according to a study published online March 24 in Surgery for Obesity and Related Diseases.
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