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Category: Surgery | Monthly Briefing

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August 2011 Briefing - Surgery

Last Updated: September 01, 2011.

 

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

Predictors of Child Ventricular Assist Device Mortality ID'd

WEDNESDAY, Aug. 31 (HealthDay News) -- In children with ventricular assist device (VAD) support, congenital etiology, norepinephrine requirement, C-reactive protein (CRP) levels higher than 6.3 mg/dL, and central venous pressure (CVP) greater than 17 mm Hg are independent predictors of in-hospital mortality, according to a study published in the Sept. 6 issue of the Journal of the American College of Cardiology.

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Lower Early Restenosis Rate With Drug-Eluting Balloons

WEDNESDAY, Aug. 31 (HealthDay News) -- Drug-eluting balloons (DEBs) seem to be safe and effective for treating long infrapopliteal lesions, according to a study published online Aug. 29 in the Journal of the American College of Cardiology.

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Composition of ICU Team Affects Professional Burnout

WEDNESDAY, Aug. 31 (HealthDay News) -- The composition of caregiver teams in intensive care units (ICUs) affects the risk of professional burnout, with an increased proportion of female nurses associated with a decreased risk, according to a study published online Aug. 18 in the American Journal of Respiratory and Critical Care Medicine.

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Increasing BMI Ups Atonic Uterus Hemorrhage Risk

TUESDAY, Aug. 30 (HealthDay News) -- The risk of postpartum atonic uterus hemorrhage increases with increasing maternal body mass index (BMI), but there is no correlation between obesity and postpartum hemorrhage with retained placenta, according to a study published in the September issue of Obstetrics & Gynecology.

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ESC: Addition of IABC to PCI Doesn't Reduce Infarct Size

TUESDAY, Aug. 30 (HealthDay News) -- For patients with anterior ST-segment elevation myocardial infarction (STEMI) without shock, use of intra-aortic balloon counterpulsation (IABC) plus percutaneous coronary intervention (PCI) does not reduce the size of myocardial infarct more than PCI alone, according to a study published online Aug. 29 in the Journal of the American Medical Association, to coincide with its presentation at the European Society of Cardiology Congress 2011, held Aug. 27-31, in Paris, France.

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Public Sector Funds Large Part of State Obesity-Related Costs

MONDAY, Aug. 29 (HealthDay News) -- Between 22 and 55 percent of U.S. state-level obesity-related costs are financed by the public sector via Medicare and Medicaid, according to a study published online June 16 in Obesity.

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High Demand, But Minority of Ob-Gyns Provide Abortions

FRIDAY, Aug. 26 (HealthDay News) -- In the United States, 97 percent of practicing obstetrician-gynecologists (ob-gyns) encounter patients seeking abortions, but only 14 percent perform abortions, according to a study published in the September issue of Obstetrics & Gynecology.

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Complementary Medicine Used More by Health Care Workers

FRIDAY, Aug. 26 (HealthDay News) -- U.S. health care workers, especially health care providers, are more likely to use complementary and alternative medicine (CAM) than the general, employed U.S. population, according to a study published online Aug. 22 in Health Services Research.

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Pharmaceutical Ads Often Don't Adhere to U.S. FDA Guidelines

THURSDAY, Aug. 25 (HealthDay News) -- Physician-targeting pharmaceutical advertisements have low rates of adherence to U.S. Food and Drug Administration (FDA) guidelines and provide inadequate information for safe prescribing, according to a study published online Aug. 17 in PLoS One.

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EMR Language Analysis Identifies Post-Op Complications

TUESDAY, Aug. 23 (HealthDay News) -- Natural language process analysis of electronic medical records has higher sensitivity and lower specificity for identifying postoperative complications than patient safety indicators based on discharge coding for patients undergoing surgical procedures, according to a study published in the Aug. 24/31 issue of the Journal of the American Medical Association.

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Five Strategies Suggested to Reduce HCC Recurrence

MONDAY, Aug. 22 (HealthDay News) -- Hepatocellular carcinoma (HCC) recurrence in patients who have undergone liver transplantation may be reduced by following potential strategies in five steps before and after transplant surgery, according to a study published online Aug. 10 in the American Journal of Transplantation.

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Dalteparin Sodium Effective, Safe in Upper-Extremity DVT

MONDAY, Aug. 22 (HealthDay News) -- Patients with upper-extremity deep-vein thrombosis (DVT) may be treated safely with either dalteparin sodium followed by warfarin or dalteparin sodium monotherapy for three months with a successful outcome, according to a study published online Aug. 12 in the Journal of Thrombosis and Haemostasis.

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Pre-Surgery Factor VIII in Hemophilia A Ups Inhibitor Risk

FRIDAY, Aug. 19 (HealthDay News) -- Patients with hemophilia A treated with intensive factor VIII (FVIII) treatment for surgery at first exposure are at an increased risk of developing inhibiting antibodies toward FVIII (inhibitors), as compared to those treated for bleeding and given prophylactic FVIII, according to a review published online Aug. 12 in the Journal of Thrombosis and Haemostasis.

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Donor-Specific Antibody Tied to Renal Graft Rejection Risk

FRIDAY, Aug. 19 (HealthDay News) -- The presence of donor-specific antibody (DSA) increases the risk of antibody-mediated rejection (AMR) and cell-mediated rejection (CMR) of kidney allografts, according to a study published online Aug. 3 in the American Journal of Transplantation.

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CDC: 2010/2011 Flu Vaccination Coverage Studied

THURSDAY, Aug. 18 (HealthDay News) -- Influenza vaccination coverage among health care personnel (HCP) and pregnant women in the 2010/2011 influenza season was similar to coverage for the 2009/2010 season, according to two reports in the Aug. 19 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Majority of DVT Cases After Surgery Linked to Catheter Use

THURSDAY, Aug. 18 (HealthDay News) -- Following general surgical operations, the incidence of deep venous thrombosis (DVT) is low, but more than 60 percent of cases are catheter-induced, according to a study published online Aug. 15 in the Archives of Surgery.

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High Cumulative Malpractice Risk for All Physicians

THURSDAY, Aug. 18 (HealthDay News) -- Physicians in all specialties have a high cumulative risk of facing a malpractice claim by age 65; although most claims do not lead to indemnity payments, according to a study published in the Aug. 18 issue of the New England Journal of Medicine.

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Bispectral Index Guided Anesthesia Not Superior

WEDNESDAY, Aug. 17 (HealthDay News) -- Intraoperative anesthesia guided by a protocol incorporating the electroencephalogram derived bispectral index (BIS) is not superior to a protocol incorporating standard monitoring of end-tidal anesthetic-agent concentration (ETAC) for the prevention of intraoperative awareness, according to a study published in the Aug. 18 issue of the New England Journal of Medicine.

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Diabetic Dermopathy Tied to Abnormal Skin Blood Flow

WEDNESDAY, Aug. 17 (HealthDay News) -- The pretibial surfaces of the legs of patients with diabetic dermopathy have significantly lower skin blood flow on normal-appearing skin than in control patients, whereas dermopathy lesions have higher blood flow, according to a study published in the September issue of the Journal of the American Academy of Dermatology.

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Large Variation in Reoperation Rate After Colorectal Surgery

WEDNESDAY, Aug. 17 (HealthDay News) -- Reoperation rates after colorectal surgery vary significantly between hospitals and among surgeons in England, according to a study published online Aug. 16 in BMJ.

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AdV-tk Plus Valacyclovir Safe in New Malignant Gliomas

WEDNESDAY, Aug. 17 (HealthDay News) -- The administration of an adenoviral vector containing the herpes simplex virus thymidine kinase gene (AdV-tk), plus valacyclovir, is safe and can be delivered with surgery and accelerated radiation in patients with newly diagnosed malignant gliomas, according to a study published online Aug. 15 in the Journal of Clinical Oncology.

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Surgical Residents Benefit From Communication Training

WEDNESDAY, Aug. 17 (HealthDay News) -- Surgical residents who undergo training to improve patient-centered communication skills have superior case-specific performance, according to a study published in the August issue of the Archives of Surgery.

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Coronary Stents and Peri-Op Antiplatelet Drug Use Reviewed

TUESDAY, Aug. 16 (HealthDay News) -- In patients on dual antiplatelet therapy (DAPT) undergoing non-cardiac surgery (NCS) within one year of coronary stenting, APT withdrawal should be decided after assessing the risk of perioperative bleeding and cardiac ischemic events, particularly stent thrombosis (ST), according to a review published online Aug. 5 in the Journal of Thrombosis & Haemostatis.

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Patient Care Improves With Anticoagulation Service

TUESDAY, Aug. 16 (HealthDay News) -- A Pharmacist-Directed Anticoagulation Service (PDAS) improves the quality of care for patients taking the anticoagulant drug warfarin in an inpatient setting by coordinating the transition of care from an inpatient to an outpatient setting, according to a study published online Aug. 10 in the Journal of Hospital Medicine.

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Clindamycin More Effective in Treating Soft Tissue Infections

MONDAY, Aug. 15 (HealthDay News) -- Use of trimethoprim-sulfamethoxazole and β-lactams for treatment of pediatric skin and soft tissue infections (SSTIs) is associated with increased risks of treatment failure and recurrence compared to treatment with clindamycin, according to a study published online Aug. 15 in Pediatrics.

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Psychiatric Comorbidity Affects Costs in Severe Back Pain

FRIDAY, Aug. 12 (HealthDay News) -- Patients with severe back pain undergoing disc surgery have high direct and indirect costs, which are influenced by psychiatric comorbidity, according to a study published in the July issue of The Spine Journal.

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tPA, DNase Improves Fluid Drainage in Pleural Infection

THURSDAY, Aug. 11 (HealthDay News) -- Combined intrapleural tissue plasminogen activator (t-PA) and DNase therapy improves fluid drainage in patients with pleural infection and reduces hospital stay duration and the frequency of surgical referral, according to a study published in the Aug. 11 issue of the New England Journal of Medicine.

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Rat-Tested PEG-HA Soft Tissue Implant Feasible in Humans

WEDNESDAY, Aug. 10 (HealthDay News) -- A biosynthetic soft-tissue replacement composed of polyethylene glycol (PEG) photocrosslinked with hyaluronic acid (HA) tested on rats, is feasible in humans, without serious adverse events, according to a study published online July 27 in Science Translational Medicine.

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Most Colostomies After Anal Cancer Therapy Tumor Related

WEDNESDAY, Aug. 10 (HealthDay News) -- Most colostomies performed following radiotherapy or chemoradiotherapy for anal cancer are tumor related, with one-third therapy related, according to a study published online Aug. 8 in the Journal of Clinical Oncology.

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More Accurate Alignment With Computer-Aided Knee Surgery

WEDNESDAY, Aug. 10 (HealthDay News) -- Computer-assisted total knee arthroplasty results in a more accurate implant alignment compared to conventional surgery with intramedullary or extramedullary guides, according to a study published in the Aug. 3 issue of The Journal of Bone & Joint Surgery.

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Knowledge, Beliefs Affect Judgment of Hand Hygiene Risk

TUESDAY, Aug. 9 (HealthDay News) -- Individual differences in knowledge levels and beliefs among health care workers (HCWs) affect their risk perception regarding pathogen transfer, with touching patient skin believed to be riskier than touching objects, according to a study published in the August issue of the American Journal of Infection Control.

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Encouraging Results With the Mobility Prosthesis Ankle Implant

TUESDAY, Aug. 9 (HealthDay News) -- The clinical and radiographic results of total ankle arthroplasty with Mobility prosthesis are appreciable and comparable to that of other modern three-component implants, according to a study published in the Aug. 3 issue of The Journal of Bone & Joint Surgery.

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Obstructive CAD Detection Rates Vary Between Hospitals

TUESDAY, Aug. 9 (HealthDay News) -- Significant interhospital variation exists in the rate of detection of obstructive coronary artery disease (CAD) in patients undergoing elective coronary angiography, according to a study published in the Aug. 16 issue of the Journal of the American College of Cardiology.

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Sirolimus Regimens Do Not Improve Transplant Outcomes

MONDAY, Aug. 8 (HealthDay News) -- In renal allograft recipients, sirolimus (SRL)-based regimens have similar survival rates and Nankivell glomerular filtration rates (GFR) as regimens containing tacrolimus (TAC) and mycophenolate mofetil (MMF), but the rate of graft rejection and discontinuation due to adverse events is higher, according to a study published in the August issue of the American Journal of Transplantation.

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New Score System Predicts Lower-Extremity Amputation Risk

FRIDAY, Aug. 5 (HealthDay News) -- A new scoring system that stratifies the risk of nontraumatic lower-extremity amputation (LEA) among patients hospitalized for a diabetic foot infection, has been developed and validated, according to a study published in the August issue of Diabetes Care.

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Cost of Interacting With Payers Higher in U.S. Than Canada

FRIDAY, Aug. 5 (HealthDay News) -- Physician practices in the United States spend considerably more on interactions with health plans than Canadian practices, according to a study published in the August issue of Health Affairs.

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Hyperspectral Imaging Assesses Intra-Op Hemoglobin Saturation

FRIDAY, Aug. 5 (HealthDay News) -- DLP Hyperspectral imaging (HSI) serves as a fast, noninvasive method to assess renal hemoglobin saturation parameters intraoperatively, according to a study published in the August issue of The Journal of Urology.

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Gastric Bypass Tied to Reduced Fat Intake in Humans, Rats

THURSDAY, Aug. 4 (HealthDay News) -- Gastric bypass is associated with reduced intake of and preference for fat in rats, and reduced intake of dietary fat for humans, according to an experimental study published online in July 6 in the American Journal of Physiology.

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Tissue-Engineered Interverterbral Implant Feasible

WEDNESDAY, Aug. 3 (HealthDay News) -- After being implanted into the caudal spine, a living, tissue-engineered intervertebral disc (IVD) gets integrated into the spine, maintains disc space height, and produces new extracellular matrix (ECM) and intact motion segment similar to the native IVD, according to an experimental study published online Aug. 1 in the Proceedings of the National Academy of Sciences.

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Neurologic Lesions Common in Reverse Shoulder Arthroplasty

WEDNESDAY, Aug. 3 (HealthDay News) -- Peripheral neurologic lesions following reverse shoulder arthroplasty are common but usually temporary, and may be attributed to arm lengthening, according to a study published in the July 20 issue of The Journal of Bone & Joint Surgery.

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Endoscopic Instrumentation Linked to Insulation Failures

TUESDAY, Aug. 2 (HealthDay News) -- Robotic and laparoscopic endoscopic instrumentations -- particularly robotic -- are associated with high incidence and prevalence of insulation failure (IF) after 10 procedures, according to a study published in the August issue of the American Journal of Obstetrics & Gynecology.

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Causes of Failure to Prevent Retained Surgical Sponges ID'd

TUESDAY, Aug. 2 (HealthDay News) -- Failure to prevent retained sponges after surgical procedures occurs at different points in the perioperative process and may be due to a wide range of causes, including distraction, multitasking, not following procedure, and time pressure, according to a study published in the August issue of the AORN Journal.

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Infection Incidence After Spinal Tumor Surgery ~10 Percent

TUESDAY, Aug. 2 (HealthDay News) -- The incidence of surgical site infections (SSIs) following spinal tumor surgery ranges from 8.89 to 13.7 percent, and the risk is associated with perioperative factors, including previous spinal surgeries, increased number of comorbidities, previous hospital-acquired infection, and increased hospital stay, according to a study published in the Aug. 1 issue of Spine.

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FDA: GEM Premier 4000 PAK Cartridges Recalled

MONDAY, Aug. 1 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care professionals and patients that the GEM Premier 4000 PAK Cartridges for use on the GEM Premier 4000 System have been recalled, as test results may lead to inappropriate patient treatment and may cause serious adverse effects, including death.

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Tamoxifen Chemoprophylaxis Offers Cost-Effective Benefits

MONDAY, Aug. 1 (HealthDay News) -- Tamoxifen chemoprophylaxis is a cost-effective policy which reduces breast cancer incidence, and improves life expectancy for postmenopausal women younger than 55 years, following active treatment, according to a study published in the Aug. 1 issue of Cancer.

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CA 19-9, Ultrasound Feasible for Pancreatic Cancer Detection

MONDAY, Aug. 1 (HealthDay News) -- Screening for tumor marker CA 19-9 followed by targeted endoscopic ultrasound (EUS) when the level is elevated represents a feasible approach for identifying early pancreatic adenocarcinoma in a high-risk population, according to a study published in the July issue of Gastrointestinal Endoscopy.

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Infrastructure Tied to Most U.K. Obesity-Related Safety Events

MONDAY, Aug. 1 (HealthDay News) -- The majority of obesity-associated safety incidents reported to the United Kingdom's National Patient Safety Agency (NPSA) are related to infrastructure, and are classified as low or no harm, according to a study published online July 25 in the Postgraduate Medical Journal.

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One-Shot Flu Vaccine Partially Effective After Teen Transplant

MONDAY, Aug. 1 (HealthDay News) -- A single dose of pandemic influenza A (pH1N1/09) vaccine offers a modest rate of seroconversion in pediatric liver transplant patients above the age of 10 years, according to a study published in the August issue of Liver Transplantation.

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