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Category: Surgery | Monthly Briefing

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September 2011 Briefing - Surgery

Last Updated: October 03, 2011.

 

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

Better Outcomes for Cervical Spine Arthroplasty Than Fusion

FRIDAY, Sept. 30 (HealthDay News) -- For treatment of single-level degenerative cervical disc disease, the use of cervical disc arthroplasty is associated with significantly superior outcomes at 48 months versus anterior cervical discectomy with fusion, according to a study published in the Sept. 21 issue of The Journal of Bone & Joint Surgery.

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Doctors, Patients Identify Tacit Clues in Their Interactions

FRIDAY, Sept. 30 (HealthDay News) -- Both doctors and patients identify tacit clues as well as judgments based on these clues during video elicitation interviews of health maintenance examinations, according to a study published in the October issue of the Journal of Evaluation in Clinical Practice.

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Spinal MRI Reviewer Accuracy Equal Across Training Levels

FRIDAY, Sept. 30 (HealthDay News) -- Doctors at multiple levels of training can accurately and efficiently interpret the integrity of the posterior ligamentous complex (PLC) on spinal magnetic resonance imaging (MRI), according to a study published in the August issue of The Spine Journal.

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High Risk of Salvage Transplant Failure Post Liver Resection

FRIDAY, Sept. 30 (HealthDay News) -- Initial liver resection (LR) in hepatocellular carcinoma (HCC) within Milan criteria (MC) is a valid treatment for patients with good liver function who develop recurrence within MC, but salvage transplantation (ST) has a high rate of failure for those with recurrence beyond MC, according to a study published online Sept. 19 in Hepatology.

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Three Weekly Hyaluronate Shots Improve Ankle Arthritis

THURSDAY, Sept. 29 (HealthDay News) -- Three weekly intra-articular injections of hyaluronate are safe and effective for patients with unilateral ankle arthritis, according to a study published in the Sept. 21 issue of The Journal of Bone & Joint Surgery.

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Stratified Care May Be Best Option for Back Pain Patients

THURSDAY, Sept. 29 (HealthDay News) -- Stratifying back pain patients by prognosis may be more effective and less costly than a one-size-fits-all approach, according to research published online Sept. 29 in The Lancet.

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Fear of Childbirth Tied to Higher Odds of Cesarean Section

WEDNESDAY, Sept. 28 (HealthDay News) -- Emergency and elective cesarean sections (CS) are more common in women with a fear of childbirth, even after psychological counseling, according to a study published online July 24 in Acta Obstetricia et Gynecologica Scandinavica.

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Elderly Recover Adequately After Cervical Laminoplasty

WEDNESDAY, Sept. 28 (HealthDay News) -- Elderly patients with cervical spondylotic myelopathy (CSM) can benefit from laminoplasty and have adequate recoveries in terms of achieved Japanese Orthopedic Association (JOA) scores for cervical myelopathy, according to a study published online Sept. 8 in Spine.

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Calcineurin-Inhibitor-Sparing Regimens Improve Outcomes

WEDNESDAY, Sept. 28 (HealthDay News) -- Use of calciuneurin-inhibitor-sparing regimens immediately after kidney transplantation is associated with improved outcomes, including less delayed graft function, improved graft function, and less new-onset diabetes, according to a meta-analysis published online Sept. 23 in the Journal of the American Society of Nephrology.

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Operator Experience Tied to Carotid Stenting Mortality Risk

TUESDAY, Sept. 27 (HealthDay News) -- Carotid stenting in older patients performed by operators with low annual volume or less experience is associated with higher 30-day mortality risk, according to a study published in the Sept. 28 issue of the Journal of the American Medical Association.

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U.S. Docs Feel They Give More Patient Care Than Required

TUESDAY, Sept. 27 (HealthDay News) -- Many primary care physicians in the United States believe that their patients are receiving too much medical care, and that the pressure to do more than is necessary could be reduced by malpractice reform, adjusting financial incentives, and spending more time with patients, according to a study published in the Sept. 26 issue of the Archives of Internal Medicine.

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Colorectal Cancer Subsite Risk Tied to Fruit/Vegetable Intake

TUESDAY, Sept. 27 (HealthDay News) -- The risk of colorectal cancer (CRC) associated with different fruit and vegetable (F/V) consumption varies depending on the tumor location within the large bowel, according to a study published online Sept. 26 in the Journal of the American Dietetic Association.

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Reasons for Referral to Specific Docs Differ Among Physicians

TUESDAY, Sept. 27 (HealthDay News) -- Primary care physicians (PCPs) and medical and surgical specialists differ in their reasons for selecting specific colleagues for referrals, with PCPs more concerned about physician communication and medical record sharing than specialists, according to a study published online Sept. 16 in the Journal of General Internal Medicine.

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Updated Guides Compare Treatments for GERD

MONDAY, Sept. 26 (HealthDay News) -- Updated, evidence-based, reader-friendly reports comparing treatments for gastroesophageal reflux disease (GERD) have been released by the Agency for Healthcare Research and Quality (AHRQ) to help guide patient and physician decision-making in treating this condition that affects up to 4 percent of Americans.

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Generic Tacrolimus Safe for Liver, Kidney Recipients

MONDAY, Sept. 26 (HealthDay News) -- Patients who have undergone liver or kidney transplants may safely switch from brand-name to generic tacrolimus with no change in the indices of liver or kidney function or rejection, according to a study published in the September issue of the American Journal of Transplantation.

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Stereotactic Radiosurgery Reasonable for Brain Mets

FRIDAY, Sept. 23 (HealthDay News) -- Salvage stereotactic radiosurgery (SRS) is a reasonable treatment for breast cancer brain metastases, with a median overall survival (OS) of more than nine months, according to a study published online Sept. 14 in Cancer.

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Study Compares Great Saphenous Vein Insufficiency Therapies

THURSDAY, Sept. 22 (HealthDay News) -- Endovenous laser treatment (EVLT) and high ligation and stripping (HLS) are equally safe and effective in treating great saphenous vein (GSV) insufficiency, according to a study published online Sept. 19 in the Archives of Dermatology.

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Stroke Outcomes Similar With CT-Perfusion, Time Criteria

THURSDAY, Sept. 22 (HealthDay News) -- For patients with ischemic stroke, use of computed tomography perfusion (CTP)-based criteria for selecting patients for endovascular treatment has similar rates of functional outcome and intracranial hemorrhage compared to time-guided selection, according to a study published online Sept. 19 in the Journal of Neurointerventional Surgery.

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Videos Prior to Spine Surgery Aid, Strengthen Patient Choices

WEDNESDAY, Sept. 21 (HealthDay News) -- Watching an evidence-based videotape decision aid helps patients with lumbar spine disorders form and/or strengthen a treatment preference in a balanced, unbiased way, according to a study published online Aug. 15 in Spine.

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Soft Tissue Sarcoma Therapy Limb Salvage Rate 81 Percent

WEDNESDAY, Sept. 21 (HealthDay News) -- Tumor necrosis factor-α (TNF) and melphalan-based isolated limb perfusion (TM-ILP) therapy has a limb salvage rate of 81 percent in patients with locally advanced extremity soft tissue sarcomas (STSs) who would have otherwise undergone amputation, according to a study published online Sept. 19 in the Journal of Clinical Oncology.

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Mortality Up in Hospitals With More Minority Trauma Patients

WEDNESDAY, Sept. 21 (HealthDay News) -- The odds of in-hospital mortality for trauma patients are associated with the proportion of minority patients in the hospital, according to a study published online Sept. 19 in the Archives of Surgery.

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Model Predicts Erectile Function After Prostate Cancer Therapy

TUESDAY, Sept. 20 (HealthDay News) -- Erectile function two years after prostate cancer treatment can be predicted based on patient and treatment characteristics, according to a study published in the Sept. 21 issue of the Journal of the American Medical Association.

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Platelet Reactivity Status Predicts Ischemic Event Risk

TUESDAY, Sept. 20 (HealthDay News) -- High residual platelet reactivity (HRPR) after clopidogrel loading is significantly associated with an increased risk of short- and long-term ischemic events in patients receiving platelet reactivity-guided antithrombotic medication after percutaneous coronary intervention (PCI), according to a study published in the Sept. 21 issue of the Journal of the American Medical Association.

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Chronic Total Occlusion PCI Improves Outcomes in Diabetes

TUESDAY, Sept. 20 (HealthDay News) -- Percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) is associated with reduced mortality and reduced need for coronary artery bypass grafting in patients with diabetes mellitus (DM), according to a study published in the Oct. 1 issue of The American Journal of Cardiology.

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Treatment Delays Identified in Regional STEMI Systems

TUESDAY, Sept. 20 (HealthDay News) -- Treatment delays occur in standardized regional systems for transfer of patients with ST-segment-elevation myocardial infarction (STEMI) to receive primary percutaneous coronary intervention (PCI), with delays most frequently occurring at the referral hospital, PCI center, and during the transport process, according to a study published online Sept. 19 in Circulation.

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Cold Ischemia Time Tied to Delayed Kidney Graft Function

MONDAY, Sept. 19 (HealthDay News) -- Increasing cold ischemia time (CIT) in expanded-criteria donor (ECD) kidney pairs is a risk factor for delayed graft function (DGF), but has no effect on graft survival, according to a study published online Sept. 11 in the American Journal of Transplantation.

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Work Intensity Similar Across Physician Specialties

MONDAY, Sept. 19 (HealthDay News) -- The level of physician work intensity appears to be similar among specialties, with variations in the specific dimensions of stress, physical demands, performance, and temporal demand, according to a study published online Sept. 3 in Medical Care.

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Posterior Shoulder Dislocation Has Low Prevalence

MONDAY, Sept. 19 (HealthDay News) -- Prevalence of posterior dislocation is low, with recurrent instability the most common complication after injury, and functional deficit persisting at two years after injury, according to a study published in the Sept. 7 issue of The Journal of Bone & Joint Surgery.

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Racial Disparities in Radical Prostatectomy Decreasing

MONDAY, Sept. 19 (HealthDay News) -- The racial disparity in the utilization rates of minimally invasive radical prostatectomy (MIRP) in the United States is decreasing, according to a study published online Sept. 6 in Cancer.

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Lineage-Restricted Stem Cells Regenerate Digit Tip in Mice

MONDAY, Sept. 19 (HealthDay News) -- Lineage-restricted, tissue-resident stem cells are involved in the regeneration of the distal digits in mice, according to an experimental study published online Aug. 25 in Nature.

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Liver X Receptor Agonist Ups Glioblastoma Cell Death

FRIDAY, Sept. 16 (HealthDay News) -- Liver X receptor (LXR) agonists cause inducible degrader of low-density lipoprotein receptor (LDLR)(IDOL)-mediated LDLR degradation and elevated expression of the ABCA1 cholesterol efflux transporter, which promotes cell death in a glioblastoma model, according to an experimental study published online Sept. 15 in Cancer Discovery.

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Thrombomodulin Gene Variants Up Post-CABG Mortality Risk

FRIDAY, Sept. 16 (HealthDay News) -- Genetic variants in the thrombomodulin gene (THBD) are independently associated with an increased risk of long-term all-cause mortality after coronary artery bypass graft (CABG) surgery, according to a study published in the Sept. 13 issue of Circulation.

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Pre-Liver Transplant Serum Ferritin Level Predicts Mortality

FRIDAY, Sept. 16 (HealthDay News) -- Elevated serum ferritin (SF) concentration in combination with low transferrin saturation (TFS) prior to liver transplantation (LT) is an independent predictor of mortality following transplantation, according to a study published online Sept. 2 in Hepatology.

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Global Rates of Breast, Cervical Cancer Up Over Last 20 Years

THURSDAY, Sept. 15 (HealthDay News) -- The global incidence of breast and cervical cancer increased from 1980 to 2010, with breast cancer mortality rates increasing and cervical cancer mortality rates decreasing during the same period, according to a study published online Sept. 15 in The Lancet.

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Surgery Effective for Subaxial Cervical Synovial Cysts

THURSDAY, Sept. 15 (HealthDay News) -- Surgical resection can be an effective treatment for patients presenting with cervical radiculopathy or myelopathy who have a subaxial cervical synovial cyst with minimal postoperative complications, according to a study published in the Sept. 15 issue of Spine.

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Glare Disability Predicts Post-Cataract Surgery Visual Gains

THURSDAY, Sept. 15 (HealthDay News) -- Preoperative questionnaire score and preoperative mesopic and photopic glare disability (GD) show significant correlation with improvements in visual functioning after surgery for symptomatic nonadvanced cataract, according to a study published in the September issue of the Archives of Ophthalmology.

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New Tiered Sharing Policy Suggested for Liver Transplants

THURSDAY, Sept. 15 (HealthDay News) -- An algorithm incorporating a national sharing policy with a tiered policy, such as the model for end-stage liver disease (MELD), may reduce the number of wait-list deaths and organ travel distances, according to a study published in the September issue of Liver Transplantation.

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Optic Radiation Delineated by Tractography During Surgery

WEDNESDAY, Sept. 14 (HealthDay News) -- Optic radiation during anterior temporal lobe resection (ATLR) for refractory temporal lobe epilepsy (TLE) can be delineated by diffusion tensor imaging (DTI) tractography, and propagated onto postoperative images during neurosurgery, according to a study published online Sept. 2 in the Annals of Neurology.

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Mammography Screening Ups Breast Cancer Surgery Rates

WEDNESDAY, Sept. 14 (HealthDay News) -- The annual rate of breast surgery increased significantly from 1993-1995 to 2005-2008 for women in Norway aged 50 to 69 years who were invited to undergo mammography screening, according to a study published online Sept. 13 in BMJ.

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Congenital Heart Disease Ups Endotoxemia Risk in Children

WEDNESDAY, Sept. 14 (HealthDay News) -- Children undergoing surgery for congenital heart disease are at an increased risk of intestinal mucosal injury, endotoxemia, and activation of endotoxin signaling pathways that are associated with adverse outcome, according to a study published online Aug. 25 in the American Journal of Respiratory and Critical Care Medicine.

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Number of Lymph Nodes Tested for Colon CA Up 1988 to 2008

TUESDAY, Sept. 13 (HealthDay News) -- For patients treated surgically for colon cancer, the number of lymph nodes evaluated increased from 1988 to 2008; however, there was no significant increase in lymph node positivity during the same period, according to a study published in the Sept. 14 issue of the Journal of the American Medical Association.

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Aortic Dissection Incidence Higher in Individuals With BAV

TUESDAY, Sept. 13 (HealthDay News) -- Aortic dissection incidence is higher in individuals with bicuspid aortic valves (BAVs) than in the general population, according to a study published in the Sept. 14 issue of the Journal of the American Medical Association.

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Supply Chain Optimization Feasible in Pediatric Hospitals

TUESDAY, Sept. 13 (HealthDay News) -- Optimization of the supply chain process is feasible in a pediatric perioperative setting, according to a study published in the September issue of the AORN Journal.

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Venlafaxine, Clonidine Reduce Hot Flashes in Breast Cancer

TUESDAY, Sept. 13 (HealthDay News) -- Venlafaxine and clonidine effectively manage hot flashes in patients with breast cancer, with hot flash scores reducing more immediately with venlafaxine than clonidine, and reducing more significantly with clonidine during week 12 of treatment than with venlafaxine, according to a study published online Sept. 12 in the Journal of Clinical Oncology.

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Earlier Cancer Onset in Second Generation BRCA Carriers

MONDAY, Sept. 12 (HealthDay News) -- Women who are carriers of BRCA mutations for breast or ovarian cancer are more likely to be diagnosed with cancer at an earlier age than members of the previous generation, according to a study published online Sept. 12 in Cancer.

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Arterial Calcification Tied to Vascular Brain Disease

FRIDAY, Sept. 9 (HealthDay News) -- Arterial calcification in various vessel beds is associated with larger white matter lesion (WML) volume and the presence of cerebral infarcts, according to a study published online Aug. 25 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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HPPH-Photodynamic Therapy Safe in Precancerous Barrett's

THURSDAY, Sept. 8 (HealthDay News) -- Photodynamic therapy (PDT) with 2-[1-hexyloxyethyl]-2-devinyl pyropheophorbide-a (HPPH) is safe with promising efficacy in precancerous lesions associated with Barrett's esophagus, according to a study published in the September issue of Lasers in Surgery and Medicine.

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Post-Breast Reduction Weight Loss Tied to Shape Discontent

THURSDAY, Sept. 8 (HealthDay News) -- Most patients undergoing reduction mammaplasty before massive weight loss are initially satisfied with the results of breast appearance, but after weight loss, they are dissatisfied with the breast contour and shape, according to a study published in the September issue of Plastic and Reconstructive Surgery.

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Stenting Inferior to Aggressive Medical Management in Stroke

WEDNESDAY, Sept. 7 (HealthDay News) -- Medical management alone is better at preventing recurrent stroke for patients with intracranial arterial stenosis than in combination with percutaneous transluminal angioplasty and stenting (PTAS), according to a study published online Sept. 7 in the New England Journal of Medicine.

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No Reduction in Infections With Immediate Adenoidectomy

WEDNESDAY, Sept. 7 (HealthDay News) -- Children who are selected for adenoidectomy for recurrent upper respiratory tract infections and undergo immediate adenoidectomy have the same number of infections per person-year as those who undergo an initial watchful watching, according to a study published online Sept. 6 in BMJ.

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Medical Students Show Racial, Cultural Patient Preference

WEDNESDAY, Sept. 7 (HealthDay News) -- Medical students may have a preferential bias toward whites and wealthier patients, but this does not appear to influence their clinical decision making or physician-patient interactions, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Odds of Board Certification Vary in New Doctors

WEDNESDAY, Sept. 7 (HealthDay News) -- Certification of recent U.S. medical school graduates by the American Board of Medical Specialties (ABMS) varies across specialties by educational and demographic factors, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Many Hospital Staff Uniforms Contaminated With Bacteria

WEDNESDAY, Sept. 7 (HealthDay News) -- More than 60 percent of hospital staff uniforms are contaminated with potentially pathogenic bacteria, including drug-resistant species, according to a study published in the September issue of the American Journal of Infection Control.

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Training Protocols Do Not Affect Ventilation Knowledge

TUESDAY, Sept. 6 (HealthDay News) -- For first-time examinees of the American Board of Internal Medicine (ABIM), training in a high-intensity ventilator protocol environment does not correlate with worse knowledge about mechanical ventilation management compared to training in a low-intensity environment, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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More Weight Loss for Duodenal Switch Than Gastric Bypass

TUESDAY, Sept. 6 (HealthDay News) -- Duodenal switch results in greater reduction in body mass index (BMI) and total and low-density lipoprotein (LDL) cholesterol than gastric bypass, but has a higher rate of adverse events than gastric bypass, according to a study published in the Sept. 6 issue of the Annals of Internal Medicine.

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MRI Tumor Assessment Predicts Rectal Cancer Survival

FRIDAY, Sept. 2 (HealthDay News) -- Magnetic resonance imaging (MRI) assessment of tumor regression grade (TRG) and circumferential resection margin (CRM) can be used to predict survival for good and poor responders in rectal cancer, according to a study published online Aug. 29 in the Journal of Clinical Oncology.

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Fewer Male Infants Being Circumcised in U.S. Hospitals

THURSDAY, Sept. 1 (HealthDay News) -- The practice of circumcising newborn males in U.S. hospitals, which increased from the late 1980s to about 2000, appears to be on the wane, according to a report published in the Sept. 2 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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NPe6 May Beat Photofrin Photodynamic Therapy in Lung CA

THURSDAY, Sept. 1 (HealthDay News) -- NPe6-photodynamic therapy (PDT) is a better treatment for patients with lung cancer than photofrin-PDT, and the efficacy of PDT may improve based on individual expression status of the anti-apoptotic protein Bcl-2 and breast cancer-resistant protein (BCRP), according to a study published online Aug. 23 in Lasers in Surgery and Medicine.

Abstract
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Traumatic Brain Injury Deaths Tied to Life Support Removal

THURSDAY, Sept. 1 (HealthDay News) -- For patients with traumatic brain injury, most deaths are associated with withdrawal of life-sustaining therapy, according to a study published online Aug. 29 in CMAJ, the journal of the Canadian Medical Association.

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Dexamethasone Dose of >0.1 mg/kg Reduces Post-Op Pain

THURSDAY, Sept. 1 (HealthDay News) -- Dexamethasone at doses of greater than 0.1 mg/kg decreases postoperative pain and reduces opioid consumption, according to a meta-analysis published in the September issue of Anesthesiology.

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