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Category: Surgery | Monthly Briefing

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October 2011 Briefing - Surgery

Last Updated: November 01, 2011.

 

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

Transvestibular Approach to Middle Cranial Base Feasible

MONDAY, Oct. 31 (HealthDay News) -- Use of a transvestibular endoscopic approach allows safe exposure, exploration, and resection of lesions in the infratemporal fossa (ITF) and parapharyngeal space (PPS), according to a study published in the October issue of The Laryngoscope.

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Exparel Approved for Post-Surgery Pain

MONDAY, Oct. 31 (HealthDay News) -- Exparel (bupivacaine liposome injectable suspension) has been approved by the U.S. Food and Drug Administration to treat post-surgical pain, maker Pacira Pharmaceuticals said Monday.

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Noncarriers of BRCA Do Not Have Increased Breast CA Risk

MONDAY, Oct. 31 (HealthDay News) -- Women testing negative for their family-specific BRCA1 or BRCA2 mutation (noncarriers) do not have an increased risk of breast cancer, according to a study published online Oct. 31 in the Journal of Clinical Oncology.

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Switching From IV to Oral Meds Cuts Health Care Costs

MONDAY, Oct. 31 (HealthDay News) -- For patients who are clinically eligible for oral (PO) medication intake, switching from intravenous (IV) to oral medication can substantially reduce the annual cost of health care, according to a study published online Oct. 17 in Clinical Therapeutics.

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Proportion of MELD Exceptions Up From 2002 to 2010

MONDAY, Oct. 31 (HealthDay News) -- The proportion of liver transplant candidates who are model for end-stage liver disease (MELD) exceptions increased from 2002 to 2010, and since April 2005, exceptions have been associated with a reduced risk of wait-list mortality, according to a study published in the November issue of the American Journal of Transplantation.

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Disc Herniation Symptom Duration Tied to Outcome

MONDAY, Oct. 31 (HealthDay News) -- Longer pretreatment symptom duration from lumbar disc herniation is associated with poorer outcomes after both surgical and nonsurgical intervention, according to a study published in the Oct. 19 issue of The Journal of Bone & Joint Surgery.

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Pre-Op Erythropoietin Reduces Need for Peri-Op Transfusion

MONDAY, Oct. 31 (HealthDay News) -- Preoperative administration of erythropoietin and an iron supplement significantly reduces the requirement for perioperative transfusion in anemic patients undergoing valvular heart surgery, according to a study published in the November issue of Anesthesiology.

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ATA: Thyroidectomy Improves Sleep Apnea Symptoms

FRIDAY, Oct. 28 (HealthDay News) -- Surgical reduction or removal of an enlarged thyroid gland improves obstructive sleep apnea (OSA) symptoms, including snoring, according to a study being presented in the annual meeting of the American Thyroid Association, held from Oct. 26 to 30 in Palm Springs, Calif.

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Self-Reported Knee Function, Pain Worse Than Doc-Assessed

FRIDAY, Oct. 28 (HealthDay News) -- Following total knee arthroplasty, self-reported American Knee Society pain and function subscores are worse than clinician-assessed scores, but self- and clinician-assessment of the Oxford Knee Score is similar, according to a study published in the Oct. 19 issue of the Journal of Bone and Joint Surgery.

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Cartilage Reshaping With Laser Safe for Protruding Ears

FRIDAY, Oct. 28 (HealthDay News) -- Non-invasive laser-assisted cartilage reshaping (LACR) is a safe and satisfactory alternative to invasive surgical otoplasty for treatment of protruding ears, according to a study published in the November issue of Lasers in Surgery and Medicine.

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Nipple-Sparing Mastectomy Safe for Selected Patients

FRIDAY, Oct. 28 (HealthDay News) -- Nipple-sparing mastectomy (NSM) can be safe when used for properly-selected women with breast cancer, according to a study published in the November issue of Plastic and Reconstructive Surgery.

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Nonclinical Factors Impact Back Pain Treatment Decisions

FRIDAY, Oct. 28 (HealthDay News) -- Nonclinical factors, including gender, socioeconomic status, and patient presentation, influence physicians' treatment recommendations for acute nonspecific low back pain, with patient presentation the most influential factor, according to a study published in the Nov. 1 issue of Spine.

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Ovarian Stimulation Ups Risk of Ovarian Tumors in Later Life

THURSDAY, Oct. 27 (HealthDay News) -- Ovarian stimulation for in vitro fertilization (IVF) is associated with an increase in the risk of ovarian malignancies, especially borderline ovarian tumors, according to a study published online Oct. 26 in Human Reproduction.

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Ghost Authorship Prevalent in About One-Fifth of Articles

WEDNESDAY, Oct. 26 (HealthDay News) -- The prevalence of articles with honorary authorship, ghost authorship, or both is 21 percent, which marks a significant decrease since 1996, according to a study published online Oct. 25 in BMJ.

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Clinical, Genetic Factors Linked to Early Stent Thrombosis

TUESDAY, Oct. 25 (HealthDay News) -- Both genetic and clinical factors are independently associated with early stent thrombosis, according to a study published in the Oct. 26 issue of the Journal of the American Medical Association.

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Breast Reconstruction Ups Psychosocial, Sexual Health

MONDAY, Oct. 24 (HealthDay News) -- Women undergoing autologous tissue breast reconstruction experience significant gains in breast satisfaction, and psychological and sexual well-being as early as three weeks post surgery, according to a study published online Oct. 24 in Cancer.

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Excision Margin of 2 cm Safe in Melanoma Thicker Than 2 mm

MONDAY, Oct. 24 (HealthDay News) -- For patients with cutaneous melanoma thicker than 2 mm, a surgical excision margin of 2 cm is sufficient and has similar overall survival as with a 4-cm excision margin, according to a study published online Oct. 24 in The Lancet.

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High Rate of Elevated BP Post Pediatric Liver Transplant

FRIDAY, Oct. 21 (HealthDay News) -- For children who undergo liver transplant (LT), there is a high prevalence of elevated blood pressure (BP) at five to 10 years post-transplant, and this can be predicted by age at LT, decreased calculated glomerular filtration rate (cGFR), and recent steroid use, according to a study published online Oct. 12 in the American Journal of Transplantation.

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Drug-Eluting Stents With Abnormal ABI Tied to Mortality

THURSDAY, Oct. 20 (HealthDay News) -- For patients undergoing drug-eluting stent (DES) implantation, an abnormal ankle brachial index (ABI) is independently associated with one-year risk of total mortality and cardiovascular mortality, but not with risk of stroke, nonfatal acute coronary syndrome (ACS), or newer revascularization, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

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Platelet-Rich Fibrin Matrix Shots Induce Cellular Changes

THURSDAY, Oct. 20 (HealthDay News) -- Administration of platelet-rich fibrin matrix (PRFM) into the deep dermis and immediate subdermis stimulates cellular changes, including activated fibroblasts, new collagen deposition, new blood vessel development, intradermal adipocyte collection, and subdermal adipocyte stimulation, according to a study published online Oct. 17 in the Archives of Facial Plastic Surgery.

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IBD Increases Risk of Post-Op Thromboembolism

THURSDAY, Oct. 20 (HealthDay News) -- Patients with inflammatory bowel disease (IBD) have an increased risk of developing postoperative deep vein thrombosis (DVT) and pulmonary embolism (PE), with a higher risk in those undergoing nonintestinal surgery, according to a study published online Oct. 17 in the Archives of Surgery.

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3-D CT Useful for Classification of Ligament Ossification

THURSDAY, Oct. 20 (HealthDay News) -- Use of three-dimensional computed tomography (3-D CT) to visualize ossification of the posterior longitudinal ligament (OPLL) can aid with classification of lesions, according to a study published in the October issue of The Spine Journal.

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H. pylori Not Detected in Hyperplastic Adenoids

WEDNESDAY, Oct. 19 (HealthDay News) -- Helicobacter pylori (H. pylori) and other Helicobacteraceae family members do not majorly contribute toward development of hyperplastic adenoids in children, according to a study published in the October issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Adjuvant S-1 Improves Five-Year Outcomes in Gastric Cancer

WEDNESDAY, Oct. 19 (HealthDay News) -- Postoperative adjuvant therapy with oral fluoropyrimidine derivative, S-1, improves overall and relapse-free survival at five years in patients with stage II or III gastric cancer who undergo D2 gastrectomy, according to a study published online Oct. 17 in the Journal of Clinical Oncology.

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High Resource Use Ups Congenital Heart Surgery Risk

WEDNESDAY, Oct. 19 (HealthDay News) -- Adults with high resource use (HRU) undergoing congenital heart surgery in pediatric hospitals have higher mortality, according to a study published online Oct. 18 in Circulation: Cardiovascular Quality and Outcomes.

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Readmission Risk Models Display Poor Predictive Ability

TUESDAY, Oct. 18 (HealthDay News) -- Most hospital readmission risk models have poor predictive ability, according to a review published in the Oct. 19 issue of the Journal of the American Medical Association.

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Cardiac Device Lead Removal by Laser Safe for Octogenarians

TUESDAY, Oct. 18 (HealthDay News) -- Laser assisted extraction of leads from implanted cardiac devices (pacemakers and defibrillators) is safe and effective in the octogenarian population, with risks similar to those in the non-octogenarian population, according to a study published online Oct. 17 in Circulation: Arrhythmia and Electrophysiology.

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Bariatric Surgery Offers Health Benefits to Patients' Family

TUESDAY, Oct. 18 (HealthDay News) -- Adult family members and children of patients undergoing Roux-en-Y gastric bypass surgery experience weight loss and improved healthy behaviors one year following surgery, according to a study published in the October issue of the Archives of Surgery.

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Single Kidney Outcome Similar With Nephrectomy, Ablation

MONDAY, Oct. 17 (HealthDay News) -- For patients with a tumor in a solitary kidney, short-term renal function outcomes are similar for treatment with partial nephrectomy or percutaneous ablation, according to a study published in the November issue of The Journal of Urology.

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High-Volume Liver Transplant Centers Up Recipient Survival

MONDAY, Oct. 17 (HealthDay News) -- Liver transplant centers with high annual procedure volumes use donors with higher mean donor risk index (DRI) livers and have better risk-adjusted recipient and allograft survival than centers with low annual procedure volumes, according to a study published in the October issue of Liver Transplantation.

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Same Cognition With Cerebral Perfusion, Hypothermic Arrest

FRIDAY, Oct. 14 (HealthDay News) -- For patients undergoing pulmonary endarterectomy (PEA), antegrade cerebral perfusion (ACP) confers no additional benefits over deep hypothermic circulatory arrest (DHCA) for improving cognitive function, according to a study published in the Oct. 15 issue of The Lancet.

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Blacks Fare Worse Than Whites Despite Same Colon CA Therapy

FRIDAY, Oct. 14 (HealthDay News) -- In patients with resected stage II and III colon cancer treated with identical adjuvant therapy, blacks have worse overall and recurrence-free survival than whites, but a similar recurrence-free interval, according to a study published online Oct. 12 in the Journal of the National Cancer Institute.

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Patients Remain Seizure-Free Long After Epilepsy Surgery

FRIDAY, Oct. 14 (HealthDay News) -- Approximately half of patients with refractory focal epilepsy who undergo surgery remain seizure-free in the long term following epilepsy surgery, with seizure recurrence varying with the type of surgery, according to a study published in the Oct. 15 issue of The Lancet.

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No Effect of Prophylaxis Type on Pulmonary Embolism Rate

FRIDAY, Oct. 14 (HealthDay News) -- The rate of pulmonary embolism after total hip arthroplasty does not differ by the type of prophylaxis or anesthesia used, according to a study published in the Oct. 5 issue of The Journal of Bone & Joint Surgery.

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Rare Disorders ID'd by NIH Undiagnosed Diseases Program

THURSDAY, Oct. 13 (HealthDay News) -- The extensive application of genomic technology under the U.S. National Institutes of Health Undiagnosed Diseases Program (NIH-UDP) helps diagnose complex and rare multisystem disorders, according to a report published online Sept. 26 in Genetics in Medicine.

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Increased Travel Time to Trauma Centers in 2007

THURSDAY, Oct. 13 (HealthDay News) -- Geographic access to trauma centers in the United States declined from 2001 to 2007, especially in communities with higher numbers of poor, uninsured, African-American residents, and individuals living in rural areas, according to a study published in the October issue of Health Affairs.

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Financial Conflicts of Interest Prevalent, Under-Reported

WEDNESDAY, Oct. 12 (HealthDay News) -- Conflicts of interest (COI) are prevalent among members and chairs of guideline panels, and are under-reported, according to a study published online Oct. 11 in BMJ.

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High False-Negative Rate for HER2 Status Using Oncotype DX

WEDNESDAY, Oct. 12 (HealthDay News) -- Genomic Health's (GHI) Oncotype DX test, a human epidermal growth factor receptor 2 (HER2) assay for breast cancer that uses a method of reverse transcription polymerase chain reaction (RT-PCR), has an unacceptable false-negative rate, according to a study published online Oct. 11 in the Journal of Clinical Oncology.

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ICD Deactivation Knowledge Lacking in End-of-Life Care

TUESDAY, Oct. 11 (HealthDay News) -- Patients and providers require more knowledge about the functions of implantable cardioverter-defibrillators (ICDs) and end-of-life options in order to facilitate timely ICD deactivation discussions, according to a review published in the October issue of the American Journal of Nursing.

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Good Long-Term Outcomes With Selective Thoracic Fusion

TUESDAY, Oct. 11 (HealthDay News) -- Selective thoracic fusion for adolescent idiopathic scoliosis (AIS) yields long-term stable spinal balance and lumbar curve correction, with outcome measures comparable to long instrumented fusion, according to a study published online Sept. 30 in Spine.

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Children More Likely to Have SLN Mets Than Young Adults

TUESDAY, Oct. 11 (HealthDay News) -- Children and adolescents are more likely to have sentinel lymph node (SLN) metastases than young adults, and SLN biopsy use is predicted by tumor thickness and ulceration, according to a study published online Oct. 5 in Cancer.

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Septicemia Most Costly Reason for Hospitalization in 2009

MONDAY, Oct. 10 (HealthDay News) -- Septicemia was the single most expensive condition treated in U.S. hospitals in 2009, with expenditure totaling nearly $15.4 billion, according to an October statistical brief based on Healthcare Cost and Utilization Project (HCUP) data published by the Agency for Healthcare Research and Quality (AHRQ).

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Electronic Records Enhance Care Transitions for Elderly

MONDAY, Oct. 10 (HealthDay News) -- Implementation of electronic health care record (EHR) systems is likely to enhance communication and patient care during care transitions, particularly for older patients, according to a study published in the October issue of the AORN Journal.

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Infliximab Improves Clinical Outcome in Ulcerative Colitis

FRIDAY, Oct. 7 (HealthDay News) -- For patients with ulcerative colitis treated with infliximab, mucosal healing after eight weeks is associated with improved long-term clinical outcomes and a reduced likelihood of progressing to colectomy, according to a study published in the October issue of Gastroenterology.

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Adding HLA-C Matching Cuts Cord Blood Transplant Death

FRIDAY, Oct. 7 (HealthDay News) -- Umbilical-cord blood transplantation-related deaths can be reduced by matching donor units with recipients at the human leukocyte antigen (HLA)-C locus in addition to the HLA-A, B, and DRB1 loci, even if there is a single mismatch at these loci, according to a study published online Oct. 7 in The Lancet Oncology.

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Uterine Artery Embolization Beats Surgery in Short Term

FRIDAY, Oct. 7 (HealthDay News) -- Women with heavy menstrual bleeding due to symptomatic uterine fibroids show better short-term outcomes with uterine artery embolization than with surgery, while the mid- and long-term results are similar except for higher reintervention rate, according to a review published in the October issue of the American Journal of Obstetrics & Gynecology.

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Early ID of Morbidly Obese Improves Surgical Care

THURSDAY, Oct. 6 (HealthDay News) -- Early identification of patients with a body mass index (BMI) of 35 kg/m² or more improves perioperative care and outcomes, according to a study published in the October issue of the AORN Journal.

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Many Elderly in U.S. Undergo Surgery in Last Year of Life

THURSDAY, Oct. 6 (HealthDay News) -- A considerable proportion of elderly people in the United States undergo surgery in the year before their death, with the rate varying with age and geographical region, according to a study published online Oct. 6 in The Lancet.

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More Minority Patients in Low-Quality, High-Cost Hospitals

THURSDAY, Oct. 6 (HealthDay News) -- Hospitals where the quality is low and costs high (worst hospitals) in the United States care for a higher proportion of elderly black, Hispanic, and Medicaid patients than high-quality, low-cost institutions (best hospitals), according to a study published in the October issue of Health Affairs.

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Pre-Op Anemia Ups Mortality After Non-Cardiac Surgery

THURSDAY, Oct. 6 (HealthDay News) -- For patients undergoing non-cardiac surgery, even a mild degree of preoperative anemia is independently associated with an increased risk of 30-day morbidity and mortality, according to a study published online Oct. 6 in The Lancet.

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Membrane Oxygenation Reduces Mortality in H1N1-Related ARDS

WEDNESDAY, Oct. 5 (HealthDay News) -- For patients with H1N1-related acute respiratory distress syndrome (ARDS), referral and transfer to an extracorporeal membrane oxygenation (ECMO) center is associated with lower hospital mortality, according to a study published online Oct. 5 in the Journal of the American Medical Association.

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Advance Directives Linked to Regional Medical Expenditures

TUESDAY, Oct. 4 (HealthDay News) -- Advance directives (living wills) specifying limitations in end-of-life care are associated with significantly lower levels of Medicare spending, lower likelihood of in-hospital death, and higher use of hospice care during the last six months of life for patients living in regions with high medical expenditures but not in other regions, according to a study published in the Oct. 5 issue of the Journal of the American Medical Association.

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Alcohol-Impaired Driving Down by 30 Percent in U.S.

TUESDAY, Oct. 4 (HealthDay News) -- U.S. adults drive after drinking "a bit too much" about a third less often than they did in 2006; still, about 1.8 percent of adults (four million people) reported alcohol-impaired driving in 2010, according to a report in the Oct. 4 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Lower Overall Survival for Men Than Women With Breast Cancer

TUESDAY, Oct. 4 (HealthDay News) -- Male patients with breast cancer have later onset and more advanced disease, and worse overall survival than female patients, according to a study published online Oct. 3 in the Journal of Clinical Oncology.

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MRI Safe, Feasible in Some With Implanted Cardiac Devices

TUESDAY, Oct. 4 (HealthDay News) -- Magnetic resonance imaging (MRI) can be performed safely in certain patients with implanted cardiac devices by using a protocol based on device selection and programming, along with proper electrophysiologic back-up support, according to a study published in the Oct. 4 issue of the Annals of Internal Medicine.

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HPV 16 Diagnostic Tests Vary in Accuracy, Prognostic Value

TUESDAY, Oct. 4 (HealthDay News) -- Diagnostic tests for human papillomavirus-16 (HPV16) in oropharyngeal squamous cell carcinoma (OPSCC) differ in accuracy and prognostic value, with a combination of p16 immunohistochemistry (p16 IHC) and DNA quantitative polymerase chain reaction (qPCR) proving to be the best discriminator of favorable outcome, according to a study published in the Oct. 1 issue of Clinical Cancer Research.

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Breast Cancer Deaths Falling in United States

TUESDAY, Oct. 4 (HealthDay News) -- In the United States, the rate of death from breast cancer has fallen faster for wealthier women than for poor women, who are less likely to get screened for breast cancer, according to a report published online Oct. 3 in CA: A Cancer Journal for Clinicians.

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Smoking Complicates Joint Replacement Outcomes

MONDAY, Oct. 3 (HealthDay News) -- Smoking is associated with higher rates of complications such as infections, stroke, pneumonia, and death following elective total hip replacement (THR) and total knee replacement (TKR) surgeries, according to research published in the October issue of Arthritis Care & Research.

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Early Anesthesia Exposures Tied to Learning Disabilities

MONDAY, Oct. 3 (HealthDay News) -- Exposure to multiple anesthesia/surgery before the age of 2 years is a significant risk factor for the development of learning disabilities (LDs) later in life, but not for the receipt of an individualized education program for an emotional/behavior disorder (IEP-EBD), according to a study published online Oct. 3 in Pediatrics.

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Risk Factors ID'd for Post-Spine Surgery Death, Morbidity

MONDAY, Oct. 3 (HealthDay News) -- Older age, wound infections, and other medical comorbidities increase the risk of immediate morbidity or mortality in patients undergoing spine surgery, according to a study published in the Sept. 7 issue of The Journal of Bone & Joint Surgery.

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Sevoflurane Anesthesia Does Not Up Incident Cancer Risk

MONDAY, Oct. 3 (HealthDay News) -- In cancer-free patients who undergo surgery under sevoflurane anesthesia, neither the duration of anesthesia (TANESTH) nor the time measured with the bispectral index (BIS) under 45 (TBIS<45) are associated with the risk of new malignant disease within five years, according to a study published in the October issue of Anesthesia & Analgesia.

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