Here are what the editors at HealthDay consider to be the most important developments in Surgery for December 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.
Use of Propofol Saves Time Compared to Midazolam/Ketamine
FRIDAY, Dec. 30 (HealthDay News) -- Procedural sedation with propofol accelerates patient management in emergency departments, and saves time in comparison with midazolam/ketamine sedation, according to a study published in the Dec. 21 issue of The Journal of Bone & Joint Surgery.
Anesthesia Boosts Colonoscopy Price Tag
THURSDAY, Dec. 29 (HealthDay News) -- In asymptomatic adults who undergo screening colonoscopies, the use of anesthesia significantly increases the cost of the procedure and is most likely to be ordered by a surgeon, according to research published in the January issue of Clinical Gastroenterology and Hepatology.
Enoxaparin Doesn't Reduce Death Rate for Acutely Ill
WEDNESDAY, Dec. 28 (HealthDay News) -- For hospitalized, acutely ill medical patients, use of enoxaparin plus elastic stockings with graduated compressions, does not reduce the rate of death from any cause at 30 days, according to a study published in the Dec. 29 issue of the New England Journal of Medicine.
First U.S. Face Transplants Performed in 2011
WEDNESDAY, Dec. 28 (HealthDay News) -- In 2011, three patients successfully underwent full-face transplantation, the first such procedures ever performed in the United States; the details of these surgeries have been published online Dec. 28 in the New England Journal of Medicine.
Study Assesses Fusion Failure After Anterior Screw Fixation
WEDNESDAY, Dec. 28 (HealthDay News) -- Risk of fusion failure following anterior odontoid screw fixation increases with both delays in surgery and fracture gaps larger than 2 mm, according to a study published in the Jan. 1 issue of Spine.
Irradiation of Left Breast Linked to Coronary Stenosis Risk
WEDNESDAY, Dec. 28 (HealthDay News) -- Women with irradiated left sided breast cancer (BC) have an increased risk of high-grade coronary artery stenosis in the mid and distal left anterior descending artery and distal diagonal (mdLAD + dD), according to a study published online Dec. 27 in the Journal of Clinical Oncology.
Obese Patients Have Worse Colon Cancer Outcomes
TUESDAY, Dec. 27 (HealthDay News) -- Obese patients with colon cancer are less likely to have deficient mismatch repair (dMMR) tumors and have a worse prognosis compared with normal-weight patients, independent of other tumor variables, according to a study published online Dec. 27 in the Journal of Clinical Oncology.
Perceptions of Inappropriate Care Prevalent Among ICU Staff
TUESDAY, Dec. 27 (HealthDay News) -- Perceptions of inappropriate care are prevalent among intensive care unit (ICU) clinicians in Europe and Israel, according to a study published in the Dec. 28 issue of the Journal of the American Medical Association.
Trace Element Levels Linked to Pancreatic Cancer Risk
TUESDAY, Dec. 27 (HealthDay News) -- High bodily levels of the trace elements nickel and selenium may lower the risk of developing the most common type of pancreatic cancer, while high levels of lead, arsenic, and cadmium could increase the likelihood of developing the disease, according to a study published online Dec. 19 in Gut.
Risk Factors for Post-Spinal Fusion Visual Loss Identified
TUESDAY, Dec. 27 (HealthDay News) -- Significant risk factors for ischemic optic neuropathy (ION) after spinal fusion surgery include male gender, obesity, Wilson frame use, longer anesthetic duration, greater estimated blood loss, and lower percent colloid administration, according to a study published in the January issue of Anesthesiology.
Norway Shows Rise in Gastro-Oesophageal Reflux Symptoms
TUESDAY, Dec. 27 (HealthDay News) -- The prevalence of gastro-oesophageal reflux symptoms (GORS) in a Norwegian county increased substantially between 1995-7 and 2006-9, according to a study published online Dec. 21 in Gut.
Study Compares Onset of Action of Two Types of Botulinum Toxin
MONDAY, Dec. 26 (HealthDay News) -- Two botulinum neuromodulators demonstrate early improvements in the appearance of lateral orbital rhytids (crow's feet), but abobotulinumtoxinA results in greater improvement than onabotulinumtoxinA, according to a study published online Dec. 19 in the Archives of Facial Plastic Surgery.
Correcting Anemia Reduces Odds of Renal Transplant Failure
THURSDAY, Dec. 22 (HealthDay News) -- Complete correction of anemia (hemoglobin, ≥13 g/dL) in kidney transplant recipients slows progression to chronic allograft nephropathy, according to a study published online Dec. 22 in the Journal of the American Society of Nephrology.
Aflibercept Shows Clinical Activity for Malignant Ascites
WEDNESDAY, Dec. 21 (HealthDay News) -- Aflibercept, a potent inhibitor of vascular endothelial growth factor (VEGF), shows clinical activity and increases the time to repeat paracentesis for patients with advanced chemo-resistant ovarian cancer and recurrent symptomatic malignant ascites, according to a study published online Dec. 21 in The Lancet Oncology.
Trauma Quality Indicators Linked to Clinical Outcomes
WEDNESDAY, Dec. 21 (HealthDay News) -- Several of the American College of Surgeons Committee on Trauma (ACSCOT) quality indicators have significant associations with in-hospital mortality and the composite outcome of death or major complications, according to a study published online Dec. 19 in the Archives of Surgery.
Medical Team Training Program Cuts Surgical Morbidity Rate
WEDNESDAY, Dec. 21 (HealthDay News) -- The Veterans Health Administration Medical Team Training (MTT) program is associated with a significant decrease in the annual surgical morbidity rate, according to a study published in the December issue of the Archives of Surgery.
Initial Wound Debridement Faster With Maggot Therapy
TUESDAY, Dec. 20 (HealthDay News) -- Compared with conventional therapy, wound debridement is significantly faster with maggot therapy during the first week of treatment, but there is no significant difference at day 15, according to a study published online Dec. 19 in the Archives of Dermatology.
Liver Transplants for NASH Up 600 Percent in 10 Years
TUESDAY, Dec. 20 (HealthDay News) -- The proportion of liver transplants performed in patients diagnosed with nonalcoholic steatohepatitis (NASH) increased dramatically from 1997-2003 to 2004-2010, but post-transplant survival in this population is excellent, with one-year survival rates near 88 percent, according to a study published online Sept. 19 in Liver Transplantation.
Physician Opinions on Benefits of Open Visit Notes Vary
MONDAY, Dec. 19 (HealthDay News) -- Primary care physicians (PCPs) have varied opinions about open access to doctors' notes; and most users of a personal health record (PHR) system are interested in sharing access to their information, according to two studies published in the Dec. 20 issue of the Annals of Internal Medicine.
Variation Seen in Accelerated Breast Irradiation Use
MONDAY, Dec. 19 (HealthDay News) -- In women with breast cancer, accelerated partial breast irradiation using brachytherapy (APBIb) after breast-conserving surgery varies by race, ethnicity, and region, particularly in patients who may not be suitable for the technique, according to research published online Dec. 16 in the Journal of the National Cancer Institute.
Patient Isolation During Hospitalization Tied to Delirium
FRIDAY, Dec. 16 (HealthDay News) -- Patients who are newly placed under contact precautions during hospitalization are at a higher risk for delirium, according to a study published in the January issue of Infection Control and Hospital Epidemiology.
Fetal Tracheal Occlusion Improves Neonatal Survival
WEDNESDAY, Dec. 14 (HealthDay News) -- Fetal endoscopic tracheal occlusion (FETO) is associated with improved neonatal survival in severe isolated congenital diaphragmatic hernia (CDH), according to a study published online Dec. 14 in Ultrasound in Obstetrics & Gynecology.
PCI Outcomes No Worse in Centers Without On-Site Surgery
TUESDAY, Dec. 13 (HealthDay News) -- Similar rates of in-hospital mortality and emergency coronary artery bypass grafting (CABG) surgery for percutaneous coronary intervention (PCI) are seen at centers with and without on-site surgery, according to a review published in the Dec. 14 issue of the Journal of the American Medical Association.
Hispanic Race, Obesity Tied to Pediatric Gallbladder Disease
TUESDAY, Dec. 13 (HealthDay News) -- Hispanic ethnicity and obesity are strongly associated with symptomatic pediatric gallbladder disease, according to a study published online Dec. 12 in Pediatrics.
Infection Prevention Up in VA, Non-Federal Hospitals
TUESDAY, Dec. 13 (HealthDay News) -- From 2005 to 2009, there was a significant increase in the use of hospital-acquired infection (HAI) prevention practices in non-federal and Veterans Affairs (VA) hospitals, according to a study published online Dec. 6 in the Journal of General Internal Medicine.
Chemo, Radiation Worsen Cognition in Breast CA Survivors
MONDAY, Dec. 12 (HealthDay News) -- Breast cancer survivors treated with chemotherapy plus radiation or radiation alone may experience poorer cognitive functioning over time, according to a study published online Dec. 12 in Cancer.
Post-Mastectomy Reconstruction Feasible for Older Women
FRIDAY, Dec. 9 (HealthDay News) -- Breast reconstruction after mastectomy is safe, feasible, and well tolerated in older women, according to a study published in the December issue of The American Surgeon.
Factors Affecting Micro-RNA Detection Accuracy Identified
FRIDAY, Dec. 9 (HealthDay News) -- Accurate detection and quantitation of circulating microRNAs (miRNAs) is affected by inherent differences in plasma samples, methods used for their collection and analysis, and the presence of specific inhibitors in plasma, according to a study published online Dec. 9 in the Journal of Molecular Diagnostics.
Similar Prognosis for BRCA1 Carriers, Sporadic Breast Cancer
THURSDAY, Dec. 8 (HealthDay News) -- The risks of distant recurrence and death are similar for BRCA1 mutation carriers and for those with sporadic breast cancer, whereas women with BRCA2 mutations have higher risks on univariable analysis, and similar risks on multivariable analysis, according to a study published online Dec. 5 in the Journal of Clinical Oncology.
LV Dyssynchrony Has Prognostic Value After Acute MI
TUESDAY, Dec. 6 (HealthDay News) -- In patients admitted with ST-segment elevation acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI), left ventricular (LV) dyssynchrony is a strong predictor of long-term mortality and hospitalization for heart failure, over known clinical and echocardiographic risk factors, according to research published in the Dec. 15 issue of The American Journal of Cardiology.
1 in 5 Limb Fractures in Children Receive Delayed Care
TUESDAY, Dec. 6 (HealthDay News) -- Approximately one in five children with an accidental extremity fracture receive their first medical evaluation more than eight hours after the injury, according to a study published online Dec. 5 in Pediatrics.
Transplant Patients Want a Role in Liver Quality Decisions
TUESDAY, Dec. 6 (HealthDay News) -- Patients waiting for liver transplantation want to be involved in decisions about organ quality, and the level of risk they are prepared to tolerate is influenced by the presentation format, according to a study published in the December issue of Liver Transplantation.
Medical Students Fail to ID Hand Hygiene Indications
MONDAY, Dec. 5 (HealthDay News) -- Medical students who are about to start the clinical phase of their education have a lack of knowledge regarding the correct indications for hand disinfection, according to a study published in the December issue of the American Journal of Infection Control.
C. difficile Infection Ups Duration of Hospital Stay
MONDAY, Dec. 5 (HealthDay News) -- Hospital-acquired infection with Clostridium difficile (C. difficile) significantly and independently lengthens the duration of stay in the hospital, according to a study published online Dec. 5 in CMAJ, the journal of the Canadian Medical Association.
Quality of Life Up in Obese A-Fib Patients Post-Ablation
FRIDAY, Dec. 2 (HealthDay News) -- For obese patients with atrial fibrillation (AF), but not for their non-obese counterparts, quality of life (QoL) scores improve significantly following catheter ablation, according to a study published in the December issue of Heart Rhythm.
Most Non-Mobile Spinal Mets Patients Walk Post-Surgery
FRIDAY, Dec. 2 (HealthDay News) -- The majority of nonambulatory patients with epidural spinal metastasis become ambulatory postoperatively, according to a study published in the November issue of The Spine Journal.
Early Post-Op Complications Identified in Rett Syndrome
FRIDAY, Dec. 2 (HealthDay News) -- A high rate of early postoperative medical complications is seen among patients with Rett syndrome (RS) undergoing spinal fusion, according to a study published online Nov. 19 in Spine.
Time of Operation Not Linked to Postoperative Mortality
FRIDAY, Dec. 2 (HealthDay News) -- The timing of general surgery and the moon phase are not associated with 30-day mortality after surgery, according to a study published in the December issue of Anesthesia & Analgesia.
Portal Thrombosis Preventable in Islet Transplantation
FRIDAY, Dec. 2 (HealthDay News) -- For patients undergoing percutaneous islet implantation, portal venous thrombosis (PVT) can be prevented by therapeutic anticoagulation, ablation of the portal catheter tract, and limiting packed cell volume (PCV), according to a study published in the December issue of the American Journal of Transplantation.
Risk Factors ID'd for Pressure Ulcers in Prolonged Surgery
THURSDAY, Dec. 1 (HealthDay News) -- Pressure ulcer development during surgical procedures that last more than three hours is significantly related to the type of positioning device, table surface, skin assessment, and gender; with use of a foam pad and a lower day-one Braden score significantly predictive of pressure ulcers, according to a study published in the December issue of the AORN Journal.
MicroRNAs Distinguish Tumors in Von Hippel-Lindau Syndrome
THURSDAY, Dec. 1 (HealthDay News) -- MicroRNA (miRNA), miR-9 and miR-200a, signatures facilitate distinction of hemangioblastomas from metastatic clear cell renal cell carcinomas (Met CCRCC) in Von Hippel-Lindau Syndrome, according to a study published online Nov. 15 in Brain Pathology.
Learning Assessment Tool IDs R.N. Educational Needs
THURSDAY, Dec. 1 (HealthDay News) -- A learning needs assessment (LNA), which evaluates the knowledge of registered nurses (RNs) on procedural sedation for pediatric patients, is able to help identify knowledge deficits and differential needs, and can be a useful tool for providing continuing education, according to a study published in the December issue of the AORN Journal.
Anticoagulant Self-Monitoring Safe Option for Suitable Patients
THURSDAY, Dec. 1 (HealthDay News) -- Self-monitoring and self-management of oral coagulation is associated with a significant reduction in thromboembolic events and is a safe option for suitable patients of all ages, according to a review published online Dec. 1 in The Lancet.
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