Here are what the editors at HealthDay consider to be the most important developments in Surgery for May 2012. 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.
More Bone Grafts, Screws Tied to Less Spinal Reconstruction Stress
THURSDAY, May 31 (HealthDay News) -- Increasing the number of bone grafts and screws used for fusing multiple cervical spine segments yields a more stable construct that decreases the stresses at the graft end plate and bone-screw interfaces, according to a study published online May 10 in The Spine Journal.
Pre-Op Chemoradiotherapy Ups Survival in Esophageal Cancer
WEDNESDAY, May 30 (HealthDay News) -- For patients with esophageal or esophagogastric-junction cancer, treatment with neoadjuvant chemoradiotherapy followed by surgical resection is associated with improved survival compared with surgery alone, according to a study published in the May 31 issue of the New England Journal of Medicine.
Repeat CT Scan Urged for Head Trauma Patients on Warfarin
WEDNESDAY, May 30 (HealthDay News) -- Minor head trauma patients taking warfarin should have a repeat computed tomography (CT) scan prior to discharge to detect delayed hemorrhage, particularly in those with an initial international normalized ratio (INR) higher than 3, according to research published in the June issue of the Annals of Emergency Medicine.
Post-Transplant, eGFR Impacts Cardio Risk Independently
WEDNESDAY, May 30 (HealthDay News) -- In stable kidney transplant recipients, kidney function, as determined by estimated glomerular filtration rate (eGFR), is independently associated with cardiovascular (CVD) events and death, according to research published online May 17 in the American Journal of Transplantation.
Pathologic Response Prediction of Survival Aided by Tumor Type
WEDNESDAY, May 30 (HealthDay News) -- Pathologic complete response (pCR) is more highly predictive of recurrence-free survival (RFS) when specific breast cancer tumor type is factored in, according to a study published online May 29 in the Journal of Clinical Oncology.
Worse Survival for Recipients of Lungs From Smokers
TUESDAY, May 29 (HealthDay News) -- Recipients of lungs from donors with a positive smoking history have worse three-year survival, but their probability of survival is better than for those who remain on the waiting list, according to a study published online May 29 in The Lancet.
Transvaginal Mesh Op Restores Pelvic Organ Prolapse at Price
FRIDAY, May 25 (HealthDay News) -- Transvaginal mesh (TVM) procedures are effective for anatomical restoration of pelvic organ prolapse (POP), but patients report a worsening of sexual function following surgery, according to a study published online May 21 in The Journal of Sexual Medicine.
Pancreatectomy OK Without Downstaging From Therapy
FRIDAY, May 25 (HealthDay News) -- Pancreatectomy improves median survival in pancreatic cancer patients even when presurgical neoadjuvant therapy does not lead to radiographic downstaging of tumors, according to a study published online May 17 in Cancer.
Posterior Repair Successful for Cervical Pseudarthrosis
THURSDAY, May 24 (HealthDay News) -- Posterior cervical lateral mass screw fixation and fusion can be successfully used to manage patients with symptomatic cervical pseudarthrosis that develops after anterior cervical discectomy and fusion, according to a study published in the May issue of the Journal of Spinal Disorders & Techniques.
Characteristics of STEMI Reperfusion Systems Identified
WEDNESDAY, May 23 (HealthDay News) -- Successful ST-segment elevation myocardial infarction (STEMI) reperfusion systems share common characteristics, and these characteristics can be used to set standards for coordinated care, according to research published online May 22 in Circulation: Cardiovascular Quality and Outcomes.
Instrumented Spinal Fusion Method Impacts Infection Rate
MONDAY, May 21 (HealthDay News) -- For patients who undergo instrumented spinal fusion, the rates of infection are higher among those who receive posterior lumbar interbody fusion compared with those who receive posterior or posterolateral fusion, according to a study published online May 10 in the Journal of Spinal Disorders & Techniques.
Neurally Controlled Arm Lets Tetraplegics Reach, Grasp
THURSDAY, May 17 (HealthDay News) -- For tetraplegic individuals, use of a neural interface system is a feasible approach to direct robotic arm actions to reach and grasp, according to a letter published online May 16 in Nature.
Predictors of Length of Hospital Stay After Spine Surgery ID'd
THURSDAY, May 17 (HealthDay News) -- A variety of pre-, intra-, and postoperative factors contribute to increased length of stay (LOS) for patients who undergo level 1 minimally invasive (MIS) transforaminal interbody fusions (TLIF) spine surgery, according to a study published online May 8 in Spine.
Some Function Returned to Hand in Spinal Cord Injury Patient
WEDNESDAY, May 16 (HealthDay News) -- For patients with spinal cord injury (SCI), nerve transfer may represent a therapeutic option, according to a case report published online May 15 in the Journal of Neurosurgery.
Better Outcomes at High-Volume Stroke Centers
TUESDAY, May 15 (HealthDay News) -- High-volume endovascular stroke centers provide faster times to treatment, and patients are more likely to have good clinical outcomes and successful reperfusion, according to a study published online May 13 in the Journal of NeuroInterventional Surgery.
New Technique Removes Inoperable Abdominal Tumors
FRIDAY, May 11 (HealthDay News) -- Multivisceral ex vivo surgery can successfully remove invasive abdominal tumors previously deemed unresectable due to location and vascular involvement, according to a case report published in the May issue of the American Journal of Transplantation.
Lowest Fused Vertebral Level Linked to Motion in Scoliosis
THURSDAY, May 10 (HealthDay News) -- For postoperative patients with adolescent idiopathic scoliosis (AIS), preservation of vertebral motion segments allows for greater distribution of functional motion, according to a study published in the May 1 issue of Spine.
Lack of Sleep Not Necessarily Detrimental to Surgical Skills
WEDNESDAY, May 9 (HealthDay News) -- Sleep-deprived medical students are able to perform and learn surgical skills, although they have an increased total subjective mental workload, according to a study published in the January issue of the American Journal of Surgery.
Criteria for Surveillance of Small Renal Mass Examined
MONDAY, May 7 (HealthDay News) -- Active surveillance of patients with small renal masses is driven by a tumor size less than 3 cm, poor performance score (PS), and an endophytic lesion, among other patient, tumor, and surgeon characteristics, according to research published in the May issue of Urology.
Hospitals Lack Hand Surgeons for Emergencies
MONDAY, May 7 (HealthDay News) -- There is a shortage of hand specialists to provide emergency coverage in the state of Tennessee, according to research published in the May issue of the Annals of Plastic Surgery.
Training Helps OR Nurses Manage Disruptive Physician Behavior
FRIDAY, May 4 (HealthDay News) -- Communication skills training may help nurses manage disruptive physician behavior, according to a study published in the May issue of the AORN Journal.
CMS Policy Helping Hospitals to Prevent Targeted Infections
FRIDAY, May 4 (HealthDay News) -- Hospitals seem to be paying greater attention to preventing targeted health care-associated infections (HAIs) as a result of the Centers for Medicare and Medicaid Services (CMS) nonpayment policy, according to a study published in the May issue of the American Journal of Infection Control.
Low Vitamin D Linked to Poorer Outcomes in Lung Recipients
THURSDAY, May 3 (HealthDay News) -- For lung transplant recipients, 25-hydroxyvitamin D (25[OH]D) deficiency is associated with increased incidence of acute rejection and infection, and deficiency at one year after transplant is linked with increased mortality, according to a study published online March 5 in The Journal of Heart and Lung Transplantation.
Office Evaluation Comparable to Pre-Op Urodynamic Testing
THURSDAY, May 3 (HealthDay News) -- For women with uncomplicated stress incontinence, preoperative office evaluation alone is noninferior to urodynamic testing with respect to success of treatment at one year, according to a study published online May 2 in the New England Journal of Medicine.
TAVI Is a Reasonable Option for High-Risk Elderly Patients
THURSDAY, May 3 (HealthDay News) -- For high-risk elderly patients with aortic stenosis, transcatheter aortic-valve implantation (TAVI) is a reasonable option, according to a study published in the May 3 issue of the New England Journal of Medicine.
Perioperative Interruptions Lead to Miscommunication
THURSDAY, May 3 (HealthDay News) -- The number of miscommunications that occur during surgery is inversely associated with the length of time a team has worked together, and positively associated with the number of interruptions during surgery, according to a study published in the May issue of the AORN Journal.
No Adverse Effect of Weekend, Nighttime Liver Transplants
WEDNESDAY, May 2 (HealthDay News) -- Performing liver transplantation procedures at night or on weekends does not appear to affect patient or liver graft survival, according to research published in the May issue of Liver Transplantation.
Methodological Heterogeneity Seen in Clinical Trials
TUESDAY, May 1 (HealthDay News) -- Clinical studies registered with ClinicalTrials.gov from 2007 and 2010 are predominately small, single-center trials and contain significant heterogeneity in methodology, according to a study published in the May 2 issue of the Journal of the American Medical Association.
Minimally Invasive Esophagectomy Offers Benefits
TUESDAY, May 1 (HealthDay News) -- Compared with open transthoracic esophagectomy, minimally invasive transthoracic esophagectomy is associated with significantly fewer pulmonary infections and with other short-term benefits in patients with resectable cancer of the esophagus, according to research published online May 1 in The Lancet.
Index Identifies Clot Risk in Outpatient Surgery Patients
TUESDAY, May 1 (HealthDay News) -- Using a weighted risk index, the highest-risk outpatient surgery patients have an almost 20-fold increase in risk of venous thromboembolism (VTE) requiring therapy, according to a study published online April 13 in the Annals of Surgery.
Electronic Records Show Variation in Blood Usage
TUESDAY, May 1 (HealthDay News) -- Electronic information systems can be used to generate detailed information about blood component use by individual providers and surgical services, and they reveal significant variation in utilization, according to research published online April 23 in Anesthesiology.
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