Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for April 2009. 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.
New Web-based Information Source to Support UK Clinicians
THURSDAY, April 30 (HealthDay News) -- The United Kingdom's National Institute for Health and Clinical Excellence (NICE) has announced the launch of NHS Evidence, a Web-based evidence resource for clinicians, public health professionals of the National Health Service, and others involved in making patient care decisions. The announcement came in the April 30 issue of The Lancet.
NEJM Commends New Conflict of Interest Proposal
THURSDAY, April 30 (HealthDay News) -- A new proposal to control conflict of interest is notable for its breadth and variety of recommended solutions, according to a Perspective article published online April 29 in the New England Journal of Medicine.
FDA Requires OTC Pain Relievers to Display Warnings
WEDNESDAY, April 29 (HealthDay News) -- Popular over-the-counter (OTC) pain relievers and fever medications containing acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) will be required to display prominent warnings about the risks of liver damage and internal bleeding, under a new rule announced April 28 by the U.S. Food and Drug Administration (FDA).
Pharmacist Involvement May Decrease Medication Errors
TUESDAY, April 28 (HealthDay News) -- Adding a pharmacist to health care teams may significantly decrease patients' risk of adverse drug events and medication errors, according to a report published in the April 27 issue of the Archives of Internal Medicine. A second study indicates that an interdisciplinary medication reconciliation intervention can also reduce unintentional medication discrepancies with potential for harm.
Steep Copayments Increase Risk of Non-Adherence
TUESDAY, April 28 (HealthDay News) -- In patients who are newly diagnosed with a chronic disease, higher out-of-pocket costs for medications are associated with an increased likelihood of non-treatment, according to a study published in the April 27 issue of the Archives of Internal Medicine.
Range of Motion May Not Predict Spinal Surgery Outcome
FRIDAY, April 24 (HealthDay News) -- Preoperative segmental lumbar range of motion (s-ROM) and total range of motion (t-ROM) do not appear to predict postoperative range of motion following lumbar total disc replacement, according to research published in the April 20 issue of Spine.
Shoe Insoles Don't Appear to Prevent Back Pain
THURSDAY, April 23 (HealthDay News) -- Shoe insoles do not appear to be effective for preventing back pain, and limited evidence neither supports nor discourages their use for treating low back pain, according to research published April 20 in Spine.
Cervical Spine Fusion More Common in Elderly
THURSDAY, April 23 (HealthDay News) -- Between 1992 and 2005, the adjusted rates of cervical spine fusions increased by 206 percent among Medicare beneficiaries, according to a study published in the April 20 issue of Spine.
Having Health Insurance May Not Improve Mortality Risk
THURSDAY, April 23 (HealthDay News) -- People without health insurance have about the same mortality rate as people with health insurance, according to an observational study published online April 21 in Health Services Research.
Oral Bisphosphonates Link to Esophageal Cancer Analyzed
WEDNESDAY, April 22 (HealthDay News) -- Oral bisphosphonate does not appear to increase risk for esophageal cancer, according to analyses of Danish and U.S. data reported by separate researchers in the April 23 issue of the New England Journal of Medicine.
Stretches Without Health Insurance More Common
WEDNESDAY, April 22 (HealthDay News) -- Periods of uninsurance have become more common in recent decades, particularly among those with less education, according to research published in the April 23 issue of the New England Journal of Medicine.
Continuity of Care Declining for Medicare Beneficiaries
TUESDAY, April 21 (HealthDay News) -- Medicare beneficiaries in the hospital in 2006 were much less likely to be seen there by a familiar physician than those in the hospital a decade earlier, according to a study reported in the April 22/29 issue of the Journal of the American Medical Association.
Leisure Sports, Exercise May Not Be Back Pain Risk Factors
TUESDAY, April 21 (HealthDay News) -- Participating in leisure time sports or exercise does not appear to be a risk factor for developing lower back pain (LBP), but the evidence is conflicting when it comes to other leisure and work activities, according to a review of medical literature reported in the April 15 issue of Spine.
Children Wearing Spine Device Often Suffer Complications
MONDAY, April 20 (HealthDay News) -- Children wearing a halo device for spinal correction or immobilization should be closely monitored for complications, such as pin site infection or neurological damage, according to a study in the April 15 issue of SPINE.
Spine Patients Choose Surgery to Improve Functioning
FRIDAY, April 17 (HealthDay News) -- Improving daily functioning, such as walking, rather than relieving pain is the primary reason that people with back deformities choose risky surgery over nonoperative therapies, according to a report in the April 15 issue of Spine.
Surgery Can Be Appropriate for C2 Fractures in Elderly
THURSDAY, April 16 (HealthDay News) -- Surgical treatment of C2 fractures in the elderly appears reasonably safe and effective, according to research published in the April issue of the Journal of Spinal Disorders & Techniques.
Initial Cobb Angle Predicts Scoliosis Curve Progression
THURSDAY, April 16 (HealthDay News) -- In patients with idiopathic scoliosis, the Cobb angle on initial presentation is the most important predictor of long-term curve progression, according to a study published in the April 1 issue of Spine.
Treatment, Imaging Decisions Vary in Facet Dislocations
TUESDAY, April 14 (HealthDay News) -- Spine surgeons may show a great deal of variability in how they respond to cervical facet dislocations, according to research published in the April Journal of Spinal Disorders & Techniques.
Review Looks at Injuries in Spinal Disorders
MONDAY, April 13 (HealthDay News) -- A review of outcomes following spinal injuries in individuals with ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH) suggests appropriate management strategies in these cases, according to research published in the April issue of the Journal of Spinal Disorders & Techniques.
Magnesium Improves Function After Spinal Cord Injury
MONDAY, April 13 (HealthDay News) -- Magnesium treatment shortly after spinal cord injury in rats improves motor function and spares white matter, according to study findings published in the April issue of the Journal of Neurosurgery: Spine.
Chronic Opioid Use for Pain Impairs Functional Rehab
MONDAY, April 13 (HealthDay News) -- Patients with musculoskeletal injuries are more likely to benefit from a functional restoration program if they are not chronic users of opioids for pain, researchers report in the April issue of the Journal of Bone & Joint Surgery.
Financial Rewards for Healthy Behavior Can Be Effective
FRIDAY, April 10 (HealthDay News) -- Although paying people to engage in healthy behaviors or successfully tackle unhealthy ones can be effective, it may carry unintended consequences, according to an editorial published online April 9 in BMJ.
Zoledronic Acid Improves Bone Loss From Glucocorticoid Use
FRIDAY, April 10 (HealthDay News) -- A single yearly infusion of zoledronic acid improved bone mineral density better than daily doses of risedronate among patients at risk for osteoporosis due to glucocorticoid use for inflammatory or immune-mediated disorders, researchers report in the April 11 issue of The Lancet.
Shoulder Dislocations Plague US Military
FRIDAY, April 10 (HealthDay News) -- In the U.S. military population, shoulder dislocation is an endemic problem, according to a report published in the April issue of the Journal of Bone & Joint Surgery.
Vitamin D Deficiency Common in Breast Cancer Patients
THURSDAY, April 9 (HealthDay News) -- In premenopausal breast cancer patients who are undergoing adjuvant chemotherapy, vitamin D supplementation at even double the current recommended dietary allowance is too low to increase serum 25-hydroxyvitamin D (25-OHD) to sufficient levels, according to a report published online ahead of print April 6 in the Journal of Clinical Oncology.
Accelerated Care Cost-Effective After Joint Replacement
THURSDAY, April 9 (HealthDay News) -- In patients who receive total hip and knee arthroplasty, an accelerated perioperative care and rehabilitation protocol is more cost-effective than a more standard protocol, according to a study published in the April issue of the Journal of Bone & Joint Surgery.
Lumbar Arthrodesis Good Option for Older Patients
THURSDAY, April 9 (HealthDay News) -- In selected older patients with degenerative disc disease, single-level posterolateral lumbar arthrodesis with an iliac crest bone graft is a beneficial treatment, according to a study published in the April issue of the Journal of Bone & Joint Surgery.
Dynamic Plates Seen As Preferable to Rigid Plates
WEDNESDAY, April 8 (HealthDay News) -- In patients undergoing cervical spine surgery for degenerative conditions, dynamic plate systems may be preferable to rigid plate systems because they are associated with a lower risk for implant failure-related revision surgery, according to a study published in the April 1 issue of Spine.
Clinicians and Radiologists May Differ in MRI Readings
MONDAY, April 6 (HealthDay News) -- In the evaluation of MRI conducted in patients with symptomatic lumbar disc herniation, there is excellent agreement between clinicians and radiologists when comparing herniation vertebral level and location within level, but only fair agreement when comparing herniation morphology, according to a study published in the April 1 issue of Spine.
Electronic Prescribing Online-Learning Tools Launched
THURSDAY, April 2 (HealthDay News) -- U.S. physicians will be able to better evaluate electronic prescribing systems thanks to a new online learning center on ePrescribing launched April 1 by the American Medical Association.
Less Invasive Back Surgery Offers Advantages
WEDNESDAY, April 1 (HealthDay News) -- A less-invasive posterior lumbar interbody fusion appears to provide improved outcomes compared to the standard version of the surgery, according to research published in the March 15 issue of Spine.
Changes Needed in New-Drug Evaluation Process
WEDNESDAY, April 1 (HealthDay News) -- The evaluation process for new drugs is overdue for an overhaul, which could provide benefits for the public and the pharmaceutical industry, according to a point-counterpoint commentary published online March 31 in BMJ.
New Health Program Leads to Questions in the UK
WEDNESDAY, April 1 (HealthDay News) -- A new British program to improve patient choices and competition in the health care marketplace may lead to excess capacity in some areas and instability in others, according to a commentary published online March 31 in BMJ.
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