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Category: Surgery | Monthly Briefing

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April 2009 Briefing - Surgery

Last Updated: May 01, 2009.

 

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

NICE home page
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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.

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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).

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China's Organ Procurement Troubles Most US Clinicians

WEDNESDAY, April 29 (HealthDay News) -- Because of China's organ procurement practices, including organ harvesting from executed prisoners, most health care professionals involved in liver transplantation do not recommend patients seek a transplant in that country, according to a study released online Jan. 12 in advance of publication in Clinical Transplantation.

Abstract
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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.

Abstract - Murray
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Abstract - Schnipper
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Editorial

Glucose Control During Surgery Linked to Better Outcomes

TUESDAY, April 28 (HealthDay News) -- Aggressive glycemic control during surgery reduces the risk of major cardiovascular events, researchers report in the May issue of Anesthesiology.

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Margins Important After Pancreatic Cancer Surgery

TUESDAY, April 28 (HealthDay News) -- Patients with pancreatic cancer have better long-term survival after surgery if the resected tumor has a margin clearance of more than 1.5 mm, according to a study published online ahead of print April 27 in the Journal of Clinical Oncology.

Abstract
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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.

Abstract
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Editorial

Grafts Can Improve Outcome For High-Risk Dialysis Patients

FRIDAY, April 24 (HealthDay News) -- Autologous tissue-engineered vascular grafts can help end-stage renal disease patients gain a better outcome from hemodialysis, according to a study published in the April 25 issue of The Lancet.

Abstract
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Electronic Medical Records Have Proven Their Worth

FRIDAY, April 24 (HealthDay News) -- The electronic medical record system that has been used by the Department of Veterans Affairs health care facilities since the mid-1980s has proven to be a useful way to reduce costs and errors and improve hands-off communication in the surgical setting, according to an article published in the April issue of the AORN Journal.

Abstract
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Perioperative Bullying Reduces Nurses' Effectiveness

FRIDAY, April 24 (HealthDay News) -- The perioperative setting is vulnerable to workplace bullying, but interventions to eliminate intimidating and unsettling behavior among nursing staff can help eliminate the problem, according to an article published in the April issue of the AORN Journal.

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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.

Abstract
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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.

Abstract
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Parents Need More Education About Child's Cardiac Surgery

THURSDAY, April 23 (HealthDay News) -- Parents of patients undergoing fast-track cardiac surgery need to be educated and informed more fully prior to surgery if they are to be more effectively involved in their child's care, according to a study published in the April issue of the AORN Journal.

Abstract
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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.

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Superobese Patients Benefit From Bariatric Surgery

WEDNESDAY, April 22 (HealthDay News) -- Superobese patients gain quality of life benefits from bariatric surgery, even though they may remain severely obese after surgery, according to a study published in the April issue of the Archives of Surgery. In the same issue, another study shows that bariatric surgery does not need to be performed in a center of excellence to get optimum results.

Abstract-Suter
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Abstract-Livingston
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Radiation Exposure Affects Course of Thyroid Cancer

WEDNESDAY, April 22 (HealthDay News) -- In patients with thyroid cancer, increased radiation exposure is associated with poorer outcomes, according to a study published in the April issue of the Archives of Otolaryngology: Head & Neck Surgery.

Abstract
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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.

Abstract
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Transplant Center Distance No Factor in Kidney Transplant

TUESDAY, April 21 (HealthDay News) -- Living in a rural area or far from a kidney transplant center does not significantly affect a patient's chances of getting a transplant, according to a study in the April 22/29 issue of the Journal of the American Medical Association.

Abstract
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Defibrillator Implant Success Varies by Specialty

TUESDAY, April 21 (HealthDay News) -- Patients who receive an implantable cardioverter-defibrillator (ICD) are more apt to get the most appropriate device and are less likely to suffer complications if an electrophysiologist performs the procedure, according to a study reported in the April 22/29 issue of the Journal of the American Medical Association.

Abstract
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Robotic Surgery Safe For Some Head And Neck Tumors

TUESDAY, April 21 (HealthDay News) -- Robot-assisted surgery to treat upper aerodigestive tract tumors is feasible and safe provided certain criteria are met, according to a study published in the April issue of the Archives of Otolaryngology- Head & Neck Surgery.

Abstract
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Web-Based System Can Help Track Surgical Adverse Events

TUESDAY, April 21 (HealthDay News) -- A simple to use Web-based system can be used to track surgical complications and identify patterns of adverse events, according to a study published in the April issue of the Archives of Surgery.

Abstract
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Infertility Period Linked to Pregnancy Rate in Varicocele

MONDAY, April 20 (HealthDay News) -- Following varicocelectomy, men with longer periods of infertility achieve lower pregnancy rates, indicating a harmful effect from the varicocele on the testicles over time, according to research published in the April issue of Urology.

Abstract
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Minimally Invasive Surgery for Gastric Cancer Effective

MONDAY, April 20 (HealthDay News) -- Patients with gastric cancer who undergo laparoscopic surgery have shorter hospital stays, less pain, and fewer complications than patients undergoing open surgery, with similar survival, according to a study published online April 4 in Annals of Surgical Oncology.

Abstract
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Revascularization Not Linked to Long-Term Benefit

FRIDAY, April 17 (HealthDay News) -- In patients with high cardiac risk undergoing major vascular surgery, preoperative coronary revascularization was not associated with better long-term outcomes, according to research published April 1 in the American Journal of Cardiology.

Abstract
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Admission Time Affects Surgery for Renal Colic

FRIDAY, April 17 (HealthDay News) -- Patients with renal colic who are admitted on weekends are less likely to receive surgery than those admitted on weekdays; however, in the sickest patients, surgery is performed at the same rate regardless of the time of admission, according to a study published in the April issue of Urology.

Abstract
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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.

Abstract
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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.

Abstract
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Stem Cells Repair Corneal Damage in Mice

THURSDAY, April 16 (HealthDay News) -- Stem cells from human corneas can be used in a mouse model to treat corneal scarring resulting from trauma or inflammation that can lead to blindness, according to a study published online April 9 in Stem Cells.

Abstract
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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.

Abstract
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Pelvic Cooling Technique Beneficial in Prostatectomy

THURSDAY, April 16 (HealthDay News) -- Hypothermic nerve-sparing radical prostatectomy is a safe and feasible procedure that results in an earlier return to continence, according to a report published in the April issue of Urology.

Abstract
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Perioperative Nurses May Lack Knowledge of Hypothermia

THURSDAY, April 16 (HealthDay News) -- Perioperative nurses may not have sufficient education or be guided by adequate practice guidelines to identify and manage hypothermia, according to a report published in the April issue of the AORN Journal.

Abstract
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Laser Treatment Effective for Mouth Ulcers

WEDNESDAY, April 15 (HealthDay News) -- Low-power laser treatment is effective in treating or preventing oral mucositis, a painful side effect of radiotherapy, in cancer patients, according to a study published online April 3 in Lasers in Surgery and Medicine.

Abstract
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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.

Abstract
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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.

Abstract
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Intensive Bladder Cancer Care May Not Improve Mortality Risk

MONDAY, April 13 (HealthDay News) -- Intensive treatment in early-stage bladder cancer does not appear to affect patient survival or avert major interventions later, according to a study published online April 7 in the Journal of the National Cancer Institute.

Abstract
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Editorial

Blacks Less Likely to Receive Lung Cancer Treatment

MONDAY, April 13 (HealthDay News) -- In patients with non-small cell lung cancer (NSCLC), racial disparities in treatment did not significantly narrow during a recent 12-year period, according to an article published online April 13 in Cancer.

Abstract
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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.

Abstract
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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.

Abstract
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Low Risk of Thromboembolism Found in Podiatric Surgery

MONDAY, April 13 (HealthDay News) -- Venous thromboembolism presents a low risk in podiatric surgery, but practitioners should consider prophylactic treatment if the patient has at least two risk factors, according to a study reported in the April issue of the journal Chest.

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Avoterim May Speed Healing, Reduce Scarring

FRIDAY, April 10 (HealthDay News) -- Transforming growth factor β3 (TGFβ3), also known as avotermin, significantly improved the appearance of scars in both the short term and long term in a series of three studies conducted in the United Kingdom, according to research published in the April 11 issue of The Lancet.

Abstract
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Genetic Components Affect Liver Transplant Prognosis

FRIDAY, April 10 (HealthDay News) -- In liver transplant recipients, killer cell immunoglobulin-like receptor genotype and killer cell immunoglobulin-like receptor-human leukocyte antigen C ligand compatibility may significantly affect the recurrence and progression of hepatitis C disease, according to a study published in the April issue of Liver Transplantation.

Abstract
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Editorial

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.

Editorial

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.

Abstract
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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.

Abstract
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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.

Abstract
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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.

Abstract
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Socioeconomic Status a Risk Factor in Child Heart Transplant

WEDNESDAY, April 8 (HealthDay News) -- Children from lower socioeconomic groups are at greater risk for graft failure following a heart transplant than children from higher socioeconomic groups, according to a study published online April 7 in Circulation: Heart Failure.

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New Cerebrovascular Intervention Statement Issued

TUESDAY, April 7 (HealthDay News) -- In response to the rapid pace of technological development in the field of intracranial endovascular cerebrovascular interventions, the American Heart Association has released guidelines on performance of such procedures to treat a range of cerebrovascular disorders. The indications were laid out in a statement published online April 6 in Circulation: Journal of the American Heart Association.

Abstract
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Age, Disease Stage May Decide Vaginal Cancer Outcome

MONDAY, April 6 (HealthDay News) -- Women treated with laser vaporization for vaginal intraepithelial neoplasia may be at greater risk of recurrence if they are aged 48 or younger or if they were diagnosed with stage III cancer, compared to their older counterparts and those with less advanced disease, according to a study published online March 16 in Lasers in Surgery and Medicine.

Abstract
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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.

Abstract
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Bleeding Linked to Cardiovascular Events After PCI

MONDAY, April 6 (HealthDay News) -- Bleeding complications associated with percutaneous coronary intervention (PCI) may raise the risk of adverse outcomes in patients, according to research published in the April 1 issue of the American Journal of Cardiology.

Abstract
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Men With Heart Disease Less Likely to Find Full-Time Work

MONDAY, April 6 (HealthDay News) -- Males who have had surgery for congenital heart disease are more likely than males in the general population to find a part-time job or minor employment than a full-time job, according to a study published online February 5 in Congenital Heart Disease.

Abstract
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Bracing Routinely Applied After Spinal Procedures

MONDAY, April 6 (HealthDay News) -- In patients who undergo spinal surgery for degenerative conditions, most surgeons use post-operative bracing, but there is no consensus concerning the most appropriate type, duration and indications for immobilization, according to the results of a study published in the April issue of the Spine Journal.

Abstract
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LASIK Linked to High Patient Satisfaction Rates

MONDAY, April 6 (HealthDay News) -- Most patients report that they are satisfied with the results of LASIK surgery, which is the most commonly performed elective procedure, according to research published in the April issue of Ophthalmology.

Abstract
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Complications Linked to Laser Skin Resurfacing

MONDAY, April 6 (HealthDay News) -- Severe dermatologic complications can develop in patients who undergo fractional CO2 laser resurfacing, according to a study published online March 16 in Lasers in Surgery and Medicine.

Abstract
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Catheter-Based Therapies May Benefit Stroke Patients

FRIDAY, April 3 (HealthDay News) -- In some patients who aren't candidates for intravenous thrombolysis, catheter-based therapy (CBT) provides an optional treatment for acute ischemic stroke, according to research published in the April 1 issue of Catheterization and Cardiovascular Interventions.

Abstract
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Benefits Seen From Early Epilepsy Surgery

FRIDAY, April 3 (HealthDay News) -- Surgery to treat epilepsy in young children appears generally safe and effective, according to research published online ahead of print Jan. 21 in Epilepsia.

Abstract
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Social Deprivation Impairs Cardiac Surgery Prognosis

FRIDAY, April 3 (HealthDay News) -- Potentially modifiable risk factors that are associated with social deprivation -- such as smoking, extremely high or low body mass index, and diabetes -- adversely affect the outcome of cardiac surgery, according to a report published online April 2 in BMJ.

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Concurrent Radiation, Chemo Tolerated After Lumpectomy

THURSDAY, April 2 (HealthDay News) -- For women who have undergone lumpectomy, partial breast irradiation (PBI) and chemotherapy can be used concurrently without producing intolerable toxicities, according to a report published online March 30 in the Journal of Clinical Oncology.

Abstract
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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.

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Selected Older Kidneys Match Younger Organs for Transplant

WEDNESDAY, April 1 (HealthDay News) -- Carefully selected kidneys transplanted from donors aged 70 or older can produce outcomes similar to organs from donors 60 to 69 years old, according to a letter in the April 2 issue of the New England Journal of Medicine.

Abstract
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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.

Abstract
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Rebleeding Risk Low for Treated Intracranial Aneurysm

WEDNESDAY, April 1 (HealthDay News) -- Though the risk of recurrent bleeding in patients with a ruptured intracranial aneurysm is higher in those treated with endovascular coiling compared to surgical clipping, the risk of later death was lower in the coiled group, according to research published online March 28 in The Lancet Neurology.

Abstract
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Editorial

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.

Abstract - Garattini
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Abstract - Tremblay
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Adult Spinal Stem Cells Reverse Paralysis in Rats

WEDNESDAY, April 1 (HealthDay News) -- Spinal stem cells taken from adult rats with an injured spinal cord are effective at differentiating into oligodendrocytes and motor neurons and can reverse paralysis when transplanted into rats with a spinal cord injury, according to a study published in the March issue of Stem Cells.

Abstract
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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.

Abstract
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Surgeon Experience Affects Outcomes After Laparoscopy

WEDNESDAY, April 1 (HealthDay News) -- Among prostate cancer surgery patients, lower recurrence rates have been found among those whose surgeon has performed more laparoscopic prostatectomies than among patients with low-volume surgeons, but the learning curve for laparoscopic prostatectomy is slower than for open surgery, according to a report published online April 1 in The Lancet Oncology.

Abstract
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