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Category: Surgery | Monthly Briefing

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May 2009 Briefing - Surgery

Last Updated: June 01, 2009.

 

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

Links Between Bleeding, PCI, Mortality Explored

FRIDAY, May 29 (HealthDay News) -- Major bleeding may play a causal role in mortality in patients undergoing percutaneous coronary intervention (PCI), according to a paper published in the June 2 Journal of the American College of Cardiology.

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Nonobstetric D&Cs Linked to Low Complication Rate

FRIDAY, May 29 (HealthDay News) -- The intraoperative complication rate for nonobstetric dilation and curettage (D&C) procedures in a sample of women was relatively low, according to research published in the June issue of Obstetrics & Gynecology.

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Cell Transplantation May Improve Bladder Function

FRIDAY, May 29 (HealthDay News) -- In rats with spinal cord injury, transplantation of neuronal-glial restricted precursors or bone marrow stromal cells leads to significant improvement in bladder function but falls short of inducing full recovery, according to a study published in the June issue of The Journal of Urology.

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Medical School Faculty, Students Conflict Over Priorities

FRIDAY, May 29 (HealthDay News) -- Medical school faculty and new physicians who have completed internship training hold differing views about the procedures that are essential to learn during internship, according to a study published in the April issue of Medical Teacher.

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Electrophysiology Predicts Tachycardia After Heart Failure

THURSDAY, May 28 (HealthDay News) -- Patients with ischemic cardiomyopathy who go on to develop ventricular tachycardia have differences in the electrophysiology and electroanatomy of the scarred areas, according to a study published online May 27 in the Journal of the American College of Cardiology.

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Careful Processing Urged for Loaner Instruments

THURSDAY, May 28 (HealthDay News) -- At hospitals and ambulatory surgery centers, instruments loaned from other institutions may arrive in poor or contaminated condition, creating problems for both the loaning and receiving facilities and compromising patient safety, according to a report published in the May issue of the AORN Journal.

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Postoperative Voiding Rules May Need Review

THURSDAY, May 28 (HealthDay News) -- The requirement of postoperative voiding before discharge may unnecessarily delay patients from leaving the hospital, particularly with the growing number of surgical procedures that are now performed on an outpatient basis, according to an article published in the May issue of the AORN Journal.

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Gastric Bypass Surgery Linked to Kidney Stones

THURSDAY, May 28 (HealthDay News) -- Obese patients who undergo gastric bypass surgery may have a significantly increased risk of kidney stone disease and the need to undergo kidney stone surgery, according to a study published in the June issue of The Journal of Urology.

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Computerized Prescription Order Errors a Risk for Patients

THURSDAY, May 28 (HealthDay News) -- Computerized provider order entry systems are prone to input errors that may put patients at risk, according to a study published in the May 25 issue of the Archives of Internal Medicine.

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Focus on Meaningful Work Protects Doctors From Burnout

THURSDAY, May 27 (HealthDay News) -- Academic faculty physicians who focus on what they find most meaningful are less likely to experience burnout, according to a study published in the May 25 issue of the Archives of Internal Medicine.

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Gene Finding May Influence Kidney Transplant Outcomes

WEDNESDAY, May 27 (HealthDay News) -- Kidney transplant recipients who have T allelic variants in exons 21 or 26 of the ABCB1 gene may have a greater likelihood of several adverse events related to cyclosporine A, according to research published online May 21 in the Journal of the American Society of Nephrology.

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Colorectal Cancer Outcomes Improve at Two Cancer Centers

WEDNESDAY, May 27 (HealthDay News) -- Outcomes for patients with metastatic colorectal cancer have markedly improved at two leading cancer centers since 1997 because of increased use of liver resection and the introduction of new cancer drugs, according to a study published online May 26 in the Journal of Clinical Oncology.

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Lower-Insurance Mortality Unaffected by Comorbidities

WEDNESDAY, May 27 (HealthDay News) -- Comorbidity levels do not explain why patients with colorectal cancer who have private insurance have lower death rates than patients who are uninsured or have government insurance, according to a study published online May 26 in the Journal of Clinical Oncology. In a related study in the same issue, hospital factors such as quality can help explain some of the higher mortality in black patients with breast or colon cancer.

Abstract - Robbins
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Abstract - Breslin
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Age at Diagnosis of Prostate Cancer Decreased Since 1980s

TUESDAY, May 26 (HealthDay News) -- The age at which prostate cancer is diagnosed has declined in recent decades, according to research published online May 22 in Cancer.

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Vitamin D Linked to Cognitive Function in Men

MONDAY, May 25 (HealthDay News) -- The level of vitamin D in the blood is associated with cognitive function in middle-aged and older men, according to a study published online May 21 in the Journal of Neurology, Neurosurgery & Psychiatry.

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Music Reduces Confusion After Hip or Knee Surgery

MONDAY, May 25 (HealthDay News) -- In older adults who undergo hip or knee surgery, postoperative music therapy may reduce acute confusion, according to a study published in the May issue of Applied Nursing Research.

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Bioresorbable, Titanium Plates Similar in Spinal Fusion

FRIDAY, May 22 (HealthDay News) -- Patients with degenerative disc disease undergoing cervical spine fusion with plate fixation do equally well with a bioresorbable plate compared with a titanium plate, according to a study in the May issue of the Journal of Spinal Disorders & Techniques.

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Fenofibrate May Help Prevent Amputations in Diabetics

FRIDAY, May 22 (HealthDay News) -- In patients with type 2 diabetes, fenofibrate may lower the risk of minor amputation, according to a study published in the May 23 issue of The Lancet.

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Democrats Set Ambitious Goal for Health Care Reform

THURSDAY, May 21 (HealthDay News) -- Congressional Democrats face formidable challenges in their efforts to pass health care reform legislation by July 31, but physicians can take the lead to ensure changes are enacted, according to two perspectives published online May 20 in the New England Journal of Medicine.

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Hybrid Revascularization Procedures Seem Feasible

THURSDAY, May 21 (HealthDay News) -- A hybrid approach to treating carotid and coronary artery disease with back-to-back procedures may be a feasible therapeutic strategy, according to research published in the May issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

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Editorial (subscription or payment may be required)

Statins May Cut Liver Cancer and Cholecystectomy Risks

THURSDAY, May 21 (HealthDay News) -- Statin use is associated with reduced risk for cholecystectomy and for liver cancer, according to two studies published in the May issue of Gastroenterology.

Abstract - Tsai
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Abstract - El-Serag
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Pregnancy Linked to Poorer Thyroid, Parathyroid Outcomes

THURSDAY, May 21 (HealthDay News) -- Pregnant women who undergo thyroid or parathyroid surgery are more likely to have worse clinical outcomes than non-pregnant women in terms of complications and length of stay, according to research published in the May issue of the Archives of Surgery.

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Sticking to Work Hours Limits Very Costly

WEDNESDAY, May 20 (HealthDay News) -- Adherence to the 2003 Accreditation Council for Graduate Medical Education (ACGME) limits on work hours, and other measures aimed at reducing fatigue among residents, would be costly with no proven benefits, according to an article published in the May 21 issue of the New England Journal of Medicine.

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Dipyridamole Can Cut Risk of Hemodialysis Stenosis

WEDNESDAY, May 20 (HealthDay News) -- A combination of aspirin and dipyridamole can yield a modest reduction in the risk of arterovenous graft stenosis in patients undergoing hemodialysis, and can increase the duration of patency in new grafts, according to a study published in the May 21 issue of the New England Journal of Medicine.

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Door-to-Balloon Delays Increase Risk of Death

WEDNESDAY, May 20 (HealthDay News) -- In patients admitted with ST elevation myocardial infarction, any delay in primary percutaneous coronary intervention is associated with an increased risk of death, according to a study published online May 19 in BMJ.

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Device, Surgery Both Found Effective in Sleep Apnea

WEDNESDAY, May 20 (HealthDay News) -- The mandibular advancement device (MAD) is effective in the treatment of most obstructive sleep apnea (OSA), while surgery should be reserved for patients in whom conservative treatments have failed, according to studies reported in the May issue of the Archives of Otolaryngology: Head & Neck Surgery.

Abstract - Lee
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Abstract - Shine
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Prognosis Remains Poor in Gallbladder Cancer

WEDNESDAY, May 20 (HealthDay News) -- Median survival time for patients with gallbladder cancer has increased for more than four decades, but many patients still present with advanced disease and prognosis remains poor, according to a paper in the May Archives of Surgery.

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Transformational Learning Helps Nurses Improve

WEDNESDAY, May 20 (HealthDay News) -- Transformational learning, whereby individuals reflect on their actions, question faulty assumptions and revise their actions, can help improve the performance of perioperative nurses, according to an article published in the May issue of the AORN Journal.

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Coronary Artery Bypass Care Quality Not Tied to Quantity

TUESDAY, May 19 (HealthDay News) -- Adherence to quality measures in coronary artery bypass follow-up care results in similar mortality rates whether the procedure is performed at a high-volume or low-volume cardiac care center, according to a study reported in the May 19 issue of the Annals of Internal Medicine.

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Editorial (subscription or payment may be required)

Facial Fractures in Car Accidents Decreasing

TUESDAY, May 19 (HealthDay News) -- Improvements in car design with a view to minimizing the effects of crashes may help explain the decrease in facial fractures as a result of car accidents, while use of seat belts and other restraints continues to be an important aspect of injury prevention, according to a study published in the May/June issue of the Archives of Facial Plastic Surgery.

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American Pain Society Offers Back Pain Treatment Guidance

MONDAY, May 18 (HealthDay News) -- The American Pain Society (APS) has issued a new series of recommendations to guide clinicians deciding among the various surgical and nonsurgical options for treating low back pain (LBP). The guidelines are presented in separate studies in the May 1 issue of Spine.

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Nurses in Kuwait Want More Professional Opportunities

MONDAY, May 18 (HealthDay News) -- Among the multicultural population of nurses working in Kuwait, professional opportunities and extrinsic rewards are the greatest sources of dissatisfaction with work, according to a study published in the May issue of Applied Nursing Research.

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Workweek Cuts a Concern for Neurosurgery Residents

MONDAY, May 18 (HealthDay News) -- Many involved in the training of neurosurgeons express concern that further reductions in residents' weekly work hours would threaten the quality of their education and patient care, according to two studies in the May Journal of Neurosurgery.

Abstract - Jagannathan
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Abstract - Grady
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Virtual Laparoscopy Training Superior to Standard Training

FRIDAY, May 15 (HealthDay News) -- Danish gynecology students trained in laparoscopic surgery using a virtual simulator scored substantially higher on a proficiency scale than those receiving standard clinical training, according to research published online May 14 in BMJ.

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Imaging Technology Assesses Graft During Off-Pump CABG

FRIDAY, May 15 (HealthDay News) -- Intraoperative fluorescence imaging (IFI) can evaluate graft patency during off-pump coronary artery bypass graft (CABG) surgery, making possible immediate graft revision, if needed, and potentially better clinical outcomes, according to a study in the May issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

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Maintaining Airway Pressure Benefits Post-Op Patients

FRIDAY, May 15 (HealthDay News) -- Maintaining positive airway pressure in patients after cardiac surgery can improve arterial oxygenation and reduce pulmonary complications, according to a study published in the May issue of Chest.

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Patient Selection Crucial for Transcatheter AVR

THURSDAY, May 14 (HealthDay News) -- Transcatheter aortic valve replacement (AVR) is becoming an increasingly used option for patients with symptomatic aortic stenosis who aren't good candidates for surgical valve replacement, according to an overview published in the May 19 issue of the Journal of the American College of Cardiology.

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Cement-Free Hip Replacement Has Good Long-Term Results

THURSDAY, May 14 (HealthDay News) -- Porous-coated acetabular metal shells inserted without the use of cement during total hip arthroplasty produce good long-term results, according to a study published in the May issue of the Journal of Bone & Joint Surgery.

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Role of Patent Foramen Ovale in Stroke Needs More Study

WEDNESDAY, May 13 (HealthDay News) -- Greater patient involvement in ongoing trials is needed to guide clinical decisions on the optimal treatment of patent foramen ovale (PFO) for stroke prevention, according to an advisory published online May 11 in Circulation.

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Exercise and Diet Support Slows Cancer Survivor Decline

TUESDAY, May 12 (HealthDay News) -- Exercise, diet and weight loss support can slow the functional decline of long-term cancer survivors, according to a study in the May 13 issue of the Journal of the American Medical Association.

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Child Post-Mortem Organ Donation Procedures Vary

TUESDAY, May 12 (HealthDay News) -- While most children's hospitals have policies for post-mortem organ donation, they vary on key points, such as the processes for pronouncing death and withdrawing life support, according to a study reported in the May 13 issue of the Journal of the American Medical Association.

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Abnormal Bone Growth More Common in War Wounds

MONDAY, May 11 (HealthDay News) -- War wounds are more likely than civilian wounds to result in heterotopic ossification, and the complication is common among patients who undergo amputation as a result of blast injuries and those who undergo amputation within the zone of injury, according to a study published in the May issue of the Journal of Bone & Joint Surgery.

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NSAID Use Inhibits Post-Surgery Spine Fusion

MONDAY, May 11 (HealthDay News) -- The use of the nonsteroidal anti-inflammatory drug (NSAID) diclofenac sodium for pain after vertebrae-fusing surgery appears to inhibit the successful fusion of the vertebrae, according to a study published in the May issue of The Spine Journal.

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Spinal Outcomes Linked to Pre-Surgery Time Off

MONDAY, May 11 (HealthDay News) -- Patients with symptomatic disc degeneration have a greater improvement in pain and disability after surgery if they were off work less than 13 weeks before surgery, according to a study in the May issue of The Spine Journal.

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Better Treatment of Brain Hemorrhage Needed

FRIDAY, May 8 (HealthDay News) -- Given that death rates for patients with non-traumatic cerebral hemorrhage have not improved in the last decade, better clinical management is needed to reduce death and increase functional survival, according to a study in the May 9 issue of The Lancet.

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Simple Plastic Glasses Can Protect Orthopedic Surgeons

FRIDAY, May 8 (HealthDay News) -- Orthopedic surgeons can best protect themselves from conjunctival contamination during surgery with simple, disposable plastic glasses, according to a study published in the May issue of the Journal of Bone and Joint Surgery.

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Drug-Eluting Stents Beneficial for Off-Label Use

THURSDAY, May 7 (HealthDay News) -- Patients implanted with drug-eluting stents for off-label indications have lower rates of repeat target vessel revascularization and death without affecting the heart attack rate compared with bare-metal stents, according to a study in the May 12 issue of the Journal of the American College of Cardiology.

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Drug-Eluting Stents May Help Prevent Restenosis

WEDNESDAY, May 6 (HealthDay News) -- Drug-eluting stents had lower rates of restenosis and lower rates of lesion and vessel revascularization in head-to-head trials against bare-metal stents in two studies published in the May 7 issue of the New England Journal of Medicine.

Abstract - Stone
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Abstract - James
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Physical Therapists Can Successfully Treat Clubfoot

WEDNESDAY, May 6 (HealthDay News) -- Physical therapists can use the Ponseti method to treat clubfoot as effectively as surgeons and their patients have fewer recurrences, according to a study published in the May issue of the Journal of Bone and Joint Surgery.

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High Urine Albumin Linked to Venous Thromboembolism

TUESDAY, May 5 (HealthDay News) -- Already a recognized risk factor for arterial thromboembolism, microalbuminuria also is a risk factor for venous thromboembolism (VTE), according to a study published in the May 6 issue of the Journal of the American Medical Association.

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Heart Arrhythmias Increase Mortality in Catheterizations

TUESDAY, May 5 (HealthDay News) -- The incidence of ventricular tachycardia or fibrillation (VT/VF) during and after percutaneous coronary intervention (PCI) is associated with higher death rates within 90 days, according to a study published in the May 6 issue of the Journal of the American Medical Association.

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Rivaroxaban Effective in Preventing Thrombosis

TUESDAY, May 5 (HealthDay News) -- A phase III trial of oral rivaroxaban has shown that it is more effective than subcutaneous enoxaparin in preventing venous thromboembolism after total knee arthroplasty, according to a study published online May 5 in The Lancet.

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Editorial (subscription or payment may be required)

Medical Center Press Releases Often Lacking Key Details

TUESDAY, May 5 (HealthDay News) -- Press releases from academic medical centers may often overstate the importance of research findings while failing to acknowledge relevant limitations of the studies, according to research published in the May 5 Annals of Internal Medicine.

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Genotype Linked to Cardiac Surgery Outcomes

TUESDAY, May 5 (HealthDay News) -- Patients who were homozygous for the low activity catechol-O-methyltransferase (COMT) L allele had a higher risk of vasodilatory shock and acute kidney injury following cardiac surgery with cardiopulmonary bypass, according to research published online April 30 in the Journal of the American Society of Nephrology.

Abstract
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Pancreas Graft Function Affects Survival in Diabetics

MONDAY, May 4 (HealthDay News) -- Patients with type 1 diabetes and severe renal dysfunction who receive a simultaneous pancreas-kidney transplant have better survival if the pancreas remains functional a year after the transplant, according to a study published online ahead of print April 30 in the Clinical Journal of the American Society of Nephrology.

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Chemical Explains Problems After External Circulation

MONDAY, May 4 (HealthDay News) -- Cyclohexanone, a compound used to make intravenous bags and extracorporeal circulation equipment, can leach into the contained fluids and cause cardiovascular morbidities similar to those observed after extracorporeal circulation, according to a study published in the May issue of the American Journal of Physiology - Heart and Circulatory Physiology.

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More Americans Reporting Disability

FRIDAY, May 1 (HealthDay News) -- The number of Americans reporting disabilities rose by 7.7 percent from 44.1 million in 1999 to 47.5 million in 2005, according to a report in the May 1 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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