Here are what the editors at HealthDay consider to be the most important developments in Surgery for April 2006. 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.
Report Sheds Light on X-SCID Gene Therapy Cancer Risk
THURSDAY, April 27 (HealthDay News) -- Gene therapy for treatment of X-linked severe combined immunodeficiency syndrome (X-SCID), while largely successful, may cause T-cell leukemias because of the nature of the therapeutic gene rather than insertional mutagenesis, according to a brief communication in this week's issue of Nature.
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CT Scan May Predict Therapy Success in Acute Lung Injury
WEDNESDAY, April 26 (HealthDay News) -- The percentage of potentially recruitable lung in acute respiratory distress syndrome (ARDS) varies and is associated with the response to positive end-expiratory pressure (PEEP), according to a study in the April 27 issue of the New England Journal of Medicine.
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FDA Warns of Danger of Oxygen Regulator Fires
WEDNESDAY, April 26 (HealthDay News) -- The U.S. Food and Drug Administration (FDA) has received 12 reports of incidents in which oxygen regulators used with oxygen cylinders have exploded or burned, in some cases causing injury. The accidents appear to be caused by re-use of plastic crush gaskets designed for single use, resulting in an improper seal and oxygen leakage, according to the FDA and the National Institute for Occupational Safety and Health (NIOSH).
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Hospital Adherence To Guidelines Improves Heart Patient Outcome
TUESDAY, April 25 (HealthDay News) -- Patients with acute coronary syndrome are less likely to die if they receive care at a hospital with higher adherence to American College of Cardiology/American Heart Association treatment guidelines, according to a study published in the April 26 issue of the Journal of the American Medical Association.
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Implantable Defibrillators Fail More Often Than Pacemakers
TUESDAY, April 25 (HealthDay News) -- Implantable cardioverter-defibrillators (ICDs) have a significantly higher malfunction rate than pacemakers and replacement of the defective devices can cause serious complications, including infections and death, according to two studies in the April 26 issue of the Journal of the American Medical Association.
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FDA Drug Advisory Committee Conflicts of Interest Assessed
TUESDAY, April 25 (HealthDay News) -- Conflict-of-interest disclosures are common at U.S. Food and Drug Administration (FDA) Drug Advisory Committee meetings and may warrant excluding members who have large financial interests, according to a study in the April 26 issue of the Journal of the American Medical Association.
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Most Physicians Would Halt Chemo at Patient's Request
MONDAY, April 24 (HealthDay News) -- The majority of physicians would halt chemotherapy if a terminal cancer patient insisted, but fewer would comply with a patient's request to speed death with drugs, according to a survey of physicians in six European countries and Australia published in the April 24 issue of the Archives of Internal Medicine.
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Risk Models Predict Carotid Endarterectomy Complications
MONDAY, April 24 (HealthDay News) -- Researchers have identified two risk models that are best at predicting the broad range of complications that can occur following carotid endartarectomy, according to a report in the April 24 issue of the Archives of Internal Medicine.
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AtrialEsophageal Fistula Rare Complication After Ablation
MONDAY, April 24 (HealthDay News) -- Physicians should be alert for atrial-esophageal fistulas, a rare but potentially fatal complication that can develop in patients who have undergone catheter ablation for atrial fibrillation, according to a study published in the April 18 issue of the Annals of Internal Medicine.
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Mortality Risk Higher in Diabetics with Peptic Ulcer
FRIDAY, April 21 (HealthDay News) -- Patients with diabetes are at higher risk of short-term mortality from peptic ulcer bleeding and perforation, according to a study published in the April issue of Diabetes Care.
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Seven Cases of CJD in U.K. Transplant Patients
FRIDAY, April 21 (HealthDay News) -- There were seven cases of Creutzfeldt-Jakob disease (CJD) in the United Kingdom associated with human dura mater transplants between 1970 and 2003, according to a report published online in the Journal of Neurology, Neurosurgery and Psychiatry. What's more, an additional case was diagnosed in a patient with a porcine dura mater transplant, which would make it a worldwide first, although it may have been a case of sporadic CJD.
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Large Acromion Extension Linked to Rotator Cuff Tears
FRIDAY, April 21 (HealthDay News) -- A large lateral extension of the acromion is associated with full-thickness tear of the rotator cuff, according to a report in the April issue of the Journal of Bone and Joint Surgery.
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CDC Reports U.S. Death Rate Has Fallen to Record Low
THURSDAY, April 20 (HealthDay News) -- The United States death rate has fallen to a record low, life expectancy is increasing and the life expectancy gender gap is narrowing, according to a summary report, issued April 19 by the National Center for Health Statistics.
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Lawnmower Injuries More Common in Teens, Elderly
THURSDAY, April 20 (HealthDay News) -- People aged 60 to 69 are the most likely to be injured in a lawnmower accident, followed by adolescents aged 15 to 19 years, according to a study published online in April in the Annals of Emergency Medicine. There was a trend towards increased lawnmower injuries in the United States between 1996 and 2004, suggesting more should be done to prevent such injuries, the report indicates.
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Prior Pain, Function Predict Outcome for Hip Arthroplasty
WEDNESDAY, April 19 (HealthDay News) -- Patients undergoing revision hip arthroplasty who have less self-reported pain and better function scores than other patients before surgery tend to have better long-term postoperative outcomes, according to a study in the April issue of the Journal of Bone & Joint Surgery.
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Women May Feel Shut Out of Male 'Surgery Club'
TUESDAY, April 18 (HealthDay News) -- While both men and women entering medicine may forgo a career in surgery because of perceptions about the lifestyle and workload, women are specifically deterred because of the perception that surgical culture is male-oriented, according to a report in the April issue of Archives of Surgery.
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Study Finds Wrong-Site Surgery Is Rare
TUESDAY, April 18 (HealthDay News) -- An analysis of over 2.8 million surgeries at institutions in the United States finds that while wrong-site surgery is unacceptable, it is "exceedingly rare" and major injury from it is even rarer. The results are published in the April issue of the Archives of Surgery.
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Fewer Post-Op Infections with Good Glycemic Control
TUESDAY, April 18 (HealthDay News) -- Diabetic patients who have good blood sugar control are less likely to have infections or other complications after non-cardiac surgical procedures, according to a report in the April issue of Archives of Surgery.
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LASIK Surgery Review Addresses Complications
MONDAY, April 17 (HealthDay News) -- Like other procedures, LASIK surgery can result in complications that threaten otherwise healthy eyes, but proper patient selection and care before, during and after surgery can help minimize the risk, according to a review in the April issue of American Journal of Ophthalmology. The report addresses recognition and management of four major groups of complications.
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Oxidized LDL Predicts Restenosis after Stenting for MI
MONDAY, April 17 (HealthDay News) -- Elevated plasma levels of oxidized low-density lipoprotein (LDL) in patients who have undergone stenting for acute myocardial infarction is a predictor of later stent restenosis, according to a study in the April issue of Arteriosclerosis, Thrombosis, and Vascular Biology.
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Sperm Retrieval More Costly During Vasectomy Reversal
FRIDAY, April 14 (HealthDay News) -- Sperm retrieval and cryopreservation is not cost-effective when conducted during surgery to reverse a vasectomy, according to a report in the April issue of Fertility and Sterility. Instead, it is more cost effective to harvest sperm at the time of in vitro fertilization from patients who are still azoospermic after the reversal procedure, the authors say.
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Bile Acid is a Key Stimulus of Liver Regeneration
FRIDAY, April 14 (HealthDay News) -- Liver regeneration is triggered by a "homeotrophic" response where hepatocytes sense higher levels of bile acids and increase bile acid signaling through the nuclear hormone receptor FXR, according to a report in the April 14 issue of Science.
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Surgery Best for Twin Reversed Arterial Perfusion
FRIDAY, April 14 (HealthDay News) -- The best overall outcome for twin reversed arterial perfusion (TRAP) sequence is achieved with surgery, but the surgical approach and technique should be tailored to individual cases, according to a study in the April issue of the American Journal of Obstetrics & Gynecology.
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Gastric Electrical Stimulation May Help Treat Obesity
THURSDAY, April 13 (HealthDay News) -- Gastric electrical stimulation (GES), in which mucosal electrodes are endoscopically placed in the fundus, may be a potential treatment for obesity, according to a study published in the April issue of the American Journal of Gastroenterology.
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Expectant Management An Option For Bile Stones
THURSDAY, April 13 (HealthDay News) -- Expectant management after endoscopic retrograde cholangiography with sphincterotomy (ERC-S) for common bile duct stones may be a reasonable strategy in elderly patients, but it depends on the probability of recurrent symptoms, according to a study in the April issue of the American Journal of Gastroenterology.
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Patent Foramen Ovale Closure Improves Migraine
THURSDAY, April 13 (HealthDay News) -- In patients with patent foramen ovale (PFO), transcatheter defect closure may be an effective and safe treatment for PFO-associated migraine headache with aura (MHA), according to a study in the April issue of the American Heart Journal.
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Burch Colposuspension Reduces Stress Incontinence
WEDNESDAY, April 12 (HealthDay News) -- In women without stress incontinence who undergo abdominal sacrocolpopexy for prolapse, Burch colposuspension significantly reduces the risk of postoperative stress incontinence, according to a study in the April 13 issue of the New England Journal of Medicine.
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Diabetes, Hypertension Risk After Kidney Stone Treatment
WEDNESDAY, April 12 (HealthDay News) -- Patients who undergo shock wave treatment for kidney stones have an almost fourfold higher risk of developing diabetes and 1.5-fold higher risk of hypertension compared with patients managed with medication, according to a study published in the May issue of the Journal of Urology.
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Tests Predict Outcome After Living Donor Liver Transplant
TUESDAY, April 11 (HealthDay News) -- Two liver function tests remain altered in donors and recipients after living donor liver transplantation (LDLT), and a noninvasive test may be useful in predicting graft function after transplantation, according to two studies in the April issue of Liver Transplantation.
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Platinum Stents Useful in Treating Aortic Coarctations
MONDAY, April 10 (HealthDay News) -- Cheatham-platinum stents are a safe and viable option for patients with aortic coarctations who develop an aneurysm or have complications from conventional stents, or who are at high risk of complications due to age or complex lesions, according to a study in the April 4 issue of the Journal of the American College of Cardiology.
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Mouse Study Shows Serotonin Key in Liver Regeneration
FRIDAY, April 7 (HealthDay News) -- Platelet-derived serotonin may be involved in the initiation of liver regeneration, according to the results of an animal study published in the April 7 issue of Science. The finding suggests that serotonin agonists may benefit liver transplant patients, who often have a platelet deficiency.
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Longer Waiting Times for Pediatric Liver Transplants
FRIDAY, April 7 (HealthDay News) -- Wait-list times have increased for pediatric liver transplants since the early 1990s, with wait-list mortality highest for infants and toddlers, according to a study published in the April issue of Liver Transplantation.
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Collagen Gene Mutation May Cause Stroke Susceptibility
WEDNESDAY, April 5 (HealthDay News) -- A mutation in the procollagen type IV alpha1 (Col4a1) gene in mice leaves the brain fragile and susceptible to hemorrhage, according to a report published in the April 6 issue of the New England Journal of Medicine. The authors found a similar mutation in a French family with small-vessel disease and a history of fatal intracerebral hemorrhage, retinal hemorrhage, infantile hemiparesis and migraine with aura.
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Adenotonsillectomy May Improve Children's Behavior
TUESDAY, April 4 (HealthDay News) -- Adenotonsillectomy can relieve a variety of neurobehavioral symptoms in children with sleep-disordered breathing, according to research published in the April issue of Pediatrics.
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Engineered Bladders Promising in First Clinical Trial
TUESDAY, April 4 (HealthDay News) -- New bladders engineered from a patient's own cells grown on a biodegradable scaffold have been implanted in 7 myelomeningocele patients who normally would have undergone intestinal cystoplasty due to end-stage bladder disease, according to a report published online April 4 in The Lancet.
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Only Minority of MI Patients Receive Angioplasty
TUESDAY, April 4 (HealthDay News) -- While primary percutaneous coronary intervention (PCI) is considered the best procedure for most of the 400,000 ST-segment-elevation myocardial infarction (STEMI) patients seen each year in the United States, the treatment is only offered to a minority and access should be widened, according to an American Heart Association (AHA) consensus statement published online March 28 in Circulation: Journal of the American Heart Association.
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