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August 2007 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for August 2007. 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.

Angiogenic Agent Helps Women with Angina

FRIDAY, Aug. 31 (HealthDay News) -- Use of a novel angiogenic agent, alferminogene tadenovec (Ad5FGF-4), appears to improve measures of refractory angina in women, and could be a promising treatment in the future, according to the results of a study published online Aug. 23 in the Journal of the American College of Cardiology.

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Lack of Data on Vaginal Cosmetic Surgery

FRIDAY, Aug. 31 (HealthDay News) -- Vaginal cosmetic procedures are increasing, despite the lack of scientific data on their efficacy and the risks involved, according to an opinion paper from the Committee on Gynecologic Practice of the American College of Obstetricians and Gynecologists published in the September issue of Obstetrics & Gynecology.

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Few Indications Seen for Total Disc Replacement

FRIDAY, Aug. 31 (HealthDay News) -- In the overall population of patients presenting with discogenic low back pain, there is an extremely low incidence of indications for total disc replacement, according to a report published in the July/August issue of the Spine Journal.

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Retrolisthesis May Not Exacerbate Disc Herniation

THURSDAY, Aug. 30 (HealthDay News) -- In patients with lumbar 5-sacral 1 (L5-S1) disc herniation, those with retrolisthesis do not have worse baseline pain or function than those who do not have retrolisthesis, according to study findings published in the July/August issue of the Spine Journal.

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FDA Approves First Human Thrombin Since 1954

THURSDAY, Aug. 30 (HealthDay News) -- Evithrom (human thrombin) -- a blood-clotting protein derived from human plasma -- was approved this week by the U.S. Food and Drug Administration. It's the first human thrombin the FDA has approved since 1954, the only such product currently licensed, and is applied to the surface of tissue during surgery to help control oozing and minor bleeding from capillaries and small veins.

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Hypnosis Cuts Pain, Anesthetic Use in Breast Surgery

WEDNESDAY, Aug. 29 (HealthDay News) -- A 15-minute hypnosis session prior to breast surgery reduced the amount of anesthesia required during the operation, the level of post-surgical pain and nausea, and the cost of the procedure, according to the results of a randomized controlled trial published online Aug. 28 in the Journal of the National Cancer Institute.

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Rats Given Clopidogrel Show Improved Skin Flap Survival

TUESDAY, Aug. 28 (HealthDay News) -- Administering the platelet inhibitor clopidogrel after surgical raising of epigastric island flaps in rats was associated with significantly better flap survival, according to study results published in the August issue of the Journal of Plastic, Reconstructive and Aesthetic Surgery.

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Crystal Deposition Observed in Intervertebral Discs

TUESDAY, Aug. 28 (HealthDay News) -- In human intervertebral discs, crystal deposition is a common occurrence and may have the same degenerative effects that it does in articular cartilage matrix, according to study findings published in the July/August issue of the Spine Journal.

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Most Plastic Surgery Patients Are Happy with Results

MONDAY, Aug. 27 (HealthDay News) -- Patients who have aesthetic plastic surgery show significantly increased postoperative satisfaction with their health and with their appearance, according to study findings published in the August issue of the Journal of Plastic, Reconstructive and Aesthetic Surgery.

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Peptide May Help Predict No-Reflow Phenomenon

MONDAY, Aug. 27 (HealthDay News) -- N-terminal pro-brain-type natriuretic peptide (NT-pro-BNP) may predict no-reflow phenomenon after primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction, according to a report in the Aug. 15 issue of the American Journal of Cardiology.

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Breast Cancer Patients More Satisfied with Specialists

MONDAY, Aug. 27 (HealthDay News) -- Breast cancer patients treated by surgeons who treat a high percentage of breast cancer cases are more satisfied with the decision-making process than those treated at low-volume practices, according to the results of a study published in the Aug. 20 issue of the Journal of Clinical Oncology.

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TV Reality Shows Boost Interest in Plastic Surgery

FRIDAY, Aug. 24 (HealthDay News) -- People who regularly watch television reality shows featuring plastic surgery feel more knowledgeable about the subject and may be more likely to pursue a consultation for a cosmetic procedure, according to a study published in the July issue of Plastic and Reconstructive Surgery.

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HDL Predicts Atherosclerotic Progression in Vein Grafts

FRIDAY, Aug. 24 (HealthDay News) -- In patients with a previous coronary artery bypass graft (CABG) using a saphenous vein graft, predictors of atherosclerosis progression in the graft include low HDL cholesterol and existing atherosclerotic burden, according to study findings published in the Aug. 15 issue of the American Journal of Cardiology.

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Swallowing and Vocal Problems Fade After Cervical Surgery

FRIDAY, Aug. 24 (HealthDay News) -- Patients who undergo anterior cervical decompression (ACD) commonly experience swallowing and vocal problems following surgery, but these difficulties are usually temporary and do not interfere with patient satisfaction overall, according to study findings published in the August issue of the Journal of Neurosurgery: Spine.

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Outcome Better with Planned Caesarean Hysterectomy

THURSDAY, Aug. 23 (HealthDay News) -- A planned Caesarean hysterectomy results in less blood loss, fewer transfusions and lower rates of complications compared with emergent Caesarean hysterectomy, researchers report in the August issue of the American Journal of Obstetrics & Gynecology.

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Cardiac Valve Surgery Can Result in Saccadic Palsy

THURSDAY, Aug. 23 (HealthDay News) -- In patients who develop saccadic palsy after cardiac surgery, the selective loss of all types of saccades but not other eye movements suggests that the brainstem circuit that generates saccades may be malfunctioning, according to study findings published online Aug. 14 in the Annals of Neurology.

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Non-Alcoholic Fatty Liver Common in Would-Be Donors

THURSDAY, Aug. 23 (HealthDay News) -- More than six out of 10 prospective living liver donors have non-alcoholic fatty liver disease, according to the results of a Korean study published in the August issue of the Journal of Hepatology.

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Bariatric Surgery Increases Longevity for Obese

WEDNESDAY, Aug. 22 (HealthDay News) -- In severely obese patients, bariatric surgery leads to sustained weight loss and reduces the risk of death, according to two studies published in the Aug. 23 issue of the New England Journal of Medicine.

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Ultrasound Device Stimulates Heart Without Pacing Lead

WEDNESDAY, Aug. 22 (HealthDay News) -- A new ultrasound device that achieves cardiac stimulation without a pacing lead is safe and effective in patients in the short term, researchers report in a study published in the Aug. 28 issue of the Journal of the American College of Cardiology.

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Variables Identified in Congenital Melanocytic Nevi

WEDNESDAY, Aug. 22 (HealthDay News) -- In patients with congenital melanocytic nevi, the major dermoscopic patterns vary by age and lesion site, according to a report published in the August issue of the Archives of Dermatology.

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Resident Duty-Hour Cuts Curb Surgeon Job Satisfaction

WEDNESDAY, Aug. 22 (HealthDay News) -- Reforms limiting resident duty hours are increasing surgeons' workloads and may be negatively affecting patient care, researchers report in the August issue of the Archives of Surgery.

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On-Demand Surgery for Peritonitis Less Costly

TUESDAY, Aug. 21 (HealthDay News) -- In patients with severe secondary peritonitis, on-demand relaparotomy has similar rates of morbidity and mortality as planned relaparotomy but with shorter hospital stays and lower medical costs, according to a report in the Aug. 22/29 issue of the Journal of the American Medical Association.

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Editorial - Dellinger
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Insurance Status Liked to Laryngeal Cancer Stage

TUESDAY, Aug. 21 (HealthDay News) -- Among patients who are diagnosed with laryngeal cancer, advanced-stage disease is significantly more common among those who are uninsured or covered by Medicaid, according to a report published in the August issue of the Archives of Otolaryngology - Head & Neck Surgery.

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Implantable Defibrillators May Reduce Mortality

TUESDAY, Aug. 21 (HealthDay News) -- In adult patients with left ventricular systolic dysfunction, implantable cardioverter defibrillators, or ICDs, effectively reduce the risk of death, according to a systematic review published in the Aug. 21 issue of the Annals of Internal Medicine.

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Liver Transplantation Safe in Older Patient Populations

TUESDAY, Aug. 21 (HealthDay News) -- Liver transplantation in septuagenarians results in similar rates of survival compared to younger transplant recipients, assuming other risk factors are controlled, according to a report published in the August issue of the Archives of Surgery.

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Some Aortic Dissections May Need Earlier Intervention

MONDAY, Aug. 20 (HealthDay News) -- Acute distal aortic dissection patients with large false lumen diameters may be at higher risk for aneurysm or death and as such make better candidates for early intervention than other such patients, according to a report in the Aug. 21 issue of the Journal of the American College of Cardiology.

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Esophageal Cancer Surgery Has Low Cure Rate

MONDAY, Aug. 20 (HealthDay News) -- Short-term survival rates are poor for patients undergoing surgery or surgery with chemotherapy for esophageal cancer unless all resection tissue margins are disease-free, making the identification of new chemotherapeutic regimens a high priority, according to a report published in the Aug. 20 issue of the Journal of Clinical Oncology.

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Hemochromatosis Fades as Threat in Liver Transplants

FRIDAY, Aug. 17 (HealthDay News) -- The survival rates of liver transplant patients who have hemochromatosis have improved dramatically over the past decade and are now almost identical to the average survival rate of all liver transplant patients, researchers report in the August issue of Gastroenterology.

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Induced Limb Ischemia May Reduce Post-CABG Injury

FRIDAY, Aug. 17 (HealthDay News) -- Patients scheduled for coronary artery bypass grafting (CABG) seem to have less post-surgical myocardial injury if they first undergo ischemic preconditioning in which the upper limb circulation is occluded in five-minute cycles, according to study findings published in the Aug. 18 issue of The Lancet.

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FDA OKs Updated Warfarin Label That Reflect Genetics

FRIDAY, Aug. 17 (HealthDay News) -- The U.S. Food and Drug Administration has approved new labeling for warfarin and the brand-name version of the drug, Coumadin, that explain how a patient's genetic makeup may affect their reaction to treatment. Patients with certain variants of the CYP2C9 and VKORC1 genes can have an unexpected response to the initial dose.

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Left Ventricular Device an Option for Transplant-Ineligible

THURSDAY, Aug. 16 (HealthDay News) -- Heart failure patients who aren't eligible for transplantation are more likely to survive if given a left ventricular assist device rather than optimal medical therapy, researchers report in the Aug. 21 issue of the Journal of the American College of Cardiology.

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Eye Cancer Risk Elevated in Kidney-Transplant Patients

THURSDAY, Aug. 16 (HealthDay News) -- Kidney-transplant patients have an increased risk of ocular squamous cell carcinoma, according to the results of a study published online Aug. 14 in the Journal of the National Cancer Institute. Because HIV patients also have an increased risk, the finding suggests that this malignancy is an immune deficiency-associated cancer.

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Small Kidney Stones May Be Safe in Renal Transplant

THURSDAY, Aug. 16 (HealthDay News) -- In patients undergoing live donor renal transplant, the presence of small asymptomatic renal calculi in the donor kidney does not appear to lead to obstructive complications, according to a small case series published in the August issue of Urology.

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Sonicating Explanted Prosthetic Joints Helps Detect Infection

WEDNESDAY, Aug. 15 (HealthDay News) -- Sonicating explanted hip and knee prostheses to dislodge bacterial biofilms can detect infections better than standard tissue culture, according to the results of a study published in the Aug. 16 issue of the New England Journal of Medicine.

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Needle Gauge Affects Risk of Disc Injury in Spine Surgery

TUESDAY, Aug. 14 (HealthDay News) -- Choosing spinal needles that are 22-gauge or smaller may help reduce leakage after anular puncture, according to tests conducted on human and porcine discs. The findings are published in the Aug. 1 issue of Spine.

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Stable Patients Often Get Angioplasty, Despite No Benefit

TUESDAY, Aug. 14 (HealthDay News) -- Physicians often perform percutaneous coronary intervention on stable heart patients, even though the risks may outweigh the benefits, and they sometimes do so for non-medical reasons, such as to ease a patient's anxiety. The findings are published in the Aug. 13/27 issue of the Archives of Internal Medicine.

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IL-1Ra Enriched Serum Relieves Lumbar Compression Pain

MONDAY, Aug. 13 (HealthDay News) -- Epidural perineural injection of autologous serum that has been treated to increase the content of interleukin-1 receptor antagonist (IL-1Ra) may be more effective than triamcinolone for the relief of pain of lumbar radicular compression, according to the results of a randomized trial published in the Aug. 1 issue of Spine. IL-1Ra is a natural inhibitor of interleukin-1.

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Post-Prostatectomy Erectile Dysfunction Helped by Statin

FRIDAY, Aug. 10 (HealthDay News) -- Men with prostate cancer who take statins are less likely to have erectile dysfunction after nerve-sparing surgery than those taking sildenafil alone, researchers report in the August issue of the Journal of Urology.

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Back Surgery Patients May Overestimate Graft Site Pain

THURSDAY, Aug. 9 (HealthDay News) -- Patients who undergo low-level spinal fusion operations using bone grafts from the iliac crest probably cannot distinguish between postoperative pain originating at the graft site and pain originating at the primary surgery site, according to a report published in the Aug. 1 issue of Spine.

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Drug Prevents Bleeding After Surgery for Gastric Cancer

THURSDAY, Aug. 9 (HealthDay News) -- A proton pump inhibitor is more effective than an H2-receptor antagonist in preventing delayed bleeding after endoscopy for early gastric cancer, according to the results of a study published in the August issue of the American Journal of Gastroenterology.

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Stem Cell Transplant Patients At Risk for Infertility

WEDNESDAY, Aug. 8 (HealthDay News) -- Cancer patients who undergo myeloablative stem cell transplant have a higher prevalence of infertility and concerns about infertility than their siblings or friends, according to a report published online Aug. 8 in the Journal of Clinical Oncology.

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Surgical Delay Works for Many with Pancreatic Neoplasms

TUESDAY, Aug. 7 (HealthDay News) -- Fewer than one in five patients with pancreatic branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) should have surgery, according to a report in the August issue of Gut.

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Orthopaedic Specialty Hospitals May Have Better Outcomes

MONDAY, Aug. 6 (HealthDay News) -- Patients who undergo total hip or knee arthroplasty at specialty orthopaedic hospitals tend to have fewer complications than their counterparts who undergo these surgeries at general hospitals, even after correcting for the fact that specialty hospitals tend to treat less-complicated cases, according to a report in the Aug. 1 issue of the Journal of Bone & Joint Surgery.

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First Successful Ovarian Tissue Transplant Between Sisters

FRIDAY, Aug. 3 (HealthDay News) -- A woman with premature ovarian failure due to chemotherapy received the first-ever successful ovarian tissue transplantation from her genetically non-identical sister, researchers report in the August issue of Human Reproduction.

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Physician's Briefing