Here are what the editors at HealthDay consider to be the most important developments in Surgery for August 2010. 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.
Preventive Surgeries Linked to Benefit With BRCA Mutations
TUESDAY, Aug. 31 (HealthDay News) -- Among women with BRCA1 or BRCA2 mutations, risk-reducing mastectomy is linked to a lower risk of breast cancer, and risk-reducing salpingo-oophorectomy is associated with numerous benefits, including lower risk of ovarian cancer and first breast cancer diagnosis, according to research published in the Sept. 1 issue of the Journal of the American Medical Association.
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Costs of Vehicle-Related Injury Exceeded $99 Billion in 2005
TUESDAY, Aug. 31 (HealthDay News) -- In 2005, motor vehicle crashes in the United States resulted in more than 3.7 million deaths or injuries requiring medical care, as well as loss of productivity and medical costs reaching nearly $100 billion, according to research published in the August issue of Traffic Injury Prevention.
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Nearly One in Three Deliveries in U.S. Is Cesarean Section
TUESDAY, Aug. 31 (HealthDay News) -- Almost a third of deliveries in the United States are by cesarean section, and more than 30 percent of cesareans can be attributed to pre-labor repeat cesarean delivery due to a previous uterine scar, according to research published online Aug. 13 in the American Journal of Obstetrics & Gynecology.
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Black Race Independent Predictor of Stent Thrombosis
MONDAY, Aug. 30 (HealthDay News) -- Black race is a distinct risk factor for developing stent thrombosis (ST) after drug-eluting stent (DES) implantation, according to a study published online Aug. 30 in Circulation.
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Post-Op Delirium Linked to Cerebral Vascular Disease
MONDAY, Aug. 30 (HealthDay News) -- Delirium after spinal fusion in elderly patients is more common in those with a history of cerebral vascular disease, low hemoglobin and hematocrit levels after surgery, and poor nutrition, according to a study in the Aug. 15 issue of Spine.
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PET/CT Imaging Restages Prostate Cancer After Surgery
FRIDAY, Aug. 27 (HealthDay News) -- Positron emission tomography/computerized tomography (PET/CT) to detect [11C]choline uptake appears to be useful for re-evaluating prostate cancer disease stage for men who have increasing prostate-specific antigen (PSA) levels after radical prostatectomy and no evidence of disease on conventional imaging, according to a study in the September issue of The Journal of Urology.
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Racial/Ethnic Disparities Seen in Liver Transplantation Rates
THURSDAY, Aug. 26 (HealthDay News) -- Subgroups of Hispanics and Asians in the United States have a lower rate of deceased donor liver transplantation (DDLT) than whites, and geographic variation appears to be a main factor accounting for disparities in liver transplantation among racial and ethnic groups, according to research published in the September issue of Liver Transplantation.
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Post-Transplant Survival High in Cardiac Patient Subset
THURSDAY, Aug. 26 (HealthDay News) -- Patients with hypertrophic cardiomyopathy (HCM) who undergo heart transplants have comparable short-term survival and possibly better long-term survival than people who receive heart transplants for other reasons, according to research published online Aug. 24 in Circulation: Heart Failure.
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Transapical Aortic Valve Procedure Appears Promising
THURSDAY, Aug. 26 (HealthDay News) -- Transapical aortic valve implantation is associated with favorable outcomes and may be a reasonable choice for treating high-risk patients with severe valve stenosis, according to research published in the Aug. 31 issue of the Journal of the American College of Cardiology.
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Surgery for Undescended Testes Often Occurs After Age 2
MONDAY, Aug. 23 (HealthDay News) -- Clinical guidelines recommend orchidopexy by age 1 for treatment of congenital undescended testes, but a substantial number of boys do not undergo the surgery even by age 2, according to research published online Aug. 23 in Pediatrics.
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Stress, Shorter Sobriety Predict Drinking Post-Transplant
THURSDAY, Aug. 19 (HealthDay News) -- The length that a patient receiving a liver transplant due to alcoholic liver disease stays sober prior to surgery is the strongest predictor of a return to alcohol use, and those who have more life stressors immediately after transplant are more likely start drinking alcohol again, according to a study published online Aug. 19 in the American Journal of Transplantation.
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Kidneys From Cardiac-Death, Brain-Dead Patients Equal
THURSDAY, Aug. 19 (HealthDay News) -- Kidneys transplanted from donors with controlled cardiac death perform as well as organs from brain-dead donors, according to research published online Aug. 19 in The Lancet.
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Surgery in Developing Countries Has Low Mortality
WEDNESDAY, Aug. 18 (HealthDay News) -- Operative mortality is generally low in surgical programs in resource-limited countries, according to a study in the August issue of the Archives of Surgery.
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Body Position and Anesthesia Can Alter Scoliosis Deformity
WEDNESDAY, Aug. 18 (HealthDay News) -- Spine curvature in scoliosis is corrected somewhat by different body positions and anesthesia during surgery, which can confound the determination of fusion levels, according to a study in the August issue of the Journal of Spinal Disorders & Techniques.
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Steroids in Cadaveric Donor Don't Benefit Kidney Recipient
WEDNESDAY, Aug. 18 (HealthDay News) -- Treating deceased kidney donors with corticosteroids in advance of kidney harvesting does not reduce the incidence or duration of acute renal failure (ARF) after transplantation in organ recipients, according to a study in the Aug. 17 issue of the Annals of Internal Medicine.
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Totally Tubeless PCNL Effective, Safe in Elderly
WEDNESDAY, Aug. 18 (HealthDay News) -- Totally tubeless (tubeless and stentless) percutaneous nephrolithotomy (PCNL) is routinely used for adults with renal stones, and it appears to be safe, effective, and feasible even in elderly patients, according to research published in the August issue of Urology.
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Antibiotic Sponges Fail to Fend Off Infections
TUESDAY, Aug. 17 (HealthDay News) -- In cardiac surgery patients with diabetes and/or a high body mass index, the use of two gentamicin-collagen sponges does not reduce the sternal wound infection rate 90 days post-surgery compared with no intervention, according to a study published in the Aug. 18 issue of the Journal of the American Medical Association.
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Disclosing Medical Errors May Cut Malpractice Claims, Costs
TUESDAY, Aug. 17 (HealthDay News) -- A malpractice claims management system implemented in Michigan that mandates full disclosure of medical errors accompanied by a monetary offer to the patient has resulted in a reduced claims rate, fewer lawsuits, faster time to resolution of claims, and lower costs, according to a study in the Aug. 17 issue of the Annals of Internal Medicine.
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Bariatric Surgery for Diabetes Patients Cuts Medication, Costs
MONDAY, Aug. 16 (HealthDay News) -- In type 2 diabetes patients, bariatric surgery is associated with dramatic reductions in the use of diabetes medications and in annual health care costs in the years after surgery, according to research published in the August issue of the Archives of Surgery.
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Mortality Lower for Hip Surgery Patients With Home Care
MONDAY, Aug. 16 (HealthDay News) -- Most elderly patients who are discharged home after hemiarthroplasty do not receive home care, but those who do are 43 percent less likely to die within three months than those who are sent home without home care, according to research published online Aug. 16 in CMAJ, the journal of the Canadian Medical Association.
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FDA: 6 French Engage Introducer Devices Recalled
MONDAY, Aug. 16 (HealthDay News) -- The U.S. Food and Drug Administration has alerted health care providers of a class I recall of 6 French (6F) Engage Introducer devices, manufactured by St. Jude Medical, as affected devices have the potential to lead to a possibly fatal bleeding episode.
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Insurance Type May Affect Kidney Patient Predialysis Care
FRIDAY, Aug. 13 (HealthDay News) -- Kidney disease patients insured by federally-sponsored national health care organizations such as the Department of Veterans Affairs (DVA) and the Department of Defense (DoD) are more likely to begin hemodialysis with an arteriovenous fistula (AVF) than patients with other types of insurance coverage, according to research published online Aug. 12 in the Journal of the American Society of Nephrology.
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Minimally Invasive Fusion Found Superior to Open Surgery
FRIDAY, Aug. 13 (HealthDay News) -- Minimally invasive transforaminal lumbar interbody fusion (TLIF) is superior to open surgical approaches for the treatment of 1-level degenerative lumbar diseases, according to research published in the Aug. 1 issue of Spine.
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Screening, Eradication Curtail Post-Surgery Staph Infections
FRIDAY, Aug. 13 (HealthDay News) -- Methicillin-sensitive Staphylococcus aureus (S. aureus) colonization is more prevalent among orthopedic surgeons than a high-risk patient group, but an institution-wide prescreening program for detecting and eradicating methicillin-sensitive and methicillin-resistant S. aureus among orthopedic surgery patients is feasible and can reduce surgical site infection rates, according to a pair of studies in the Aug. 4 issue of the Journal of Bone & Joint Surgery.
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Osteobiologic Risks, Benefits Should Be Individualized
THURSDAY, Aug. 12 (HealthDay News) -- All available osteobiologic options for spine fusion carry risk, but some are not fully known, and patients may not be aware of the risks and benefits of specific fusion materials, according to research published in the Aug. 1 issue of Spine.
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Two Wrist Fracture Treatments Have Similar Outcomes
THURSDAY, Aug. 12 (HealthDay News) -- Elderly patients with distal radial fractures treated with either surgery or cast immobilization achieve similar functional status one year later, although the surgical patients have greater grip strength, according to a study in the Aug. 4 issue of the Journal of Bone & Joint Surgery.
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Patients, Doctors Often Have Communication Discrepancies
WEDNESDAY, Aug. 11 (HealthDay News) -- Hospitalized patients and physicians may have differing beliefs regarding patients' knowledge and aspects of their care, suggesting a need for improved patient-physician communication, according to research published in the Aug. 9/23 issue of the Archives of Internal Medicine.
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Spinal Fusion Procedure Safe in Obese Patients
MONDAY, Aug. 9 (HealthDay News) -- Obese patients undergoing extreme lateral interbody fusion (XLIF) for degenerative disease of the lumbar and thoracic spine do not have more complications than non-obese patients who undergo the procedure, according to research published in the August issue of the Journal of Spinal Disorders & Techniques.
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Angiography Urged for Vascular Bleeding After Spine Surgery
MONDAY, Aug. 9 (HealthDay News) -- Evaluation of possible vascular injuries occurring during spinal surgery should be rapid, starting with computed tomography (CT) in most cases and progressing immediately to angiography if arterial bleeding is suspected, according to research published in the August issue of the Journal of Spinal Disorders & Techniques.
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Menstrual Phase Linked to Tracheal Intubation Response
MONDAY, Aug. 9 (HealthDay News) -- Menstrual cycle phase appears to influence the hemodynamic response to tracheal intubation (TI), according to research published in the August issue of Anesthesia & Analgesia.
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Few Procedures Account for Most Ortho Adverse Events
MONDAY, Aug. 9 (HealthDay News) -- Most adverse events that occur within 30 days after orthopedic surgery arise from a small number of procedures, according to research published in the Aug. 4 issue of the Journal of Bone & Joint Surgery.
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Nurse Liaisons Smooth Perioperative Experience
FRIDAY, Aug. 6 (HealthDay News) -- Perioperative nurse liaisons for family members of patients undergoing surgical procedures may help family members manage stress and view the process in a more positive light, according to an article in the August issue of the AORN Journal.
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Podiatric Care Reduces Amputation Risk in Diabetes
FRIDAY, Aug. 6 (HealthDay News) -- Foot amputation or hospitalization resulting from foot ulcers in diabetes patients can be prevented or delayed with timely care from a podiatrist, and increased podiatry use by diabetes patients may result in substantial health care cost savings, according to research presented at the annual scientific meeting of the American Podiatric Medical Association, held from July 15 to 18 in Seattle.
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Omentectomy Not Linked to Better Metabolic Function
FRIDAY, Aug. 6 (HealthDay News) -- In obese patients, surgical removal of the omentum, either alone or along with Roux-en-Y gastric bypass, doesn't improve metabolic function, according to research published in the August issue of Gastroenterology.
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Specific Factors Sway Nurses' Smoke Evacuation Compliance
FRIDAY, Aug. 6 (HealthDay News) -- Perioperative nurses' adherence to surgical smoke evacuation recommendations tends to be inconsistent, and key factors influencing levels of compliance are identified in research published in the August issue of the AORN Journal.
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Cost to Train Personnel in Sterile Processing Has Doubled
FRIDAY, Aug. 6 (HealthDay News) -- Since 1998, the cost required to train sterile processing personnel to a competent level has increased substantially, according to research published in the August issue of the AORN Journal.
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ASA Survey Finds Exaggerated Anxiety About Anesthesia
THURSDAY, Aug. 5 (HealthDay News) -- As many as one in four patients might postpone surgery because of anxiety about anesthesia, according to the American Society of Anesthesiologists (ASA) "Vital Health Report," a survey of the attitudes and beliefs the general public has about anesthesia.
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Sponges Do Not Prevent Surgical-Site Infections
THURSDAY, Aug. 5 (HealthDay News) -- The use of gentamicin-collagen sponges in patients undergoing colorectal surgery is not an effective method for preventing surgical-site infection, and even appears to increase the risk of infection, according to a study published online Aug. 4 in the New England Journal of Medicine.
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Smoking Tied to Increased Risk for Breast Abscesses
THURSDAY, Aug. 5 (HealthDay News) -- The risk of developing primary or recurring breast abscesses increases with smoking, and subareolar breast abscesses may be associated with nipple piercing, according to research published in the July issue of the Journal of the American College of Surgeons.
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Autograft Aortic Root Replacement Beats Homograft
TUESDAY, Aug. 3 (HealthDay News) -- Autograft aortic root replacement (Ross procedure) in patients with aortic valve disease results in significantly improved clinical outcomes compared to homograft aortic root replacement, according to a study published online Aug. 3 in The Lancet.
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In-Lab Clopidogrel as Effective as Pre-Loading Before PCI
TUESDAY, Aug. 3 (HealthDay News) -- Giving clopidogrel after coronary angiography but before percutaneous coronary intervention (PCI) appears to be as effective as pre-loading the drug four to eight hours before PCI, according to research published in the Aug. 10 issue of the Journal of the American College of Cardiology.
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Nurse Anesthetists Give Safe Care Without Supervision
TUESDAY, Aug. 3 (HealthDay News) -- Certified registered nurse anesthetists providing anesthesia services without supervision by a physician do not put patients at increased risk of death or complications, according to research published in the August issue of Health Affairs.
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Industry-Funded Clinical Trials Yield More Positive Outcomes
TUESDAY, Aug. 3 (HealthDay News) -- Drug clinical trials supported by industry are more likely to produce favorable results than trials supported by government or nonprofit/nonfederal organizations, and they are less likely to be published within two years of the study being completed, according to research published in the Aug. 3 issue of the Annals of Internal Medicine.
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