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December 2007 Briefing - Surgery

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

Obesity May Hinder Access to Kidney Transplantation

FRIDAY, Dec. 28 (HealthDay News) -- In patients who need a kidney transplant, obesity is associated with a decreased likelihood of receiving one, according to a study published online Dec. 19 in the Journal of the American Society of Nephrology.

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Oophorectomy, Chemo Ups Breast Cancer Survival Odds

FRIDAY, Dec. 28 (HealthDay News) -- In premenopausal women with operable breast cancer, adjuvant oophorectomy and tamoxifen improves the odds of survival, according to a report published online Dec. 17 in the Journal of Clinical Oncology.

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Alexandrite Laser Effective in Treating Facial Hirsutism

THURSDAY, Dec. 27 (HealthDay News) -- In women with polycystic ovary syndrome, the GentleLase alexandrite laser is more effective at reducing facial hirsutism than the Lumina IPL system, according to the results of a study published in the December issue of Lasers in Surgery and Medicine.

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Photodynamic Therapy Targets Root Canal Microorganism

THURSDAY, Dec. 27 (HealthDay News) -- Photodynamic therapy can inactivate Enterococcus faecalis in experimentally infected root canals of extracted teeth after their sensitization with methylene blue, according to a report published in the December issue of Lasers in Surgery and Medicine.

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Poor Results from Octogenarian Cancer Surgery

THURSDAY, Dec. 27 (HealthDay News) -- Population-based data show that high-risk cancer surgery on octogenarians has worse outcomes than previously reported case series and survival statistics indicate, researchers report in the December issue of the Journal of the American College of Surgeons.

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Early Cholecystectomy Cuts Pancreatitis Hospital Stay

THURSDAY, Dec. 27 (HealthDay News) -- For patients with mild to moderate gallstone pancreatitis, early cholecystectomy reduces the length of time spent in hospital with no additional risk of mortality or complications, according to a study published in the December issue of the Journal of the American College of Surgeons.

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Catheter Ablation Reduces Defibrillator Shock Frequency

WEDNESDAY, Dec. 26 (HealthDay News) -- Ablation of arrhythmic cardiac tissue combined with an implantable cardioverter-defibrillator (ICD) reduces the frequency of pacing and shocks better than an ICD alone in patients with a history of myocardial infarction, according to study findings published in the Dec. 27 issue of the New England Journal of Medicine.

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Combination Breast Cancer Treatment May Improve Survival

WEDNESDAY, Dec. 26 (HealthDay News) -- Paclitaxel plus bevacizumab increases progression-free survival but not overall survival compared with paclitaxel alone in patients with metastatic breast cancer, researchers report in the Dec. 27 issue of the New England Journal of Medicine.

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Survival Superior for Living Donor Liver Transplantation

WEDNESDAY, Dec. 26 (HealthDay News) -- In adults with chronic liver disease, living donor liver transplantation results in a significant survival benefit compared to either waiting for or receiving a deceased donor liver transplantation, according to study findings published in the December issue of Gastroenterology.

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Surgical Smoke Plume An Underrated Biohazard

WEDNESDAY, Dec. 26 (HealthDay News) -- All operating rooms should have a smoke evacuation system to eliminate surgical smoke plume, the gaseous by-product of processes such as electrosurgery, laser ablation and ultrasonic scalpel dissection, according to a paper published in the December issue of the AORN Journal.

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Team Training Improves Patient Safety Awareness

WEDNESDAY, Dec. 26 (HealthDay News) -- A team-based training program that uses customized, highly interactive methods to help clinicians implement pre- and post-operative briefings, standardize communication and improve teamwork can increase awareness of patient safety and facilitate the process of continuous improvement, according to a paper published in the December issue of the AORN Journal.

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Most General Surgeons Don't Discuss Breast Reconstruction

TUESDAY, Dec. 25 (HealthDay News) -- Only one-third of women about to undergo surgery for breast cancer have discussions with their general surgeons about breast reconstruction, but women who do have such discussions are four times as likely to have mastectomies as those who do not, according to a report published online Dec. 21 in the journal Cancer.

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Australian Rules Footballer Commits Party Foul

MONDAY, Dec. 24 (HealthDay News) -- While participating in festivities, it's wise to limit consumption of alcoholic beverage containers to zero, according to an article published in the Dec. 22 issue of BMJ.

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Roenigk Score for Liver Damage Reliable

MONDAY, Dec. 24 (HealthDay News) -- The Roenigk system to classify liver fibrosis is reliable with reasonable interobserver variability, according to a report in the December issue of Archives of Dermatology.

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Neonatal Heart Can Grow After Valve Surgery

FRIDAY, Dec. 21 (HealthDay News) -- In neonates who underwent surgery for aortic valve stenosis, some left heart structures can eventually reach normal size, according to the results of a study published in the Dec. 18/25 issue of the Journal of the American College of Cardiology.

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300-Year History of U.K. Hospital Visiting Times Reviewed

FRIDAY, Dec. 21 (HealthDay News) -- A review of visiting times for patients in U.K. hospitals during the past three centuries reveals an evolving philosophy influenced by fears of infection, concerns about stress caused to the patient from visitors, and staff sentiments about interference from outsiders. The review was published in the Dec. 22 issue of BMJ.

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Mechanical Factors Worsen Acid Reflux in Elderly

THURSDAY, Dec. 20 (HealthDay News) -- The increased severity of gastroesophageal reflux disease (GERD) symptoms in the elderly may be due to age-related degradation of the gastroesophageal junction barrier and impaired esophageal clearance, according to an article published in the December issue of Clinical Gastroenterology and Hepatology.

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Total Thyroidectomy for Cancer Gets Economic Nod

THURSDAY, Dec. 20 (HealthDay News) -- In patients with low-risk papillary thyroid cancer, treatment with total thyroidectomy is probably a more cost-effective initial surgical treatment than hemithyroidectomy, though some caveats apply, according to research published in the December issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Tacrolimus Looks Promising for Renal Transplant Patients

WEDNESDAY, Dec. 19 (HealthDay News) -- A study comparing four immunosuppressive regimens for renal transplant recipients reports that a regimen of daclizumab, mycophenolate mofetil, corticosteroids and low-dose tacrolimus resulted in the best renal function, allograft survival and acute rejection rates at 12 months post-transplant, according to an article published in the Dec. 20 issue of the New England Journal of Medicine.

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Role of Tumor Suppressor Gene in Cancer Studied

WEDNESDAY, Dec. 19 (HealthDay News) -- Mutations in the tumor-suppressor protein p53 (TP53) gene are associated with reduced survival in squamous-cell head and neck cancer, and TP53 mutations in the stroma of non-hereditary invasive breast tumors may lead to metastatic spread to lymph nodes, according to two studies published in the Dec. 20 issue of the New England Journal of Medicine.

Abstract - Poeta
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Abstract - Patocs
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Radiofrequency Ablation Type Affects Liver Tumors

WEDNESDAY, Dec. 19 (HealthDay News) -- In patients with small hepatocellular carcinoma, percutaneous radiofrequency ablation may be preferable to surgical radiofrequency ablation, while the opposite may apply to patients with medium hepatocellular carcinoma, according to research published in the December issue of the Archives of Surgery.

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Virtual Visits As Good As Traditional Rounds

WEDNESDAY, Dec. 19 (HealthDay News) -- Robotic telerounds deliver the same standard of care and patient satisfaction as traditional rounds after urologic surgery, according to study findings published in the December issue of the Archives of Surgery.

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Transantral, Transoral Robotic Surgery Shows Promise

TUESDAY, Dec. 18 (HealthDay News) -- The first minimally invasive endoscopic surgical procedures in the skull base show promise for treating skull base neoplasms, according to two studies published in the December issue of the Archives of Otolaryngology -- Head & Neck Surgery. A third study in the same issue details successful utilization of this technique in radical tonsillectomies.

Abstract - Hanna
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Abstract - O'Malley
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Abstract - Weinstein
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Surgery Offers Best Chance in Laryngeal Cancer

TUESDAY, Dec. 18 (HealthDay News) -- In patients with stage IV laryngeal cancer, total laryngectomy is associated with better chance of survival than radiation therapy alone or combined chemotherapy and radiation, according to research published in the December Archives of Otolaryngology - Head & Neck Surgery.

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Post-Surgical Massage May Help Manage Pain and Anxiety

TUESDAY, Dec. 18 (HealthDay News) -- Massage may be an effective and safe adjuvant therapy for the relief of acute post-operative pain and anxiety, according to study findings published in the December issue of the Archives of Surgery.

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Pros & Cons of Bariatric Procedures Reviewed

MONDAY, Dec. 17 (HealthDay News) -- In the surgical treatment of obesity, the decision of which bariatric surgery method to use should take patient factors into account and include an individualized discussion of benefits and risks of each method, according to a review article published in the Dec. 15 issue of The Lancet.

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Wearable Kidney Safe and Effective

FRIDAY, Dec. 14 (HealthDay News) -- A wearable artificial kidney appears to be largely safe and effective in patients with end-stage kidney failure, according to study findings published in the Dec. 15 issue of The Lancet.

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Chemo After Surgery for Colon Cancer Improves Survival

FRIDAY, Dec. 14 (HealthDay News) -- Chemotherapy with fluorouracil and folinic acid reduces the risk of mortality and recurrence in patients with stage II colorectal cancer after apparently curative surgery, according to a study in the Dec. 15 issue of The Lancet.

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Pig Study Shows Vasopressin's Effect on Blood Flow

FRIDAY, Dec. 14 (HealthDay News) -- The use of low-dose vasopressin in a pig model of septic shock caused substantial redistribution of splanchnic regional and microcirculatory blood flow, resulting in significantly lower total liver blood flow and a marked decrease in microcirculatory blood flow in the pancreas, according to research published in the December issue of Critical Care.

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Surgery Benefits Subclinical Cushing's Syndrome

THURSDAY, Dec. 13 (HealthDay News) -- Adrenalectomy often improves clinical and metabolic outcomes in patients with subclinical Cushing's syndrome, according to a study in the December issue of Surgery.

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Low-Weight Heparin Reduces Bleeding in Coronary Surgery

THURSDAY, Dec. 13 (HealthDay News) -- Low-molecular-weight heparin (LMWH) significantly reduces major bleeding better than unfractionated heparin (UFH) in patients undergoing percutaneous coronary intervention without affecting the risk of ischemic complications such as death or heart attack, according to a report in the Dec. 10/24 issue of the Archives of Internal Medicine.

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FDA: Deaths Related to Radio Frequency Ablation

THURSDAY, Dec. 13 (HealthDay News) -- Use of radio frequency (RF) ablation devices in the treatment of lung tumors has resulted in some patient deaths, according to a public health notification released by the U.S. Food and Drug Administration this week.

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First Partial Face Transplant Proves Successful

WEDNESDAY, Dec. 12 (HealthDay News) -- The surgeons who performed the first partial face transplantation on a woman with severe disfigurement from a dog bite report a positive functional and cosmetic result 18 months after the surgery, according to an article published in the Dec. 13 issue of the New England Journal of Medicine.

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Technique Stabilizes Vertebra in Patients with C2 Tumors

WEDNESDAY, Dec. 12 (HealthDay News) -- Transoral kyphoplasty, a technique involving injection of bone cement into a balloon-created space within a vertebral body, is safe and effective in restoring mobility and reducing pain in patients with tumors affecting the second cervical vertebra (C2), according to an article published in the November-December issue of the Spine Journal.

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Sedative Carries Lower Risk of Acute Brain Dysfunction

TUESDAY, Dec. 11 (HealthDay News) -- A new sedative, dexmedetomidine, which acts at α2 receptors in the locus ceruleus and spinal cord, results in fewer days of delirium or coma compared to lorazepam when used in mechanically ventilated patients, according to an article published in the Dec. 12 issue of the Journal of the American Medical Association.

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Transfusions During Surgery Increase Risk of Infection

MONDAY, Dec. 10 (HealthDay News) -- Women undergoing cardiac surgery are more likely to receive blood transfusions than men, which may increase their risk of infection and may explain the higher mortality rates among women after surgery, researchers report in the December issue of the Journal of Women's Health.

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Patients Benefit from Liver Transplantation, Fat or Thin

MONDAY, Dec. 10 (HealthDay News) -- Regardless of their body mass index, patients with end-stage liver disease do better when they undergo liver transplantation versus no transplantation, according to a report published in the December issue of Liver Transplantation.

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Surgeon Preferences in Scoliosis Treatment Explored

FRIDAY, Dec. 7 (HealthDay News) -- Orthopedic surgeons report greater satisfaction with Universal Spine System implants for surgical correction of scoliosis, despite the fact that patient outcomes do not differ between that system and the Moss Miami system, researchers report in the December issue of the Journal of Bone & Joint Surgery.

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Alcohol Abuse Leads to Airway Disease After Transplant

THURSDAY, Dec. 6 (HealthDay News) -- Lung transplants from alcohol-fed rats cause obliterative bronchiolitis unless the transplant is a perfect match, according to study findings published in the Dec. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Drug Shows Promise for Skin Cancer Prevention, Treatment

WEDNESDAY, Dec. 5 (HealthDay News) -- A drug that targets a mutant cancer protein can prevent and treat ultraviolet light-induced skin tumors in a non-immunodeficient mouse model and in human skin carcinoma cells, according to a study in the Dec. 3 issue of the Journal of Clinical Investigation.

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