December 2012 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for December 2012. 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.

rhBMP-2 Linked to Increased Rate of Retrograde Ejaculation

FRIDAY, Dec. 28 (HealthDay News) -- For patients with lumbar spondylosis or spondylolisthesis of the lowest lumbar levels who undergo open anterior lumbar interbody fusion (ALIF), use of recombinant human bone morphogenetic protein-2 (rhBMP-2) is associated with an increased rate of retrograde ejaculation (RE), according to research published in the October issue of The Spine Journal.

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Surgical Never Events Costly, Cause Considerable Harm

FRIDAY, Dec. 28 (HealthDay News) -- Surgical never events, including retained foreign bodies and wrong-site, wrong-patient, and wrong-procedure surgeries, are costly and incur considerable harm to patients, according to research published online Dec. 18 in Surgery.

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EP Studies Helpful in Lumbar Spinal Stenosis Prognosis

THURSDAY, Dec. 27 (HealthDay News) -- Electrophysiological abnormalities have been identified that are of some prognostic value in determining deteriorating clinical status over the long term for patients with mild-to-moderate lumbar spinal stenosis (LSS), according to research published in the December issue of the European Spine Journal.

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Study Provides More Data for Ovarian Cancer Risk Prediction

THURSDAY, Dec. 27 (HealthDay News) -- Among asymptomatic women, high-risk categories for predicting ovarian cancer risk can be identified using CA125, transvaginal ultrasonography, or both, providing guidance for clinical decisions regarding need for surgery in these women, according to research published in the January issue of Obstetrics & Gynecology.

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Prophylactic Options Compared for Women With BRCA1/2

THURSDAY, Dec. 27 (HealthDay News) -- The results of a simulation model suggest that, when quality of life is considered, prophylactic bilateral salpingectomy with delayed oophorectomy may be an acceptable alternative to bilateral salpingo-oophorectomy for women with BRCA mutations, according to research published in the January issue of Obstetrics & Gynecology.

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Imaging Widely Used in Presumed Pediatric Appendicitis

THURDAY, Dec. 27 (HealthDay News) -- Most children with presumed appendicitis undergo preoperative computed tomography (CT) and ultrasound imaging before surgery, with significant variation by hospital type and patient sex, according to research published online Dec. 24 in Pediatrics.

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Positive Preclinical Results for Smo Inhibitor in Esophageal CA

WEDNESDAY, Dec. 26 (HealthDay News) -- In rats with induced gastroduodenoesophageal reflux, a small molecular inhibitor of smoothened (Smo) can reduce the risk of developing Barrett's esophagus and esophageal adenocarcinoma, according to a study published online Oct. 26 in the Annals of Surgery.

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Cementless Hips Survive Well in Younger Patients

WEDNESDAY, Dec. 26 (HealthDay News) -- Cementless hip implants survive well in younger adults undergoing hip replacement surgery on long-term follow-up, though the overall reoperation rates are similar to cemented implants due to greater polyethylene wear, according to a study published in the Dec. 5 issue of The Journal of Bone & Joint Surgery.

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Gattex Approved for Short Bowel Syndrome

FRIDAY, Dec. 21 (HealthDay News) -- Gattex (teduglutide) has been approved by the U.S. Food and Drug Administration to treat nutritional problems caused by short bowel syndrome.

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Increased Serum Metal Levels After Lumbar Disc Replacement

FRIDAY, Dec. 21 (HealthDay News) -- Serum metal levels of cobalt and chromium are elevated at all postoperative time points up to 36 months following metal-on-metal lumbar disc replacement, according to research published in the November issue of the European Spine Journal.

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Similar Oncologic Efficacy for Robotic, Open Cystectomy

FRIDAY, Dec. 21 (HealthDay News) -- For patients with bladder cancer undergoing radical cystectomy, a robotic approach seems to have the same oncologic efficacy as an open approach and demonstrates potential perioperative benefits, according to a pilot study published in the February issue of The Journal of Urology.

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Motor Vehicle Incidents Common in Medical Residents

FRIDAY, Dec. 21 (HealthDay News) -- During training, internal medicine residents commonly experience motor vehicle incidents, including crashes and near misses, but less commonly experience blood and body fluid (BBF) exposures, according to research published in the December issue of the Mayo Clinic Proceedings.

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Many Docs Use Social Media to Find, Share Medical Data

WEDNESDAY, Dec. 19 (HealthDay News) -- Most physicians use social media on at least a weekly basis, and report that it improves the quality of patient care they deliver, according to a study published in the September/October issue of the Journal of Medical Internet Research.

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Surgery, Exercise Long-Term Outcomes Equal for Back Pain

MONDAY, Dec. 17 (HealthDay News) -- Over nine years of follow-up, patients with chronic low back pain randomized to lumbar fusion do not report better outcomes than those receiving cognitive intervention and exercises, according to a study published in the December issue of the European Spine Journal.

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Risk Factors ID'd for Revision of Total Hip Replacement

MONDAY, Dec. 17 (HealthDay News) -- Younger, taller, and heavier patients who undergo primary total hip replacement (THR) are at a greater risk of needing a revision surgery, according to research published in the December issue of Arthritis Care & Research.

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Health Care Satisfaction Rated As High by Unacculturated Hispanics

MONDAY, Dec. 17 (HealthDay News) -- Hispanic patients, particularly unacculturated Hispanics, rate their health care experience more highly than do other patient groups, according to a study published in the October issue of the Journal of Immigrant and Minority Health.

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Omega-3 Supplements Don't Increase Surgical Blood Loss

FRIDAY, Dec. 14 (HealthDay News) -- Omega-3 fatty acid (n-3FA) supplements do not correlate with higher perioperative blood loss during spinal fusion procedures, according to a study published in the December issue of the European Spine Journal.

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Changes in Penile Length After Radical Prostatectomy Studied

FRIDAY, Dec. 14 (HealthDay News) -- Although penile shortening of about 1 cm can occur at three months after a radical prostatectomy (RP) for the treatment of localized prostate cancer, recovery of penile length begins after 24 months and is complete after 48 months, according to a study published in the December issue of Urology.

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HCV-Related Transplants Most Needed By Those Born 1941-60

THURSDAY, Dec. 13 (HealthDay News) -- Patients born between 1941 and 1960 are creating the largest demand for liver transplants due to hepatitis C virus (HCV)-associated liver disease, according to a study published in the December issue of Liver Transplantation.

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Current Health Costs Pushing Docs to Make Urgent Choices

WEDNESDAY, Dec. 12 (HealthDay News) -- The current growth in health care's share of the gross domestic product (GDP) and need to implement learning health systems is forcing physicians to make important choices, according to a perspective piece published online Dec. 12 in the New England Journal of Medicine.

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Degeneration Similar With, Without Disc Prosthesis Surgery

WEDNESDAY, Dec. 12 (HealthDay News) -- Compared with rehabilitation, disc prosthesis surgery for chronic low back pain is associated with the same level of adjacent level degeneration (ALD) but with increased facet arthropathy (FA) at the implant level, according to a study published in the Dec. 1 issue of Spine.

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Teduglutide Seems Effective, Safe for Short Bowel Syndrome

WEDNESDAY, Dec. 12 (HealthDay News) -- For patients with short bowel syndrome with intestinal failure (SBS-IF), the glucagon-like peptide 2 analogue teduglutide appears to be safe and reduces the number of days off parenteral support, according to a phase 3 study published in the December issue of Gastroenterology.

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Nonsurgical Repair of Achilles Tendon May Be Preferable

TUESDAY, Dec. 11 (HealthDay News) -- Although surgical repair of a ruptured Achilles tendon is thought to reduce the risk of rerupture, nonsurgical management shows similar rerupture rates when functional rehabilitation with early range of motion is used, according to research published in the Dec. 5 issue of The Journal of Bone & Joint Surgery.

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Number of Independent Physicians Continues to Decline

MONDAY, Dec. 10 (HealthDay News) -- Physician business models are transforming, with a sustained shift away from independent practice, according to report released by the consulting firm Accenture.

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Readmission Seen in ~7 Percent of Elective Spine Surgeries

MONDAY, Dec. 10 (HealthDay News) -- About 7 to 8 percent of Medicare beneficiaries who undergo elective spine surgery for degenerative conditions are readmitted to the hospital within 30 days, according to a study published in the October issue of The Spine Journal.

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Longer UTI Treatment Doesn't Reduce Recurrence Among Men

MONDAY, Dec. 10 (HealthDay News) -- For men with urinary tract infection (UTI), longer duration of antibiotic treatment does not reduce recurrence; and treatment of preoperative bacteriuria has no clinical benefit, according to two studies published online Dec. 3 in the Archives of Internal Medicine.

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Spinal Fusion Surgery Not Associated With Stroke

MONDAY, Dec. 10 (HealthDay News) -- Undergoing spinal fusion surgery does not affect the risk of stroke within the three years after surgery, according to a study published in the December issue of the European Spine Journal.

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Liver Transplant Outcomes No Worse With Echo Abnormalities

FRIDAY, Dec. 7 (HealthDay News) -- Intracardiac shunts (ICSs), diagnosed using an echocardiogram, or mild or moderate pulmonary hypertension (PH), do not affect short- or long-term mortality in liver transplant candidates, according to research published online in the Dec. 15 issue of The American Journal of Cardiology.

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Anticompetitive Market Power Common in Managed Care Plans

FRIDAY, Dec. 7 (HealthDay News) -- For each of the three most popular types of managed care plans in the United States (point-of-service plan [POS], health maintenance organization [HMO], and preferred provider organization [PPO]), anticompetitive market power is widespread, according to a Nov. 28 news release from the American Medical Association (AMA).

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Obese Patients Require More Operating Room Time

FRIDAY, Dec. 7 (HealthDay News) -- Heavier patients undergoing lobectomy for lung cancer require more time in the operating room, regardless of a hospital's volume of obese patients or lobectomies, according to a study published in the December issue of the Annals of Thoracic Surgery.

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Evidence Supports Premise: OR Distractions Up Surgical Errors

THURSDAY, Dec. 6 (HealthDay News) -- Typical operating room distractions and interruptions (ORDIs) potentially increase the likelihood of surgical errors among surgical trainees, according to a study published in the November issue of the Archives of Surgery.

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FDA: Public-Private Venture Set to Improve Regulatory Science

THURSDAY, Dec. 6 (HealthDay News) -- The Medical Device Innovation Consortium (MDIC), the first public-private partnership to promote medical device regulatory science, has been established, according to a Dec. 3 news release issued by the U.S. Food and Drug Administration.

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Reports Raise Concerns About Antiseptic Product Contamination

THURSDAY, Dec. 6 (HealthDay News) -- Recent reports linking outbreaks of infection to antiseptic products have prompted the U.S. Food and Drug Administration to evaluate the need for sterile manufacture of such products, according to a perspective piece published in the Dec. 6 issue of the New England Journal of Medicine.

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Breath Test Shows Potential for Detecting Colorectal Cancer

WEDNESDAY, Dec. 5 (HealthDay News) -- Analysis of volatile organic compounds (VOCs) from breath samples is able to distinguish healthy patients from those with colorectal cancer with more than 75 percent accuracy, according to a study published in the January issue of the British Journal of Surgery.

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Five-Hour Protected Sleep Feasible for Medical Interns

TUESDAY, Dec. 4 (HealthDay News) -- Implementation of a five-hour period of protected sleep is feasible for medical interns on long shifts, resulting in interns getting more uninterrupted sleep and feeling more alert the next day, according to a study published in the Dec. 5 issue of the Journal of the American Medical Association.

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Increasing Number of Workers in Self-Insured Health Plans

MONDAY, Dec. 3 (HealthDay News) -- There has been a recent increase in the percentage of workers in the private sector who are enrolled in self-insured health plans, in which the employer assumes the financial risk related to health insurance (unlike a fully-insured plan, where the insurance company assumes the risk), according to research published in the November issue of the Employee Benefit Research Institute's Notes.

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Collaborative Program Cuts Colorectal Sx Site Infections

MONDAY, Dec. 3 (HealthDay News) -- Implementation of a collaborative quality improvement program correlates with a more than 60 percent reduction in surgical site infections for patients undergoing colorectal procedures, according to a report published online Nov. 28 by the Cedars-Sinai Medical Center in Los Angeles.

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