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February 2009 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for February 2009. 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.

Spine Surgery Outcomes Affect Patient Satisfaction

THURSDAY, Feb. 26 (HealthDay News) -- In patients undergoing cervical spine surgery, clinical improvement -- especially in neck pain -- is associated with improved patient satisfaction, according to a report published in the March issue of The Spine Journal.

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Balloon Kyphoplasty Can Treat Vertebral Fractures

WEDNESDAY, Feb. 25 (HealthDay News) -- Painful vertebral fractures can be safely and effectively treated with balloon kyphoplasty, a minimally invasive procedure, according to research published online Feb. 25 in The Lancet.

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Insurance Essential for Good Health, Well-Being

TUESDAY, Feb. 24 (HealthDay News) -- Having health insurance is vital for health and well-being, and when rates of uninsurance are high, even insured people are more likely to struggle to obtain necessary care, according to a new report from the Institute of Medicine released online Feb. 24.

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US Health Spending May Have Hit $2.4 Trillion in 2008

TUESDAY, Feb. 24 (HealthDay News) -- Health spending in the United States was estimated to be $2.4 trillion last year, and is expected to account for an unprecedented share of the economy this year, according to a report published online Feb. 24 in Health Affairs.

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DVT Prevention to Be Considered for All Urologic Surgeries

MONDAY, Feb. 23 (HealthDay News) -- Consideration of deep vein thrombosis (DVT) prophylaxis is recommended for all patients undergoing a urological surgical procedure, according to a best practice statement from the American Urological Association published in the March issue of the Journal of Urology.

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Procedure Significantly Improves Urinary Incontinence

MONDAY, Feb. 23 (HealthDay News) -- A transobturator tape procedure resulted in nearly an 80 percent improvement in urge urinary incontinence, according to research published in the March issue of Obstetrics & Gynecology.

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Racial Disparity Persists in Total Knee Replacements

MONDAY, Feb. 23 (HealthDay News) -- Racial disparity between blacks and whites in total knee replacement procedures has persisted, despite adoption of a Healthy People 2010 objective to eliminate these disparities, according to a report published in the Feb. 20 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Increased Cesarean Efficiency with Improvement Program

MONDAY, Feb. 23 (HealthDay News) -- Cesarean delivery efficiency, measured by the time from decision to incision, significantly improved over two years with the implementation of a quality improvement program, according to research published in the March issue of Obstetrics & Gynecology.

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Medicaid Patients May Travel Long Distance for Spine Care

MONDAY, Feb. 23 (HealthDay News) -- Medicaid patients may have less access to local spine care than patients with private, commercial health insurance, according to a report published in the March issue of The Spine Journal.

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Brain Surgery Shows Benefit in Pediatric Stroke Patients

MONDAY, Feb. 23 (HealthDay News) -- Periinsular hemispherotomy may be useful in treating stroke-induced refractory epilepsy in children, according to research published in the February issue of the Journal of Neurosurgery: Pediatrics.

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Tibolone Linked to Breast Cancer Recurrence

MONDAY, Feb. 23 (HealthDay News) -- The synthetic steroid tibolone increases the risk of breast cancer recurrence, according to a report published in the February issue of The Lancet Oncology.

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Contralateral Prophylactic Mastectomy Use On The Rise

FRIDAY, Feb. 20 (HealthDay News) -- During recent years, contralateral prophylactic mastectomy has become a more commonly used treatment in women with ductal carcinoma in situ, according to research published online Feb. 17 in the Journal of Clinical Oncology.

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PCI Shows Benefit in Elderly With MI, Cardiogenic Shock

FRIDAY, Feb. 20 (HealthDay News) -- Among patients with myocardial infarction and cardiogenic shock who underwent percutaneous coronary intervention, elderly patients showed similar one-year survival and other outcomes as younger patients, according to research published in the February Journal of the American College of Cardiology: Cardiovascular Interventions.

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Gunshot Victims May Lie About Source of Their Injuries

FRIDAY, Feb. 20 (HealthDay News) -- Emergency-department personnel should be alert to the possibility that some patients may conceal the fact that their injuries were caused by gunfire, according to a letter published in the Feb. 21 issue of The Lancet.

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Vertebroplasty May Protect Osteoporotic Vertebrae

FRIDAY, Feb. 20 (HealthDay News) -- Prophylactic vertebroplasty may protect adjacent intact vertebrae from fatigue injury in some patients with osteoporosis, according to a biomechanical study in the Feb. 15 issue of Spine.

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Chorionic Villus Sampling Method Deemed Safe

THURSDAY, Feb. 19 (HealthDay News) -- Chorionic villus sampling (CVS) is a frequent and safe prenatal method for genetic screening, according to the conclusions of a review published online Feb. 11 in the Journal of Craniofacial Surgery.

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Proposed Changes to Health Care Would Reduce Costs

THURSDAY, Feb. 19 (HealthDay News) -- Simultaneous gains in universal health coverage, improved health outcomes and slowed spending growth would have a major impact on the development of public policy, according to a perspective published in the Feb. 26 issue of the New England Journal of Medicine.

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Transparency, Globalization Growing in Clinical Research

THURSDAY, Feb. 19 (HealthDay News) -- All clinical trial data and the U.S. Food and Drug Administration database should be publicly available, and global clinical research should be conducted in relevant populations for potential applications of the intervention, according to two articles published in the Feb. 19 issue of the New England Journal of Medicine.

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Pharmacogenetic Algorithm Improves Warfarin Dosage

WEDNESDAY, Feb. 18 (HealthDay News) -- A pharmacogenetic dosing algorithm for warfarin is better able to predict the stable therapeutic dose, providing a basis for a larger clinical trial to test the efficacy of these algorithms, according to research published in the Feb. 19 issue of the New England Journal of Medicine.

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Coronary Artery Bypass Grafting Best for Certain Patients

WEDNESDAY, Feb. 18 (HealthDay News) -- Coronary artery bypass grafting (CABG), and not percutaneous coronary intervention (PCI), results in lower incidence of cardiac or cerebrovascular events in patients with three-vessel or left main coronary artery disease, and should therefore remain the standard of care, according to research released online Feb. 18 in advance of publication in the Mar. 5 issue of the New England Journal of Medicine.

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Protected Block Surgical Resident Course Effective

WEDNESDAY, Feb. 18 (HealthDay News) -- A course given to surgical residents in their first and second years during protected time away from clinical duties is effective in improving knowledge, communication and surgical skills, according to an article published in the February issue of Archives of Surgery.

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Implementing a Quality Improvement Faculty Path

WEDNESDAY, Feb. 18 (HealthDay News) -- A new career pathway in academic medicine, termed clinicians in quality improvement, is a justified concept to achieve and recognize excellence in patient safety, according to a commentary published in the Feb. 18 issue of the Journal of the American Medical Association.

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Videofluoroscopy Useful in Observing Apneic Changes

WEDNESDAY, Feb. 18 (HealthDay News) -- Patients with obstructive sleep apnea demonstrated soft palate changes during normoxygenated and desaturated periods while sleeping, as viewed with sleep videofluoroscopy (SVF), according to research published in the February issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Incidence of ICU MRSA Infections Declining

TUESDAY, Feb. 17 (HealthDay News) -- Incidence of methicillin-resistant Staphylococcus aureus (MRSA) central line-associated bloodstream infections has decreased over recent years in most intensive care units (ICUs), according to research published Feb. 18 in the Journal of the American Medical Association.

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Ads Featuring 'Drug Facts Box' Help Educate Consumers

TUESDAY, Feb. 17 (HealthDay News) -- Replacing the brief summary in direct-to-consumer ads with a "drug facts box" may result in improved consumer knowledge and judgment about medication benefits and side effects, according to study findings released online Feb. 17 in advance of publication in the Apr. 21 issue of the Annals of Internal Medicine.

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Risk of Death After Surgery Lower at Teaching Hospitals

TUESDAY, Feb. 17 (HealthDay News) -- Patients receiving surgery at major teaching hospitals are less likely to die and less likely to die after complications, although this finding is not observed among black patients, according to a report in the February issue of the Archives of Surgery.

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Pain Varies After Ear, Nose and Throat Surgeries

TUESDAY, Feb. 17 (HealthDay News) -- Certain factors may be helpful in predicting postoperative pain in patients undergoing ear, nose and throat surgery, according to research published in the February issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Breast Imaging Useful for Assessing Cancer Extent

MONDAY, Feb. 16 (HealthDay News) -- Breast MRI can be useful for assessing the extent of disease in women diagnosed with breast cancer, but surgical treatment decisions should not be made solely on breast MRI results, according to a review in the February issue of the Journal of the National Comprehensive Cancer Network.

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Motor Cortex Stimulation Has Good Results in Chronic Pain

FRIDAY, Feb. 13 (HealthDay News) -- Motor cortex stimulation may lead to a significant improvement in symptoms for patients who experience severe chronic neuropathic pain resistant to medical treatment, according to research published in the February issue of the Journal of Neurosurgery.

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Psychiatric Problems Common in Teen Transplant Recipients

FRIDAY, Feb. 13 (HealthDay News) -- Adolescent renal transplant recipients are more likely to have learning disabilities, social competence problems and psychiatric problems than healthy adolescents, according to the results of a study published online Oct. 7 in advance of publication in Pediatric Transplantation.

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Thrombolysis Window May Be Longer Than Thought

THURSDAY, Feb. 12 (HealthDay News) -- Patients with acute stroke may have a diffusion-perfusion mismatch after nine hours of stroke onset, particularly those with proximal arterial occlusion, suggesting the treatment window for stroke may be extended in some cases, according to the results of a study published in the March issue of Radiology.

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Additional Drug Improves Survival in Early Breast Cancer

WEDNESDAY, Feb. 11 (HealthDay News) -- Tamoxifen or anastrozole treatment of premenopausal women with endocrine-responsive early breast cancer leads to similar rates of disease-free survival, which is improved by additional treatment with zoledronic acid, according to a report in the Feb. 12 issue of the New England Journal of Medicine.

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Parkinsonism Induced by Deep Brain Stimulation

WEDNESDAY, Feb. 11 (HealthDay News) -- Bilateral deep vein stimulation of the globus pallidus internus (GPi) for craniocervical dystonia induced reversible parkinsonism in a patient who did not have pre-existing bradykinesia, according to a case report published in the February issue of the Journal of Neurosurgery.

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Surgery Helps Amputees Control Complex Artificial Arms

TUESDAY, Feb. 10 (HealthDay News) -- Patients with arm amputations may have improved control of artificial arms that use electromyogram signals after undergoing targeted muscle reinnervation surgery that transfers remaining arm nerves to the chest or upper-arm muscles, according to research published in the Feb. 11 issue of the Journal of the American Medical Association.

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Care Coordination Programs Don't Benefit Medicare Patients

TUESDAY, Feb. 10 (HealthDay News) -- For Medicare beneficiaries with chronic illnesses, most care coordination programs have little impact on reducing hospitalizations and costs or improving quality of care, according to a report published in the Feb. 11 issue of the Journal of the American Medical Association.

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Spine Surgeons Receptive to Total Disc Arthroplasty

TUESDAY, Feb. 10 (HealthDay News) -- Spine surgeons are generally enthusiastic about cervical and lumbar disc replacement, but are also concerned about long-term outcomes and reimbursement issues, according to research published in the February issue of the Journal of Spinal Disorders & Techniques.

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FDA OKs Drug Produced Using Genetically Engineered Goats

MONDAY, Feb. 9 (HealthDay News) -- For the first time, the U.S. Food and Drug Administration has approved a product that is produced using genetically engineered animals, according to a release issued by the agency.

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RFA May Offer Benefit in Hepatocellular Carcinoma

MONDAY, Feb. 9 (HealthDay News) -- Radiofrequency ablation (RFA) may provide better three-year overall survival for patients with small hepatocellular carcinomas compared with percutaneous ethanol injection, according to research published in the February issue of Hepatology.

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ASCO Guide Addresses High Costs of Cancer Care

MONDAY, Feb. 9 (HealthDay News) -- Communication between patients and their doctors regarding the high cost of cancer care may be improved with the Feb. 5 release of a new patient guide from the American Society of Clinical Oncology (ASCO).

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C-Arm Fluoroscopes Carry Radiation Exposure Risk

MONDAY, Feb. 9 (HealthDay News) -- Orthopedic surgeons who use large-c-arm and mini-C-arm fluoroscopy to examine patients should be mindful of their exposure to radiation, particularly when imaging body parts larger than the hand or wrist or when the extremity is closer to the x-ray source, according to a report published in the February issue of the Journal of Bone & Joint Surgery.

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Low Back Pain Treatable with a Range of Options

MONDAY, Feb. 9 (HealthDay News) -- Since most cases of low back pain will resolve in the short term even without treatment, clinicians should typically first address this complaint with a non-surgical approach, according to an overview of symptomatic lumbar degenerative disc disease published in the February issue of the Journal of the American Academy of Orthopaedic Surgeons.

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Rotator Cuff Tears Common Among the Elderly

MONDAY, Feb. 9 (HealthDay News) -- Rotator cuff tears are common among elderly patients and can significantly reduce shoulder function, specifically abduction strength, even when they do not cause pain or other symptoms, according to study findings published in the February issue of the Journal of Bone & Joint Surgery.

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Artificial Disc Articles Found Lacking on the Internet

MONDAY, Feb. 9 (HealthDay News) -- Because Web sites often publish potentially misleading articles about lumbar artificial disc replacement, physicians should caution patients about relying on the Internet for information about the procedure, according to a report published in the February issue of the Journal of Spinal Disorders & Techniques.

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Capn4 Linked to Metastasis and Invasion in Liver Cancer

FRIDAY, Feb. 6 (HealthDay News) -- Overexpression of calpain small subunit 1 (Capn4) appears to play a role in invasion and metastasis following liver transplantation for hepatocellular carcinoma, according to research published in the February issue of Hepatology.

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Vasopressin Improves Some Hysterectomy Outcomes

FRIDAY, Feb. 6 (HealthDay News) -- Intracervical injection of the peptide hormone vasopressin prior to vaginal hysterectomy reduces blood loss but increases postoperative pain, according to research published in the February issue of Obstetrics & Gynecology.

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Preoperative Reduction in Smoking is Cost-Beneficial

FRIDAY, Feb. 6 (HealthDay News) -- Preoperative interventions for smoking cessation can result in modest cost savings, which may accumulate with the use of an institution-based smoking cessation program through reduced total hospitalization costs, according to research published in the February issue of Chest.

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Electromyographic Monitoring Useful During Spinal Surgery

FRIDAY, Feb. 6 (HealthDay News) -- In patients undergoing anterior cervical discectomy and fusion, intraoperative electromyography may identify the operative events leading to recurrent laryngeal nerve palsy and help reduce the risk of operative recurrent laryngeal nerve injury, researchers report in the February issue of the Journal of Spinal Disorders & Techniques.

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Growth Hormone May Benefit Bariatric Surgery Patients

FRIDAY, Feb. 6 (HealthDay News) -- In obese women who undergo laparoscopic-adjustable silicone gastric banding, treatment with growth hormone in combination with a standardized low-calorie diet and exercise program helps prevent the loss of lean body mass, according to a report published online Dec. 9 in the Journal of Clinical Endocrinology & Metabolism.

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Single Drug Dose Prevents Migration of Hip Replacement

FRIDAY, Feb. 6 (HealthDay News) -- A single dose of zoledronic acid helps prevent migration of a total hip replacement, according to a report in the February issue of the Journal of Bone & Joint Surgery.

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Exercise, Endovascular Therapy Help Claudication

FRIDAY, Feb. 6 (HealthDay News) -- Treating intermittent claudication with revascularization may offer immediate advantages over a supervised exercise intervention, but the two offer similar benefits after six months, according to research published in the February issue of Radiology.

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Risk of Venous Thrombosis After Spinal Surgery Low

FRIDAY, Feb. 6 (HealthDay News) -- The risk of deep venous thrombosis after spinal surgery is relatively low, and the condition can be prevented by using compression stockings or pneumatic sequential compression devices, according to a review in the Feb. 1 issue of Spine.

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Graded Exercise Program Improves Low Back Pain

THURSDAY, Feb. 5 (HealthDay News) -- A graded exercise intervention emphasizing stabilizing exercises reduces disability and improves physical health better than daily walks in patients with recurrent low back pain, researchers report in the Feb. 1 issue of Spine.

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Eye Region Gives Hints for Age, Level of Fatigue

TUESDAY, Feb. 3 (HealthDay News) -- Individuals use the eye region to make age and fatigue judgments about another person, suggesting that eyes are disproportionately important for providing facial cues, according to research published in the February issue of Ophthalmology.

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Early Transplants Not Better for Alcoholic Cirrhosis Patients

TUESDAY, Feb. 3 (HealthDay News) -- Patients with Child-Pugh stage B alcoholic cirrhosis do not benefit from immediate listing for liver transplantation versus waiting until the disease progresses to stage C before listing for transplantation, according to an article published in the Feb. 3 issue of the Annals of Internal Medicine.

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Teen Athletes at Risk of a Variety of Shoulder Injuries

MONDAY, Feb. 2 (HealthDay News) -- Adolescent athletes are prone to developing a number of sudden or chronic shoulder injuries, including clavicle fractures, throwing injuries and joint instability, according to an overview published in the February issue of the Journal of Bone & Joint Surgery.

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Physician's Briefing
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