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July 2007 Briefing - Surgery

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

Bariatric Surgery Complications Less Likely at Some Hospitals

TUESDAY, July 31 (HealthDay News) -- Bariatric surgery patients have fewer complications if they undergo surgery at high-volume hospitals rather than low-volume hospitals, according to a report from HealthGrades, a health care ratings company.

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Surgery and Radiation Effective for Spinal Cord Injury

TUESDAY, July 31 (HealthDay News) -- Carefully timed microsurgery to relieve fluid buildup and radiation to eliminate cells that interfere with repair nearly doubles the repair and preservation of injured spinal cord in rats, according to a study in the July 18 issue of PLoS ONE.

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Sentinel Lymph Node Biopsy Unneeded in Most Skin Cancer

MONDAY, July 30 (HealthDay News) -- In patients with high-risk nonmelanoma skin cancer, the yield from sentinel lymph node biopsy may be too low to justify its routine use, according to a small study published in the July issue of Dermatologic Surgery.

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Redundant Nerve Roots Predict Spondylolisthesis Severity

FRIDAY, July 27 (HealthDay News) -- In patients with lumbar 4-5 (L4-5) spondylolisthesis, those with magnetic resonance imaging (MRI) evidence of redundant nerve roots of the cauda equina are more likely to present with severe clinical symptoms, according to the results of a study published in the July issue of the Journal of Neurosurgery: Spine.

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Early Surgery Urged for Thoracic Myelopathy

THURSDAY, July 26 (HealthDay News) -- In patients with thoracic myelopathy, decompressive surgery is more successful in those with a shorter preoperative duration of symptoms and milder myelopathy, suggesting that early diagnosis and treatment are important, according to a report published in the July issue of the Journal of Neurosurgery: Spine.

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Hysterectomies Have Slight Effect on Fracture Risk

THURSDAY, July 26 (HealthDay News) -- Hysterectomies, including oophorectomies, don't increase the long-term risk of osteoporotic fractures of the hip, spine or wrist except in cases in which surgery is performed for uterine prolapse, according to study findings published in the July issue of Fertility and Sterility.

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Barbed Sutures More Durable Than Conventional Sutures

THURSDAY, July 26 (HealthDay News) -- Polypropylene barbed sutures approved by the U.S. Food and Drug Administration for use in facelifts are significantly stronger and stiffer than conventional sutures, according to a study in the July issue of the Archives of Dermatology.

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Keratotic Lesions Signal Skin Cancer Risk After Transplant

THURSDAY, July 26 (HealthDay News) -- Keratotic skin lesions are strongly associated with skin cancers in organ transplant patients, and the greater the number of lesions the higher the risk, according to the results of a study published in the July issue of the Journal of Investigative Dermatology. In addition, other major risk factors include childhood sunburns and skin type.

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Aortic Dissection Mortality Higher with Lumen Thrombosis

WEDNESDAY, July 25 (HealthDay News) -- Partial thrombosis of the false lumen after acute aortic dissection is associated with an increased risk of death after hospital discharge, according to a report in the July 26 issue of the New England Journal of Medicine.

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Lactation May Be Unimpaired by Breast Reduction Surgery

WEDNESDAY, July 25 (HealthDay News) -- Women with macromastia who have undergone superior, medial or inferior pedicle breast reduction surgery have similar breast-feeding success rates as matched controls, according to a report published in the July issue of Plastic and Reconstructive Surgery.

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Lumbar Spondylolisthesis Surgeries Found Effective

WEDNESDAY, July 25 (HealthDay News) -- In patients with lumbar spondylolisthesis, anterior lumbar interbody fusion and posterior lumbar interbody fusion are both effective treatments. But patients who receive anterior lumbar interbody fusion may be less likely to develop adjacent-segment degeneration, researchers report in the July issue of the Journal of Neurosurgery: Spine.

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Pulmonary Artery Catheterizations Fall Sharply

TUESDAY, July 24 (HealthDay News) -- Since 1993, pulmonary artery catheterization has dramatically declined in hospitals within the United States in response to a growing body of evidence that the procedure does not benefit and may even harm patients, according to a report published in the July 25 issue of the Journal of the American Medical Association.

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Surgeon's Skill Linked to Prostate Cancer Recurrence

TUESDAY, July 24 (HealthDay News) -- The chance that a patient's prostate cancer will recur after radical prostatectomy is significantly lower when an experienced surgeon performs the surgery, according to a study published online July 24 in the Journal of the National Cancer Institute. The study also found that a surgeon's degree of success continues to improve through approximately 250 operations.

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Cardioverter Defibrillators Showing Greater Benefit

TUESDAY, July 24 (HealthDay News) -- In patients with hypertrophic cardiomyopathy, the risk of sudden cardiac death is lower in those who have an implantable cardioverter-defibrillator (ICD), according to a study published in the July 25 issue of the Journal of the American Medical Association.

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Benefits of Drug-Eluting Stents May Outweigh Risks

MONDAY, July 23 (HealthDay News) -- The benefit of drug-eluting stents, a reduction in the risk of clinically necessary target lesion revascularization, appears to outweigh the slightly increased risk of later stent thrombosis and myocardial infarction, according to a report published in the July 31 issue of the Journal of the American College of Cardiology.

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Prophylactic Anticoagulation Reduces Clots, Not Deaths

MONDAY, July 23 (HealthDay News) -- Routine prophylactic anticoagulation in hospitalized patients can reduce venous thromboembolic risks compared to placebo, but not mortality, according to study findings published in the July 23 issue of the Archives of Internal Medicine.

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Outpatient Blood Clots Present Public Health Challenge

MONDAY, July 23 (HealthDay News) -- Outpatients are more likely than inpatients to develop venous thromboembolism, indicating a need for more aggressive anticoagulant prophylaxis, according to a study published in the July 23 issue of the Archives of Internal Medicine.

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Residents' Decreased Duty-Hours May Have Downside

MONDAY, July 23 (HealthDay News) -- Most internal medicine faculty members believe that decreased resident duty-hours have had adverse effects on both residents and faculty, according to a report published in the July 23 issue of the Archives of Internal Medicine.

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FDA Issues Class I Recall of Baxter Infusion Pumps

MONDAY, July 23 (HealthDay News) -- The U.S. Food and Drug Administration and Baxter Healthcare Corp. of Round Lake, Ill., notified health care professionals and consumers July 20 of a class I recall of the Baxter Upgraded COLLEAGUE Triple Channel Volumetric Infusion Pumps, model numbers 2M8153, 2M8163, and 2M9163.

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Poor Prognosis for Squamous Cell Carcinoma of Ureter

THURSDAY, July 19 (HealthDay News) -- Among patients with squamous cell carcinoma of the renal pelvis and ureter, fewer than 10 percent survive five years following surgery, according to a report published in the July issue of the Journal of Urology.

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Donor Hematopoietic Stem Cells Don't Produce Beta-Cells

THURSDAY, July 19 (HealthDay News) -- Hematopoietic-derived stem cells from an adult donor may not differentiate into the pancreatic beta-cells thought to help reverse diabetes when transplanted into patients, researchers report in the July issue of Diabetes.

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Prostate Cancer Patients May Not Need Digital Rectal Exam

THURSDAY, July 19 (HealthDay News) -- In men who undergo radical treatment for prostate cancer, routine digital rectal examination is usually not necessary because prostate-specific antigen (PSA) tests can reliably identify disease recurrence, according to a report published in the July issue of the Journal of Urology.

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FDA OKs First Artificial Disc for Cervical Degenerative Disease

TUESDAY, July 17 (HealthDay News) -- The U.S. Food and Drug Administration has approved the first artificial disc for the treatment of cervical degenerative disease. The Prestige Cervical Disc, made by Medtronic Sofamor Danek, is as safe and effective as cervical fusion, according to clinical trials.

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Loss of Taste Unlikely After Tonsillectomy

TUESDAY, July 17 (HealthDay News) -- Contrary to some published reports, patients are unlikely to have an impaired sense of taste following tonsillectomy, according to the results of a small study published in the July issue of the Archives of Otolaryngology--Head & Neck Surgery.

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FDA OKs Rapid Molecular Test for Sentinel Lymph Nodes

TUESDAY, July 17 (HealthDay News) -- The U.S. Food and Drug Administration has approved a rapid molecular test that can be used to detect breast cancer metastasis in sentinel and other lymph nodes. The GeneSearch BLN (Breast Lymph Node) Assay has a sensitivity and specificity similar to more extensive microscopic examination, which typically takes one to two days.

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Diabetic Trauma Patients at Greater Risk of Complications

TUESDAY, July 17 (HealthDay News) -- Among patients hospitalized for trauma, those with diabetes mellitus are significantly more likely than non-diabetics to develop complications and require a higher level of care, which increases the cost of their hospitalization, according to study findings published in the July issue of the Archives of Surgery.

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Prevalence, Severity of C. Difficile Colitis Increasing

TUESDAY, July 17 (HealthDay News) -- The prevalence, total mortality rate and colectomy rate of Clostridium difficile colitis has dramatically increased in the United States since 1993, according to a report in the July issue of the Archives of Surgery.

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Temporalis Tendon Transfer Can Help Facial Paralysis

MONDAY, July 16 (HealthDay News) -- Temporalis tendon transfer is a minimally invasive procedure for treating facial paralysis that gets high patient marks for improved muscle function and reanimation of facial features, according to a report in the July/August issue of the Archives of Facial Plastic Surgery.

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Sacroplasty Cuts Pain from Sacral Insufficiency Fractures

MONDAY, July 16 (HealthDay News) -- Sacroplasty is a safe, effective and rapid treatment for sacral insufficiency fractures in patients with osteoporosis, and improvements are sustained for at least a year, according to a report in the July issue of Spine.

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Hospitals That Ace Quality Measures Have Lower Mortality

MONDAY, July 16 (HealthDay News) -- Hospitals scoring highest on publicly reported performance measures for myocardial infarction, heart failure and pneumonia have lower mortality rates compared to low-scoring hospitals, according to a report published in the July/August issue of Health Affairs.

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Bladder Cancer Therapy May Lower Disease-Free Survival

FRIDAY, July 13 (HealthDay News) -- Treatment of T1 high-grade bladder cancer with potentially bladder-sparing intravesical therapy (IVT), including chemotherapy and immunotherapy before progressing to radical cystectomy, may decrease disease-free survival, according to study findings in the July issue of the British Journal of Urology.

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Shaving Spine Incision Site Boosts Risk of Infection

FRIDAY, July 13 (HealthDay News) -- Shaving the incision site before spinal surgery may increase the risk for postoperative infection, researchers report in the July issue of Spine.

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Post-Radiation Therapy Skin Lesions Difficult to Diagnose

FRIDAY, July 13 (HealthDay News) -- In breast cancer patients who undergo postoperative radiation therapy and develop vascular proliferations in mammary skin, there may be a significant overlap between atypical vascular lesions and angiosarcoma, according to a report published in the July issue of the Journal of the American Academy of Dermatology.

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Transient Elastography No Substitute for Liver Biopsy

FRIDAY, July 13 (HealthDay News) -- Transient elastography, a non-invasive technique for predicting liver fibrosis, is very useful in patients with chronic liver disease, but is not sufficiently reproducible to warrant replacement of liver biopsy in patients with certain conditions, according to the results of a study published in the July issue of Gut.

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Study Questions Shorter Pain-to-Balloon Time Paradigm

WEDNESDAY, July 11 (HealthDay News) -- In patients transferred for primary percutaneous coronary intervention, a shorter pain-to-balloon time is not associated with a decrease in infarct size, and such patients may in fact have a larger infarct, according to a study published in the July issue of the American Journal of Cardiology. This may be because such patients have the most severe symptoms and already have a larger infarct due to unavoidable delays in treatment, the authors suggest.

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Gender-Neutral System Classifies Pattern Baldness

WEDNESDAY, July 11 (HealthDay News) -- A new way of classifying pattern hair loss could replace separate systems for men and women with an accurate, gender-neutral universal classification system, researchers report in the July issue of the Journal of the American Academy of Dermatology.

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Magazine's Ranking Omits Some Top Heart Hospitals

MONDAY, July 9 (HealthDay News) -- The U.S. News & World Report rankings of "America's Best Hospitals for Heart and Heart Surgery" fall short in identifying all the top hospitals for heart attack patients, researchers report in the July 9 issue of the Archives of Internal Medicine.

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Sciatic Nerve Release May Improve Fracture Neuropathy

MONDAY, July 9 (HealthDay News) -- Patients who have fracture-associated sciatic neuropathy who undergo sciatic nerve release during acetabular reconstruction may have an improvement in symptoms, including a reduction in radicular pain, weakness or footdrop, according to the results of a small study in the July issue of the Journal of Bone & Joint Surgery.

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Merck Recalls Three Lots of Invanz Due to Glass Shards

FRIDAY, July 6 (HealthDay News) -- Three lots of Invanz (ertapenem sodium) were recalled this week due to two incidents in which pieces of broken glass were found in the reconstituted solution for injection. Merck & Co., Inc., of Whitehouse Station, N.J., issued a letter to health care professionals noting that it is working closely with the U.S. Food and Drug Administration to inform its direct customers of the recall.

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Von Hippel-Lindau Disease Linked to Hearing Loss

THURSDAY, July 5 (HealthDay News) -- In patients with von Hippel-Lindau disease, irreversible sensorineural hearing loss associated with endolymphatic sac tumors may occur suddenly or gradually, suggesting a need for early intervention, according to a study published in the July 4 issue of the Journal of the American Medical Association.

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Surgery to Clear Kidneys Can Impair Renal Function

TUESDAY, July 3 (HealthDay News) -- Surgery to clear blocked kidney arteries often releases debris that can impair renal function, according to study findings published in the July issue of the Journal of Vascular Surgery.

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Lung Lesion Probes Allow Minimally Invasive Biopsies

TUESDAY, July 3 (HealthDay News) -- The combined use of endobronchial ultrasound (EBUS) and electromagnetic navigation bronchoscopy (ENB) is safe and effective for improving the diagnostic yield of flexible bronchoscopy in peripheral lung lesions without surgery, according to a report published in the July issue of the American Journal of Respiratory and Critical Care Medicine.

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Health Courts a Promising Model for Malpractice Suits

TUESDAY, July 3 (HealthDay News) -- The American Medical Association has backed the idea of health courts for states without caps on claims for medical malpractice, stating that they are an option that deserves greater exploration. This information was released by the AMA on June 26.

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Human Bite Wounds Pose Management Challenge

MONDAY, July 2 (HealthDay News) -- Emergency departments find human bite wounds difficult to manage, according to a report published in the July Issue of the Emergency Medicine Journal.

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Lymph Node Biopsies Detect Early Breast Cancer

MONDAY, July 2 (HealthDay News) -- The growing trend of diagnostic use of sentinel lymph node biopsies in community settings correlates with the rising rate of some early-stage metastatic breast cancers, according to the results of a population-based study published online June 27 in the Journal of the National Cancer Institute.

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Physician's Briefing
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