Here are what the editors at HealthDay consider to be the most important developments in Surgery for March 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.
Safe Practice Scores Do Not Add Up to Fewer Patient Deaths
TUESDAY, March 31 (HealthDay News) -- In hospitals, higher self-reported scores for improvements in safe practices do not correlate with reduced mortality rates, researchers report in the April 1 issue of the Journal of the American Medical Association.
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Neck Disc Offers Good Results After Earlier Fusion
TUESDAY, March 31 (HealthDay News) -- Clinical outcomes following placement of an artificial cervical disc were similar in patients with and without previous adjacent cervical fusion, according to research published in the March 15 issue of Spine.
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Staff Education Can Help Reduce Elective Labor Inductions
TUESDAY, March 31 (HealthDay News) -- Staff education and more rigorous enforcement of guidelines for labor induction can reduce the number of unwarranted inductions and lower the cesarean birth rate for first-time births, researchers report in the April issue of Obstetrics & Gynecology.
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Obese Women Face High First-Time Pregnancy Risks
MONDAY, March 30 (HealthDay News) -- Obese women who are pregnant for the first time have an elevated risk of preterm birth, cesarean section delivery and preeclampsia, according to a report in the April issue of the American Journal of Obstetrics & Gynecology.
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Seated Postures Linked to Different Muscle Activities
MONDAY, March 30 (HealthDay News) -- The use of electromyography provides helpful details regarding the regional muscle activity that occurs during three sagittally balanced seated postures, according to research published in the March 15 issue of Spine.
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Reduced Platelet Reactivity After Adjunctive Cilostazol
FRIDAY, March 27 (HealthDay News) -- In patients undergoing coronary stenting who develop high post-treatment platelet reactivity (HPPR), adjunctive cilostazol reduces platelet aggregation better than maintenance clopidogrel, researchers report in the March 31 issue of the Journal of the American College of Cardiology.
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ACCF/AHA Update Covers Heart Failure in Adults
FRIDAY, March 27 (HealthDay News) -- Updated American College of Cardiology Foundation/American Heart Association guidelines on heart failure in adults include new recommendations for hospitalized patients, and the guidelines were published online March 26 in the Journal of the American College of Cardiology.
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Pregnancy Feasible After Anterior Spinal Surgery
THURSDAY, March 26 (HealthDay News) -- In women of childbearing age, anterior spinal surgery may not affect fertility, although it may be associated with a higher rate of cesarean section deliveries, according to the results of a study published in the April issue of The Spine Journal.
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Substantia Nigra Shows Role in Reinforcement Learning
THURSDAY, March 26 (HealthDay News) -- Neurons in the substantia nigra appear to play a key role in human reinforcement learning, according to research published online March 13 in Science.
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Routine Tests Can Induce Stress Cardiomyopathy
THURSDAY, March 26 (HealthDay News) -- Routine procedures and tests using catecholamines and beta-receptor agonists can precipitate stress cardiomyopathy, according to study findings released online March 25 in advance of publication in the April 14 issue of the Journal of the American College of Cardiology.
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Somatosensory Evoked Potential Monitoring Useful
THURSDAY, March 26 (HealthDay News) -- In patients undergoing lumbosacral spinal surgery, monitoring of upper-limb somatosensory evoked potential may help prevent position-related peripheral nerve injuries, according to a report published in the April issue of The Spine Journal.
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Circumcision Lowers Risk of Sexually Transmitted Disease
WEDNESDAY, March 25 (HealthDay News) -- In a study of Ugandan men, circumcision reduced both the incidence of herpes simplex virus (HSV-2) and the prevalence of human papillomavirus (HPV), two co-factors in HIV/AIDs, according to a report in the March 26 issue of the New England Journal of Medicine.
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Cost Barriers Slow Adoption of Electronic Health Records
WEDNESDAY, March 25 (HealthDay News) -- Citing cost barriers, relatively few U.S. hospitals have adopted electronic health records, posing a major obstacle for policy makers who say health information technology is critical to the improvement of health care quality and cost-effectiveness, according to an article published online March 25 in the New England Journal of Medicine.
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Active Surveillance Safe for Some Prostate Cancer Patients
WEDNESDAY, March 25 (HealthDay News) -- Active surveillance of certain prostate cancer patients is a safe and effective strategy for prevention of systemic progression of the disease, according to a study published in the April issue of the Journal of Urology.
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U.S. Emergency Care Access Varies Widely
WEDNESDAY, March 25 (HealthDay News) -- While most people in the United States can get to an emergency department within a half-hour, there are geographic inequities that could impact medical outcomes in time-critical medical emergencies, such as heart attack, stroke or major trauma, according to a report in the Feb. 9 online edition of the Annals of Emergency Medicine.
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Genetic Heart Disease Often Deadly for Children
TUESDAY, March 24 (HealthDay News) -- A genetic cardiomyopathy that strikes children is associated with serious heart dysfunction and often death, according to a report in the March 25 issue of the Journal of the American Medical Association.
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Pediatric Anesthesia Linked to Learning Disability Risk
TUESDAY, March 24 (HealthDay News) -- Multiple early exposures to anesthesia may be an important risk factor for developing learning disabilities later in childhood, researchers report in the April issue of Anesthesiology.
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Vitamin D Insufficiency Increasing in United States
TUESDAY, March 24 (HealthDay News) -- About three out of four American adolescents and adults currently have insufficient levels of vitamin D, though oral vitamin D supplementation is effective in preventing fractures among older adults, according to two studies published in the March 23 issue of the Archives of Internal Medicine.
Abstract - Ginde
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Abstract - Bischoff-Ferrari
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Laser Effective in Treating Postsurgical Skin Discoloration
MONDAY, March 23 (HealthDay News) -- Pulsed-dye laser is an effective treatment for facial skin discoloration from ecchymoses following cosmetic surgery, according to a report in the March/April issue of the Archives of Facial Plastic Surgery.
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Fiber-Reinforced Cement Excels in Simulated Skull Repair
MONDAY, March 23 (HealthDay News) -- Fiber-reinforced calcium phosphate bone cement (FRC) exhibited superior strength and structural integrity when compared with non-reinforced cement (NRC), according to a study in the March/April issue of the Archives of Facial Plastic Surgery.
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Metastases in Breast Cancer Patients Should Be Tested
MONDAY, March 23 (HealthDay News) -- Treatment for breast cancer patients with metastatic disease is often changed when tests reveal discordance between the receptor status of primary and metastatic tumors, according to an article published online March 18 in the Annals of Oncology.
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Instrument Contamination by Toner or Ink Not Significant
FRIDAY, March 20 (HealthDay News) -- Contamination from ink or toner on printed count sheets and labels used to account for surgical instruments in the operating room does not pose a significant cytotoxic hazard, according to a report in the March issue of the AORN Journal.
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TESTIN May Have Role in Head and Neck Cancer Survival
FRIDAY, March 20 (HealthDay News) -- Inactivation of the TESTIN gene may play a role in the survival odds of patients with head and neck squamous cell carcinoma, researchers report in the March issue of the Archives of Otolaryngology - Head & Neck Surgery.
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Age, Diabetes May Affect Coronary Disease Treatments
FRIDAY, March 20 (HealthDay News) -- In most patients with multivessel coronary disease who are suitable for either coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), long-term mortality is similar for either treatment. In diabetics and older patients, however, CABG may be associated with a significant survival advantage, according to an article published online March 20 in The Lancet.
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Google Searches May Lead to False Medical Information
FRIDAY, March 20 (HealthDay News) -- Google keyword searches may generate sponsored links to Web pages that contain misleading medical claims, according to a Views & Reviews article published online March 18 in BMJ.
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Pressure Ulcer Prevention Important in Surgical Patients
THURSDAY, March 19 (HealthDay News) -- Nurses should consider every surgical patient "at-risk" for pressure ulcers and devise an individualized plan to mitigate that risk, according to an article in the March issue of the AORN Journal.
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Imatinib Improves Survival After Gastrointestinal Tumor
THURSDAY, March 19 (HealthDay News) -- A phase III trial of imatinib mesylate adjuvant therapy has shown that the drug is safe and increases the odds of recurrence-free survival after primary gastrointestinal stromal tumor resection, according to study findings published online March 19 in The Lancet.
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Hospital Quality Measure Inaccurate, May Increase Bias
WEDNESDAY, March 18 (HealthDay News) -- A widely used hospital quality measure that compares mortality rates and takes into account the mix of cases is inaccurate and may increase the bias that case mix adjustment is intended to decrease, according to research published March 18 in BMJ Online First.
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Botulinum Drug for Wrinkles Found Well-Tolerated
WEDNESDAY, March 18 (HealthDay News) -- The use of a botulinum toxin type A product (Reloxin) appeared to be well-tolerated and effective after repeated treatments, according to research published in the March/April Archives of Facial Plastic Surgery.
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Obesity Boosts Postoperative Pancreatic Cancer Risks
TUESDAY, March 17 (HealthDay News) -- Obese pancreatic cancer patients who undergo surgery have higher cancer recurrence and metastasis rates and a greater risk of death than non-obese patients, according to research published in the March issue of the Archives of Surgery.
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Hospitalization Decreases Mobility in Elderly
TUESDAY, March 17 (HealthDay News) -- Using a life-space measure, which combines a person's destination, frequency of going there and degree of dependency in reaching it, shows that hospitalization restricts elders' subsequent mobility, according to an article published in the March 17 issue of the Annals of Internal Medicine.
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Survival in Transplant Patients Hinges on Key Risk Factors
TUESDAY, March 17 (HealthDay News) -- Low-risk combined heart and kidney transplantation recipients with a low estimated glomerular filtration rate (eGFR) have improved survival after the transplantation when compared with isolated heart transplant recipients, according to research published in the March issue of the Archives of Surgery.
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Absorbable Everolimus-Eluting Stent Safe and Effective
FRIDAY, Mar. 13 (HealthDay News) -- A trial of a bioabsorbable everolimus-eluting coronary stent system shows that it is clinically safe, restores vasomotion and prevents restenosis, researchers report in the Mar. 14 issue of The Lancet.
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BRCA+ Women Receptive to Prophylactic Mastectomy
FRIDAY, Mar. 13 (HealthDay News) -- Women who test positive for the BRCA1 or BRCA2 mutation and are at high risk for breast cancer are more receptive to prophylactic mastectomy to reduce risk than women who test negative, according to research published in the Apr. 15 issue of Cancer.
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Drugs Still Best First Step for Non-Acute Heart Disease
FRIDAY, Mar. 13 (HealthDay News) -- Medical therapy is still the best initial management strategy for non-acute coronary artery disease despite innovations in catheter-based treatment, according to a study published in the Mar. 14 issue of The Lancet, while a second study describes the positive initial findings of a phase II trial of SCH 530348, an oral platelet protease-activated receptor-1 antagonist used in percutaneous coronary intervention.
Abstract - Trikalinos
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Specialist Nurses Help Grieving Parents Agree to Autopsy
FRIDAY, Mar. 13 (HealthDay News) -- Bereaved parents are more likely to consent to a request for post-mortem imaging for research purposes if they are approached by a specially trained nurse with experience in family and bereavement counseling, according to a study published online Mar. 12 in the Archives of Disease in Childhood.
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Bariatric Surgery Has Double Benefits for Diabetic Patients
THURSDAY, Mar. 12 (HealthDay News) -- Most type 2 diabetes patients who undergo bariatric surgery see improvements, not just in weight loss but also in diabetes control, according to a study published in the March issue of The American Journal of Medicine.
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Fast-Track Program Offers Benefits After Colon Surgery
THURSDAY, Mar. 12 (HealthDay News) -- A fast-track protocol for patients undergoing elective colon surgery was linked to lower morbidity and a shorter hospital stay, according to research published in the March issue of Gastroenterology.
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Local Antibiotics After Spinal Surgery Reduce Infection
THURSDAY, Mar. 12 (HealthDay News) -- Rabbits have reduced levels of infection after spinal surgery if the wounds are prophylactically treated with antibiotic-containing controlled-release microspheres, according to a study in the Mar. 1 issue of Spine.
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Many Factors Affect Lymph Node Biopsy in Melanoma
THURSDAY, Mar. 12 (HealthDay News) -- The use of sentinel lymph node biopsy for clinical stage I and II melanoma is associated with socioeconomic factors, according to research published online Mar. 9 in the Journal of Clinical Oncology.
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Non-Simultaneous Transplants Can Increase Kidney Donation
WEDNESDAY, Mar. 11 (HealthDay News) -- A series of 10 kidney transplantations initiated by a single altruistic donor demonstrates the potential of such chains to increase the number of transplantations and improve donor-recipient matches, according to a report published in the Mar. 12 issue of the New England Journal of Medicine.
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Tube Feeding Shows Benefits in Short Bowel Syndrome
WEDNESDAY, Mar. 11 (HealthDay News) -- Following the postoperative period, patients with short bowel syndrome may have greater nutrient absorption with tube feeding than oral feeding, according to research published in the March issue of Gastroenterology.
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Age Affects Optimal Treatment for Spinal Metastases
WEDNESDAY, Mar. 11 (HealthDay News) -- Although surgery for spinal metastases is generally superior to radiation, the treatment giving the best outcome is strongly affected by age, researchers report in the Mar. 1 issue of Spine.
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Routine Screening of Excised Breast Tissue Can Backfire
WEDNESDAY, Mar. 11 (HealthDay News) -- Most plastic surgeons routinely send breast reduction tissue for routine histological testing, effectively screening women under the age of 50 for breast cancer without their consent, according to an article published online Mar. 10 in BMJ. Three related editorials discuss the surgical management problems, ethical dilemmas and implications for patients of such a practice.
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Editorial - Treasure
Editorial - Sugarman
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Specialists Spend Much Time on Routine Care
TUESDAY, Mar. 10 (HealthDay News) -- A substantial portion of medical specialists' office-based activity is devoted to routine and preventive care for known patients, for services that might often be handled by primary care physicians, according to research published in the March/April issue of the Annals of Family Medicine.
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Dissection of Skeletal Tissue Reduces Spinal Stiffness
TUESDAY, Mar. 10 (HealthDay News) -- Skeletal tissue dissection performed as part of the upper instrumented vertebra anchor site preparation and placement can reduce the stiffness of the proximal adjacent motion segment, researchers report in the Mar. 1 issue of Spine.
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Radiation Reduces Rectal Cancer Recurrence
FRIDAY, Mar. 6 (HealthDay News) -- Preoperative radiation is more effective than postoperative radiation in reducing local recurrence in patients with rectal cancer, researchers report in the Mar. 7 issue of The Lancet.
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Measures Assess Cancer Care Based on Patient Concerns
FRIDAY, Mar. 6 (HealthDay News) -- Three measures used to assess the quality of medical care at the time of cancer diagnosis and treatment are reliable and valid, and reflect the concerns of patients about a lack of communication about their diagnosis and treatment as well as their treatment experience, according to a report published online Mar. 2 in the Journal of Clinical Oncology.
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Transdermal Patches Pose Burn Risk During Scans
FRIDAY, Mar. 6 (HealthDay News) -- The U.S. Food and Drug Administration has issued a warning about the risk of burns as a result of wearing medicated patches, such as those used for smoking cessation or pain relief, during MRI scans.
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Gastric Bypass Surgery May Improve Sex Life in Obese Men
THURSDAY, Mar. 5 (HealthDay News) -- In obese men, Roux-en-Y gastric bypass surgery may be associated with increased production of reproductive hormones and improved sexual function, according to study findings released online Jan. 27 in advance of publication in the Journal of Clinical Endocrinology & Metabolism.
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Unnecessary Laparotomies Prevented in Pregnant Women
THURSDAY, Mar. 5 (HealthDay News) -- MRI can help to prevent unnecessary laparotomies in pregnant patients with suspected acute appendicitis, according to research published in the March issue of Radiology.
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Obama Wants to Spend $630 Billion on Health Care Reform
THURSDAY, Mar. 5 (HealthDay News) -- Achieving health care reform is one of President Barack Obama's major challenges, and his newly released spending plan calls on Congress to commit $630 billion over the next decade to finance that reform, according to an article published online Mar. 4 in the New England Journal of Medicine.
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Proton Pump Inhibitors May Reduce Benefits of Clopidogrel
TUESDAY, Mar. 3 (HealthDay News) -- Acute coronary syndrome patients who are prescribed clopidogrel in combination with a proton pump inhibitor are at increased risk of adverse outcomes compared with patients prescribed clopidogrel alone, according to a report published in the Mar. 4 issue of the Journal of the American Medical Association.
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Classification Systems for Spinal Tumors Reliable
TUESDAY, Mar. 3 (HealthDay News) -- Two systems to stage and manage spinal tumors have moderate interobserver reliability and substantial intraobserver reliability, according to the results of a study published in the Feb. 15 issue of Spine.
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Vitamin K Doesn't Reduce Bleeding in Warfarin Patients
TUESDAY, Mar. 3 (HealthDay News) -- In patients receiving warfarin, vitamin K does not reduce bleeding, according to study findings published in the Mar. 3 issue of the Annals of Internal Medicine.
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US Motor Vehicle-Related Death Rates Vary Geographically
MONDAY, Mar. 2 (HealthDay News) -- Although the mortality rate related to motor vehicles remained almost unchanged from 1999 to 2005 in the United States, on closer inspection the data reveals wide variations from state to state, as well as by gender and ethnicity, according to a report published in the Feb. 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
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Patients' Rights Documents Usually Difficult to Understand
MONDAY, Mar. 2 (HealthDay News) -- Patients' bill of rights documents in U.S. hospitals are generally written at a complexity level that far exceeds the average adult's reading ability, according to a report published online Feb. 3 in the Journal of General Internal Medicine.
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