Here are what the editors at HealthDay consider to be the most important developments in Surgery for March 2011. 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.
Areas With More Surgeons Have Fewer Car Crash Deaths
THURSDAY, March 31 (HealthDay News) -- Areas with more surgeons available have fewer deaths from motor vehicle crashes (MVCs), according to a study published online March 29 in the Journal of the American College of Surgeons.
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Online Health Records Less Used by Minorities, Poor
WEDNESDAY, March 30 (HealthDay News) -- Online personal health records (PHRs) are less frequently used by racial or ethnic minorities and patients with low annual income, according to a study published in the March 28 issue of the Archives of Internal Medicine.
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Air Pollution May Compromise Lung Transplant Patients
TUESDAY, March 29 (HealthDay News) -- Lung transplant patients who have high exposure to traffic-related air pollution may be at increased risk for bronchiolitis obliterans syndrome (BOS) and death, according to research published online March 23 in Thorax.
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Conflicts of Interest Abound in Cardiology Guidelines
TUESDAY, March 29 (HealthDay News) -- Conflicts of interest (COIs) are prevalent in cardiology clinical practice guidelines, but there is still a substantial number of experienced expert guideline writers and reviewers without COIs, according to a study published in the March 28 issue of the Archives of Internal Medicine.
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Bariatric Surgery Weight Loss Tied to Migraine Improvement
TUESDAY, March 29 (HealthDay News) -- Severely obese people who suffer from migraines experience improvement in their headaches after losing a significant amount of weight following bariatric surgery, according to a study published in the March 29 issue of Neurology.
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Decline Seen in Global Youth Mortality Over Last 50 Years
TUESDAY, March 29 (HealthDay News) -- Overall mortality declined substantially between 1955 and 2004 in children aged 14 years or younger and in females aged 15 to 24, but a smaller decline was evident for males aged 15 to 24 years, according to a study published online March 29 in The Lancet.
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Room Cleaning Linked to Lower Drug-Resistant Infections
TUESDAY, March 29 (HealthDay News) -- Enhanced intensive care unit (ICU) cleaning may reduce methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) transmission, according to a study published in the March 28 issue of the Archives of Internal Medicine.
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Guidelines Provided for Deep Vein Thrombosis Management
MONDAY, March 28 (HealthDay News) -- Blood thinners should not be the only therapy considered for patients with deep vein thrombosis (DVT), according to a scientific statement published online March 21 in Circulation.
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Disclosing Agent Determines If Operating Rooms Are Clean
MONDAY, March 28 (HealthDay News) -- The use of an environmentally stable disclosing agent allows hospital staff to determine if an operating room (OR) has been cleaned and reveals that many surfaces are not cleaned, according to a study published in the March issue of the AORN Journal.
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Bariatric Surgery Linked to Bone Density Loss in Teens
MONDAY, March 28 (HealthDay News) -- Adolescents who undergo bariatric surgery have reductions in bone mineral density (BMD), although the level is still within the age-appropriate norm, according to a study published online March 28 in Pediatrics.
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ISICEM: Decompressive Craniectomy May Be Harmful
FRIDAY, March 25 (HealthDay News) -- The use of decompressive craniectomy in patients with severe diffuse traumatic brain injury and refractory intracranial hypertension appears to lower intracranial pressure and shorten intensive care unit (ICU) stays but is associated with more unfavorable outcomes, according to a study published online March 25 in the New England Journal of Medicine to coincide with research presented at the 31st International Symposium on Intensive Care and Emergency Medicine, held from March 22 to 25 in Brussels, Belgium.
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Safety Programs Boost Staff Perception of Safety Culture
THURSDAY, March 24 (HealthDay News) -- Obstetrics patient safety programs can improve staff perceptions of safety and the safety culture, according to a study published in the March issue of the American Journal of Obstetrics & Gynecology.
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Thromboembolism May Recur With Residual Vein Obstruction
THURSDAY, March 24 (HealthDay News) -- In patients with provoked or unprovoked deep vein thrombosis (DVT), residual vein obstruction (RVO) is associated with a slight increase in the risk of recurrent venous thromboembolism (VTE) but does not seem to predict recurrent VTE in patients with unprovoked DVT following discontinuation of anticoagulation therapy, according to a meta-analysis published online March 7 in the Journal of Thrombosis and Haemostasis.
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Early Tranexamic Acid Reduces Bleeding-Related Death
THURSDAY, March 24 (HealthDay News) -- Early administration of tranexamic acid reduces mortality due to bleeding in trauma patients; given more than three hours after injury, however, the agent could raise the risk of death, according to research published online March 24 in The Lancet.
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Reduced Hours for Trainees Has Had Little Effect in U.S.
THURSDAY, March 24 (HealthDay News) -- Reducing work hours for doctors in training to less than 80 per week has had little impact on patient outcomes or postgraduate training in the United States, according to a literature review published online March 22 in BMJ.
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Bariatric Surgery in Youth Warrants Caution
WEDNESDAY, March 23 (HealthDay News) -- Bariatric surgery in older children may result in significant weight loss and improvement in quality of life, though long-term data on safety, efficacy, and cost-effectiveness are limited, according to a literature review published online March 3 in Clinical Obesity.
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Dalteparin Not Superior to Unfractionated Heparin
TUESDAY, March 22 (HealthDay News) -- Dalteparin, a low-molecular-weight heparin, does not appear any more effective in lowering the incidence of proximal deep-vein thrombosis than unfractionated heparin, according to research published online March 22 in The New England Journal of Medicine.
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Long-Term Weight Loss After Laparoscopic Gastric Banding
TUESDAY, March 22 (HealthDay News) -- Despite the success of laparoscopic adjustable gastric banding (LAGB) for morbid obesity in terms of long-term weight loss, follow-up suggests poor outcomes, according to a study published online March 21 in the Archives of Surgery.
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CDC: HIV Transmitted Through Living Kidney Donation
THURSDAY, March 17 (HealthDay News) -- Despite HIV screening of the donor, using serologic testing, HIV was transmitted from a living kidney donor to the transplant recipient recently in New York City, according to a report in the March 18 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
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Professional Values of U.S. and U.K. Doctors Examined
THURSDAY, March 17 (HealthDay News) -- A core of professional values exists among doctors in the United States and the United Kingdom, though significant differences exist in how these values are expressed and prioritized, according to a study published online March 7 in BMJ Quality & Safety.
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Decontamination of Autologous Bone Fragments Evaluated
THURSDAY, March 17 (HealthDay News) -- Effective decontamination of autologous bone fragments which are accidentally dropped during operations can be achieved with minimal toxicity by using a povidone-iodine solution followed by a saline solution rinse, according to a study published in the March 2 issue of The Journal of Bone & Joint Surgery.
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CABG Ups Quality of Life More Than Drug-Eluting Stents
THURSDAY, March 17 (HealthDay News) -- Coronary artery bypass grafting (CABG) still has slightly better outcomes than percutaneous coronary intervention (PCI) in terms of relief from angina and improved quality of life when the latter involves drug-eluting stents rather than bare-metal stents, according to research published in the March 17 issue of the New England Journal of Medicine.
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Short Nurse Staffing Linked to Higher Patient Mortality
WEDNESDAY, March 16 (HealthDay News) -- Patient mortality appears to be higher when nurse staffing falls eight or more hours below target level and during nursing shifts when patient turnover is high, according to research published in the March 17 issue of the New England Journal of Medicine.
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U.S. Death Rate Reaches All-Time Low
WEDNESDAY, March 16 (HealthDay News) -- The age-adjusted death rate for the United States has fallen for 10 straight years and has reached an all-time low of 741 per 100,000, or 2,436,682 deaths, in 2009, down 2.3 percent from 2008, according to a new report issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.
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Smokers Advised to Stop Even Just Before Surgery
WEDNESDAY, March 16 (HealthDay News) -- There is no evidence to suggest that quitting smoking within eight weeks prior to surgery increases postoperative complications, according to a meta-analysis published online March 14 in the Archives of Internal Medicine.
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Bariatric Surgery Viable Option for Severely Obese
TUESDAY, March 15 (HealthDay News) -- Bariatric surgery is a viable option that often leads to long-term weight loss and reductions in cardiac and other risk factors in severely obese patients who have failed other weight-loss therapies, according to an American Heart Association (AHA) scientific statement published online March 14 in Circulation.
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Sharps Injuries Continue to Increase in Surgical Settings
MONDAY, March 14 (HealthDay News) -- Despite legislation introduced in 2000, surgical sharps injuries continue to increase, according to a study published in the March issue of the AORN Journal.
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Colonic Stenting No Better Than Emergency Surgery
MONDAY, March 14 (HealthDay News) -- Colonic stenting does not offer a decisive advantage over emergency surgery in patients with acute obstructive left-sided colorectal cancer, and may pose safety concerns, according to a study published online March 12 in The Lancet Oncology.
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Lower Survival Associated With GI Brain Metastasis
FRIDAY, March 11 (HealthDay News) -- Surgical resection and whole brain radiation therapy of gastrointestinal (GI) brain metastases is associated with prolonged survival and improved quality of life, but survival is still lower compared to metastases arising from other tumors, according to a review published online Feb. 11 in Cancer.
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Device OK'd to Continue Blood Flow During Brain Surgery
FRIDAY, March 11 (HealthDay News) -- A device that permits the rerouting of blood flow during surgery to treat a brain aneurysm or tumor in people at greater risk of stroke has been approved by the U.S. Food and Drug Administration.
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Automated Propofol and Remifentanil Delivery Effective
FRIDAY, March 11 (HealthDay News) -- Automated delivery of propofol and remifentanil using a controller maintains the Bispectral Index (BIS) values better than manual administration during general anesthesia, according to a study published in the March issue of Anesthesia & Analgesia.
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Laparoscopic Hernia Repair Safe in Transplant Patients
THURSDAY, March 10 (HealthDay News) -- Laparoscopic incisional hernia repair (LIHR) appears to be a reasonable alternative to open surgery in kidney and/or pancreas transplant patients, as it is in nontransplant patients, according to research published in the February issue of the American Journal of Transplantation.
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Socioeconomic Factors Predict Risk of Amputation
THURSDAY, March 10 (HealthDay News) -- Patients with critical limb ischemia (CLI) are more likely to be treated in a low-volume hospital and to undergo amputation rather than limb salvage procedures if they are of a minority race, a lower socioeconomic status, or on Medicaid, according to a study published in the February issue of the Journal of Vascular Surgery.
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Nitrous Oxide May Up Risk of Myocardial Infarction
THURSDAY, March 10 (HealthDay News) -- The administration of nitrous oxide in surgeries longer than two hours is linked to an increased long-term risk of myocardial infarction (MI), but not death or stroke, according to a report in the February issue of Anesthesia & Analgesia.
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HealthGrades Finds Rates of Patient Safety Events Vary
WEDNESDAY, March 9 (HealthDay News) -- Patients treated at hospitals rated with a HealthGrades Patient Safety Excellence Award have, on average, a 46 percent lower risk of experiencing a patient safety incident compared to those treated at the lowest-ranked hospitals, according to the eighth annual HealthGrades Patient Safety in American Hospitals Study published online March 9.
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Ethnic Differences Seen in Academic Measures for U.K. Docs
WEDNESDAY, March 9 (HealthDay News) -- United Kingdom-trained physicians and medical students with ethnic minority backgrounds tend to underperform academically compared to their white peers, according to a meta-analysis published online March 8 in BMJ.
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Duodenal Villous Atrophy Relates to Diarrhea After Transplant
WEDNESDAY, March 9 (HealthDay News) -- Duodenal villous atrophy (DVA) is related to chronic diarrhea in solid organ transplant (SOT) patients and may be caused by mycophenolic acid (MPA) therapy, according to a review published in the March issue of the American Journal of Transplantation.
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Pharmacological Meta-Analyses Rarely Report Disclosures
TUESDAY, March 8 (HealthDay News) -- Meta-analyses of pharmacological treatments rarely include information addressing primary study funding and conflicts of interest (COIs) of the authors for the included randomized control trials (RCTs), according to a study published in the March 9 issue of the Journal of the American Medical Association.
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Majority of Pediatric Burn Admissions Due to Scalding
TUESDAY, March 8 (HealthDay News) -- Although admission rates for burn injury declined from 1983 to 2008, more than half of burn-injury hospital admissions for children younger than 5 years of age in Western Australia are due to scalding, according to a study published online March 7 in Pediatrics.
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Tissue-Engineered Urethral Graft in Boys Effective
TUESDAY, March 8 (HealthDay News) -- Tubularized urethras engineered from boys' own cells appear to be functional and viable for up to six years, according to research published online March 8 in The Lancet.
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Enough Transplant Surgeons Likely Being Trained
FRIDAY, March 4 (HealthDay News) -- Sufficient numbers of fellows, some say more than enough, are being trained to meet the foreseeable demand for abdominal organ transplant surgeons, according to research published in the February issue of the American Journal of Transplantation.
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Neoatherosclerosis Frequency Up With Drug-Eluting Stents
FRIDAY, March 4 (HealthDay News) -- Neoatherosclerosis appears to occur more often and sooner with the implantation of drug eluting stents (DES) than with bare-metal stents (BMS), according to research published online March 2 in the Journal of the American College of Cardiology.
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Physical Activity Tied to Mortality in Kidney Recipients
FRIDAY, March 4 (HealthDay News) -- Low physical activity (PA) in renal transplant recipients (RTRs) is independently associated with increased risk for cardiovascular and all-cause mortality, according to a study published online March 3 in the Clinical Journal of the American Society of Nephrology.
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Racial Disparity in Deceased Donor Kidney Transplant Rate
FRIDAY, March 4 (HealthDay News) -- There are discrepancies in the waiting times and rates of deceased donor kidney transplantation for whites and ethnic racial minorities in the United States, according to a study published online March 3 in the Journal of the American Society of Nephrology.
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Rule Predicts Ability to Walk After Spinal Cord Injury
FRIDAY, March 4 (HealthDay News) -- A new clinical prediction rule, which accounts for age and four neurological variables, can predict independent walking one year following traumatic spinal cord injury, according to a study published online March 4 in The Lancet.
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Depression Tied to Lower Priority of Care in Heart Attack
THURSDAY, March 3 (HealthDay News) -- Heart attack patients with a documented history of depression in their charts may be triaged to lower priority of care than patients with no documented history of depression, and they are more likely to have worse associated performance on quality indicators, according to research published online Feb. 28 in CMAJ, the journal of the Canadian Medical Association.
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Women With Fibroids Prefer Minimally Invasive Treatment
THURSDAY, March 3 (HealthDay News) -- Women are willing to wait longer with their symptoms to delay a more invasive procedure for uterine fibroids compared to how long they would delay a noninvasive one, according to a study published online March 1 in Radiology.
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Corneal Graft Survival Associated With Its Indications
THURSDAY, March 3 (HealthDay News) -- Corneal graft survival in patients younger than 20 varies more by indication than by the recipient's age, according to research published in the March issue of Ophthalmology.
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Women Underrepresented in Cardiovascular Device Trials
WEDNESDAY, March 2 (HealthDay News) -- There is a lack of sex-specific data relating to the safety and effectiveness of high-risk cardiovascular devices prior to U.S. Food and Drug Administration approval, according to a review published online March 1 in Circulation: Cardiovascular Quality and Outcomes.
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Type of Health Care-Associated Infections Is Falling
TUESDAY, March 1 (HealthDay News) -- The incidence of central line-associated blood stream infections (CLABSIs) in intensive care units (ICUs) has decreased by more than half since 2001, but the infections continue to occur in substantial numbers in inpatient wards and outpatient hemodialysis centers, according to research published in the March 1 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
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Risk of Death From Heart Attacks Not Linked to Gender
TUESDAY, March 1 (HealthDay News) -- The association between female gender and increased mortality among patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) does not persist after adjusting for age and comorbidities, according to a study published in the January issue of the American Heart Journal.
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Helmets Protect Motorcyclists From Cervical Spine Injury
TUESDAY, March 1 (HealthDay News) -- Motorcyclists who wear helmets are less likely to suffer a cervical spine injury after a collision, according to a study published in the March issue of the Journal of the American College of Surgeons.
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