May 2010 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for May 2010. 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.

Statins May Reduce Revision Risk After Hip Arthroplasty

FRIDAY, May 28 (HealthDay News) -- The risk of revision after primary total hip arthroplasty is lower among those using statins than those not on statins, according to a study published in the May 1 issue of the Journal of Bone & Joint Surgery.

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PCI Using Fractional Flow Reserve Effective at Two Years

THURSDAY, May 27 (HealthDay News) -- The use of percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) in patients with multivessel coronary artery disease (CAD) significantly reduces mortality and myocardial infarction at two years compared with standard angiography-guided PCI, according to a study published online May 26 in the Journal of the American College of Cardiology.

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Shunting Options Compared in Infant Heart Defect Procedure

WEDNESDAY, May 26 (HealthDay News) -- Use of a right ventricle-pulmonary artery (RVPA) shunt in infants undergoing the Norwood procedure results in better transplantation-free survival in the short term than use of a modified Blalock-Taussig (MBT) shunt, but the advantage fades in longer follow-up, according to a study in the May 27 issue of the New England Journal of Medicine.

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Stents, Endarterectomy Equally Effective at Preventing Stroke

WEDNESDAY, May 26 (HealthDay News) -- Carotid-artery stenting and carotid endarterectomy are equally effective in preventing stroke in the long term, according to a study published online May 26 in the New England Journal of Medicine to coincide with its presentation at the European Stroke Conference, held from May 25 to 28 in Barcelona, Spain.

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Spine Fracture Classification Scoring System Found Valid

WEDNESDAY, May 26 (HealthDay News) -- A novel system for the classification of spinal fractures, which produces a numeric score to guide the management approach, appears to consistently suggest treatment in keeping with past treatment recommendations, according to a retrospective study in the May issue of the Journal of Spinal Disorders & Techniques.

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Kidney Weight May Predict Transplant Complication Risk

FRIDAY, May 21 (HealthDay News) -- In kidney transplantation, receipt of an organ that is low in weight in relation to the body weight of the recipient raises the recipient's risk of complications and transplant failure, according to a study published May 20 in Journal of the American Society of Nephrology.

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Novel Stent Appears Effective in Coronary Artery Stenosis

THURSDAY, May 20 (HealthDay News) -- At one year, the novel thin-strut platinum chromium alloy TAXUS Element paclitaxel-eluting stent appears comparable to the TAXUS Express stent in treating coronary artery stenoses, according to research published in the July 20 issue of the Journal of the American College of Cardiology.

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Nonorganic Pain Drawings Linked to Inferior Outcomes

THURSDAY, May 20 (HealthDay News) -- A nonorganic pain drawing used during lumbar spinal fusion surgery is a significant risk factor for inferior outcome, according to a study published in the May issue of The Spine Journal.

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Long-Term Aneursym Repair Survival Rates Similar

WEDNESDAY, May 19 (HealthDay News) -- Survival rates are similar six years after open or endovascular repair of abdominal aortic aneurysms, though secondary interventions are more common after endovascular treatment, according to research published in the May 20 New England Journal of Medicine.

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Optimism Not Linked to Plastic Surgery Satisfaction

WEDNESDAY, May 19 (HealthDay News) -- Baseline pessimism and optimism are not associated with patient satisfaction with facial plastic surgery, and those treated for depression show greater satisfaction than patients not treated for depression, according to research published in the May/June issue of the Archives of Facial Plastic Surgery.

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Age Affects Benefits of Cochlear Implants

TUESDAY, May 18 (HealthDay News) -- Elderly patients can benefit significantly from cochlear implants, though not as much as younger patients on some measures, according to a study in the May issue of Archives of Otolaryngology -- Head & Neck Surgery. According to another study in the same journal, the substantial increase in endoscopic surgery for chronic sinus problems in the Medicare population is of uncertain value.

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Family, Gender Affect Surgical Residents' Career Plans

MONDAY, May 17 (HealthDay News) -- Marital status, gender and children each appear to have a significant effect on general surgery residents' career-planning decisions, according to research published in the May issue of Archives of Surgery.

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Prompt Thyroid Cancer Treatment Doesn't Improve Survival Odds

MONDAY, May 17 (HealthDay News) -- Patients who are definitively treated within a year of diagnosis for papillary thyroid cancer that is limited to the thyroid gland have survival rates that are comparable to those who do not receive definitive treatment, according to a study reported in the May issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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FDA and GE Issue Class I Recall of Anesthesia Systems

THURSDAY, May 13 (HealthDay News) -- The U.S. Food and Drug Administration and GE Healthcare have alerted health care professionals of a Class I recall of specific lots of Aisys and Avance Anesthesia Systems due to a defect in the control board wiring harnesses.

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IOL for Infant Cataracts Not Superior to Contact Lenses

THURSDAY, May 13 (HealthDay News) -- Contact lenses for infants who undergo surgery for congenital cataracts result in short-term vision outcomes comparable to those with intraocular lens (IOL) implantation, but with fewer additional operations performed, according to research published online May 10 in the Archives of Ophthalmology.

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New FDA Program Targets Misleading Drug Advertising

WEDNESDAY, May 12 (HealthDay News) -- The U.S. Food and Drug Administration has announced the launch of a new program to educate health care providers regarding their role in making certain that advertisements and promotions for prescription drugs are truthful and not misleading.

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N-Acetylcysteine Does Not Improve Angioplasty Outcomes

TUESDAY, May 11 (HealthDay News) -- N-acetylcysteine reduces oxidative stress but adds no other clinical benefit in ST-segment elevation myocardial infarction (STEMI) patients undergoing angioplasty, according to a study published in the May 18 issue of the Journal of the American College of Cardiology.

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Kidney Removal in Elderly Does Not Improve Survival

MONDAY, May 10 (HealthDay News) -- Surgical management of localized renal tumors in elderly patients is not associated with increased survival compared with active surveillance, according to a study published online May 10 in Cancer.

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Laser Treatment Improves Eyes With Retinal Venous Occlusion

FRIDAY, May 7 (HealthDay News) -- Patients with central retinal vein occlusion (CRVO) who have laser-induced chorioretinal venous anastomosis (L-CRA) may have greater improvement in visual acuity at 18-month follow-up than patients who receive usual care, according to a study in the May issue of Ophthalmology.

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Article Lays Out Nurses' Role in Safe Handling of Chemotherapy

FRIDAY, May 7 (HealthDay News) -- Perioperative nurses can play a crucial role in developing best practices for handling chemotherapy in perioperative practice, and in providing preoperative and postoperative education to patients and their families, according to an article published in the April issue of the AORN Journal.

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Incomplete Revascularization Linked to Higher Risk of Death

FRIDAY, May 7 (HealthDay News) -- Patients with significant coronary artery disease (CAD) who are not amenable to traditional revascularization have a risk of three-year mortality that is significantly higher than that of patients who undergo complete revascularization, according to a study published in the May 1 issue of Catheterization & Cardiovascular Interventions.

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Long-Term Effects Similar With CABG, Stents in LMCA Disease

THURSDAY, May 6 (HealthDay News) -- The rate of long-term adverse outcomes is similar in patients with unprotected left main coronary artery (LMCA) disease who undergo stenting or coronary artery bypass grafting (CABG), although those who undergo stenting have higher rates of target vessel revascularization, according to research published online May 5 in the Journal of the American College of Cardiology.

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Deep Brain Stimulation Beneficial in Parkinson's

THURSDAY, May 6 (HealthDay News) -- Patients with advanced Parkinson's disease who undergo deep brain stimulation (DBS) in addition to the best medical therapy report better quality of life than patients who receive only best medical therapy, though they are at increased risk of serious adverse events, according to a study published online April 29 in The Lancet Neurology.

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Seminar Addresses State of Childhood Obesity

THURSDAY, May 6 (HealthDay News) -- Although the rapid increase in childhood obesity prevalence in developed countries may be stabilizing, rates have risen substantially since the 1970s, and efforts to prevent obesity should continue at all levels, though bariatric surgery should be used only as a last-resort treatment in extreme cases, according to a seminar published online May 6 in The Lancet.

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Everolimus-Eluting Superior to Paclitaxel-Eluting Stent

WEDNESDAY, May 5 (HealthDay News) -- Coronary everolimus-eluting stents result in superior clinical outcomes compared with paclitaxel-eluting stents, and reduced rates of target-lesion failure at one year seen with everolimus-eluting stents are consistent in all patients except those with diabetes, according to research published in the May 6 issue of the New England Journal of Medicine.

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FDA Orders Recall of Colleague Volumetric Infusion Pumps

WEDNESDAY, May 5 (HealthDay News) -- The U.S. Food and Drug Administration has notified Baxter Healthcare Corp. that the company must recall and destroy all Colleague Volumetric Infusion Pumps currently being used in the United States, which may number 200,000.

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Stent Type Does Not Affect Non-Cardiac Surgery Events

WEDNESDAY, May 5 (HealthDay News) -- Patients who undergo non-cardiac surgery after receiving a stent, especially within 42 days, are at increased risk for complications including death -- particularly after an acute coronary syndrome -- but the type of stent used is not an influencing factor, according to research published online May 4 in Circulation: Cardiovascular Interventions.

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Prognosis Varies Per Glycemic Index Pre-Revascularization

WEDNESDAY, May 5 (HealthDay News) -- Having a low -- but not too low -- glycemic index prior to surgery is optimal for best cardiovascular outcomes after coronary revascularization in patients with type 2 diabetes mellitus (DM), according to a study in the April 1 issue of the American Journal of Cardiology.

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Global Endometrial Ablation Helpful for Bleeding Disorders

WEDNESDAY, May 5 (HealthDay News) -- Women with bleeding disorders who undergo global endometrial ablation (GEA) for menorrhagia report improved health-related quality of life (HRQoL) and high satisfaction after the procedure, according to research published in the April issue of the American Journal of Obstetrics & Gynecology.

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Noncardia Gastric Cancer Rate Up in Young White Adults

TUESDAY, May 4 (HealthDay News) -- The incidence of noncardia gastric cancer has declined overall in America since the late 1970s but increased among whites aged 25 to 39, and the use of adjuvant chemotherapy for gastric cancer is associated with lower mortality risk compared to surgery alone, according to two studies in the May 5 issue of the Journal of the American Medical Association.

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Anti-Reflux Surgery Not Seen to Prevent Esophageal Cancers

MONDAY, May 3 (HealthDay News) -- Contrary to arguments supporting the theory that anti-reflux surgery prevents the subsequent development of esophageal and cardia cancers, it does not appear to have any such preventive benefit, according to research published in the April issue of Gastroenterology.

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