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November 2006 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for November 2006. 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.

Surgical Techniques Improve HIV-Associated Facial Wasting

WEDNESDAY, Nov. 29 (HealthDay News) -- HIV-associated facial lipoatrophy can be successfully treated with either lipofilling or submalar silicone implants, according to a study published in the November issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

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Complications Studied in Abdominoplasty

WEDNESDAY, Nov. 29 (HealthDay News) -- Abdominoplasty is associated with high rates of early and late complications and the need for revision surgery, according to study findings published in the November issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

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Inhibiting Receptor Prevents Craniosynostosis in Mice

WEDNESDAY, Nov. 29 (HealthDay News) -- Blocking the fibroblast growth factor receptor 2 (Fgfr2) pathway could help in treatment of craniosynostosis and other bone disorders, according to a report published online Nov. 28 in the Proceedings of the National Academy of Sciences Early Edition.

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Smoking Status Unclear in Plastic Surgery Candidates

WEDNESDAY, Nov. 29 (HealthDay News) -- Patients undergoing elective plastic surgery may often falsely report non-smoking status or underestimate the number of cigarettes they smoke, according to the results of a study published in the November issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

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Radiofrequency Ablation of Renal Tumors Can Fail

TUESDAY, Nov. 28 (HealthDay News) -- Radiofrequency ablation of renal tumors without resection can sometimes be ineffective and lead to tumor progression and the formation of renocolic fistulas, according to two cases reported in the November issue of Urology.

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FDA Issues Warning About Methadone

TUESDAY, Nov. 28 (HealthDay News) -- The U.S. Food and Drug Administration has issued a public health advisory warning to health care professionals prescribing methadone hydrochloride (Dolophine). Death and life-threatening side effects, such as severe respiratory problems and cardiac arrhythmias, have occurred in patients prescribed the drug for new pain, or who are being switched from other narcotic pain relievers.

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Stem Cell Transplant Poses Long-Term Second Cancer Risk

MONDAY, Nov. 27 (HealthDay News) -- While hematopoietic stem cell transplantation offers the chance of a cure for diseases such as leukemia and myelodysplastic syndrome, it also increases the 10-year risk of developing a second, solid cancer by 85 percent, according to a report published online Nov. 27 in Cancer.

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Follicular Unit Extraction Studied in Hair Transplants

MONDAY, Nov. 27 (HealthDay News) -- In hair transplant patients, follicular unit extraction (FUE) has some advantages over classical strip harvesting but is limited by a high rate of transection, researchers report in the November issue of Dermatologic Surgery.

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FDA Approves Generic Ondansetron for Injection

MONDAY, Nov. 27 (HealthDay News) -- The U.S. Food and Drug Administration has approved two generic injected forms of the drug Zofran (ondansetron) to be used for the prevention of nausea and vomiting after chemotherapy or surgery.

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Pigmented Basal Cell Carcinomas Studied

FRIDAY, Nov. 24 (HealthDay News) -- For complete tumor resection, pigmented basal cell carcinomas (PBCC) require a smaller surgical margin than non-pigmented basal cell carcinomas (NPBCC), according to the results of a study published in the November issue of Dermatologic Surgery.

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Silicone Breast Implants Have Low Rupture Rate in Study

THURSDAY, Nov. 23 (HealthDay News) -- The Style 410 silicone breast implants introduced in 1993 are safe with a low rate of rupture, and most women receiving the implants report being satisfied, researchers report in the November issue of Plastic and Reconstructive Surgery.

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Colorectal Cancer Surgery Quality Indicators Studied

THURSDAY, Nov. 23 (HealthDay News) -- Newly identified process-based quality indicators may improve care for patients undergoing surgery for colorectal cancer, according to a report published in the Nov.15 issue of the Journal of the National Cancer Institute.

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Bivalirudin Monotherapy Benefits Cardiac Patients

WEDNESDAY, Nov. 22 (HealthDay News) -- In patients with moderate- or high-risk acute coronary syndromes, treatment with bivalirudin alone is associated with similar rates of ischemia, significantly lower rates of bleeding and an improved net outcome compared to heparin plus glycoprotein IIb/IIIa inhibitors, according to a study in the Nov. 23 issue of the New England Journal of Medicine.

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Tumors Not Usually Found in Mastectomy Scars

WEDNESDAY, Nov. 22 (HealthDay News) -- The routine histologic examination of clinically unsuspected mastectomy scars does not help identify any new or metastatic tumors, researchers report in the November issue of Plastic and Reconstructive Surgery.

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Injections Counter HIV-Associated Facial Wasting

WEDNESDAY, Nov. 22 (HealthDay News) -- In patients with HIV-associated facial wasting, or lipoatrophy, treatment with serial injections of poly-L-lactic acid (PLLA) is safe, effective and well-tolerated, according to the results of a study published in the November issue of Dermatologic Surgery.

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Trial Questions Benefits of Herniated Disc Surgery

TUESDAY, Nov. 21 (HealthDay News) -- The benefits of surgery compared with non-operative treatment for lumbar disc herniation appear to be limited, or at least inconclusive, according to two reports in the Nov. 22/29 issue of the Journal of the American Medical Association.

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Oral Rinse Cuts Nosocomial Infection After Cardiac Surgery

TUESDAY, Nov. 21 (HealthDay News) -- Cardiac surgery patients who undergo chlorhexidine gluconate decontamination of the nasopharynx and oropharynx have lower rates of post-surgery nosocomial infections, including lower respiratory tract and surgical site infections, according to the results of a study published in the Nov. 22/29 issue of the Journal of the American Medical Association.

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Computed Tomography Helps to Design Facial Implants

TUESDAY, Nov. 21 (HealthDay News) -- Facial implants that use high-resolution computed tomography modeling allow surgeons to achieve excellent results during facial reconstruction surgery following trauma, according to a report in the November/December issue of the Archives of Facial Plastic Surgery.

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Parental Leave Policies Vary Across Specialty Boards

TUESDAY, Nov. 21 (HealthDay News) -- Restrictions on how long residents can take parental-leave breaks from training and still qualify for specialty board certification are not uniform, and current policies lack the flexibility working parents need, according to a report in the November issue of the Mayo Clinic Proceedings.

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Residents and Fellows Are Cheapest Way to Staff ICUs

TUESDAY, Nov. 21 (HealthDay News) -- Using non-physician providers to staff intensive care units is less cost-effective than using residents and fellows, according to the results of a study published in the November issue of the Mayo Clinic Proceedings.

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Family, Lifestyle Key Factors in Surgical Career Choice

TUESDAY, Nov. 21 (HealthDay News) -- Although female medical students are more likely than their male counterparts to report that raising a family is a priority, both men and women cite lifestyle and family as important factors in the decision to choose a surgical career, according to a paper in the November issue of Archives of Surgery.

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Single-Dose Antibiotics Effective for Surgery Infection

TUESDAY, Nov. 21 (HealthDay News) -- The risk of surgical site infection can be reduced just as effectively with a single dose of antibiotics prior to surgery as with a 24-hour dosing regimen, according to a study in the November issue of the Archives of Surgery.

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FDA Approves Breast Implants Containing Silicone Gel

FRIDAY, Nov. 17 (HealthDay News) -- The U.S. Food and Drug Administration announced on Friday that it will allow two companies to market silicone gel-filled breast implants for use in women 22 and older who are undergoing breast augmentation or reconstruction. The companies must perform large, post-approval studies following about 40,000 women for 10 years after implant surgery.

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Central Venous O2 Linked to Postop Complications

FRIDAY, Nov. 17 (HealthDay News) -- Low central venous oxygen saturation (ScvO2) during high-risk surgery is linked to postoperative complications, according to a report published Nov. 13 online in the peer-reviewed open access journal Critical Care.

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Chemotherapy Helps After Colon Cancer-Liver Resection

THURSDAY, Nov. 16 (HealthDay News) -- In patients with resected liver metastases from colorectal cancer, even a suboptimal regimen of chemotherapy may provide a significant disease-free survival benefit compared to surgery alone, according to a report in the Nov. 1 issue of the Journal of Clinical Oncology.

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Grip Strength Similar When Preserving Ulnar Bursa

WEDNESDAY, Nov. 15 (HealthDay News) -- Preserving rather than dividing the ulnar bursa within the carpal tunnel during surgery for carpal tunnel syndrome does not affect grip strength or symptoms, researchers report in the November issue of the Journal of Bone & Joint Surgery.

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Paclitaxel-Coated Balloon Catheter Reduces Restenosis

TUESDAY, Nov. 14 (HealthDay News) -- In patients with coronary in-stent restenosis, treatment with paclitaxel-coated balloon catheters may significantly reduce the risk of restenosis, according to a study published online Nov. 13 in the New England Journal of Medicine.

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Unfractionated Heparin May Cause Higher Risk in Women

FRIDAY, Nov. 10 (HealthDay News) -- Women undergoing surgery who are treated with unfractionated heparin have a high incidence of heparin-induced thrombocytopenia, according to a report in the Nov. 1 issue of Blood. The risk from low-molecular-weight heparin is minimal, regardless of treatment setting.

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Deep-Brain Stimulation Studied in Dystonia

WEDNESDAY, Nov. 8 (HealthDay News) -- In patients with primary generalized or segmental dystonia, bilateral pallidal deep-brain stimulation is more effective than sham stimulation, according to a study published in the Nov. 9 issue of the New England Journal of Medicine.

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Kidney Transplant Induction Therapies Compared

WEDNESDAY, Nov. 8 (HealthDay News) -- In patients who receive kidney transplants from deceased donors, induction therapy with antithymocyte globulin reduces the incidence and severity of acute rejection compared to basiliximab, but not the incidence of delayed graft function, according to a report in the Nov. 9 issue of the New England Journal of Medicine.

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Ob/Gyn Residents Report High Rate of Burnout, Depression

WEDNESDAY, Nov. 8 (HealthDay News) -- Although established obstetrician/gynecologists are equally satisfied in academic or private practices, residents report a high rate of burnout and depression, according to two studies in the November issue of the American Journal of Obstetrics & Gynecology.

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Pregnancy Complications Likely After Fibroid Treatment

WEDNESDAY, Nov. 8 (HealthDay News) -- Women who have undergone uterine artery embolization to treat fibroids have a significantly higher risk of delivery by Caesarean section as well as an increase in preterm delivery, postpartum hemorrhage, miscarriage and lower pregnancy rates compared to the general obstetric population, according to study findings published in the November issue of the American Journal of Obstetrics & Gynecology.

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More Procedures after Pneumatic Dilatation for Achalasia

TUESDAY, Nov. 7 (HealthDay News) -- Patients with achalasia treated initially with pneumatic dilatation have a greater risk for a subsequent intervention at one, five and 10 years compared to those who had primary surgical myotomy, according to a report in the Nov. 8 issue of the Journal of the American Medical Association.

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Left Main Coronary Artery Narrowing More Likely in Men

TUESDAY, Nov. 7 (HealthDay News) -- In patients who undergo coronary angiography, men are more likely than women to have left main coronary artery significant stenosis (LMSS) and at a younger age, according to a study in the November issue of the American Journal of Cardiology.

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Transmitting EKG May Cut Door-to-Reperfusion Time

MONDAY, Nov. 6 (HealthDay News) -- If emergency technicians transmit electrocardiographic data to a cardiologist's hand-held device before arrival at the hospital, it may result in a shorter door-to-reperfusion time for patients with ST-segment elevation myocardial infarction (STEMI), according to the results of a pilot study published in the November issue of the American Journal of Cardiology.

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Multiple Organ Failure Causes Most ICU Deaths

FRIDAY, Nov. 3 (HealthDay News) -- Multiple organ failure is responsible for about half of deaths of critically ill patients in the intensive care unit (ICU), while malignant tumor disease and chronic cardiovascular disease were the most frequent causes of death after ICU discharge, according to the results of a study published online Nov. 3 in Critical Care.

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Jehovah's Witnesses Have Same Heart Surgery Outcomes

FRIDAY, Nov. 3 (HealthDay News) -- When blood conservation protocols are used, Jehovah's Witnesses have comparable open cardiac surgery clinical outcomes to those of non-Jehovah's Witnesses, according to research published in the Nov. 1 issue of the American Journal of Cardiology.

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Diabetics Have Significantly More Coronary Restenosis

THURSDAY, Nov. 2 (HealthDay News) -- Diabetics have significantly higher coronary restenosis rates than non-diabetics due to inferior procedural outcomes and increased neointimal cell proliferation, according to a report in the November issue of the American Journal of Cardiology.

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Left Ventricular Assist Device Can Reverse Heart Failure

THURSDAY, Nov. 2 (HealthDay News) -- Many patients with severe heart failure secondary to non-ischemic cardiomyopathy could be treated effectively and see regression of their disease with the use of a left ventricular assist device, according to a report in the Nov. 2 New England Journal of Medicine.

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Commercial HMOs Embrace Pay-for-Performance Programs

WEDNESDAY, Nov. 1 (HealthDay News) -- Pay-for-performance programs are now used by a majority of commercial health maintenance organizations, according to a special report published in the Nov. 2 issue of the New England Journal of Medicine.

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PSA Velocity Predicts Prostate Cancer Outcomes

WEDNESDAY, Nov. 1 (HealthDay News) -- Prostate-specific antigen (PSA) velocity, the rate at which PSA increases or decreases, predicts survival in men who later develop prostate cancer, according to a study published in the Nov. 1 issue of the Journal of the National Cancer Institute.

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Gene Linked to Greater Tolerance of Pain

WEDNESDAY, Nov. 1 (HealthDay News) -- The GTP cyclohydrolase gene, GCH1, is an essential component in neurotransmitter production and may also be a key modulator of pain sensitivity, according to a report in the Oct. 22 advance online edition of Nature Medicine. Individuals carrying particular variants of GCH1 seem to be more tolerant of acute pain.

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