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October 2006 Briefing - Surgery

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

Women's Access to Caesareans Insufficient Around World

TUESDAY, Oct. 31 (HealthDay News) -- Sub-Saharan African women have dangerously poor access to Caesarean sections, while many Latin American women undergo the procedure unnecessarily, researchers report in the Oct. 28 issue of The Lancet.

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Partial Nephrectomy for Cancer May Reveal Benign Lesion

TUESDAY, Oct. 31 (HealthDay News) -- Despite expert radiologic interpretation, about 16 percent of small, solitary renal masses thought to be renal cancer and treated with partial nephrectomy turn out to be benign. Parenchyma-sparing methods should be performed in patients with suspected renal cell carcinoma to prevent undue morbidity, according to a study in the October issue of Urology.

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Hospital Delay Reduces Survival in Primary Angioplasty

MONDAY, Oct. 30 (HealthDay News) -- The survival benefit of angioplasty over clot-busting drugs for ST-elevation myocardial infarction declines with increasing door-to-balloon times and also varies with patient characteristics, according to a study published online Oct. 30 in Circulation: Journal of the American Heart Association.

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Multidetector CT Scan Can Rule Out Acute Coronary Syndrome

MONDAY, Oct. 30 (HealthDay News) -- In patients presenting with acute chest pain, coronary multidetector computed tomography (MDCT) may help rule out acute coronary syndrome and improve the accuracy of triage, according to a study published online Oct. 30 in Circulation: Journal of the American Heart Association.

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Non-Invasive Therapy Studied for Rheumatoid Arthritis

MONDAY, Oct. 30 (HealthDay News) -- A mouse study has shown that transdermal photodynamic therapy may be a promising method for minimally invasive synovectomy in rheumatoid arthritis, according to a report in the October issue of Lasers in Surgery and Medicine.

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Breast Reconstruction Complications Analyzed

MONDAY, Oct. 30 (HealthDay News) -- In women undergoing immediate breast reconstruction, latissimus dorsi myocutaneous flap with or without an implant may represent a compromise between complication risk and a good cosmetic result, researchers report in the October issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

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Tattooing of Nipple-Areola Complex Usually Successful

FRIDAY, Oct. 27 (HealthDay News) -- In women who have undergone mastectomy and breast reconstruction, tattooing the nipple-areola complex is a simple and safe procedure that results in a high patient-satisfaction rate, according to a study published in the October issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

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Aspirin Reduces Platelet Aggregation After Laser Therapy

FRIDAY, Oct. 27 (HealthDay News) -- Treatment of platelet-rich plasma with aspirin can reduce platelet aggregation by 58 percent after high-energy excimer laser treatment, according to a study in animals in the October issue of Lasers in Surgery and Medicine.

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Simple Stenting Best for Coronary Artery Bifurcation

FRIDAY, Oct. 27 (HealthDay News) -- Treating de novo coronary artery bifurcation lesions with sirolimus-eluting stents (SES) produces excellent results, with a simple stenting strategy associated with reduced times for both the procedure and fluoroscopy, according to a report published online Oct. 23 in Circulation: Journal of the American Heart Association.

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Radiation After Breast Reconstruction Ups Capsule Risk

FRIDAY, Oct. 27 (HealthDay News) -- After immediate breast reconstruction, capsule formation is three times more likely in breast cancer patients who undergo radiotherapy, according to the results of a study published in the October issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

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Minorities Seen Less Often at High-Volume Hospitals

TUESDAY, Oct. 24 (HealthDay News) -- Non-whites, Medicaid recipients and the uninsured are less likely to receive treatment at high-volume hospitals in California, which are associated with better outcomes, according to a report in the Oct. 25 issue of the Journal of the American Medical Association.

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Surgical Guidelines Often Ignored in Colorectal Cancer

FRIDAY, Oct. 20 (HealthDay News) -- Most patients with locally advanced colorectal cancer do not received multivisceral resection as recommended by the National Cancer Institute and the American Society of Colon and Rectal Surgeons, according to a study published in the Oct. 18 issue of the Journal of the National Cancer Institute.

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Obesity Boosts Complications of Sleep Apnea Surgery

THURSDAY, Oct. 19 (HealthDay News) -- Patients undergoing surgery to relieve sleep apnea are at higher risk of serious complications if they have other medical conditions, are undergoing concurrent non-nasal procedures, have more severe sleep apnea, or have a high body mass index, according to a study in the October issue of Archives of Otolaryngology--Head and Neck Surgery.

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Postmastectomy Reconstruction Safe for Breast Cancer

THURSDAY, Oct. 19 (HealthDay News) -- Breast cancer patients requiring radiotherapy who undergo reconstructive surgery at the time of mastectomy have no more complications than those who do not have reconstructive surgery, researchers report in the October issue of Plastic and Reconstructive Surgery.

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Dilated Cardiomyopathy More Common in Boys

THURSDAY, Oct. 19 (HealthDay News) -- In patients under age 18, dilated cardiomyopathy is more common in boys than girls and in blacks than whites, and their outcomes are similar to those seen in adults, according to a study in the Oct. 18 issue of the Journal of the American Medical Association.

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Endarterectomy Safer Than Stenting for Carotid Stenosis

WEDNESDAY, Oct. 18 (HealthDay News) -- In patients with 60 percent or greater carotid artery stenosis, endarterectomy has better survival and a lower incidence of stroke in the short term than stenting, according to the results of a randomized trial published in the Oct. 19 issue of the New England Journal of Medicine. The study was halted early due to the clear superiority of endarterectomy.

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Uterine Fibroid Tumor Therapy Costs U.S. Over $2 Billion

WEDNESDAY, Oct. 18 (HealthDay News) -- During the year 2000, the total direct cost to treat uterine fibroid tumors in the United States was $2.1 billion, which was due mostly to the cost of inpatient care for hysterectomy, according to a study published in the October issue of the American Journal of Obstetrics & Gynecology.

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In-Office Treatment Safe for Non-Melanoma Skin Cancer

WEDNESDAY, Oct. 18 (HealthDay News) -- Non-melanoma skin cancer should be managed in an office-based setting because it is more cost-efficient, according to the results of a study published in the October issue of Dermatologic Surgery.

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Breathing Exercises Reduce Pneumonia Risk After Bypass

TUESDAY, Oct. 17 (HealthDay News) -- Patients who are at high risk of pneumonia or other pulmonary complications after coronary artery bypass graft surgery are less likely to experience problems if they undergo preoperative inspiratory muscle training (IMT), according to study results published in the Oct. 18 issue of the Journal of the American Medical Association.

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Donor's Hepatitis C Affects Heart-Transplant Outcome

TUESDAY, Oct. 17 (HealthDay News) -- Short- and long-term survival is significantly lower among heart-transplant patients who receive hearts from donors who were positive for the hepatitis C virus (HCV) than among patients who receive hearts from virus-free donors, according to a report published in the Oct. 18 issue of the Journal of the American Medical Association.

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Part-Time Surgery Training Boosts Interest in Specialty

MONDAY, Oct. 16 (HealthDay News) -- Part-time training in general surgery is appealing to a significant minority of medical students and surgical residents who might not otherwise be interested in pursuing general surgery, according to a report in the October issue of the Archives of Surgery.

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U.S. Hospital Mortality Rates Improve, But Quality Varies

MONDAY, Oct. 16 (HealthDay News) -- Although mortality rates at U.S. hospitals are generally improving, the quality varies widely, with a typical Medicare patient having a 69 percent lower chance of dying in the best hospitals compared with the worst hospitals, according to a report published Oct. 16 by HealthGrades, an independent health care rating group.

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Computer Program Helps Wean Mechanical Ventilation

MONDAY, Oct. 16 (HealthDay News) -- A computer-based weaning program can reduce the time critical patients spend on mechanical ventilation and, in turn, help shorten their stay in the intensive care unit, according to a report in the Oct. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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Nano-Hemostat Solutions Quickly Stop Bleeding

FRIDAY, Oct. 13 (HealthDay News) -- Biodegradable, peptide-containing nano-hemostat solutions stop bleeding in wounded rodents within seconds and could be used to reduce the amount of blood needed during surgery, according to the results of a study published online Oct. 13 in Nanomedicine.

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Race, Sex, Age Impact Level-I Trauma Center Transfers

THURSDAY, Oct. 12 (HealthDay News) -- Even after controlling for injury severity, non-clinical factors such as race, gender, age and insurance status significantly impact a patient's risk for hospital transfer to level-I trauma centers, researchers report in the October issue of the Journal of Bone and Joint Surgery.

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Whites Receive Total Knee Replacements More Often

WEDNESDAY, Oct. 11 (HealthDay News) -- Despite better access to care, high-income Medicare recipients have the same incidence of osteoarthritis as low-income enrollees, according to a report in the October issue of the Journal of Bone and Joint Surgery. However, total knee replacement is substantially less likely among minorities than whites, even after controlling for income.

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FDA Says Company Selling Untested Orthopedic Devices

MONDAY, Oct. 9 (HealthDay News) -- The U.S. Food and Drug Administration is seeking a permanent injunction against Endotec Inc. of Orlando, as well as the company's president, medical director and director of regulatory affairs to halt the illegal distribution of total joint replacement devices.

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Exercise Before Joint Replacement Benefits Patients

WEDNESDAY, Oct. 4 (HealthDay News) -- In patients scheduled to undergo hip or knee replacement, a six-week pre-surgical exercise program can significantly reduce the odds of discharge to an inpatient rehabilitation facility, according to study findings released online in advance of publication in the Oct. 15 issue of Arthritis Care & Research.

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Polypropylene Mesh Prevents Hernia After Bariatric Surgery

MONDAY, Oct. 2 (HealthDay News) -- The prophylactic placement of a polypropylene mesh patch during gastric bypass has shown encouraging results in terms of preventing hernia, which can occur in 25 percent of patients, according to a report in the October issue of the British Journal of Surgery.

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Patient's Attitude Predicts Time to Joint Arthroplasty

MONDAY, Oct. 2 (HealthDay News) -- A patient's willingness to consider total joint arthroplasty for treatment of osteoarthritis is the strongest predictor of the time to first procedure, according to a report in the October issue of Arthritis & Rheumatism.

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