September 2007 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for September 2007. 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.

Botox Before Chemabrasion Reduces Wrinkle Severity

FRIDAY, Sept. 28 (HealthDay News) -- Injections of botulinum toxin type A before chemabrasion reduces the severity of vertical wrinkles in the upper lip region after as little as 90 days, researchers report in the September issue of Dermatologic Surgery.

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Variable Results for Web Sites Comparing Hospital Quality

THURSDAY, Sept. 27 (HealthDay News) -- Web sites comparing the quality of surgery at hospitals often give inconsistent results and use suboptimal measures of quality, researchers report in the September issue of Archives of Surgery.

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Role of Post-Prostatectomy Radiation Clarified

THURSDAY, Sept. 27 (HealthDay News) -- Immediate postoperative radiotherapy following prostatectomy appears beneficial in improving disease-free survival in patients with positive, but not negative, surgical margins, according to study findings published in the Sept. 20 issue of the Journal of Clinical Oncology.

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Post-Heart Attack Cardiac Rehabilitation Underused

THURSDAY, Sept. 27 (HealthDay News) -- Older patients are missing out on cardiac rehabilitation, despite the fact that it has been proven to prolong survival and reduce disability, according to a report published online Sept. 24 in Circulation: Journal of the American Heart Association.

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Antibodies Increase Risk of Kidney Transplant Rejection

WEDNESDAY, Sept. 26 (HealthDay News) -- The presence of antibodies against a particular surface antigen increases the likelihood of kidney transplant rejection, even when the patient and kidney are well matched, researchers report in the Sept. 27 issue of the New England Journal of Medicine.

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Operative Delivery Techniques Offer Varying Success Rates

WEDNESDAY, Sept. 26 (HealthDay News) -- Cases of operative vaginal delivery that utilize vacuum extraction are more likely to fail than those using forceps, and in most instances of failed vacuum extraction, the practitioner then attempts a forceps delivery, according to research presented in the September issue of the American Journal of Obstetrics & Gynecology.

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Norepinephrine May Improve Survival in Hemorrhagic Shock

WEDNESDAY, Sept. 26 (HealthDay News) -- In the treatment of trauma victims with uncontrolled bleeding and shock, early-phase fluid resuscitation plus norepinephrine may offer a new strategy for improving the odds of survival, according to the results of an animal study published in the October issue of Anesthesiology.

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Prompt Replacement May Work in Some Implant Infections

TUESDAY, Sept. 25 (HealthDay News) -- The traditional approach to breast infections following implant surgery entails removing the implant and waiting until the infection clears to replace it. However, surgical exchange of the implant without delay may be appropriate in some patients who have had breast reconstruction following mastectomy, according to a presentation of cases in the Sept. 1 issue of Plastic and Reconstructive Surgery.

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Familiar Doctor Linked to More Satisfaction for Urgent Care

TUESDAY, Sept. 25 (HealthDay News) -- Patients who receive urgent medical care from family physicians or after-hours clinics affiliated with their physicians are more likely to be satisfied with the encounter than patients who use other sources of urgent care, according to research published in the September/October issue of the Annals of Family Medicine.

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Medications, Diet May Help Prevent Prostate Cancer

MONDAY, Sept. 24 (HealthDay News) -- During the past 15 years, prostate cancer prevention has become a major area of scientific and clinical investigation, and ongoing studies may soon identify effective chemoprevention strategies, according to a report published online Sept. 24 in the journal Cancer.

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Risk of Stroke May Be Due to Childhood Residence

MONDAY, Sept. 24 (HealthDay News) -- People who grew up in the group of seven southern states known as the "Stroke Belt" or who live there as adults are at greater risk of stroke than people elsewhere in the United States, according to a report in the September issue of Stroke.

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Resection Eradicates Genetic Abnormalities in Barrett's

MONDAY, Sept. 24 (HealthDay News) -- Stepwise radical endoscopic resection of the Barrett's segment with early neoplasia eliminates pre-existing genetic abnormalities, according to a report published in the September issue of the American Journal of Gastroenterology.

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Minimally Invasive Valve Surgery Beneficial to Patients

FRIDAY, Sept. 21 (HealthDay News) -- In patients who have undergone previous cardiac surgery, minimally invasive, video-assisted keyhole valve surgery is associated with high patient satisfaction and lower mortality than open-chest valve surgery, according to study findings published in a cardiovascular surgery supplement to the Sept. 4 issue of Circulation: Journal of the American Heart Association.

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Gene Predicts Worse Outcome Post-Transplant in Leukemia

FRIDAY, Sept. 21 (HealthDay News) -- Patients with acute leukemia treated with hematopoietic stem cell transplant (HSCT) from an unrelated donor may be more likely to have a relapse and die if they have certain variants of the NOD2/CARD15 gene, which is involved in inflammation, according to a report in the Sept. 20 issue of the Journal of Clinical Oncology.

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Current Risk Estimates for Face Transplant Inaccurate

FRIDAY, Sept. 21 (HealthDay News) -- Previous estimates of the immunologic risks of facial transplantation, which have influenced a number of major organizations' positions on the procedure, are based on factors deemed irrelevant to facial transplantation, researchers report in the Sept. 1 issue of Plastic and Reconstructive Surgery.

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Silicone Implants Do Not Lead to Paraproteinemias

FRIDAY, Sept. 21 (HealthDay News) -- Women with silicone implants who subsequently developed connective-tissue disease do not appear to be at increased risk for paraproteinemias, according to study findings published in Arthritis Research & Therapy in September.

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Skin Cooling Linked to Post-Laser Treatment Discoloration

FRIDAY, Sept. 21 (HealthDay News) -- In patients with acquired bilateral nevus of Ota-like macules, laser treatment accompanied by cold-air cooling may increase the risk of post-inflammatory hyperpigmentation, according to a report published in the September issue of the Archives of Dermatology.

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Surgery Beats Photodynamic Therapy for Basal Carcinoma

THURSDAY, Sept. 20 (HealthDay News) -- Although excision surgery for primary nodular basal cell carcinoma is associated with a lower recurrence than treatment with topical methyl aminolevulinate photodynamic therapy (PDT), the latter method offers benefits that make it more suitable in certain cases, according to the results of a randomized, prospective trial published in the September issue of the Archives of Dermatology.

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Intracapsular Tonsillectomy Linked to Fewer Complications

THURSDAY, Sept. 20 (HealthDay News) -- The incidence of post-operative complications, such as severe bleeding and pain, is significantly lower with intracapsular tonsillectomy than with traditional tonsillectomy, according to the results of a study published in the September issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Adolescent Girls More Likely to Survive Traumatic Injury

THURSDAY, Sept. 20 (HealthDay News) -- Adolescent girls who experience severe trauma are more than twice as likely to survive as adolescent boys subjected to equivalent trauma, according to a report published in the September issue of the Archives of Surgery.

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FDA Approves Rapid Test for Platelet Contamination

THURSDAY, Sept. 20 (HealthDay News) -- The U.S. Food and Drug Administration has approved a disposable test strip that can be used in hospitals to detect bacterial contamination of blood platelets prior to transfusions. The Platelet Pan Genera Detection Test System is made by Verax Biomedica Inc. of Worcester, Mass., and can be used to retest platelets shortly before use.

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Urethral Strictures Associated with Early Urinary Retention

WEDNESDAY, Sept. 19 (HealthDay News) -- Men who develop early urinary retention after radical prostatectomy are more likely to develop a symptomatic urethral stricture, according to a prospective database report published in the August issue of Urology.

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Cost of Physiotherapy Interventions Compared

WEDNESDAY, Sept. 19 (HealthDay News) -- A treatment for back and neck pain that utilizes traditional physical therapy appears to be more cost-effective than a newer approach based on cognitive-behavioral principles, according to research published in the September issue of Rheumatology.

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Lidocaine-Tetracaine Peel Useful in Range of Procedures

WEDNESDAY, Sept. 19 (HealthDay News) -- A blend of lidocaine and tetracaine -- called the LT peel -- offers many benefits when used before a variety of dermatological procedures, according to a paper published in the September issue of Dermatologic Surgery.

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Medical Schools Vary in Approach to Case Reports

WEDNESDAY, Sept. 19 (HealthDay News) -- Most medical school institutional review boards (IRBs) don't treat individual case reports as "research," as it's defined by the United States Government Code of Federal Regulations, according to a research letter published in the Sept. 19 issue of the Journal of the American Medical Association.

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Survival on Heart Transplant List Improved Since 1990

TUESDAY, Sept. 18 (HealthDay News) -- The survival of patients listed for heart transplantation has significantly improved since 1990, with the greatest benefit for those at greatest risk of death, according to a study published in the Sept. 25 issue of the Journal of the American College of Cardiology.

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Excellent Long-Term Outcomes for Testis-Sparing Surgery

TUESDAY, Sept. 18 (HealthDay News) -- Testis-sparing surgery for Leydig cell tumors results in an excellent long-term outcome in terms of survival, according to a report in the September issue of the Journal of Urology.

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FDA Approves Panel of Blood-Typing Tests

TUESDAY, Sept. 18 (HealthDay News) -- The U.S. Food and Drug Administration has approved 15 blood-typing reagents for use in analyzing donor blood. The new reagents, including several for rare blood types, had not previously been licensed for use in the United States.

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Congenital Heart Defect Boosts Mortality Risk Later On

TUESDAY, Sept. 18 (HealthDay News) -- Children who undergo surgery for congenital heart defect have a higher risk of death due to cardiac and non-cardiac causes later in life than their peers who have not had a congenital heart defect, according to study findings published online Sept. 9 in the Journal of the American College of Cardiology.

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Nasal Surgery Feminizes Transsexuals' Facial Profiles

MONDAY, Sept. 17 (HealthDay News) -- In male-to-female transsexuals, nasal feminization surgery may play an important role in the gender reassignment process, researchers report in the September/October issue of the Archives of Facial Plastic Surgery.

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Woman's Gallbladder Removed Through Vagina

MONDAY, Sept. 17 (HealthDay News) -- A team of surgeons has removed a woman's gallbladder through her vagina, with a quick recovery and no pain or scars, according to a case report published in the September issue of the Archives of Surgery.

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Heart-Patient Discharge Protocol Adherence Faulted

MONDAY, Sept. 17 (HealthDay News) -- Improved adherence to the American Heart Association's Get With the Guidelines discharge protocols could help prevent secondary cardiovascular events in patients who are hospitalized for heart disease, especially those who undergo coronary artery bypass graft surgery, according to a study published in a supplement to the Sept. 4 issue of Circulation: Journal of the American Heart Association.

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Acupuncture Eases Pain for Those Waiting for Arthroplasty

MONDAY, Sept. 17 (HealthDay News) -- Acupuncture can offer acute knee pain patients awaiting knee replacement surgery temporary relief from pain and mobility problems, according to the findings of a randomized trial published in the September issue of Rheumatology.

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Off-Pump Bypass Surgery Improves Women's Survival

FRIDAY, Sept. 14 (HealthDay News) -- Women who undergo off-pump coronary artery bypass graft surgery are less likely to die or suffer strokes or heart attacks than women who undergo conventional on-pump surgery, and more likely to achieve outcomes comparable to those of male bypass patients, according to study findings published online Sept. 11 in a cardiovascular surgery supplement to Circulation: Journal of the American Heart Association.

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Dabigatran Etexilate Reduces Hip Surgery Blood Clot Risk

FRIDAY, Sept. 14 (HealthDay News) -- Oral dabigatran etexilate reduces the risk of venous thromboembolism after hip replacement surgery just as effectively as subcutaneous enoxaparin, according to a report published in the Sept. 15 issue of The Lancet.

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Higher Serum Calcium Linked to Smaller Infarct Volumes

WEDNESDAY, Sept. 12 (HealthDay News) -- In patients with acute ischemic stroke, those with the highest serum calcium levels had the smallest infarct volume, according to a report published in the September issue of the Archives of Neurology.

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Hip Synovectomy Helps Young Rheumatoid Arthritis Patients

TUESDAY, Sept. 11 (HealthDay News) -- Open hip-joint synovectomy is safe for juvenile rheumatoid arthritis patients and often benefits hip mobility up to five years after surgery, according to a report in the September issue of the Journal of Bone & Joint Surgery.

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Intestinal S. aureas Can Contaminate Hospital Surfaces

TUESDAY, Sept. 11 (HealthDay News) -- When hospitalized patients have Staphylococcus aureus in their stool and nostrils there is an increased risk of contamination of surrounding surfaces as well as their skin, according to a study published online Sept. 11 in BMC Infectious Diseases.

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Insulin-Producing Cells Can Regenerate in Mice

MONDAY, Sept. 10 (HealthDay News) -- A new mouse model of diabetes suggests that insulin-producing pancreatic cells have the capacity to regenerate and reverse diabetes, and immunosuppressants used in human islet transplantation may block this regeneration, according to research published in the September issue of the Journal of Clinical Investigation.

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Scars Affect Patients' Views of Skin Cancer Surgery

MONDAY, Sept. 10 (HealthDay News) -- Patients' feelings about their scars significantly influence their long-term satisfaction with skin cancer surgery, Australian researchers report in the September issue of the Journal of the American Academy of Dermatology.

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Attitude May Help Outcome in Rotator Cuff Surgery

MONDAY, Sept. 10 (HealthDay News) -- High patient expectations prior to surgery for chronic rotator cuff injuries are associated with better overall outcomes and performance, according to a report in the September issue of the Journal of Bone & Joint Surgery.

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Kneeling Increases Leg Pressure During Spinal Surgery

MONDAY, Sept. 10 (HealthDay News) -- The kneeling position adopted during spinal surgery increases intramuscular pressure in the anterior compartment of the leg, which may increase the risk of acute compartment syndrome, researchers report in the September issue of the Journal of Bone & Joint Surgery.

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Ultraviolet Light Reduces Infection Risk After Surgery

THURSDAY, Sept. 6 (HealthDay News) -- Ultraviolet light during surgery can reduce the risk of infection after joint replacement more so than laminar airflow, although appropriate safety precautions are needed, including protective eye-shields and clothing. The findings are published in the September issue of the Journal of Bone & Joint Surgery.

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Implants Can Be Safely Removed After Fractures Heal

THURSDAY, Sept. 6 (HealthDay News) -- Many orthopaedic implant patients with lingering pain after a fracture heals can safely have the implant removed to reduce pain and improve mobility, researchers report in the September issue of the Journal of Bone & Joint Surgery.

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Newer Cell Phones Still Interrupt Medical Equipment

THURSDAY, Sept. 6 (HealthDay News) -- New-generation mobile phones should still be kept at least one meter away from hospital equipment, as they can cause electromagnetic interference with critical care devices, according to a report published online Sept. 6 in Critical Care.

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Procrit Does Not Reduce Need for Transfusion in Critically Ill

WEDNESDAY, Sept. 5 (HealthDay News) -- Procrit (epoetin alfa) does not reduce the need for a blood transfusion in patients in the intensive care unit, although it may lower mortality in trauma patients and increase hemoglobin concentration and thrombotic events, according to the results of a trial published in the Sept. 6 issue of the New England Journal of Medicine.

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Resident Work-Hour Limits May Have Improved Mortality

TUESDAY, Sept. 4 (HealthDay News) -- Resident work-hour reform, implemented by the Accreditation Council for Graduate Medical Education in 2003, does not appear to have had a negative effect on patient outcomes and may actually have improved mortality rates, according to two studies published in the Sept. 5 issue of the Journal of the American Medical Association.

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Poor Bedside Manner Linked to Patient Complaints

TUESDAY, Sept. 4 (HealthDay News) -- Physicians with the lowest patient communication scores on a national clinical skills exam are more likely to have a patient complain to regulatory authorities than physicians with high scores, according to study findings published in the Sept. 5 issue of the Journal of the American Medical Association.

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Physician's Briefing