Here are what the editors at HealthDay consider to be the most important developments in Surgery for September 2009. 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.
Post-Surgery Complications, Mortality in Hospitals Analyzed
WEDNESDAY, Sept. 30 (HealthDay News) -- While post-surgery complication rates were similar across hospitals, the death rate for hospitals in the quintile with the highest complication-related mortality were nearly twice that of the lowest quintile, according to a study in the Oct. 1 issue of the New England Journal of Medicine.
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Efficacy of Treatments for Overactive Bladder Examined
WEDNESDAY, Sept. 30 (HealthDay News) -- Sacral nerve stimulation and botulinum toxin are effective treatments for overactive bladder, according to two studies in the October issue of the Journal of Urology.
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Bacterial Infections Are a Factor in Many H1N1 Deaths
WEDNESDAY, Sept. 30 (HealthDay News) -- Many patients who have died of H1N1 influenza this year had a bacterial co-infection that likely contributed to their deaths, according to a Sept. 29 early release of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
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Bladder Cancer Surgery Delay Linked to Poorer Survival
WEDNESDAY, Sept. 30 (HealthDay News) -- In patients with bladder cancer, less delay between transurethral tumor resection and cystectomy may improve the chances of survival, particularly in those with lower stage disease, according to research published in the October issue of the Journal of Urology.
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Prognostic Tool May Benefit GI Cancer Patients
TUESDAY, Sept. 29 (HealthDay News) -- In patients who undergo surgery to remove primary gastrointestinal stromal tumors, a new computer-based tool called a nomogram accurately predicts the risk of cancer recurrence and may help clinicians determine which patients are candidates for adjuvant imatinib therapy, according to a study published online Sept. 29 in The Lancet Oncology.
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Exertional Illnesses Linked to Anesthesia Complication
TUESDAY, Sept. 29 (HealthDay News) -- Possible links exist between heat- and exercise-related illnesses that strike even the physically fit and a feared complication of anesthesia, according to a review in the October issue of Anesthesia & Analgesia.
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Study Examines Effects of In Utero Heart Procedure
TUESDAY, Sept. 29 (HealthDay News) -- Successful fetal aortic valvuloplasty may lead to better growth of the aortic and mitral valves and the ascending aorta without change in left ventricular growth rate, according to research published online Sept. 28 in Circulation.
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Spinal Opioid Infusion Deemed Probable Cause of Deaths
TUESDAY, Sept. 29 (HealthDay News) -- An investigation into a cluster of deaths in patients being treated for non-cancer pain with intrathecal opioid pumps found that the pain relief therapy was the probable cause of death, according to a report in the October issue of Anesthesiology.
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Ultrasound Found Inadequate for Lymph Node Biopsy
TUESDAY, Sept. 29 (HealthDay News) -- Ultrasound scanners currently do not have sufficient resolution to biopsy sentinel lymph nodes (SLN) for evidence of cancer metastasis and cannot replace conventional SLN biopsy, according to a study published online Sept. 28 in the Journal of Clinical Oncology.
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Prophylactic Mastectomy Rare Among High-Risk Women
MONDAY, Sept. 28 (HealthDay News) -- It is relatively uncommon for women at high risk for breast cancer, but without diagnosed disease, to opt for prophylactic mastectomy, but women diagnosed with breast cancer are increasingly likely to undergo contralateral mastectomy, according to a study published online Sept. 28 in Cancer.
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H1N1 Virus's Genetic Makeup Appears to Be Staying Stable
MONDAY, Sept. 28 (HealthDay News) -- The genetic makeup of the H1N1 flu has remained stable, which means the yet-to-be-released vaccine is likely to be a good match for the virus, the U.S. Centers for Disease Control and Prevention announced at a Sept. 25 media briefing.
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Surgery May Be Better Than Other Carpal Tunnel Therapies
FRIDAY, Sept. 25 (HealthDay News) -- Surgery for carpal tunnel syndrome produced better outcomes than non-surgical therapies, but the clinical advantage was modest, according to a study in the Sept. 26 issue of The Lancet.
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Drain Can Reduce Hematoma Recurrence and Mortality
FRIDAY, Sept. 25 (HealthDay News) -- Placement of a soft silicon drain tube during the surgical procedure to drain a chronic subdural hematoma reduces both recurrence of the brain hematoma and mortality, according to a study in the Sept. 26 issue of The Lancet.
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New Paradigm for Progress in Surgery Proposed
FRIDAY, Sept. 25 (HealthDay News) -- In a series of articles in the Sept. 26 issue of The Lancet, a cohort of surgical-thought leaders proposes a new paradigm for innovation, research, and evidence-based advancement in the field of surgery.
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Live Birth Has Little Effect on Kidney Transplant Recipients
FRIDAY, Sept. 25 (HealthDay News) -- In women with a functioning kidney transplant, a live birth has no significant effect on either graft or patient survival, according to a study published online Sept. 24 in the Journal of the American Society of Nephrology.
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Maternal Bariatric Surgery Tied to Less Offspring Obesity
THURSDAY, Sept. 24 (HealthDay News) -- Bariatric surgery in women before pregnancy helps reduce the risk of childhood obesity and improve cardio-metabolic markers in their offspring by improving the intrauterine environment, according to a study in the October issue of Endocrinology.
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Procedure Compares Well for Sleep Apnea Treatment
THURSDAY, Sept. 24 (HealthDay News) -- Multilevel radiofrequency tissue volume reduction may offer similar improvements in sleep apnea-related symptoms compared to nasal continuous positive airway pressure (CPAP), according to research published in the September issue of the Archives of Otolaryngology -- Head & Neck Surgery.
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Alcohol Found to Lessen Risk for Enlarged Prostate
THURSDAY, Sept. 24 (HealthDay News) -- A man's risk of developing benign prostatic hyperplasia (BHP) decreases as his consumption of alcohol increases, but not the risk of lower urinary tract symptoms (LUTS), according to a meta-analysis reported in the October issue of the Journal of Urology.
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Review Advises Hand Washing, Other Antiviral Measures
WEDNESDAY, Sept. 23 (HealthDay News) -- Hand washing, wearing a mask, and isolating potential cases are all effective in interrupting the spread of viral respiratory infections and should be given greater attention when planning for widespread outbreaks, according to research published Sept. 22 in BMJ.
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Surgeries Offering Relief for Excessive Drooling Analyzed
WEDNESDAY, Sept. 23 (HealthDay News) -- Most patients with drooling will report improvement in symptoms following surgical treatment, according to research published in the September issue of the Archives of Otolaryngology -- Head & Neck Surgery.
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Rhinoplasty Patients Typically Want the 'Ideal Nose'
WEDNESDAY, Sept. 23 (HealthDay News) -- Rhinoplasty patients typically want results in line with the ideal parameters established by Powell and Humphreys, a common reference for the procedure, and computer imaging can help define patients' preferences, according to a study published in the September/October issue of the Archives of Facial Plastic Surgery.
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Simplified System Reduces Overtriage in Trauma Patients
WEDNESDAY, Sept. 23 (HealthDay News) -- A simplified triage system based on only four variables considerably reduces the overtriage rate with an acceptable undertriage rate in trauma patients, according to a study in the September issue of the Archives of Surgery.
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Spotlight on Social Networking Use Among Medical Students
TUESDAY, Sept. 22 (HealthDay News) -- A majority of medical schools report instances of medical students posting unprofessional content on social networking Web sites, including some instances of violations of patient confidentiality, according to a report in the Sept. 23/30 issue of the Journal of the American Medical Association.
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Physician Medical Errors Linked to Fatigue and Burnout
TUESDAY, Sept. 22 (HealthDay News) -- The incidence of medical error is associated with a host of factors related to physician fatigue, burnout, and mental and emotional well-being, according to a study in the Sept. 23/30 issue of the Journal of the American Medical Association.
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Inflammation Linked to Peripheral Atherosclerosis
TUESDAY, Sept. 22 (HealthDay News) -- Inflammatory markers are consistently associated with lower extremity peripheral arterial disease (PAD) and particular outcomes, but are not necessarily causally associated; and, although genetics may play an important role, no genetic marker has been associated with the disease, according to a review in the Sept. 29 issue of the Journal of the American College of Cardiology.
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Alcohol Linked to Decreased Mortality After Head Injury
TUESDAY, Sept. 22 (HealthDay News) -- Patients with traumatic brain injuries who test positive for alcohol are less likely to die but more likely to have complications than patients who test negative, according to a study in the September issue of Archives of Surgery.
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Acid Reflux Surgery Unaffected by Delayed Gastric Emptying
MONDAY, Sept. 21 (HealthDay News) -- Delayed gastric emptying (DGE) does not affect control and relief of acid reflux in patients with gastroesophageal reflux disease who undergo Nissen fundoplication, although patients with DGE still have more dyspeptic symptoms, according to a study in the September issue of the Archives of Surgery.
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Scoliosis Surgery Linked to Good Long-Term Outcomes
MONDAY, Sept. 21 (HealthDay News) -- In the long term, patients who receive surgical treatment for scoliosis are no more likely to develop low back pain or have an impaired quality of life than the general population, according to two studies in the Sept. 15 issue of Spine.
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Pain Linked to Functional Decline in Middle-Aged Adults
MONDAY, Sept. 21 (HealthDay News) -- In middle-aged adults, pain is associated with an accelerated decline in physical function, with mobility limitations similar to those decades older without pain, according to a study in the September issue of the Journal of the American Geriatrics Society.
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Patients' Mistrust Affects Use of Breast Cancer Treatments
MONDAY, Sept. 21 (HealthDay News) -- Women's negative attitudes toward treatment and mistrust of the medical delivery system are associated with underuse of adjuvant treatment for early-stage breast cancer, according to a study published online Sept. 21 in the Journal of Clinical Oncology.
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Low Scoliosis Revision Surgery Rate Seen at Center
FRIDAY, Sept. 18 (HealthDay News) -- In patients with idiopathic scoliosis who undergo primary fusion surgery, reoperation rates may vary greatly between institutions, according to a study in the Sept. 15 issue of Spine.
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Hispanics Show Lower Artery Bypass Rate After PCI
FRIDAY, Sept. 18 (HealthDay News) -- Despite having a higher cardiovascular risk profile than Caucasians, Hispanics are less likely to have coronary artery bypass graft (CABG) surgery in the year after percutaneous coronary intervention (PCI), according to research published in the Sept. 15 issue of the American Journal of Cardiology.
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Mediterranean Diet More Costly to Follow Than Western
FRIDAY, Sept. 18 (HealthDay News) -- Spanish university graduates who tended to follow a Mediterranean diet spent more money for their food than those following a western diet, according to a study published online Sept. 17 in the Journal of Epidemiology and Community Health.
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Weight Loss Associated With Benefits in Kidney Disease
FRIDAY, Sept. 18 (HealthDay News) -- Weight loss in patients with chronic kidney disease (CKD) and glomerular hyperfiltration -- either through surgical or non-surgical approaches -- may be associated with improvements in proteinuria and normalization of glomerular filtration rate, according to research published online Sept. 17 in the Clinical Journal of the American Society of Nephrology.
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Gastric Bypass Patients Need Modified Nursing Care
THURSDAY, Sept. 17 (HealthDay News) -- Emergency department nurses treating patients who have previously undergone gastric bypass surgery need to adapt their routine methods of care to treat such patients safely, according to an article published in the September issue of the Journal of Emergency Nursing.
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Operative Treatment of Benefit to Older Scoliosis Patients
THURSDAY, Sept. 17 (HealthDay News) -- In middle-aged and older patients with scoliosis, operative treatment may be associated with a significantly improved quality of life compared to non-operative treatment, according to two studies published in the Sept. 15 issue of Spine.
Abstract - Li
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Abstract - Bridwell
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Spinal Treatment May Not Improve Neurologic Recovery
THURSDAY, Sept. 17 (HealthDay News) -- Treatment with high-dose methylprednisolone sodium succinate (MPSS) does not improve neurologic recovery in patients who have suffered acute spinal cord injury and increases the risk of pneumonia as a complication, according to a study in the Sept. 15 issue of Spine.
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Post-Op Esophageal Bleeding Not Linked to Coagulation
THURSDAY, Sept. 17 (HealthDay News) -- Bleeding from ulceration after elective esophageal varices band ligation (EVL) does not appear to be associated with abnormal blood coagulation, according to a study in the September issue of Clinical Gastroenterology and Hepatology.
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Taxes on Sugared Sodas Could Cut Consumption
WEDNESDAY, Sept. 16 (HealthDay News) -- Imposing a tax on sugar-sweetened beverages could reduce consumption and generate income for obesity reduction and healthy eating education interventions, according to an article published online Sept. 16 in the New England Journal of Medicine.
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Exercise, Shockwave Therapy Compared for Shoulder Pain
WEDNESDAY, Sept. 16 (HealthDay News) -- For patients with subacromial shoulder pain, supervised exercise improves shoulder mobility and lessens pain better than extracorporeal shockwave treatment, according to a study published online Sept. 15 in BMJ.
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FDA Approves Four Vaccines for H1N1 Influenza
TUESDAY, Sept. 15 (HealthDay News) -- The U.S. Food and Drug Administration has approved four H1N1 influenza vaccines, according to a Sept. 15 news release issued by the agency.
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Conservative Management in Prostate Cancer Feasible
TUESDAY, Sept. 15 (HealthDay News) -- In older men with localized prostate cancer, conservative management is associated with significantly improved 10-year outcomes compared to earlier eras, according to a study published in the Sept. 16 issue of the Journal of the American Medical Association.
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Drug Interaction E-Alerts Show Benefit to Patient Safety
MONDAY, Sept. 14 (HealthDay News) -- Drug interaction alerts from electronic prescribing likely improve patient safety and reduce costs in outpatient care, despite the fact that over 90 percent of the alerts are overridden by physicians, according to a study in the Sept. 14 issue of Archives of Internal Medicine.
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FDA Clears Test to Help Detect Ovarian Cancer
MONDAY, Sept. 14 (HealthDay News) -- On Sept. 11, the U.S. Food and Drug Administration cleared OVA1, a test that helps detect ovarian cancer in women with pelvic masses requiring surgery. OVA1 was developed by Vermillion Inc., headquartered in Fremont, Calif., in conjunction with researchers at Johns Hopkins University in Baltimore.
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Perineural Invasion Points to Colorectal Cancer Outcomes
FRIDAY, Sept. 11 (HealthDay News) -- Perineural invasion (PNI) is often not included in pathology reports for colorectal cancer, but it may serve as a predictor of outcomes in these cases, according to research published online Sept. 8 in the Journal of Clinical Oncology.
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Mutated H1N1 Virus Resistant to Antiviral Drug Oseltamivir
FRIDAY, Sept. 11 (HealthDay News) -- The discovery of H1N1 mutations resistant to the neuraminidase inhibitor oseltamivir in two adolescent girls sharing a cabin at a North Carolina camp prompted a new recommendation from the U.S. Centers for Disease Control and Prevention on the proper prophylactic use of antiviral drugs, according to a case report in the Sept. 11 issue of the CDC's Morbidity and Mortality Weekly Report.
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Poverty-Mortality Association Unchanged in England
FRIDAY, Sept. 11 (HealthDay News) -- Despite myriad medical, public health, social, economic and political changes, the association between poverty and mortality in England and Wales is as strong today as it was at the start of the 20th century, according to a study published online Sept. 10 in BMJ.
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Satisfaction High Among Hip Replacement Patients
THURSDAY, Sept. 10 (HealthDay News) -- Four years after total hip arthroplasty, most patients report that their preoperative expectations were either completely or somewhat fulfilled, according to a study published in the Sept. 1 issue of the Journal of Bone & Joint Surgery.
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Compensation Status Doesn't Delay Canadians' Back Surgery
WEDNESDAY, Sept. 9 (HealthDay News) -- In Canadian patients with sciatica from a herniated lumbar disc, compensation status has no effect on waiting times for elective surgical lumbar discectomy, according to a study published in the Sept. 1 issue of Spine.
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In-Hospital Pediatric Diagnosis of VTE Up 70 Percent
WEDNESDAY, Sept. 9 (HealthDay News) -- Yearly pediatric hospital cases of venous thromboembolism (VTE) have risen 70 percent in this decade, with many children having coexisting chronic conditions, according to a study published online Sept. 7 in Pediatrics.
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Spinal Nerve Infiltration Has Potential in Low Back Pain
WEDNESDAY, Sept. 9 (HealthDay News) -- In patients with low back pain and radicular pain, an L2 spinal nerve infiltration may temporarily reduce symptoms, according to a study in the Sept. 1 issue of Spine.
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Pretreating Kidney Donors Helps Post-Transplant Function
TUESDAY, Sept. 8 (HealthDay News) -- Administering dopamine to brain-dead kidney donors can significantly improve post-transplant organ function, resulting in the need for less dialysis, according to a study in the Sept. 9 issue of the Journal of the American Medical Association.
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Costs Escalating for Patients With Spine Problems
TUESDAY, Sept. 8 (HealthDay News) -- Since 1997, national expenditures for spine conditions have dramatically increased, while self-reported mental and physical health and activity limitations in spine patients have significantly worsened, according to a study in the Sept. 1 issue of Spine.
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Corneal Transplant Method Appears Safe and Effective
TUESDAY, Sept. 8 (HealthDay News) -- A form of corneal transplantation to treat eye conditions characterized by corneal endothelial dysfunction is safe and effective, according to a review in the September issue of Ophthalmology.
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Time-of-Day, Staffing Affect Orthopedic Surgery Outcomes
MONDAY, Sept. 7 (HealthDay News) -- The time of day orthopedic surgery is performed and the number of residents available to assist in subsequent patient care can both impact medical outcomes, according to studies in the Sept. 1 Journal of Bone & Joint Surgery.
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Joint-Preserving Treatment Can Delay Hip Replacement
FRIDAY, Sept. 4 (HealthDay News) -- Periacetabular osteotomy, or reorienting a shallow hip socket to better engage the head of the femur, can preserve hip-joint function and avoid a full hip replacement for years, according to a study in the Sept. 1 Journal of Bone & Joint Surgery.
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Prostate Cancer Patients Seek Several Information Sources
FRIDAY, Sept. 4 (HealthDay News) -- Between diagnosis of local stage prostate cancer and treatment, men access an average of five information sources, according to a study published in the September issue of Urology.
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Many Orthopedic Trials Do Not Adhere to Principle for Validity
FRIDAY, Sept. 4 (HealthDay News) -- Many orthopedic randomized clinical trials do not properly follow the intention-to-treat principle, potentially producing bias in trial results and analyses, according to a report in the Sept. 1 Journal of Bone & Joint Surgery.
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Angiography Before Vascular Surgery May Be Beneficial
THURSDAY, Sept. 3 (HealthDay News) -- Routine coronary angiography may improve long-term outcomes in certain patients undergoing surgery for peripheral arterial disease, according to research published in the Sept. 8 issue of the Journal of the American College of Cardiology.
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Race Not Shown to Affect Liver Transplant Outcome
THURSDAY, Sept. 3 (HealthDay News) -- Liver transplant outcomes for patients with hepatitis B are similar regardless of whether the patient is Caucasian, Asian-American or African-American, according to a study in the September issue of Liver Transplantation.
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Endoscopy as Effective as Surgery for Esophageal Cancer
THURSDAY, Sept. 3 (HealthDay News) -- Early-stage esophageal cancer can be removed through an endoscope rather than removing the whole esophagus, with no apparent effect on survival, according to a study in the September issue of Gastroenterology.
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Statin Therapy Before Vascular Surgery Cuts Cardiac Events
WEDNESDAY, Sept. 2 (HealthDay News) -- Administering fluvastatin to patients in advance of vascular surgery can reduce the incidence of adverse cardiac events postoperatively, according to a study in the Sept. 3 issue of the New England Journal of Medicine.
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Collagenase Injections Can Improve Range of Motion
WEDNESDAY, Sept. 2 (HealthDay News) -- Injection of collagenase clostridium histolyticum into the affected hand joints of patients with Dupuytren's disease can reduce joint contracture, improve range of motion, and provide an office-based alternative to risky hand surgery, according to a study in the Sept. 3 issue of the New England Journal of Medicine.
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Safer Transplant Technique Benefits Immunodeficient Kids
WEDNESDAY, Sept. 2 (HealthDay News) -- In children with primary immunodeficiencies who are too sick to undergo traditional stem-cell transplantation, antibody-based minimal-intensity conditioning may minimize toxicities and allow for successful transplantation, according to a study published online Sept. 2 in The Lancet.
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Academic Medical Centers Active and Diverse in Research
TUESDAY, Sept. 1 (HealthDay News) -- Research at academic medical centers is active and diverse, with nearly a quarter of life-science researchers receiving no funding, and relationships with industry more commonly seen among translational and clinical researchers than basic science researchers, according to a study in the Sept. 2 issue of the Journal of the American Medical Association.
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Minimal Pain Reduction After Pelvic Nerve Ablation
TUESDAY, Sept. 1 (HealthDay News) -- Laparoscopic surgery with pelvic nerve ablation does not reduce pain or improve quality of life in women with chronic pelvic pain, according to a study in the Sept. 2 issue of the Journal of the American Medical Association.
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Surgical, Gradual Menopause Effects on Cognition Compared
TUESDAY, Sept. 1 (HealthDay News) -- Natural menopause and surgical menopause might have different effects on cognitive function, according to the results of animal research published in the September issue of Endocrinology.
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Epinephrine Dosage for Anesthetic Overdose Studied
TUESDAY, Sept. 1 (HealthDay News) -- In an experiment on rats whose hearts were stopped by anesthetic overdose, the administration of the hormone epinephrine above a dose threshold was found to counteract lipid-based resuscitation, according to a study in the September issue of Anesthesiology.
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More Problems Seen in Women With Endovascular AAA Repair
TUESDAY, Sept. 1 (HealthDay News) -- Women undergoing endovascular repair of abdominal aortic aneurysms had a higher risk of mortality and morbidity than men, according to research published in the September issue of the Journal of Vascular Surgery.
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