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September 2014 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for September 2014. 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.

American Academy of Neurology Issues Opioid Guidelines

TUESDAY, Sept. 30, 2014 (HealthDay News) -- The risks of opioids outweigh their benefits for treating chronic noncancer pain such as chronic headaches, low back pain, and fibromyalgia, according to a new statement from the American Academy of Neurology (AAN).

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FDA Criticized Over Implanted Medical Device Approval Process

TUESDAY, Sept. 30, 2014 (HealthDay News) -- Patients are receiving medical implants that may not have been rigorously tested before or after their approval by the U.S. Food and Drug Administration, two new studies contend. The findings were published online Sept. 29 in JAMA Internal Medicine.

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'Just-in-Time' Methodology Can Reduce Patient Waiting Times

MONDAY, Sept. 29, 2014 (HealthDay News) -- Having trainee physicians review cases prior to clinic hours can reduce patient waiting times, flow times, and clinic session times, according to a study published online Sept. 16 in Pain Medicine. The management process studied was first popularized by Toyota in Japan.

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Charge Data Influence Patient Surgical Treatment Decisions

MONDAY, Sept. 29, 2014 (HealthDay News) -- When presented with procedural charge data, people tend to choose the less expensive technique, according to a study published online Sept. 1 in the Annals of Surgery.

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AMA Launches Three Programs for Physician Wellness

MONDAY, Sept. 29, 2014 (HealthDay News) -- Physicians' personal health is a global concern and three initiatives are being developed to encourage positive change, according to a report from the American Medical Association (AMA).

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Daytime Cholecystectomy May Be Better for Acute Cholecystitis

MONDAY, Sept. 29, 2014 (HealthDay News) -- Patients who require cholecystectomy for acute cholecystitis are more likely to have a minimally invasive procedure if they have the surgery during daytime rather than at night, according to a study published online Sept. 20 in the American Journal of Surgery.

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Untreated Sleep Apnea May Raise Risk of Surgical Complications

FRIDAY, Sept. 26, 2014 (HealthDay News) -- Screening and treating patients for obstructive sleep apnea before they have surgery may reduce their risk of cardiovascular complications by more than half, according to a study published in the October issue of Anesthesiology.

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NIH Funds Study of Malpractice Risk, Cardiac Testing Incentives

FRIDAY, Sept. 26, 2014 (HealthDay News) -- The National Institutes of Health has granted $2 million to study the effect of malpractice risk and financial incentives on cardiac testing.

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Experiences Trump Things, Even Before Purchase

FRIDAY, Sept. 26, 2014 (HealthDay News) -- People derive value from the anticipation of purchasing something, and this anticipation tends to be greater for an experiential purchase than for a material purchase, according to a study published online Aug. 21 in Psychological Science.

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Routine Post-Op Labs Don't Often Affect Cervical Discectomy Care

FRIDAY, Sept. 26, 2014 (HealthDay News) -- In most cases, no action is taken on the basis of patient's routine postoperative laboratory data after anterior cervical discectomy and fusion (ACDF), according to a study published in the Sept. 15 issue of Spine.

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Depression Linked to Worse Bypass Grafting Outcomes

FRIDAY, Sept. 26, 2014 (HealthDay News) -- For patients with established ischemic heart disease undergoing coronary artery bypass grafting (CABG), depression is associated with increased mortality and poor cardiovascular outcomes, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Can Media Multitasking Alter Your Brain?

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Multitasking with smartphones, laptop computers, and other media devices could change the structure of your brain, according to a study published online Sept. 24 in PLOS ONE.

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NSAIDs Tied to Risk of Venous Thromboembolism

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Use of nonsteroidal anti-inflammatory drugs (NSAIDs) may increase risk of venous thromboembolism (VTE), according to new research published online Sept. 24 in Rheumatology.

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Blood Test Might Predict Speed of Recovery From Surgery

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Measuring the activity of subsets of white blood cells immediately after surgery might reveal which patients are likely to recover quickly and those who won't, a preliminary study suggests. The report was published in the Sept. 24 issue of Science Translational Medicine.

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Varicose Vein Treatments All Work, but Aren't Quite Equal

THURSDAY, Sept. 25, 2014 (HealthDay News) -- Three common treatments for varicose veins all ease symptoms, though there may be small differences in quality of life months later, according to a study published in the Sept. 25 issue of the New England Journal of Medicine.

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More HIV+ Patients Undergoing Spinal Fusion

THURSDAY, Sept. 25, 2014 (HealthDay News) -- More HIV-positive patients are undergoing spinal fusions, and these patients have higher rates of complications resulting from the procedures, according to a study published in the Sept. 15 issue of Spine.

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Most Doctors Are Over-Extended or at Full Capacity

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- Most physicians report being over-extended or at full capacity, according to a survey conducted by Merritt Hawkins for The Physicians Foundation.

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Report Identifies Game Changers for U.S. Health Care

WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- Imagine if doctors and hospitals got paid for providing better care, not more care, and patients had better data for making informed health choices. A new report suggests that's the direction the U.S. health system is headed.

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FDA Warns Doctors of Danger From 'Fake' Drugs

TUESDAY, Sept. 23, 2014 (HealthDay News) -- The number of "rogue" wholesale distributors selling fake or unapproved prescription drugs is growing, so doctors need to be vigilant when purchasing medicines, the U.S. Food and Drug Administration warned Tuesday.

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NIH Adds $10M to Encourage Gender Balance in Clinical Trials

TUESDAY, Sept. 23, 2014 (HealthDay News) -- The U.S. National Institutes of Health is investing $10 million in additional funding in scientific trials to encourage researchers to consider gender in their preclinical and clinical studies.

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Redundant Antimicrobial Therapy Is Pervasive, Costly

MONDAY, Sept. 22, 2014 (HealthDay News) -- Redundant use of antimicrobial therapy is pervasive in U.S. hospitals and is associated with considerable, potentially avoidable, health care costs, according to a study published in the October issue of Infection Control and Hospital Epidemiology.

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Operative Management of Femoral Neck Fx Has Changed

MONDAY, Sept. 22, 2014 (HealthDay News) -- Trends in operative management of femoral neck fractures by orthopedic surgeons applying for board certification have changed over time, according to research published in the Sept. 3 issue of The Journal of Bone & Joint Surgery.

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Systemwide Changes Needed to Restrain Health Care Spending

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Systemwide changes are necessary to prevent excessive health care spending, and so are tools to help consumers make better, more informed medical choices, according to a white paper published in June by Vitals.

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Breast Cancer Subtype Affects Survival With Spinal Metastasis

FRIDAY, Sept. 19, 2014 (HealthDay News) -- For patients with breast cancer with spinal metastases, estrogen receptor (ER)/hormone receptor (HR)-negative status is associated with worse survival, according to a study published in the Sept. 1 issue of Spine.

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Electronic Health Records Tied to Shorter Time in ER

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Length of emergency room stay for trauma patients is shorter with the use of electronic health records, according to a study published in the September issue of the Journal of Emergency Nursing.

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Presence of Peers Ups Health Workers' Hand Hygiene

FRIDAY, Sept. 19, 2014 (HealthDay News) -- The presence of other health care workers improves hand hygiene adherence, according to a study published in the October issue of Infection Control and Hospital Epidemiology.

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Vitamin K Antagonist + Clopidogrel Feasible for PCI

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Vitamin K antagonists (VKA) combined with clopidogrel may be a better alternative to triple anticoagulant therapy in patients on long-term VKA undergoing percutaneous coronary intervention (PCI) and stenting, according to a review published in the Sept. 23 issue of the Journal of the American College of Cardiology.

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Family Squabbles Can Derail Recovery From Cancer Surgery

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Cancer patients burdened by stress and family conflicts before surgery may face a higher risk for complications following their operation, according to a study published in a recent issue of the Journal of Gastrointestinal Surgery.

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CDC: Almost Everyone Needs a Flu Shot

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Less than half of all Americans got a flu shot last year, so U.S. health officials on Thursday urged that everyone 6 months and older get vaccinated for the coming flu season. "It's really unfortunate that half of Americans are not getting the protection from flu they could get," said Thomas Frieden, M.D., director of the U.S. Centers for Disease Control and Prevention, during a morning news conference.

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Strategies Can Help Docs Lower Their Tax Burden

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Strategies are presented to help physicians lower their tax burden in an article published Sept. 2 in Medical Economics.

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High Mortality, Costs With C. difficile After Spine Surgery

THURSDAY, Sept. 18, 2014 (HealthDay News) -- For patients undergoing lumbar spine surgery, Clostridium difficile (C. difficile) infection is associated with longer, more expensive hospital stays, and increased mortality, according to a study published in the Sept. 1 issue of Spine.

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Insulin Rx Tied to Increased Major Adverse CV Events in DM

THURSDAY, Sept. 18, 2014 (HealthDay News) -- The rate of major adverse cardiovascular events is higher in patients with diabetes mellitus (DM) and multivessel coronary artery disease treated with insulin (ITDM) versus those not treated with insulin (non-ITDM), according to a study published in the Sept. 23 issue of the Journal of the American College of Cardiology.

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ASTRO Issues Second List of Choosing Wisely Guidelines

THURSDAY, Sept. 18, 2014 (HealthDay News) -- The American Society for Radiation Oncology (ASTRO) has released a second list of five radiation oncology-specific treatments that should be discussed before being prescribed, as part of the national Choosing Wisely campaign.

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Internists Report Considerable EMR-Linked Time Loss

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Use of electronic medical record (EMR) systems is associated with considerable loss of free time per clinic day, according to a research letter published online Sept. 8 in JAMA Internal Medicine.

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Doctors Promoting Transparency With Patients

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Efforts to increase transparency among doctors are underway, according to an article published in The Boston Globe.

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Most Treatments for Acute VTE Appear Safe, Effective

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Almost all the various treatment options for acute venous thromboembolism are equally safe and effective, according to research published in the Sept. 17 issue of the Journal of the American Medical Association.

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CDC: Opioid-Related Deaths Quadrupled in Past Decade

TUESDAY, Sept. 16, 2014 (HealthDay News) -- The number of Americans dying from accidental overdoses of opioid analgesics jumped significantly from 1999 to 2011, according to a September data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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AACR: Targeted Drugs Among Successes Against Cancer

TUESDAY, Sept. 16, 2014 (HealthDay News) -- About 14.5 million U.S. cancer survivors are alive today, compared to just three million in 1971, the American Association for Cancer Research reported Tuesday.

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FDA Approves Movantik for Opioid-Induced Constipation

TUESDAY, Sept. 16, 2014 (HealthDay News) -- Movantik (naloxegol) has been approved by the U.S. Food and Drug Administration to treat opioid-induced constipation, the agency said Tuesday.

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Over a Quarter of Hospital Orders Classified As Defensive

TUESDAY, Sept. 16, 2014 (HealthDay News) -- More than one-quarter of hospital medicine services were rated by ordering physicians as at least a partially defensive order, according to a research letter published online Sept. 15 in JAMA Internal Medicine.

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Surgeon's Specialty Has Limited Effect on Spinal Surgery Outcome

MONDAY, Sept. 15, 2014 (HealthDay News) -- Surgical specialty has limited influence on short-term outcomes after elective spine surgery, with differences noted for transfusions and length of stay, according to a study published online Sept. 1 in Spine.

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Watchful Waiting May Not Be Best for Black Men With Prostate CA

MONDAY, Sept. 15, 2014 (HealthDay News) -- Watchful waiting may not be suitable for all men with early-stage prostate cancer, especially black patients, according to research published in Urologic Oncology.

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Errata Frequently Seen in Medical Literature

MONDAY, Sept. 15, 2014 (HealthDay News) -- Errata, including those that may materially change the interpretation of data, are frequent in medical publications, according to a study published in the August issue of The American Journal of Medicine.

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New Role of Patient As Consumer Requires Market Changes

FRIDAY, Sept. 12, 2014 (HealthDay News) -- The new consumer retail market in U.S. health care is necessary and will benefit consumers, and as consumers take on more costs of care, access to information to help them make informed decisions is crucial, according to a recent white paper published by Vitals.

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Opioid Overdose Prevention Needed in Young Adult Users

FRIDAY, Sept. 12, 2014 (HealthDay News) -- Many young adult nonmedical prescription opioid (PO) users are relatively uninformed about overdose awareness, avoidance, and response strategies, according to a study published online Aug. 22 in The International Journal of Drug Policy.

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Low Delivery Volume by Doctors Tied to Higher Cesarean Risk

FRIDAY, Sept. 12, 2014 (HealthDay News) -- The odds of cesarean delivery are increased for patients who undergo delivery by obstetricians with low delivery volume, according to a study published online Sept. 8 in Obstetrics & Gynecology.

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Glycemic Control Linked to Lumbar Surgery Complications

FRIDAY, Sept. 12, 2014 (HealthDay News) -- For patients with diabetes mellitus (DM) undergoing degenerative lumbar spine surgery, suboptimal glycemic control contributes to increased risk of complications and poor outcomes, according to a study published in the Sept. 15 issue of Spine.

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Non-Ablative Laser Treatments Improve Mature Burn Scars

THURSDAY, Sept. 11, 2014 (HealthDay News) -- Non-ablative fractional laser treatment may provide long-term improvement of mature burn scars, according to research published online Aug. 22 in Lasers in Surgery and Medicine.

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Physician Describes Impact of Malpractice Suit

THURSDAY, Sept. 11, 2014 (HealthDay News) -- A family doctor who was involved in a malpractice suit describes the impact on her practice of medicine in an article published online in the September/October issue of the Annals of Family Medicine.

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Fear About Disease Progression Prompts ER Returns

THURSDAY, Sept. 11, 2014 (HealthDay News) -- Perceived inability to access timely follow-up care and uncertainty and fear about disease progression are the main reasons for return visits to the emergency department, according to a study published online Sept. 2 in the Annals of Emergency Medicine.

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Interbody Fusion Rapidly Adopted For Spondylolisthesis

THURSDAY, Sept. 11, 2014 (HealthDay News) -- Interbody fusion (IF) has been rapidly adopted for the treatment of degenerative spondylolisthesis (DS), according to a study published in the Sept. 1 issue of Spine.

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Evidence Lacking for Efficacy of Implantable Devices

WEDNESDAY, Sept. 10, 2014 (HealthDay News) -- High-quality evidence for the effectiveness and safety of recent and ostensibly high-value implantable devices in major joint replacement is lacking, according to a study published online Sept. 9 in BMJ.

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Reanalyses of RCTs Can Lead to Different Conclusions

WEDNESDAY, Sept. 10, 2014 (HealthDay News) -- More than one-third of the small number of reanalyses of randomized clinical trials (RCTs) have implied conclusions different from those of the original articles, according to a study published online Sept. 9 in the Journal of the American Medical Association.

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Renal Denervation Does Not Reduce Ambulatory BP

TUESDAY, Sept. 9, 2014 (HealthDay News) -- Renal denervation does not reduce ambulatory blood pressure in patients with resistant hypertension, and denervation procedures may miss targets, according to two studies published online Sept. 8 in the Journal of the American College of Cardiology.

Abstract -- Bakris
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Abstract -- Tzafriri
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For Some, Health Insurance More Costly Than Uninsured Penalty

TUESDAY, Sept. 9, 2014 (HealthDay News) -- For some young people in the United States, the cost of paying a penalty for not buying health insurance will be lower than the lowest-cost insurance, according to a study published online Sept. 9 in the Annals of Internal Medicine.

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Disk Replacement Preserves Long-Term Spinal Motion

TUESDAY, Sept. 9, 2014 (HealthDay News) -- For treatment of degenerative cervical disk disorders in young patients, artificial disk replacement can preserve the motion of the spinal unit, according to a study published in the September issue of Spine.

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ASCO/CCO Issue New Guidelines for Advanced Prostate Cancer

TUESDAY, Sept. 9, 2014 (HealthDay News) -- Guidelines, issued jointly by the American Society of Clinical Oncology (ASCO) and Cancer Care Ontario (CCO) in Canada, highlight recent advances in treating hormone-therapy-resistant advanced prostate cancer. The guidelines were published Sept. 8 in the Journal of Clinical Oncology.

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Health Care Spending Expected to Rise in 2014 Through 2023

MONDAY, Sept. 8, 2014 (HealthDay News) -- While health spending growth was slow in 2013, health spending is expected to increase in 2014 and remain higher through 2023, according to a study published online Sept. 3 in Health Affairs.

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Peri-Op Melatonin Doesn't Cut Post-Op Delirium in Elderly

MONDAY, Sept. 8, 2014 (HealthDay News) -- For elderly patients undergoing acute surgery for hip fracture, perioperative melatonin does not reduce the incidence of delirium, according to a study published online Sept. 2 in CMAJ, the Journal of the Canadian Medical Association.

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Females Overlooked in Basic Surgical Research

MONDAY, Sept. 8, 2014 (HealthDay News) -- Female animals or cells are rarely used in surgical research studies, even though sex differences can have a major impact on medical research, according to a study published in the September issue of Surgery.

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Diabetes May Increase Risk of Visual Loss Post-Spinal Fusion

FRIDAY, Sept. 5, 2014 (HealthDay News) -- Though rare, some patients are at higher risk for perioperative visual loss (POVL) after spinal fusion surgery, according to a study published in the Sept. 1 issue of The Spine Journal.

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High-Volume Surgeons Lead Use of Robotic Procedures

FRIDAY, Sept. 5, 2014 (HealthDay News) -- From 2003 to 2010 there was widespread adoption of robot-assisted radical prostatectomy (RARP), especially among high-volume surgeons, according to a study published online Aug. 26 in BJU International.

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Skin Cells Used to Create Heart Valve for Growing Kids

THURSDAY, Sept. 4, 2014 (HealthDay News) -- Researchers say they've found a way to use a child's skin cells to construct a new pulmonary valve. The findings appear in the September issue of the Annals of Thoracic Surgery.

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Blog: Seven Most Common Physician Social Media Misses

THURSDAY, Sept. 4, 2014 (HealthDay News) -- The most common physician social media misses and missteps can be avoided, allowing doctors to take advantage of marketing opportunities on all major social media channels, according to the author of a recent Vitals blog.

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Pediatricians Have Important Role in Preoperative Process

THURSDAY, Sept. 4, 2014 (HealthDay News) -- Pediatricians have an important part in preparing surgical patients and their families for procedures, according to a policy statement published online Aug. 25 in Pediatrics.

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Guidelines Issued for HER2-Negative Advanced Breast Cancer

THURSDAY, Sept. 4, 2014 (HealthDay News) -- Evidence-based recommendations have been developed for chemotherapy and targeted therapy for women with human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. The clinical practice guideline was published online Sept. 2 in the Journal of Clinical Oncology.

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Vagal Nerve Block Therapy in Morbid Obesity Explored

WEDNESDAY, Sept. 3, 2014 (HealthDay News) -- Vagal nerve block therapy may be effective for weight loss in morbid obesity, and trends in bariatric surgery procedures have changed from 2006 to 2013, according to two studies published in the Sept. 3 issue of the Journal of the American Medical Association.

Abstract - Ikramuddin
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Malnutrition Ups Risk of Elective Spine Surgery Complications

WEDNESDAY, Sept. 3, 2014 (HealthDay News) -- Preoperative hypoalbuminemia, as a marker for malnutrition, is an independent risk factor for postoperative complications after elective spine surgery for degenerative and deformity causes, according to a study published in the Aug. 15 issue of Spine.

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Venous Thromboembolism Rare After Urological Procedures

WEDNESDAY, Sept. 3, 2014 (HealthDay News) -- Deep venous thrombosis (DVT) and pulmonary embolism (PE) are uncommon after urological surgery, according to a study published in the September issue of The Journal of Urology.

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Rate of Bilateral Mastectomy Increased From 1998 to 2011

TUESDAY, Sept. 2, 2014 (HealthDay News) -- For women diagnosed with stage 0 to III breast cancer, the rate of bilateral mastectomy increased from 1998 to 2011, according to a study published in the Sept. 3 issue of the Journal of the American Medical Association.

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Physician's Briefing
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