June 2008 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for June 2008. 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.

Gastric Bypass May Raise Risk of Kidney Stones

MONDAY, June 30 (HealthDay News) -- Morbidly obese patients who undergo Roux-en-Y gastric bypass are at risk of developing kidney stones as early as three months after surgery, researchers report in the June issue of the Journal of the American College of Surgeons.

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Recruitment Strategy Can Boost Ranks of Female Surgeons

MONDAY, June 30 (HealthDay News) -- Female surgeons account for only 16 percent of university medical faculty nationwide, but improvements to the recruitment strategy can help U.S. medical schools hire and retain more female surgeons, according to a report in the June issue of the Journal of the American College of Surgeons.

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Nurse Understaffing Adversely Affects Patients

MONDAY, June 30 (HealthDay News) -- Hospitals are routinely dealing with nurse understaffing through the use of voluntary and mandatory overtime, a practice that leads to adverse patient outcomes and increases nurse burnout, according to an article published in the June issue of the AORN Journal.

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U.K. Doctors Must Change View of National Health Service

FRIDAY, June 27 (HealthDay News) -- As the U.K.'s National Health Service reaches its 60th anniversary, its doctors should revise their vision of the organization from one primarily based on the employee/employer relationship to grapple with the true scale of the challenges that the NHS faces, according to an opinion piece published in the June 28 issue of The Lancet.

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Merits of International Medical Conferences Debated

FRIDAY, June 27 (HealthDay News) -- Are international medical conferences an outdated luxury the planet can't afford? That's the subject of a "Head to Head" debate published in the June 28 issue of BMJ.

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Improvements Needed for Research Reporting Guidelines

FRIDAY, June 27 (HealthDay News) -- There are dozens of scientific research reporting guidelines and the way in which they are developed is broadly similar, but they also differ in crucial aspects and many developers lack a strategy for the dissemination and implementation of research guides, according to an article published in the June issue of PLoS Medicine.

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Hospital Volume Linked to Deaths After Cancer Surgery

THURSDAY, June 26 (HealthDay News) -- Low-volume hospitals have higher perioperative and long-term mortality than high-volume hospitals for cancer surgery, although more deaths could be avoided by initiatives to improve long-term survival, according to a report published online June 23 in the Journal of Clinical Oncology.

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Organ Transplants in Need of Up-Front Consent Policy

WEDNESDAY, June 25 (HealthDay News) -- The United Network for Organ Sharing (UNOS) should create a policy requiring potential organ transplant recipients to go through a comprehensive consent process that allows them to specify whether they'll accept or decline all non-standard organs, according to a Sounding Board feature in the June 26 issue of the New England Journal of Medicine.

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Cannabinoids Don't Alleviate Acute Nociceptive Pain

WEDNESDAY, June 25 (HealthDay News) -- Orally administered cannabis extract did not produce significant analgesic or anti-hyperalgesic effects in two well-established human pain models -- sunburn and intradermal capsaicin -- according to study findings published in the July issue of Anesthesiology.

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Anesthesia Types Used in Combat Injuries Compared

WEDNESDAY, June 25 (HealthDay News) -- Total intravenous anesthesia, often including ketamine, did not produce better outcomes than volatile gas anesthesia in patients who underwent neurosurgery for combat-related traumatic brain injury, according to a report in the July issue of Anesthesiology.

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Outcomes of Drug-Eluting Versus Bare-Metal Stent Analyzed

TUESDAY, June 24 (HealthDay News) -- The widespread use of drug-eluting stents has decreased the incidence of repeat revascularization but has not increased the risk of death or ST-elevation myocardial infarction compared to the use of bare-metal stents, according to a report published in the June 25 issue of the Journal of the American Medical Association.

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Article Examines Use of 'Key Opinion Leaders' in Drug Sales

FRIDAY, June 20 (HealthDay News) -- Influential doctors known as "key opinion leaders" are paid generous fees to influence their peers to prescribe a company's drugs and may in fact be considered salespeople by the industry, according to an article in the June 21 issue of BMJ.

Full Text - Moynihan
Editorial - Buckwell
Editorial - Fava

Model Compares Post-Kidney Transplant Drug Regimens

THURSDAY, June 19 (HealthDay News) -- A calcineurin inhibitor (CNI) withdrawal regimen for de novo kidney transplant patients was associated with better long-term patient and graft survival, compared with common CNI-containing immunosuppressive therapies, according to research published online June 18 in the Journal of the American Society of Nephrology.

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Ultrasonic Instruments Linked to Some Surgical Benefits

THURSDAY, June 19 (HealthDay News) -- The use of ultrasonic surgical instrumentation such as scalpels and shears is safe and effective in a variety of surgical procedures, and is associated with some procedure-specific advantages, researchers report in the June Archives of Surgery.

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Nature of Casualties Changed in Iraq Following Invasion

WEDNESDAY, June 18 (HealthDay News) -- The types of casualties that the U.S. Marine Corps Forward Resuscitative Surgery System units in Iraq have treated have evolved since the invasion of Iraq due to factors including improvised explosive devices and longer transport times, according to research published in the June issue of the Archives of Surgery.

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Endovascular Aortic Repair Shows Mortality Benefit

WEDNESDAY, June 18 (HealthDay News) -- The availability of endovascular repair for patients with ruptured abdominal aortic aneurysm led to a reduction in early overall mortality, according to research published in the June issue of the Archives of Surgery.

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Amniotic Membranes Effective for Serious Skin Disease

TUESDAY, June 17 (HealthDay News) -- A patient with a rare life-threatening skin disease involving detachment of the skin over half the body recovered completely after being given intravenous immunoglobulin (IVIG) and placing amniotic membranes on the affected areas, according to a case study reported in the June issue of the Archives of Dermatology.

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Blood Substitute Can Be Alternative to Transfusion

MONDAY, June 16 (HealthDay News) -- In the largest randomized controlled study to date of hemoglobin-based oxygen carrier (HBOC) use in elective orthopedic surgical patients, the majority of patients treated with HBOC-201 were able to safely avoid red blood cell transfusions, researchers report in the June issue of the Journal of Trauma: Injury, Infection, and Critical Care.

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Surgical Technique More Effective for Low Rectal Cancer

MONDAY, June 16 (HealthDay News) -- Abdominoperineal excision of low rectal cancer removes more tissue around the tumor if a cylindrical technique performed in the prone position is used rather than the standard approach, according to a report published online June 9 in the Journal of Clinical Oncology.

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Post-Liver Transplant Surgical Infection Risks Explored

MONDAY, June 16 (HealthDay News) -- In a group of patients who underwent liver transplantation, 8.8 percent developed surgical site infections; certain procedures, previous transplants and amount of transfused blood were all associated with risk of infections, according to research published in the June issue of Liver Transplantation.

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'Transplant Tourism' May Be Inappropriate Term

FRIDAY, June 13 (HealthDay News) -- When patients cross borders to receive organ transplants, there may be serious ethical, clinical, social and economic problems, which the term "transplant tourism" does not suggest, according to an article in the June 14 issue of BMJ.

Abstract - Turner
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Abstract - Noorani
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Rate of Underinsured Adults Climbing in United States

FRIDAY, June 13 (HealthDay News) -- The number of underinsured adults in the United States climbed steeply between 2003 and 2007, with the risks of being underinsured often affecting those with higher incomes, according to a report published online June 10 in Health Affairs.

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Experts Debate Whether Organ Donors Should Be Paid

FRIDAY, June 13 (HealthDay News) -- The high success rate of kidney transplants has created demand for organ donations that far exceeds supply and raises ethical dilemmas about paying donors, according to a series of articles in the June 14 issue of BMJ.

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A Third of In-Hospital Deaths After CABG Were Preventable

WEDNESDAY, June 11 (HealthDay News) -- Approximately one-third of in-hospital deaths following coronary artery bypass graft surgery (CABG) were preventable and occurred regardless of hospitals' low all-cause mortality rates, according to a report in the June 10 issue of Circulation: Journal of the American Heart Association.

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Cancer Costs Increasing Due to More Treatment

WEDNESDAY, June 11 (HealthDay News) -- The costs associated with treating cancer in the elderly have largely increased due to more patients receiving surgery and adjuvant treatment, and rising prices for these therapies, researchers report in the June 18 issue of the Journal of the National Cancer Institute.

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Hispanic Work-Related Deaths Higher Than U.S. Average

TUESDAY, June 10 (HealthDay News) -- The death rate due to work-related injuries was consistently higher for Hispanic workers than the general U.S. workforce from 1992 to 2006, according to a report in the U.S. Centers for Disease Control and Prevention's June 6 issue of the Morbidity and Mortality Weekly Report.

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Many Nurses Not Trained for Potential Bioterrorist Attack

MONDAY, June 9 (HealthDay News) -- Many perioperative nurses may feel unprepared for the challenges of a bioterrorism event, but a relatively brief self-study guide can help improve their sense of preparedness, according to research published in the May AORN Journal.

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Endovascular Aneurysm Treatment Rises; Mortality Falls

MONDAY, June 9 (HealthDay News) -- During a recent 10-year period, endovascular treatment for cerebral aneurysms became more common, and mortality fell significantly for endovascular therapy and surgical clipping to treat aneurysms, according to research published in the June issue of the Journal of Neurosurgery.

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Osteoporosis Coordinators Seen As Beneficial

FRIDAY, June 6 (HealthDay News) -- At tertiary care centers, the hiring of a part-time osteoporosis coordinator to manage outpatients and inpatients who have fragility fractures may reduce the incidence of future hip fractures and save significant hospital costs, researchers report in the June issue of the Journal of Bone & Joint Surgery.

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For U.K. Patients, Consent Becoming a Matter of Choice

FRIDAY, June 6 (HealthDay News) -- New guidelines from the U.K. General Medical Council lack the detail necessary to help clinicians change the way they seek patient consent for surgical procedures, but they are part of a broader trend toward perceiving consent as a form of choice rather than acceptance of advice, according to an editorial published in the June 7 issue of BMJ.

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Knee Problems Linked to Cartilage Loss in Osteoarthritis

FRIDAY, June 6 (HealthDay News) -- Medial meniscal damage and varus malalignment, and lateral meniscal damage predicted tibial and femoral cartilage loss over a two-year period in patients with knee osteoarthritis, according to research published in the June issue of Arthritis & Rheumatism.

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Fewer U.S. Physicians Training in Pediatric Neurosurgery

FRIDAY, June 6 (HealthDay News) -- Very few physicians are training and becoming certified in pediatric neurosurgery, suggesting an upcoming crisis in the workforce of this subspecialty that may put children at risk, according to a report in the June issue of the Journal of Neurosurgery: Pediatrics.

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Hospital Factors Affect Pay-for-Performance Outcomes

THURSDAY, June 5 (HealthDay News) -- If pay-for-performance programs are enacted nationwide, teaching hospitals that perform a high volume of hip and knee replacements may be most likely to benefit, according to a report published in the June issue of the Journal of Bone & Joint Surgery.

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Excision Rates Useful Measure of Rectal Cancer Treatment

THURSDAY, June 5 (HealthDay News) -- Although the overall rates of abdominoperineal excision for rectal cancer have declined in the United Kingdom, there are significant variations in its application that cause unequal quality of care, according to a report published online June 5 in Gut.

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Injuries Common Among High School Baseball Players

TUESDAY, June 3 (HealthDay News) -- Although baseball is relatively safe compared to other high school sports, injuries are common -- including serious injuries resulting from being hit with a batted ball -- and could be reduced by requiring players to use appropriate safety equipment, according to a report published in the June issue of Pediatrics.

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