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Surgery

News, opinions and meeting coverage in surgery.

Stroke Rounds: Early Surgery Looks Safe After tPA

Performing carotid endarterectomy or stenting in patients who were recently treated with thrombolytic therapy for an acute stroke appeared to be safe, an observational study showed.

Medtronic Sued by 1,000 Infuse Patients

Medtronic said about 1,000 people have sued the company over its bone morphogenetic protein-2 product, Infuse, and that many more lawsuits may be coming.

Vitamin D Blog: Cutting Edema in Athletes' Bones

Vitamin D supplementation might help professional athletes who are being treated for bone marrow edema with bisphosphonates, according to a new study.

Which Bullets Are Safe in an MRI?

Don't go ballistic -- only steel bullets will cause problems in MRI, says a study of 39 kinds of the projectiles.

Drug Combo Saves Kids' Tonsils in Mild OSA

The anti-inflammatory asthma drug montelukast (Singulair) plus corticosteroids was an effective initial alternative to surgery for mild obstructive sleep apnea (OSA) in children, a retrospective study showed.

Satisfaction With Epilepsy Surgery Lasts Long Term

WASHINGTON -- More than 90% of patients who had surgery for drug-resistant epilepsy said it was worthwhile when interviewed up to 20 years later, even when quality-of-life indicators were not improved, researchers said here.

Laser Epilepsy Surgery Boosts Memory Function

WASHINGTON -- Stereotactic laser ablation of seizure foci in the hippocampus appeared to reverse certain types of memory deficits that commonly occur in this population, researchers said here.

Diabetes: TAVI Trumps Heart Surgery

Patients with diabetes who had aortic stenosis fared better in terms of mortality and kidney function during the first year if they underwent transcatheter aortic valve implantation (TAVI) rather than surgery, a post-hoc analysis found.

Fast-Acting AMA Group Hopes to Fix SGR

NATIONAL HARBOR, Md. -- A large coalition of American Medical Association members met in seclusion Sunday morning here at the interim meeting of the House of Delegates and rapidly found consensus on a proposed resolution for the repeal of Medicare's sustainable growth rate (SGR) formula.

Supplements Blamed for Liver Toxicity

WASHINGTON -- The rate of liver damage caused by dietary and herbal supplements -- especially those used for bodybuilding -- appears to be on the rise, a researcher said here.

Gestational Diabetes Tied to Perinatal Stroke

AUSTIN, Texas -- Perinatal arterial ischemic stroke has many possible risk factors, including gestational diabetes, researchers reported here.

Scoliosis Tied to HTN Risk in Adolescents

ORLANDO -- Children with severe spinal curving from scoliosis were more likely to have worsening risk indicators for pulmonary hypertension, researchers reported here.

Will You Make More $$ if You Subspecialize?

Ivan Today looks at a study that looks at whether fellowships pay off.

Heart Surgery as Infant Hikes Risk for ADHD Later

Children who underwent surgery for congenital heart disease in the first year of life appeared to carry an increased risk of attention deficit hyperactivity disorder (ADHD) once they reached school age, researchers found.

Opioid Use Common After Spine Surgery

NEW ORLEANS -- One year after surgery to relieve back pain, about of third of patients still were using narcotic painkillers, according to a study that raised new concerns about the long-term use of opioids.

N.H. Hospital May Have Exposed Patients to CJD

Health officials in New Hampshire said eight neurosurgery patients at one hospital in the state may have been unwittingly exposed to Creutzfeldt-Jakob disease (CJD).

FDA Panel Vetoes New Tolvaptan Indication

SILVER SPRING, Md. -- An FDA advisory committee has declined to endorse an expanded indication for tolvaptan (Samsca) to treat autosomal dominant polycystic kidney disease.

Losing a Tattoo, Gaining a Tumor

An unintended consequence of laser tattoo removal in a 29-year-old man was a diagnosis of malignant melanoma, according to a German case report.

Wyeth Settles Rapamune Marketing Charge

WASHINGTON, D.C. -- Pfizer's Wyeth Pharmaceuticals unit will pay $490.9 million to resolve state and federal allegations that it marketed rapamycin (sirolimus, Rapamune) for unapproved indications.

Wounds Heal Better When Debrided Often

Faster and more complete wound healing was achieved with more frequent debridement regardless of wound type, size, or duration, researchers found.

Randy Travis Gets an LVAD, Future Uncertain

Grammy award-winning country music star Randy Travis has received the Impella pump, a temporary percutaneous left ventricular assist device, to help him as he battles viral cardiomyopathy, according to his publicist.

Biological Death Needs Better Definition

An international consensus is needed on contemporary and practical criteria for brain and circulatory death, according to experts gathered in Barcelona for the annual congress of the European Society of Anesthesiology.

Shots Best Way to Give B12 After Bariatric Surgery

Vitamin B12 injections are the preferred treatment for patients who develop a deficiency following bariatric surgery, researchers found.

Zilver Stent Recalled, System May Break

Cook Medical's Zilver PTX drug-eluting stent for peripheral artery disease has been recalled because of a defect in its associated delivery system, the company and the FDA said.

On-Call Pay Varies Widely by Specialty

Surgeons commanded more than $1,000 a day for being on-call at the hospital, while primary care physicians reported compensation rates of around $150 a day, according to annually compiled data.

Full Thyroid Removal May be Best in Graves' Disease

Removing the whole thyroid lessens the chance of hyperthyroidism recurrence in Graves' disease compared with partial thyroidectomy, but it also leads to increased temporary hypoparathyroidism, researchers found.

Acute Pain Yields to Lower-Dose Diclofenac

FORT LAUDERDALE, Fla. - Lower-dose submicron particle diclofenac offered good pain control compared with placebo, researchers reported here.

Preop Ketamine May Lower Pain in Fibromyalgia

FORT LAUDERDALE, Fla. -- In fibromyalgia patients undergoing knee or hip replacement surgery, low-dose, intraoperative ketamine appeared to reduce the need for post-surgical opioid therapy, researchers said here.

Spinal Implant Prices Vary, Process Drives Up Costs

CHICAGO -- Wide variations exist in the cost of the screws, plates, and cages for spinal implants, which contributes to the escalating costs of surgery and healthcare overall, a researcher said here.

Fracture Care for Kids on Medicaid Called 'Dismal'

CHICAGO -- Children receiving Medicaid are finding it increasingly difficult to obtain prompt orthopedic care following a fracture, a researcher said here.

Mixed Results for Metal Ions Test in MoM Hips

CHICAGO -- Measurement of metal ion levels in whole blood in patients with metal-on-metal hip implants is useful, but imperfect, for identifying those whose new hips are functioning poorly and may be likely to fail, a researcher said here.

FDA Warns About Codeine Following Tonsillectomy

Products that contain codeine should not be used for pain relief in children following tonsillectomy or adenoidectomy because of a possible risk of serious adverse events or death, the FDA said Wednesday.

Painful Speed Bumps? Could Be Appendicitis

Diagnostic uncertainty surrounding appendicitis could turn into a small bump in the road, according to a study showing a high correlation between appendicitis and pain on driving over speed bumps on the way to the hospital.

No Need for Skin Preps to Be Sterile, FDA Told

WASHINGTON -- Requiring that antiseptic skin preparation products be sterile is unnecessary and wouldn't lead to a dramatic drop in infections, speakers told the FDA Wednesday.

Cardio Notes: Stress Test Finds Heart Disease in Seniors

Researchers are taking a second look at the accuracy of treadmill exercise testing for women over 65. Also this week, the birth of a subspecialty for adults with congenital heart disease and leg artery stenting.

FDA to Look at Tainted Skin Preps

Antiseptic skin preparation products can be contaminated by microbes, a problem the FDA will address at an upcoming public hearing.

Early Stroke Risk After Hip Replacement

Patients undergoing a total hip replacement appear to have an elevated risk of stroke in the weeks following the operation, researchers found.

Drug Relieves Opioid-Induced Constipation

LAS VEGAS -- An investigational opioid antagonist provided effective and durable relief from opioid-induced constipation in patients with chronic pain without interfering with analgesia, a randomized trial showed.

Cardio Notes: Sex Improves with Stenting

Opening the arteries of those with stable coronary disease also opens the door to an improved sex life. Also this week, bariatric surgery helps remodel the heart.

Recall: Device Sucks Life From Patient

A suction system for collecting surgical waste apparently killed one patient and seriously injured another, prompting its maker to recall it and several related devices, the FDA said.

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