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FDA: Boston Scientific recalls RotaWire Elite and wireClip Torquer Guidewires

Editor's Note Boston Scientific Corporation is recalling RotaWire Elite core wires because they may crack and separate from the rest of the Rotablator Rotational Atherectomy System and cause serious injury such as tamponade, myocardial infarction, and migration of wire fragments, the Food and Drug Administration reported November 27. Boston Scientific…

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By: Judy Mathias
November 30, 2015
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Psychiatric disorder linked to morbidity after fast-track total joints

Editor's Note In this study, patients with psychiatric disorders (PsDs) requiring psychopharmacological treatments had an increase in postoperative morbidity after fast-track total hip and total knee arthroplasties, regardless of treatment type and preoperative comorbidities. Among PsD patients: Pain, postoperative anemia, and pulmonary complications were the most frequent causes of length…

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By: Judy Mathias
November 19, 2015
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Door openings affect OR pressure during joint arthroplasty

Editor's Note This study from Johns Hopkins Bayview Medical Center, Baltimore, found a significant relationship between OR door openings and room pressure. The OR door was opened, on average, once every 2.5 minutes of surgery. For 77 of 191 knee and hip arthroplasties, the doors were open long enough for…

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By: Judy Mathias
November 18, 2015
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CMS finalizes rule for hip and knee bundled payments

Editor's Note The Centers for Medicare and Medicaid Services (CMS) has finalized the rule that will require hospitals in 67 geographic areas to participate in a test of bundled payments for hip and knee replacements, Modern Healthcare reports. Medicare's average bundled payment ranges from $16,500 to $33,000 for surgery, hospitalization,…

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By: Judy Mathias
November 17, 2015
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Ultrasound-guided vs angiography-guided coronary stent implantation

Editor's Note In patients requiring long coronary stents, the use of intravascular ultrasound (IVUS)-guided vs angiography-guided drug-eluting stent implantation resulted in a significantly lower rate (2.9% absolute reduction, 48% relative reduction) of major adverse cardiac events at 1 year, finds this study. These differences were mainly driven by the reduction…

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By: Judy Mathias
November 11, 2015
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‘Post hospital syndrome,’ risk for readmission in ambulatory surgery patients

Editor's Note A condition known as “post hospital syndrome” (PHS) is a significant risk factor for readmissions in patients who undergo elective ambulatory surgery, this study finds. Post hospital syndrome (PHS) is defined as having been hospitalized within 90 days before surgery. During hospitalization, patients are often sleep deprived and…

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By: Judy Mathias
November 11, 2015
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Effect of anesthetic management on total joint SSIs

Editor's Note Though recent studies using large databases have concluded that neuraxial compared with general anesthesia is associated with a decreased incidence of SSIs in total joint patients, this 11-year retrospective, controlled study found no difference. The use of peripheral nerve blocks also was not found to influence the incidence…

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By: Judy Mathias
November 10, 2015
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Appropriate use criteria reduces nonacute, inappropriate PCIs

Editor's Note Since publication of the Appropriate Use Criteria for Coronary Revascularization in 2009, the number of nonacute percutaneous coronary interventions (PCIs) has declined significantly (89,704 vs 59,375). The proportion of nonacute PCIs classified as inappropriate has also declined (26.2% vs 13.3%), although hospital-level variation persists. These findings indicate that…

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By: Judy Mathias
November 10, 2015
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Influence of race on risk of total knee revision

Editor's Note Blacks are at a significantly higher risk of having total knee revision surgery within 5 years than whites, finds a study presented at the American College of Rheumatology Annual Meeting in San Francisco. The risk of revision was 38% higher in blacks. When blacks undergo knee replacement they…

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By: Judy Mathias
November 9, 2015
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Study: ‘July phenomenon’ concerns unfounded

Editor's Note Referred to as the “July phenomenon,” the influx of new surgical residents and interns at the beginning of the academic year is assumed to be associated with poor outcomes. This study of nearly 1.5 million patients who had emergency general surgery either early (July-August)  or late (September-June) in…

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By: Judy Mathias
November 5, 2015
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