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Can we operate out diabetes?
Medscape (free subscription)
The aim of this study was to assess the long-term impact of bariatric surgery on diabetes. The authors followed 217 morbidly obese patients with elevated glycated hemoglobin (A1c) levels to determine their diabetic status. At the end of the follow-up period, there was significant improvement in A1c levels, control of blood pressure, reduction of low-density lipoprotein cholesterol levels, number of diabetic drugs taken, and use of insulin. Gastric bypass achieved significantly better results than either sleeve gastrectomy or gastric banding.
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Skip the balloon after placing carotid stent, surgeons suggest
Medical Xpress
Johns Hopkins surgeons say skipping one commonly taken step during a routine procedure to insert a wire mesh stent into a partially blocked carotid artery appears to prevent patients from developing dangerously low blood pressure, an extremely slow heart rate or even a stroke or heart attack. The surgeons say inflating a balloon inside the artery after placing the stent greatly increases patients' risk of serious complications. Current standard practice by most physicians is to inflate the balloon to open up the artery before placing the carotid stent and again afterward.
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3-D printing pen lets surgeons draw cells on damaged bones, speeding recovery
A “bio pen” that allows surgeons to draw layers of healing cells on damaged bones and cartilage is closer to entering clinical trials after its creators handed it over to scientists at St. Vincent’s Hospital in Melbourne, Australia, for further refinement. Developed at the University of Wollongong in Australia, the pen extrudes cells mixed with a biologically friendly material like seaweed extracts. The mixture is encased in a gel, which can then be painted on in layers. Each layer is cured with an ultraviolet light.
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Surgeons describe new knee ligament
Medical News Today
At the Belgian University Hospitals Leuven, two knee surgeons have for the first time given a full anatomical description of a new ligament that they term the anterolateral ligament (ALL). The new ligament is thought to play an important role in anterior cruciate ligament (ACL) tears.

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Pharmaceutical industry exerts influence on statin guidelines
By Dr. Jonathan Kaplan
On Nov. 12, the American College of Cardiology and American Heart Association came out with their 2013 guidelines for who should be on statin therapy to lower their bad cholesterol levels. When I saw them, I was surprised by the recommendations of widespread expansion of statin use. The new guidelines recommended what amounts to one-third of American adults being placed on cholesterol-lowering statins.

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New robotic technology removes diseased gallbladders through belly button
Lodi News
Then one day last summer on his way to the bank, he said he experienced the same pain along with sweating so profusely his shirt was sticking to his skin. The 61-year-old thought he was has having a heart attack. He turned the car around and went home, and his wife took him to the Lodi Memorial Hospital emergency room.

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Reactions mixed to announced meaningful use changes
By Pamela Lewis Dolan
A new proposed timeline for the meaningful use incentive program for electronic health record use was announced by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT. The change came with mixed reaction from many healthcare member organizations advocating for more flexibility in the incentive program. It was also met with some initial confusion over what the revised timeline means.
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Study raises ethical questions about limits of informed consent for 'big surgery'
Health Canal
When surgeons about to perform a high-risk operation discuss it with their patients, most do not bring up the potential for aggressive interventions afterward or determine their patients’ preferences for those interventions, according to a new study from the University of Wisconsin School of Medicine and Public Health. The study suggests that despite surgeons’ pre-operative explanations about procedural risk and their commitment to patient survival, there is little evidence that patients explicitly “buy in” to the use of aggressive interventions beyond the operation itself. The researchers say the study raises ethical questions about the boundaries of surgical informed consent.
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Ultrasound microscopy: An aid for surgeons to make the invisible, visible
Medical Xpress
An ultrasonic microscope emits a high frequency sound at an object, and the reflected sound captured by its lens is converted into two dimensional image of the object under scrutiny. Ultrasonic microscopes have a wide range of applications including determining the presence of otherwise invisible defects in components used in the automobile, aeronautical, and construction industries.
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Surgeons predict seasonal spike in Americans seeking plastic surgery abroad
Irina Gonzalez remembers thinking the hospital was far smaller than the ones she was used to seeing in the U.S. when she traveled to Colombia in 2009 for gastric bypass surgery. She returned again in 2010 for an upper body lift, lower body lift, arm lift, liposuction and breast augmentation in one fell swoop — procedures that would have taken years to complete in the U.S., she said. “The exams, in some way, seemed more casual,” Gonzalez, 27, recalled to Metro. “The first time I went in, I remember thinking the hospital wasn’t exactly state-of-the-art.”
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Are today's new surgeons unprepared?
The New York Times (opinion)
The surgeon had no prestigious named professorship, no N.I.H. grant and no plum administrative position in the hospital’s hierarchy. But to the other surgeons-in-training and me, he was exactly who we wanted to be. A decade or two earlier, he had started out like us, as a lowly resident in the medical center, but had finished his training elsewhere. When he returned to open a practice, the other doctors in town welcomed him back as one of their own. But they soon discovered that he had become a surgeon like few others. He finished in an hour operations that took most surgeons three or four and had few complications and enviable patient outcomes.
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Missed last week's issue? See which articles your colleagues read most.

    Using rapid prototyping technology in complicated surgeries (Medical Xpress)
Low rate of bleeding with factor IX fusion protein (Medpage Today)
Intuitive robots may stall in surgery, company warns (Bloomberg)
Weight-loss surgery gaining popularity (U-T San Diego)
New findings for patients who undergo face transplants (CNN)

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