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Medicare identifies best and worst hospitals for hip and knee replacements
NBCNews
Medicare has begun tracking the outcomes of hip and knee replacement surgeries, identifying 95 hospitals where elderly patients were more likely to suffer significant setbacks. The government also named 97 hospitals where patients tended to have the smoothest recoveries. The analysis, which was released last week, is the latest part of the government’s push to improve quality at the nation’s hospitals instead of simply paying Medicare patients’ bills. Medicare already assesses hospital death rates, how consistently hospitals follow basic medical guidelines and how patients rate their stays. The evaluation of hip and knee surgery outcomes is significant because for the first time, Medicare is rating hospitals’ performance on two common elective procedures.
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Reducing post-op pain in kids after high-risk surgery
Science 2.0
A new technique will significantly decrease pain for children following high-risk urology surgeries, according to a paper in the Journal of Pediatric Urology. The research team evaluated continuous infusion of local anesthesia using the ON-Q pain relief system to improve pain control in children undergoing urological procedures. While the ON-Q system is well-established as an effective pain management technique for adults, this is the first study that evaluates its pain management effectiveness in children.
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Meaningful use shows promise in cutting adverse drug events
By Pamela Lewis Dolan
Hospitals that adopted electronic health record systems featuring all five of the meaningful use program's stage 1 medication management functions had fewer adverse drug events compared with hospitals that have not yet implemented those features, according to a recent study in the American Journal of Managed Care. The findings revealed that the advanced medication systems not only improved patient safety by 63 percent, but also helped save the hospitals $4,790 per each adverse drug event that was averted.
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Kids' mood, anxiety, not affected by epilepsy surgery
Medscape (free subscription)
Epilepsy surgery doesn't appear to have a major effect on mood or anxiety in children, and some kids even do better, a new study has found. Parents often wonder whether their child's personality will change or if he or she will become more depressed or anxious after undergoing resection of the temporal or frontal lobe, the researchers say. Until now, doctors and other experts had little psychosocial information to guide them in making a recommendation for surgery.
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New technology sheds light on medical procedures
The Herald Bulletin
The dark ages of drawing blood and starting IVs, where veins are missed and needle pricks are repeated, may be a thing of the past. Nowadays, medical professionals can see veins below the skin surface with ease. And they can determine the size and depth with a VeinViewer. Community Hospital Anderson has been providing this illuminating technology to patients since October.

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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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Can a 'frailty score' predict surgical outcomes?
Medscape (free subscription)
The aim of this report was to provide quantitative information about the likelihood of a frail patient developing a postoperative complication. The assessment tool was the Hopkins Frailty Score, and it was evaluated in 189 patients undergoing urologic, oncologic, or general surgical procedures. Mean age of patients was 62 years, and 50 patients were scored as frail. Eighty-five complications developed in 73 patients, with complications twice as frequent in the group of frail or intermediately frail patients. The 3 postoperative deaths occurred in the frail patients.
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A 3-year-old boy receives 5 major organ transplants
The New York Daily News
A little boy in Miami underwent five major organ transplants, and came through with a smile on his face. Adonis Ortiz, 3, received transplants for a new liver, a pancreas, a stomach and large and small intestines at Jackson Memorial Hospital in Miami in October. The family said he is expected to make a full recovery, especially considering his positive attitude.
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Health app certification program halted
By Pamela Lewis Dolan
Happtique launched as a place physicians could go to find trusted apps, vetted for their credibility, privacy and security standards, that could be "prescribed" to patients. But just days after the first class of certified mobile apps was announced, the certification program was halted when an outside app developer and blogger found it to be significantly flawed, raising concerns about the thoroughness of the vetting and certification process.
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Lower mortality associated with opioid-sparing prostatectomy
Medscape (free subscription)
For patients undergoing prostatectomy, an opioid-sparing approach to anesthesia was associated with a lower risk for systemic prostate cancer progression and lower overall mortality than general anesthesia, according to the largest study of its kind.
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TRENDING ARTICLES
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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Colby Horton, Vice President of Publishing, 469.420.2601
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