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March 2013 Briefing - Orthopedics

March 2013 Briefing - Orthopedics

Many Uninsured Vets Will Be Eligible for Medicaid Under ACA

FRIDAY, March 29 (HealthDay News) -- A large proportion of uninsured veterans and their spouses will be eligible for Medicaid or new subsidies for coverage under the Affordable Care Act (ACA), according to a report published by the Robert Wood Johnson Foundation.

More Information (http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf405143 )

Cervical Discectomy, Fusion Is Durable and Cost-Effective

FRIDAY, March 29 (HealthDay News) -- Single-level instrumented anterior cervical discectomy and fusion (ACDF) is durable and cost-effective after five years of follow-up, according to a study published in the March 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/03150/Cost_Effectiveness_of_Single_Level_Anterior.4.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/03150/Cost_Effectiveness_of_Single_Level_Anterior.4.aspx )

Low Vitamin D Levels Common Among Spinal Fusion Patients

THURSDAY, March 28 (HealthDay News) -- A substantially high number of patients undergoing spinal fusion have a vitamin D deficiency or inadequacy, according to a study published in the March 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/03150/Preoperative_Vitamin_D_Status_of_Adults_Undergoing.10.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/03150/Preoperative_Vitamin_D_Status_of_Adults_Undergoing.10.aspx )

Regional Variation Noted in Prevalence of Delayed Care

THURSDAY, March 28 (HealthDay News) -- There is considerable county-wide variation in the prevalence of delayed care, with high prevalence linked to a weaker health care infrastructure, according to a letter published in the March 28 issue of the New England Journal of Medicine.

Full Text (http://www.nejm.org/doi/full/10.1056/NEJMc1214874 )

Study: Primary Care Extension Program Should Be Funded

THURSDAY, March 28 (HealthDay News) -- The Primary Care Extension Program (PCEP) has the potential to transform primary care and needs to be funded, according to a study published in the March/April issue of the Annals of Family Medicine.

Abstract (http://annfammed.org/content/11/2/173.abstract )Full Text (subscription or payment may be required) (http://annfammed.org/content/11/2/173.full )

Using Internet Search Logs Can Help Identify Drug Interactions

THURSDAY, March 28 (HealthDay News) -- Search logs can be used to inexpensively mine for anonymized signals that may alert authorities to potential drug interactions and add new Web-scale pharmacovigilance capabilities, according to research published online March 6 in the Journal of the American Medical Informatics Association.

Abstract (http://jamia.bmj.com/content/early/2013/02/05/amiajnl-2012-001482.abstract )Full Text (subscription or payment may be required) (http://jamia.bmj.com/content/early/2013/02/05/amiajnl-2012-001482.full.pdf+html )

Inpatient Deaths Fell by 8 Percent in Last Decade

WEDNESDAY, March 27 (HealthDay News) -- The number of inpatient hospital deaths declined by 8 percent over the last decade, although the total number of hospitalizations increased by 11 percent during the same period, according to a March data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

Full Text (http://www.cdc.gov/nchs/data/databriefs/db118.htm )

Majority of Lumbar Spine MRIs Are Inappropriately Ordered

WEDNESDAY, March 27 (HealthDay News) -- There is substantial overuse of lumbar magnetic resonance imaging (MRI) scans, according to a research letter published online March 25 in JAMA Internal Medicine.

Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1672286 )

Submitting Peer-Review Reports Could Expedite Process

WEDNESDAY, March 27 (HealthDay News) -- Attaching previous peer-review reports during the next submission of the same paper to a different journal could optimize the peer-review process, according to research published in the March/April issue of the Annals of Family Medicine.

Abstract (http://www.annfammed.org/content/11/2/179.abstract?sid=830532ac-da58-4c89-87ca-b0c3ee2f8ffc )Full Text (http://www.annfammed.org/content/11/2/179.full )Editorial (http://www.annfammed.org/content/11/2/104.full?sid=48707c4b-ebf8-4a86-b8b0-726cf918c1ed )

Elevated Blood Cobalt Levels Linked to Metal Hip Failures

TUESDAY, March 26 (HealthDay News) -- Elevated blood cobalt concentrations are associated with an increased risk of early joint failure in metal-on-metal (MoM) hip resurfacings secondary to the development of an adverse local tissue response, according to a study published online March 12 in BMJ Open.

Abstract (http://bmjopen.bmj.com/content/3/3/e001541.short?g=w_open_current_tab )Full Text (http://bmjopen.bmj.com/content/3/3/e001541.full )

Residency Reforms Reduced Duty Hours, Increased Sleep

TUESDAY, March 26 (HealthDay News) -- Additional residency reforms implemented in 2011 have reduced duty hours and increased sleep duration, but with perceived reductions in quality of patient care, according to research published online March 25 in JAMA Internal Medicine.

Abstract - Sen (http://archinte.jamanetwork.com/article.aspx?articleid=1672284#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1672284 )Abstract - Desai (http://archinte.jamanetwork.com/article.aspx?articleid=1672279#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1672279 )

High Mortality, Morbidity With Early-Onset Scoliosis Surgery

MONDAY, March 25 (HealthDay News) -- Surgery for patients with early-onset scoliosis is associated with an 18 percent mortality rate and an 84 percent complication rate, according to research published in the Feb. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/02150/Mortality_and_Morbidity_in_Early_Onset_Scoliosis.7.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/02150/Mortality_and_Morbidity_in_Early_Onset_Scoliosis.7.aspx )

Sports Concussion Management Recommendations Updated

FRIDAY, March 22 (HealthDay News) -- Recommendations for sports concussion and its management have been updated, according to a consensus statement published in the April issue of the British Journal of Sports Medicine.

Abstract (http://bjsm.bmj.com/content/47/5/250.extract )Full Text (http://bjsm.bmj.com/content/47/5/250.full )

Mobility Impaired May Have Difficulty Accessing Docs

FRIDAY, March 22 (HealthDay News) -- Many U.S. subspecialty practices cannot accommodate patients with mobility impairment, according to a study published in the March 19 issue of the Annals of Internal Medicine.

Full Text (subscription or payment may be required) (http://annals.org/article.aspx?articleid=1667265 )Editorial (subscription or payment may be required) (http://annals.org/article.aspx?articleID=1667280 )

Review Examines Winning Elements in Spine Fellowships

FRIDAY, March 22 (HealthDay News) -- Although, ultimately, job choice is multifactorial, when evaluating spine fellowship applicants, there are objective factors in an applicant's application that are associated with a significantly higher likelihood of the individual choosing to pursue an academic position after fellowship completion, according to research published in the March 1 issue of Spine.

Full Text (http://journals.lww.com/spinejournal/Fulltext/2013/03010/Factors_Related_to_Choosing_an_Academic_Career.9.aspx )

Impact of Budget Sequestration on Health Care Discussed

THURSDAY, March 21 (HealthDay News) -- The impact of sequestration will have far-reaching consequences in health care, according to a perspective piece published online March 20 in the New England Journal of Medicine.

Full Text (http://www.nejm.org/doi/full/10.1056/NEJMp1303266?query=featured_home )

Race Influences Lower Extremity Ischemia Treatment

THURSDAY, March 21 (HealthDay News) -- Even after adjustment for confounding variables, black patients are significantly more likely to undergo amputation for critical lower extremity ischemia, according to a study published online March 20 in JAMA Surgery.

Abstract (http://archsurg.jamanetwork.com/article.aspx?articleid=1669979#Abstract )Full Text (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1669979 )Editorial (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1669980 )

Effect of Immigration Status on Medicaid Eligibility Discussed

WEDNESDAY, March 20 (HealthDay News) -- Under the Affordable Care Act, a considerable proportion of low-income uninsured adults will be ineligible for Medicaid coverage due to their immigration status, and their main providers are likely to be safety-net health care providers, according to a March report published by the State Health Access Data Assistance Center.

More Information (http://www.rwjf.org/en/research-publications/find-rwjf-research/2013/03/state-estimates-of-the-low-income-uninsured-not-eligible-for-the.html )

Manual Osteopathic Treatment Improves Chronic Back Pain

WEDNESDAY, March 20 (HealthDay News) -- Treatment of nonspecific chronic low back pain with osteopathic manual treatment (OMT) is associated with moderate or substantial improvements in low back pain, according to a study published in the March/April issue of the Annals of Family Medicine.

Abstract (http://www.annfammed.org/content/11/2/122.abstract )Full Text (http://www.annfammed.org/content/11/2/122.full )

Total Knee Replacement Poses Large Public Health Burden

WEDNESDAY, March 20 (HealthDay News) --The prevalence of total knee replacement is estimated at 4.2 percent for U.S. adults aged 50 years and older, according to a study published in the March 6 issue of The Journal of Bone & Joint Surgery.

Abstract (http://jbjs.org/article.aspx?articleid=1555390 )Full Text (subscription or payment may be required) (http://jbjs.org/article.aspx?articleid=1555390 )

ER Discharge Dx/Disposition Discordant With Chief Complaint

TUESDAY, March 19 (HealthDay News) -- A considerable proportion of patients with emergency department visits with the same presenting complaint as those ultimately given a primary care-treatable diagnosis require immediate emergency care or hospital admission, according to a study published in the March 20 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1669818#Abstract )Full Text (http://jama.jamanetwork.com/article.aspx?articleid=1669818 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1669802 )

Conflict-of-Interest Disclosures Common at 2011 AAOS Meeting

TUESDAY, March 19 (HealthDay News) -- At the 2011 American Academy of Orthopaedic Surgeons (AAOS) annual meeting, voluntarily disclosed conflicts of interest were common, especially for featured symposia, according to a study published in the March 6 issue of The Journal of Bone & Joint Surgery.

Abstract (http://jbjs.org/article.aspx?articleid=1654958 )Full Text (subscription or payment may be required) (http://jbjs.org/article.aspx?articleid=1654958 )

Cervical Cord Contusions in Athletes Characterized

MONDAY, March 18 (HealthDay News) -- In professional athletes, cervical spinal cord contusion may be due, in part, to congenital stenosis, the horizontal facet orientation of the cervical C3-C4 level, and the relative hypermobility of extension in this area, according to research published in the Feb. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/02150/Cervical_Spinal_Cord_Contusion_in_Professional.6.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/02150/Cervical_Spinal_Cord_Contusion_in_Professional.6.aspx )

AAN Updates Guidelines for Sports Concussion Management

MONDAY, March 18 (HealthDay News) -- The risks, diagnosis, and management of sports concussion have been reviewed in updated guidelines published online March 18 by the American Academy of Neurology (AAN) in Neurology.

Abstract (http://www.neurology.org/content/early/2013/03/15/WNL.0b013e31828d57dd.abstract )Full Text (http://www.neurology.org/content/early/2013/03/15/WNL.0b013e31828d57dd.full.pdf+html )Editorial (http://www.neurology.org/content/early/2013/03/15/WNL.0b013e31828d9c13.full.pdf+html )

Final Rule in Notice of Benefit, Payment Parameters Issued

FRIDAY, March 15 (HealthDay News) -- The final rule of the Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2014, which expands on existing standards, has been released.

More Information (http://content.govdelivery.com/bulletins/gd/USCMS-6ebb0f )

Health Insurance Exchanges Will Mainly Be Run by Feds

FRIDAY, March 15 (HealthDay News) -- More than half of the states within the United States will allow the federal government to establish health insurance exchanges, according to a report issued by the Henry J. Kaiser Family Foundation.

More Information (http://www.statehealthfacts.org/comparemaptable.jsp?ind=962&cat=17 )

Pharmaceutical Companies Are Reducing Promotional Spending

FRIDAY, March 15 (HealthDay News) -- Pharmaceutical companies have been reducing the amount of money they spend on promotion to consumers and providers over the past decade and spend much less to promote biologics compared with small molecule drugs, according to a study published online March 4 in PLOS ONE.

Full Text (http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0055504 )

Exercise, Counseling Cut Days Off From Back Pain in Recruits

FRIDAY, March 15 (HealthDay News) -- Neuromuscular exercise and counseling decrease the number of days off due to low back pain (LBP) among young men serving in the military, according to a study published in the March 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/03010/Neuromuscular_Exercise_and_Counseling_Decrease.2.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/03010/Neuromuscular_Exercise_and_Counseling_Decrease.2.aspx )

Multiple Cone-Beam Scans Fall Within Acceptable Ranges

THURSDAY, March 14 (HealthDay News) -- The radiation dose imparted to patients undergoing multiple intraoperative lumbar single cone-beam computed tomography (CT) scans is within the dose range that patients receive during a single fan-beam abdominal CT scan, according to research published in the March 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/03010/Estimating_the_Effective_Radiation_Dose_Imparted.21.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/03010/Estimating_the_Effective_Radiation_Dose_Imparted.21.aspx )

MRI Assessment Doesn't ID Recurrent Sciatica at One Year

WEDNESDAY, March 13 (HealthDay News) -- For patients treated for sciatica and lumbar-disc herniation, magnetic resonance imaging (MRI) performed at one year does not distinguish between those with and without favorable outcome, according to a study published in the March 14 issue of the New England Journal of Medicine.

Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMoa1209250 )Editorial (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMe1215599 )

Neck Injuries Tied to Higher Costs for Patients, Spouses

WEDNESDAY, March 13 (HealthDay News) -- Neck injuries are associated with significant health, social, and economic consequences for patients and their spouses, according to research published in the March 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/03010/Health,_Social,_and_Economic_Consequences_of_Neck.14.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/03010/Health,_Social,_and_Economic_Consequences_of_Neck.14.aspx )

AMA Files Brief Contesting Insurer's Payment Practices

WEDNESDAY, March 13 (HealthDay News) -- A landmark case examining the question of whether physicians can bring a class arbitration against a health insurer who has underpaid them is currently before the U.S. Supreme Court, in a brief filed by the Litigation Center of the American Medical Association and State Medical Societies and the Medical Society of New Jersey.

More Information (http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page? )

Sentinel Injuries Are Common in Infants Who Are Abused

WEDNESDAY, March 13 (HealthDay News) -- Sentinel injuries are common among infants who suffer abuse and are rare in those who are evaluated for abuse and found to not be abused, according to a study published online March 11 in Pediatrics.

Abstract (http://pediatrics.aappublications.org/content/early/2013/03/06/peds.2012-2780.abstract )Full Text (subscription or payment may be required) (http://pediatrics.aappublications.org/content/early/2013/03/06/peds.2012-2780.full.pdf+html )

$120 Million to Be Sequestered From Health Centers in 2013

TUESDAY, March 12 (HealthDay News) -- Budget sequestration, which is expected to reduce federal spending, is likely to result in a $120 million loss in grant funding for the nation's 1,200 community health centers in 2013, according to a report published by the Geiger Gibson/ RCHN Community Health Foundation Research Collaborative.

More Information (http://sphhs.gwu.edu/departments/healthpolicy/publications/GGRCHN.pdf )

Da Vinci Robot Used in Anterior Lumbar Interbody Fusion

TUESDAY, March 12 (HealthDay News) -- The da Vinci Robotic Surgical System can be used for anterior lumbar interbody fusion, according to a case report published in the Feb. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/02150/The_da_Vinci_Robotic_Surgical_Assisted_Anterior.11.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/02150/The_da_Vinci_Robotic_Surgical_Assisted_Anterior.11.aspx )

Little Evidence Red Flags Are Useful in Detecting Spinal Woes

FRIDAY, March 8 (HealthDay News) -- Researchers have doubts as to the diagnostic accuracy or usefulness of red flag indicators to detect or exclude spinal malignancy in patients with low back pain (LBP), according to research published online Feb. 28 in The Cochrane Library.

Abstract (http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008686.pub2/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008686.pub2/full )

Risk Factors ID'd for Massive Blood Loss in Scoliosis Surgery

FRIDAY, March 8 (HealthDay News) -- For patients undergoing scoliosis surgery, the risk of massive blood loss is increased with preoperative Cobb angles bigger than 50 degrees and for those undergoing osteotomy or fusion of more than six levels, according to a study published in the Feb. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/02150/Prediction_of_Massive_Blood_Loss_in_Scoliosis.10.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/02150/Prediction_of_Massive_Blood_Loss_in_Scoliosis.10.aspx )

Double-Jointed Adolescents Risk Musculoskeletal Pain

THURSDAY, March 7 (HealthDay News) -- Joint hypermobility (JH) increases the risk of musculoskeletal pain in adolescence, particularly in the shoulder, knee, and ankle/foot, according to a study published online Feb. 28 in Arthritis & Rheumatism.

Abstract (http://onlinelibrary.wiley.com/doi/10.1002/art.37836/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/art.37836/pdf )

Clinical Trials Published Almost Two Years After Completion

WEDNESDAY, March 6 (HealthDay News) -- Clinical trials are published, on average, almost two years after completion, with time to publication affected by the funding source, number of trial participants, and journal impact factor, according to a research letter published online March 4 in JAMA Internal Medicine.

Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1657754 )

U.K. Health Performance Worse Than Comparable Countries

TUESDAY, March 5 (HealthDay News) -- The United Kingdom has worse health performance than other comparable countries, according to a study published online March 5 in The Lancet.

Abstract (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60355-4/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60355-4/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60188-9/fulltext )

Proportion of Black Males in U.S. Medical Schools Dropping

MONDAY, March 4 (HealthDay News) -- The proportion of black males in medical school is decreasing, according to a report published by the Association of American Medical Colleges (AAMC).

More Information (https://www.aamc.org/initiatives/diversity/179816/facts_and_figures.html )

Steroid Injections May Worsen Spinal Stenosis Outcomes

MONDAY, March 4 (HealthDay News) -- The use of epidural steroid injections (ESIs) may be linked to worse outcomes over four years in patients with lumbar spinal stenosis whether they are treated surgically or nonsurgically, according to a study published in the Feb. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Fulltext/2013/02150/Epidural_Steroid_Injections_Are_Associated_With.2.aspx )Full Text (http://journals.lww.com/spinejournal/Fulltext/2013/02150/Epidural_Steroid_Injections_Are_Associated_With.2.aspx )

Panel Recommends 10 Patient Safety Strategies

MONDAY, March 4 (HealthDay News) -- An expert panel is strongly encouraging the immediate adoption of 10 patient safety strategies and encouraging the adoption of a further 12, according to a supplement published in the March 5 issue of the Annals of Internal Medicine.

Full Text (http://annals.org/article.aspx?articleid=1657884 )Editorial (http://annals.org/article.aspx?articleid=1656416 )

CMS Reports on Progress Toward Improved Health Care

MONDAY, March 4 (HealthDay News) -- Considerable progress has already been made toward improving the quality and delivery of health care, according to a Centers for Medicare and Medicaid Services (CMS) bulletin published online Feb. 28.

More Information (http://content.govdelivery.com/bulletins/gd/USCMS-6e809e )

Ethnic, Socioeconomic Factors Impact Scoliosis Tx, Outcome

FRIDAY, March 1 (HealthDay News) -- For hospitalized patients with idiopathic scoliosis, ethnic and socioeconomic variables influence treatment and outcomes, according to a study published in the February issue of The Spine Journal.

Abstract (http://www.thespinejournalonline.com/article/S1529-9430(12)01281-8/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430(12)01281-8/fulltext )

Impact of Osteoporosis Tx on Spinal Fusion Unclear

FRIDAY, March 1 (HealthDay News) -- The effect of osteoporosis therapies (bisphosphonate drugs and intermittent parathyroid hormone [PTH]) on spinal fusion is unclear, according to a review published in the February issue of The Spine Journal.

Abstract (http://www.thespinejournalonline.com/article/S1529-9430(12)00276-8/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430(12)00276-8/fulltext )

Sequestration to Impact Health Care-Related Programs

FRIDAY, March 1 (HealthDay News) -- The $85 billion of mandatory cuts in federal spending that take effect March 1 as part of sequestration will be felt across health care and related programs, with cuts to Medicare providers and to the budgets of federal agencies.

More Information (http://www.cms.gov/ )