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May 2013 Briefing - Orthopedics

May 2013 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for May 2013. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

New Statement Released by Anticoagulation Forum

FRIDAY, May 31 (HealthDay News) -- The Anticoagulation Forum has endorsed a new consensus statement aimed at optimizing the delivery of anticoagulation therapy to inpatients; the statement has been published in the May issue of the Annals of Pharmacotherapy.

Abstract (http://www.theannals.com/content/47/5/714.abstract )Full Text (http://www.theannals.com/content/47/5/714.full )

Patients Who Share in Care Decisions May Up Costs of Care

THURSDAY, May 30 (HealthDay News) -- Patient preference for participating in shared decision making regarding care may increase length of hospital stays and costs of care, according to research published online May 27 in JAMA Internal Medicine.

Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1691765#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1691765 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1691772 )

Odds of Mortality Up With Elective Surgery on Friday, Weekend

THURSDAY, May 30 (HealthDay News) -- For patients undergoing elective surgery, the odds of death are significantly increased for those who undergo the procedure on Friday or at the weekend, compared with Monday, according to research published online May 28 in BMJ.

Full Text (http://www.bmj.com/content/346/bmj.f2424 )Editorial (http://www.bmj.com/content/346/bmj.f3353 )

2012 AMA Report Highlights Progress Toward Better Future

THURSDAY, May 30 (HealthDay News) -- Given the changes in America's health care system and challenges facing physicians, in 2012, the American Medical Association (AMA) focused on creating a better future for the nations' patients, physicians, and medical students, according to their annual report.

More Information (http://www.ama-assn.org/ama/pub/about-ama/ama-annual-report.page )

One-Third of Medical Students Have Implicit Anti-Fat Bias

THURSDAY, May 30 (HealthDay News) -- More than one-third of medical students have a significant implicit anti-fat bias that few are aware of, according to a study published in the July issue of Academic Medicine.

Abstract (http://journals.lww.com/academicmedicine/Abstract/publishahead/Are_Medical_Students_Aware_of_Their_Anti_obesity.99382.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/academicmedicine/Abstract/publishahead/Are_Medical_Students_Aware_of_Their_Anti_obesity.99382.aspx )

Doc Passengers Assist in Half of In-Flight Medical Emergencies

WEDNESDAY, May 29 (HealthDay News) -- Physician passengers provide medical assistance in about half of in-flight medical emergencies, which are most commonly related to syncope, respiratory symptoms, or gastrointestinal symptoms, according to a study published in the May 30 issue of the New England Journal of Medicine.

Abstract (http://www.nejm.org/doi/full/10.1056/NEJMoa1212052 )Full Text (http://www.nejm.org/doi/full/10.1056/NEJMoa1212052#t=article )

Transparency Key to Improving Value Care for Patients

WEDNESDAY, May 29 (HealthDay News) -- In order to ensure the provision of higher quality care and cost control in a post-Affordable Care Act health care system, data on price, utilization, and quality should be made publicly available unless there is a compelling publicly-acceptable justification for keeping it confidential, according to a study published online May 28 in the Annals of Internal Medicine.

Full Text (http://annals.org/article.aspx?articleid=1691701 )

Enrollment in U.S. Medical Colleges Is Increasing

WEDNESDAY, May 29 (HealthDay News) -- Enrollment in U.S. medical colleges is increasing, but there is concern about the adequacy of training opportunities, according to a report published by the Association of American Medical Colleges (AAMC).

More Information (https://members.aamc.org/eweb/upload/12-237%20EnrollmSurvey2013.pdf )

HHS: End-of-2013 Targets for EHR Use Already Reached

TUESDAY, May 28 (HealthDay News) -- The U.S. Department of Health & Human Services (HHS) has already met and exceeded its goal for 50 percent of physician offices and 80 percent of eligible hospitals to have electronic health records (EHRs) by the end of 2013, according to a report published by the department.

More Information (http://www.hhs.gov/news/press/2013pres/05/20130522a.html )

Morbid Obesity Complicates Treatment of Spine Trauma

TUESDAY, May 28 (HealthDay News) -- Morbid obesity complicates treatment of spine trauma, including imaging quality, surgical challenges, and postoperative nursing care, according to a case series published online May 21 in the Journal of Neurosurgery: Spine.

Abstract (http://thejns.org/doi/abs/10.3171/2013.4.SPINE12876 )Full Text (http://thejns.org/doi/full/10.3171/2013.4.SPINE12876 )

Telerehabilitation System Good for Assessing Low Back Pain

TUESDAY, May 28 (HealthDay News) -- A telerehabilitation system may be useful for evaluating chronic low back pain, according to a study published in the May 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/05150/Agreement_Between_Telerehabilitation_and.15.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/05150/Agreement_Between_Telerehabilitation_and.15.aspx )

Docs Anticipating Changes Ahead As ACA Progresses

MONDAY, May 27 (HealthDay News) -- Most physicians expect the Affordable Care Act (ACA) to continue as planned and expect further integration in the coming years, according to a report published by Deloitte.

More Information (http://www.deloitte.com/view/en_US/us/Insights/centers/center-for-health-solutions/a5ee019120e6d310VgnVCM1000003256f70aRCRD.htm?id=us_furl_2013physciansurvey_031813 )

Glucosamine Supplementation Linked to Intraocular Pressure

FRIDAY, May 24 (HealthDay News) -- Supplementation with glucosamine is associated with increased intraocular pressure (IOP), which decreases after discontinuation of supplementation, according to a research letter published online May 23 in JAMA Ophthalmology.

Full Text (subscription or payment may be required) (http://archopht.jamanetwork.com/article.aspx?articleid=1690919 )

Data Support Basing Health Decisions on Both Benefit, Cost

FRIDAY, May 24 (HealthDay News) -- Person-level health care expenditures per month of health status-adjusted life expectancy are much higher for adults aged 85 years and older than for 0- to 14-year-olds, but despite spending much more on health care, the aging population gets substantially less value for that spending in terms of quality and quantity of life expectancy, according to a study published in the Spring issue of the Michigan Journal of Public Affairs.

Full Text (http://www.mjpa.umich.edu/uploads/2013/davswin.pdf )

About One in Four Uninsured Could Be Excluded From ACA

FRIDAY, May 24 (HealthDay News) -- More than one in four of those eligible for new premium assistance tax credits under the Affordable Care Act (ACA) do not have a checking account and will not be able to receive premiums from insurance companies, according to a report published by Jackson Hewitt.

More Information (http://jacksonhewittaca.com/wp-content/uploads/2013/05/ACA-Banking-and-Premium-Report.pdf )

Systematic Screening of Med Adherence Will ID Barriers

WEDNESDAY, May 22 (HealthDay News) -- Implementation of systematic monitoring for medication adherence will allow for identification of barriers to adherence and tailoring of interventions, according to a viewpoint piece published in the May 22/29 issue of the Journal of the American Medical Association.

Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1690707 )

Competitive Sports Can Be Safe for Athletes With ICDs

WEDNESDAY, May 22 (HealthDay News) -- Athletes with implantable cardioverter-defibrillators (ICDs) can safely participate in competitive sports, according to a study published in the May 21 issue of Circulation.

Abstract (http://circ.ahajournals.org/content/127/20/2021.abstract )Full Text (http://circ.ahajournals.org/content/127/20/2021.full )

Study Examines Outbreak of Spinal Infections in Michigan

TUESDAY, May 21 (HealthDay News) -- Factors such as increased case finding may explain why Michigan had half of the total spinal infections associated with contaminated methylprednisolone acetate in the recent fungal meningitis outbreak, according to research published in the May 17 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

Full Text (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6219a1.htm?s_cid=mm6219a1_w )

Digital Divide Exists With Physician EHR Adoption

MONDAY, May 20 (HealthDay News) -- The majority of physicians remain reluctant to adopt health information technology (HIT), according to a report by Deloitte Touche Tohmatsu.

Report (http://www.deloitte.com/assets/Dcom-UnitedStates/Local%20Assets/Documents/Health%20Care%20Provider/us_dchs_2013PhysicianSurveyHIT_051313%20(2).pdf )

Little Evidence for Prediction Rules for Low Back Pain

FRIDAY, May 17 (HealthDay News) -- Few randomized clinical trials have been done to assess clinical prediction rules for patients with lower back pain, and the trials that have been done are of low quality and do not provide sufficient evidence to support their use, according to a review published in the April 20 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/04200/Systematic_Review_of_Randomized_Controlled_Trials.10.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/04200/Systematic_Review_of_Randomized_Controlled_Trials.10.aspx )

Prednisolone Disturbs Carbohydrate Metabolism

FRIDAY, May 17 (HealthDay News) -- In patients with inflammatory diseases without diabetes, treatment with low-dose prednisolone has deleterious effects on carbohydrate metabolism, according to a study published online May 13 in Diabetes Care.

Abstract (http://care.diabetesjournals.org/content/early/2013/05/09/dc12-2617.abstract )Full Text (subscription or payment may be required) (http://care.diabetesjournals.org/content/early/2013/05/09/dc12-2617.full.pdf+html )

Lifestyle Activities Impact Development of Spinal Stenosis

THURSDAY, May 16 (HealthDay News) -- Increased loading of the lumbar spine, arising from lifestyle activities (such as lifting heavy objects, more frequent pregnancy, and higher body mass index), could contribute to the degenerative process and lead to development of degenerative lumbar spinal stenosis (DLSS), according to a study published in the April 20 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/04200/Socioeconomic_and_Physical_Characteristics_of.21.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/04200/Socioeconomic_and_Physical_Characteristics_of.21.aspx )

Majority of Surgical Residents Object to Regulated Hours

THURSDAY, May 16 (HealthDay News) -- About 65 percent of surgical residents report that they disapprove of the 2011 Accreditation Council for Graduate Medical Education (ACGME) Common Program requirements, which place restrictions on duty hours, according to research published in the May issue of JAMA Surgery.

Abstract (http://archsurg.jamanetwork.com/article.aspx?articleid=1686084#Abstract )Full Text (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1686084 )Editorial (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1686074 )

Discectomy Post-Op Pain Worse in Patients With Retrolisthesis

THURSDAY, May 16 (HealthDay News) -- The presence of retrolisthesis in patients undergoing decompressive surgery for a lumbar disc herniation may result in significantly worse lower back pain and physical function over four years, according to a study published in the April issue of The Spine Journal.

Abstract (http://www.thespinejournalonline.com/article/S1529-9430%2812%2901293-4/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430%2812%2901293-4/fulltext )

Study Compares Surgical Procedures for Spinal Stenosis

FRIDAY, May 10 (HealthDay News) -- For patients with spinal stenosis undergoing surgery, an interspinous process with spacer alone is associated with fewer complications but higher rates of revision surgery compared with decompression or fusion, according to a study published in the May 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/05010/Interspinous_Spacers_Compared_With_Decompression.19.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/05010/Interspinous_Spacers_Compared_With_Decompression.13.aspx )

Meds for Back Pain Tied to Higher Erectile Dysfunction Risk

WEDNESDAY, May 15 (HealthDay News) -- Long-term use of painkillers for back pain is tied to an increased risk of erectile dysfunction, according to a study published in the May 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/05150/Prescription_Opioids_for_Back_Pain_and_Use_of.7.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/05150/Prescription_Opioids_for_Back_Pain_and_Use_of.7.aspx )

Combination Osteoporosis Rx Further Improves Bone Density

WEDNESDAY, May 15 (HealthDay News) -- Combination therapy with teriparatide and denosumab may be most effective in treating postmenopausal women with osteoporosis at risk for fracture, according to a study published online May 15 in The Lancet.

Abstract (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60856-9/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60856-9/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60984-8/fulltext )

No Benefit of Vertebral Body Stenting Over Kyphoplasty

WEDNESDAY, May 15 (HealthDay News) -- Among patients with painful osteoporotic vertebral fractures, there is no benefit to vertebral body stenting over balloon kyphoplasty, according to a study published in the April 3 issue of The Journal of Bone & Joint Surgery.

Abstract (http://jbjs.org/article.aspx?articleid=1668919 )Full Text (subscription or payment may be required) (http://jbjs.org/article.aspx?articleid=1668919 )

Chiropractic Therapy Helps Reduce Acute Low Back Pain

TUESDAY, May 14 (HealthDay News) -- Military personnel with acute lower back pain (LBP) who receive chiropractic manipulative therapy (CMT) in addition to standard medical care (SMC) show significantly improved scores for pain relief and physical functioning, compared to those receiving only SMC, according to a study published in the April 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/04150/Adding_Chiropractic_Manipulative_Therapy_to.2.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/04150/Adding_Chiropractic_Manipulative_Therapy_to.2.aspx )

Guidelines Issued to Prevent Infection With Dental Work

TUESDAY, May 14 (HealthDay News) -- Practitioners might consider discontinuing prophylactic antibiotics for patients with prosthetic implants undergoing dental procedures, and these patients should be encouraged to maintain appropriate oral hygiene, according to clinical practice guidelines approved by the American Academy of Orthopaedic Surgeons (AAOS) and published in the April 17 issue of The Journal of Bone & Joint Surgery.

Abstract (http://jbjs.org/article.aspx?articleid=1674961 )Full Text (subscription or payment may be required) (http://jbjs.org/article.aspx?articleid=1674961 )

Classification System Would Help Spinal Deformity Care

TUESDAY, May 14 (HealthDay News) -- The management of adult spinal deformity (ASD) and selection of optimal fusion levels is incompletely defined, according to a review article published in the April issue of The Spine Journal.

Abstract (http://www.thespinejournalonline.com/article/S1529-9430(12)01477-5/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430(12)01477-5/fulltext )

New FDA Survey to Assess Doc Attitudes on DTC Advertising

MONDAY, May 13 (HealthDay News) -- The U.S. Food and Drug Administration plans to conduct a new survey involving 2,000 health care professionals to examine their views on direct-to-consumer (DTC) advertising of prescription medications. The survey has been approved by the White House Office of Management and Budget.

More Information (http://www.pharmalive.com/fda-will-find-docs-still-detest-dtc-advertising-survey )

Self-Image Worse for Teens With Untreated Scoliosis

MONDAY, May 13 (HealthDay News) -- Adolescents with untreated adolescent idiopathic scoliosis report worse pain and worse self-image than unaffected adolescents, although the difference is clinically significant only for self-image, according to a review published in the April 20 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/04200/Comparison_of_Untreated_Adolescent_Idiopathic.12.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/04200/Comparison_of_Untreated_Adolescent_Idiopathic.12.aspx )

Poor Service, Bedside Manner Top Patients' Online Complaints

FRIDAY, May 10 (HealthDay News) -- On "rate-your-doctor" websites, patients complain more about poor bedside manner and unprofessional office staff than inadequate medical skills, according to a recent multi-city study published by Vanguard Communications.

More Information (http://vanguardcommunications.net/about/survey-results-2013/ )

User Satisfaction With Electronic Health Records Down

FRIDAY, May 10 (HealthDay News) -- Since 2010, there has been a decrease in the satisfaction and usability ratings for certified electronic health records (EHRs), according to survey results presented by the American College of Physicians (ACP) and AmericanEHR Partners.

More Information (http://www.americanehr.com/about/news/13-03-05/Survey-of-Clinicians-User-satisfaction-with-electronic-health-records-has-decreased-since-2010.aspx )

HHS Releases Data on Inpatient Charges for Hospital Services

THURSDAY, May 9 (HealthDay News) -- To promote transparency in the health care system, the first part of a three-part initiative has been released by the U.S. Department of Health and Human Services (HHS). The report provides consumers with information on hospital charges and highlights the considerable variation across the country for common inpatient services.

More Information (http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4597&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date )

Smartphones, Smartphone Apps Increasingly Used by Docs

THURSDAY, May 9 (HealthDay News) -- Smartphones and smartphone applications are increasingly being used in a professional capacity among physicians, according to two reports published in the March issue of Kantar Media Sources & Interactions Study-Medical/Surgical Edition.

Report 1 (http://www.kantarmedia-healthcare.com/how-are-physicians-using-smartphones-for-professional-purposes )Report 2 (http://www.kantarmedia-healthcare.com/more-physicians-value-and-use-mobile-apps-for-professional-purposes )

Application for Health Coverage Has Been Simplified, Shortened

WEDNESDAY, May 8 (HealthDay News) -- The application for health insurance coverage has been simplified and shortened, with the application reduced to three pages for individuals, according to a report released April 30 by the Centers for Medicare & Medicaid Services (CMS).

More Information (https://www.cms.gov/apps/media/press/release.asp?Counter=4590&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&s )

Diabetes, Hypertension Prevalent With Spinal Stenosis

TUESDAY, May 7 (HealthDay News) -- Nonelderly, older adults with lumbar spinal stenosis (LSS) have a higher prevalence of diabetes and hypertension than those without stenosis, according to a study published in the April 20 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/04200/Relationship_Between_Lumbar_Spinal_Stenosis_and.19.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/04200/Relationship_Between_Lumbar_Spinal_Stenosis_and.19.aspx )

Patients Most Annoyed by Long Waits, Unclear Test Results

FRIDAY, May 3 (HealthDay News) -- Long waiting times and unclear test results are the top patient grievances when it comes to visiting the doctor, according to a report published in the June issue of Consumer Reports.

More Information (http://www.consumerreports.org/cro/magazine/2013/06/what-bugs-you-most-about-your-doctor/index.htm )

CDC: About One in Five U.S. Adults Meets Exercise Guidelines

FRIDAY, May 3 (HealthDay News) -- In 2011, about 20 percent of U.S. adults met guidelines for both aerobic and muscle-strengthening physical activity, according to research published in the May 3 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

Full Text (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6217a2.htm?s_cid=mm6217a2_w )

Health Industry Payment Details to Be Publicly Available

THURSDAY, May 2 (HealthDay News) -- As part of the National Physician Payment Transparency Program and in compliance with a provision in the Affordable Care Act (ACA), the government will make information about financial relationships between doctors, teaching hospitals, and drug and device manufacturers publicly available on a new Centers for Medicare and Medicaid Services website, according to a report published by Kaiser Health News.

More Information (http://capsules.kaiserhealthnews.org/index.php/2013/04/new-website-will-disclose-health-%20industry-payments-to-doctors/ )

Nearly One-Third Don't Pick Up New Osteoporosis Rx

THURSDAY, May 2 (HealthDay News) -- More than 30 percent of women fail to pick up new prescriptions for osteoporosis medications, according to a study published in the April issue of Osteoporosis International.

Abstract (http://link.springer.com/article/10.1007/s00198-013-2365-y )Full Text (subscription or payment may be required) (http://link.springer.com/article/10.1007/s00198-013-2365-y )

Manufacturers Donating Limbs to Boston Victims

WEDNESDAY, May 1 (HealthDay News) -- A group of prosthetics manufacturers has pledged to provide artificial legs for victims of the Boston Marathon bombings whose insurance won't cover the full cost of prosthetic devices.

More Information (https://www.aopanet.org/index.php?option=com_content&view=article&id=412&Itemid=336 )

Neuraxial Bests General Anesthesia in Arthroplasty

WEDNESDAY, May 1 (HealthDay News) -- In patients undergoing primary joint arthroplasty, neuraxial anesthesia is associated with better postoperative outcomes than general anesthesia, according to a study published in the May issue of Anesthesiology.

Full Text (http://journals.lww.com/anesthesiology/Fulltext/2013/05000/Perioperative_Comparative_Effectiveness_of.14.aspx )

Teriparatide Injections Improve Pedicle Bone Quality

WEDNESDAY, May 1 (HealthDay News) -- Daily injection of teriparatide significantly reduces the incidence of pedicle screw (PS) loosening at one year following surgery to correct degenerative spondylolisthesis in osteoporotic postmenopausal women, according to a study published in the April 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/04150/Comparison_of_Teriparatide_and_Bisphosphonate.20.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/04150/Comparison_of_Teriparatide_and_Bisphosphonate.20.aspx )