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August 2013 Briefing - Orthopedics

August 2013 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for August 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.

Discontinuing Aspirin Seven Days Before Spinal Surgery OK

FRIDAY, Aug. 30 (HealthDay News) -- Patients who discontinue aspirin use seven days or more before lumbar fusion surgery have no differences in histological outcomes compared with those who do not use aspirin, according to a study published in the Aug. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/08150/Antithrombotic_Effects_of_Aspirin_on_1__or_2_Level.6.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/08150/Antithrombotic_Effects_of_Aspirin_on_1__or_2_Level.6.aspx )

Final Rules Issued for Individual Shared Responsibility Mandate

WEDNESDAY, Aug. 28 (HealthDay News) -- Starting 2014, the individual shared responsibility provision of the Affordable Care Act, which calls for each individual to have basic health insurance coverage, will be implemented, according to a statement from the U.S. Department of the Treasury.

More Information (http://www.treasury.gov/press-center/press-releases/Pages/jl2152.aspx )

Health Care Savings With Early Accountable Care Organizations

WEDNESDAY, Aug. 28 (HealthDay News) -- Early accountable care organization initiatives correlate with lower spending for elderly Medicare beneficiaries, but not necessarily with improved quality, according to a study published in the Aug. 28 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1733718#Abstract )Full Text (subscription of payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1733718 )

Spinal Surgery Helps Neuro Functioning in Dialysis Patients

WEDNESDAY, Aug. 28 (HealthDay News) -- Patients with spinal disorders undergoing hemodialysis can reliably achieve neurological and functional improvement from spinal surgery, according to a study published in the August issue of the Journal of Spinal Disorders & Techniques.

Abstract (http://journals.lww.com/jspinaldisorders/Abstract/2013/08000/Clinical_Outcomes_of_Spinal_Surgery_in_Patients.5.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/jspinaldisorders/Abstract/2013/08000/Clinical_Outcomes_of_Spinal_Surgery_in_Patients.5.aspx )

Imaging Important in Treating Boston Marathon Injuries

MONDAY, Aug. 26 (HealthDay News) -- Blast injuries within civilian populations such as the Boston Marathon bombings should immediately be imaged by radiology or computed tomography to quickly assess damage and determine the course of treatment, according to a study published online Aug. 26 in Arthritis Care & Research.

Abstract (http://onlinelibrary.wiley.com/doi/10.1002/acr.22113/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/acr.22113/pdf )

Cognitive, Physical Impairment Mar Driving in Chronic Whiplash

MONDAY, Aug. 26 (HealthDay News) -- Cognitive and physical impairments have an independent effect on self-reported driving difficulty in individuals with chronic whiplash-associated disorder, according to a study published in the Aug. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/08150/Contributions_of_Physical_and_Cognitive.5.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/08150/Contributions_of_Physical_and_Cognitive.5.aspx )

Calcium + Vitamin D Does Not Reduce Joint Symptoms

MONDAY, Aug. 26 (HealthDay News) -- Calcium plus vitamin D supplementation does not reduce the frequency or severity of joint symptoms in women, according to a study published online Aug. 19 in the Journal of the Academy of Nutrition and Dietetics.

Abstract (http://www.andjrnl.org/article/S2212-2672%2813%2900685-0/abstract )Full Text (subscription or payment may be required) (http://www.andjrnl.org/article/S2212-2672%2813%2900685-0/fulltext )

Multimodal Analgesia Lessens Post-Op Morphine Needs

FRIDAY, Aug. 23 (HealthDay News) -- A multimodal analgesia combination appears to be safe and effective for pain relief after lumbar decompressive laminectomy, according to a study published in the August issue of the Journal of Spinal Disorders & Techniques.

Abstract (http://journals.lww.com/jspinaldisorders/Abstract/2013/08000/A_Multimodal_Approach_for_Postoperative_Pain.1.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/jspinaldisorders/Abstract/2013/08000/A_Multimodal_Approach_for_Postoperative_Pain.1.aspx )

Reference Pricing Changes Consumers' Choices

FRIDAY, Aug. 23 (HealthDay News) -- Consumer cost sharing resulting from reference pricing redirects patient volumes and reduces hospital prices for orthopedic surgery, according to research published in the August issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/8/1392.abstract?=right )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/8/1392.full )

Baseline Pain Severity Predicts Worse Long-Term LBP Outcomes

THURSDAY, Aug. 22 (HealthDay News) -- Patients' baseline pain and the perception that their pain will persist are significant predictors of poor outcomes for low back pain (LBP) over the short and long term, according to a study published in the August issue of The Journal of Pain.

Abstract (http://www.jpain.org/article/S1526-5900%2813%2900962-0/abstract )Full Text (http://www.jpain.org/article/S1526-5900(13)00962-0/fulltext )

Tofacitinib Ups Rheumatoid Arthritis Treatment Response

THURSDAY, Aug. 22 (HealthDay News) -- The addition of tofacitinib to rheumatoid arthritis (RA) treatment regimens improves patient response to non-biologic disease-modifying antirheumatic drugs (DMARDs), according to a study published in the Aug. 20 issue of the Annals of Internal Medicine.

Full Text (subscription or payment may be required) (http://annals.org/article.aspx?articleid=1726820 )

Screening Strategy Doesn't Affect Hip Dysplasia Outcomes

THURSDAY, Aug. 22 (HealthDay News) -- Degenerative changes with hip dysplasia are similar in long-term maturity follow-up regardless of ultrasound screening approach, according to a study published online Aug. 19 in Pediatrics.

Abstract (http://pediatrics.aappublications.org/content/early/2013/08/13/peds.2013-0911.abstract )Full Text (subscription or payment may be required) (http://pediatrics.aappublications.org/content/early/2013/08/13/peds.2013-0911.full.pdf+html )

Implications, Solutions for U.S. Health Disparities Discussed

TUESDAY, Aug. 20 (HealthDay News) -- Research on health disparities in the United States, the policy implications of these disparities, and suggestions for improvement of disparities are discussed in "Health Policy Brief: Health Gaps," published Aug. 15 in Health Affairs.

Full Text (http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=98 )

Lateral Wedges No Better Than Neutral Insole for Knee OA

TUESDAY, Aug. 20 (HealthDay News) -- For patients with knee osteoarthritis, the use of lateral wedges offers no significant benefit versus a neutral insole comparator, according to research published in the Aug. 21 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1730513#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1730513 )

Spinal Radiosurgery Ups Risk of Vertebral Fracture

TUESDAY, Aug. 20 (HealthDay News) -- Vertebral compression fracture (VCF) is a common adverse effect in patients receiving spine stereotactic body radiotherapy (SBRT), according to research published online Aug. 19 in the Journal of Clinical Oncology.

Abstract (http://jco.ascopubs.org/content/early/2013/08/19/JCO.2013.50.1411.abstract )Full Text (subscription or payment may be required) (http://jco.ascopubs.org/content/early/2013/08/19/JCO.2013.50.1411.full.pdf+html )

Increasing Operating Costs Top Concern for Medical Practices

TUESDAY, Aug. 20 (HealthDay News) -- The top five concerns of medical practice executives all relate to financial management, with dealing with increasing operating costs reported as the most difficult daily challenge, according to a report published by the Medical Group Management Association (MGMA).

More Information (http://www.mgma.com/press/default.aspx?id=1374836 )

Expansion of Pharmacists' Practice Will Benefit Patients

MONDAY, Aug. 19 (HealthDay News) -- The expanding scope of pharmacists' practice will potentially improve patient care but has implications for physicians, according to an article published online Aug. 19 in CMAJ, the journal of the Canadian Medical Association.

Full Text (subscription or payment may be required) (http://www.cmaj.ca/content/early/2013/08/19/cmaj.121990 )

Bloodspot-Based Biomarker Test Identifies Fibromyalgia

MONDAY, Aug. 19 (HealthDay News) -- A rapid biomarker-based method using blood samples is able to accurately differentiate patients with fibromyalgia syndrome (FM) from those with rheumatoid arthritis (RA) or osteoarthritis (OA), according to a study published in the Aug. 21 issue of Analyst.

Abstract (http://pubs.rsc.org/en/content/articlelanding/2013/an/c3an36615d )Full Text (subscription or payment may be required) (http://pubs.rsc.org/en/content/articlelanding/2013/an/c3an36615d )

HHS Awards $67 Million to Marketplace Navigators

MONDAY, Aug. 19 (HealthDay News) -- $67 million is being awarded to Navigator grant applicants and their staff, who will serve as an in-person resource for those requiring additional assistance in shopping for and enrolling in Health Insurance Marketplace plans, according to a report published by the U.S. Department of Health and Human Services.

More Information (http://www.hhs.gov/news/press/2013pres/08/20130815a.html )

Osteoarthritis Pain Negatively Impacts a Spouse's Sleep

FRIDAY, Aug. 16 (HealthDay News) -- For patients with knee osteoarthritis, pain impacts spouses' sleep, according to a study published in the September issue of PAIN.

Abstract (http://www.sciencedirect.com/science/article/pii/S0304395913002467 )Full Text (subscription or payment may be required) (http://www.sciencedirect.com/science/article/pii/S0304395913002467 )

IOM Describes Themes Relating to Patients' Role in Health Care

FRIDAY, Aug. 16 (HealthDay News) -- Themes and messages relating to the role of patients in informed care decisions, knowledge generation, and value improvement were discussed at the Institute of Medicine's (IOM) Workshop Proceedings, according to a report published Aug. 15 in conjunction with the transcript of the proceedings.

More Information (http://www.iom.edu/Reports/2013/Partnering-with-Patients-to-Drive-Shared-Decisions-Better-Value-and-Care-Improvement.aspx )

Doctors Pessimistic About Future of U.S. Health Care

THURSDAY, Aug. 15 (HealthDay News) -- Physicians report concerns regarding health care delivery and the future of health care, according to survey findings published by athenahealth.

More Information (http://investors.athenahealth.com/phoenix.zhtml?c=213592&p=irol-newsArticle&ID=1846875&highlight= )

Involved Patients Have Better Health Care Experiences

THURSDAY, Aug. 15 (HealthDay News) -- Health care providers and patients shape the care experience, and strategies to improve care interactions should also help patients ensure that their needs are met, according to research published in the July issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/7/1299.abstract )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/7/1299.full )

Medicare Reimbursement Drives Procedural Over Cognitive Care

WEDNESDAY, Aug. 14 (HealthDay News) -- Physicians treating Medicare patients are reimbursed three to five times more for performing common procedures versus providing cognitive care, according to a study published online Aug. 12 in JAMA Internal Medicine.

Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1726999#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1726999 )

Physicians Should Consider Social Media As Public Space

WEDNESDAY, Aug. 14 (HealthDay News) -- A new approach is needed for resolving the physician online identity crisis, according to a viewpoint piece published in the Aug. 14 issue of the Journal of the American Medical Association.

Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1728725 )

Post-Op PTSD Tied to Reduced Elective Lumbar Fusion Benefit

WEDNESDAY, Aug. 14 (HealthDay News) -- Postoperative posttraumatic stress disorder (PTSD) symptoms are strongly correlated with reduced clinical benefit from elective lumbar spinal fusion, according to a study published in the Aug. 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/08010/Post_traumatic_Stress_Symptoms_After_Elective.12.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/08010/Post_traumatic_Stress_Symptoms_After_Elective.12.aspx )

New Initiative Announced for Patient-Doc Collaboration

TUESDAY, Aug. 13 (HealthDay News) -- A new Center for Patient Partnership in Healthcare (CPPH) has been launched to advance physician-patient collaboration, according to a report published by the American College of Physicians (ACP).

More Information (http://www.acponline.org/pressroom/cpph.htm?hp )

Low Risk Rule Cuts Use of X-Rays in Child Ankle Injuries

TUESDAY, Aug. 13 (HealthDay News) -- Introduction of the Low Risk Ankle Rule in emergency departments significantly reduces the rate of pediatric ankle radiography, according to research published online Aug. 12 in CMAJ, the Journal of the Canadian Medical Association.

Abstract (http://www.cmaj.ca/content/early/2013/08/12/cmaj.122050 )Full Text (http://www.cmaj.ca/content/early/2013/08/12/cmaj.122050.full.pdf+html )

Perceived Doc Verbal Abuse Impairs Nurses' Work Attitude

TUESDAY, Aug. 13 (HealthDay News) -- For registered nurses (RNs), perceived verbal abuse by physicians correlates with less favorable work conditions and attitudes, according to a study published in Nursing Outlook.

Abstract (http://www.nursingoutlook.org/article/S0029-6554(13)00005-5/abstract )Full Text (subscription or payment may be required) (http://www.nursingoutlook.org/article/S0029-6554(13)00005-5/fulltext )

U.S. Hospitals Up Exchange of Electronic Health Information

MONDAY, Aug. 12 (HealthDay News) -- Between 2008 and 2012, hospitals significantly increased their exchange of electronic health information with other providers, according to research published in the August issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/8/1346.abstract )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/8/1346.full )

Guidelines for Post-HIV Exposure Management Updated

MONDAY, Aug. 12 (HealthDay News) -- Management and prophylaxis recommendations have been updated for health care providers with occupational exposure to HIV, according to guidelines published in the September issue of Infection Control and Hospital Epidemiology.

Full Text (http://www.jstor.org/stable/10.1086/672271 )

Carbon Ion Radiation Safe and Effective for Spinal Tumors

MONDAY, Aug. 12 (HealthDay News) -- In patients with inoperable spinal tumors, carbon ion radiotherapy (CIRT) is a safe and effective treatment, according to a study published online Aug. 12 in Cancer.

Abstract (http://onlinelibrary.wiley.com/doi/10.1002/cncr.28177/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/cncr.28177/full )

Post-Op Cervical Fusion X-Rays May Be Superfluous

MONDAY, Aug. 12 (HealthDay News) -- X-rays taken during postoperative visits following cervical fusion surgery are rarely of value when history and exam are normal, according to a study published in the July issue of The Spine Journal.

Abstract (http://www.thespinejournalonline.com/article/S1529-9430(13)00074-0/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430(13)00074-0/fulltext )

Medical Center Farmers Market Aids in Medical Home Goals

MONDAY, Aug. 12 (HealthDay News) -- A seasonal farmers market at a medical center can support the institution's commitment to the goals of the medical home, according to a study published online Aug. 1 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

Full Text (http://www.cdc.gov/pcd/issues/2013/13_0105.htm )

Physicians' Malpractice Concerns Predict More Testing

FRIDAY, Aug. 9 (HealthDay News) -- Physicians' concerns about malpractice risk predict more aggressive diagnostic testing practices in office-based care, according to a study published in the August issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/8/1383.abstract )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/8/1383.full )

Endplate Junction Failure Causes Most Disc Herniations

FRIDAY, Aug. 9 (HealthDay News) -- Most cases of lumbar disc herniation (LDH) are caused by endplate junction (EPJ) avulsion rather than by annulus fibrosis (AF) rupture, according to a study published in the Aug. 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/08010/ISSLS_Prize_Winner___The_Anatomy_of_Failure_in.10.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/08010/ISSLS_Prize_Winner___The_Anatomy_of_Failure_in.10.aspx )

IPAs and PHOs Viable Option for Small Independent Practices

FRIDAY, Aug. 9 (HealthDay News) -- For small and medium-size independent practices, sharing care management and information technology resources with other practices through an independent practice association (IPA) or physician-hospital organization (PHO) is a viable alternative and may improve care for patients with chronic conditions, according to a study published in the August issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/8/1376.abstract )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/8/1376.full )

Updated Guidelines Available for Lumbar Spinal Stenosis

THURSDAY, Aug. 8 (HealthDay News) -- Updated evidence-based guidelines on the diagnosis and treatment of degenerative lumbar spinal stenosis are now available, according to report published in the July issue of The Spine Journal.

NASS website (http://www.spine.org/Pages/Default.aspx )Abstract (http://www.thespinejournalonline.com/article/S1529-9430(13)00423-3/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430(13)00423-3/fulltext )

AMA, AHA Call for Realignment of Meaningful Use Stage 2

WEDNESDAY, Aug. 7 (HealthDay News) -- The American Medical Association (AMA) and American Hospital Association (AHA) are calling for additional flexibility in the timing of the adoption of stage 2 meaningful use of electronic health records, according to a letter written to the U.S. Department of Health and Human Services (HHS).

More Information (http://www.amednews.com/article/20130805/government/130809987/1/ )

Mortality 38 Percent for Spinal Cord Injury Tied to C-Spine Fx

TUESDAY, Aug. 6 (HealthDay News) -- For older adults with spinal cord injuries (SCIs) related to cervical spine (C-spine) fractures, injury level and severity of SCI are risk factors for mortality, according to a study published in the August issue of The Spine Journal.

Abstract (http://www.thespinejournalonline.com/article/S1529-9430(13)00122-8/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430(13)00122-8/fulltext )

Participation Increases in Online CME Activities

MONDAY, Aug. 5 (HealthDay News) -- The number of physicians and non-physicians participating in continuing medical education (CME) has increased, especially in online activities, according to a report published by the Accreditation Council for Continuing Medical Education (ACCME).

More Information (http://accme.org/sites/default/files/630_2012_Annual_Report_20130724_0.pdf )

Immediate Post-Op Delirium Common in Elderly Patients

THURSDAY, Aug. 1 (HealthDay News) -- Delirium in the post-anesthesia care unit (PACU) is relatively common among elderly patients undergoing surgery with general anesthesia, according to a study published in the August issue of Anesthesia & Analgesia.

Abstract (http://www.anesthesia-analgesia.org/content/117/2/471.abstract )Full Text (http://www.anesthesia-analgesia.org/content/117/2/471.full )