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Breasts can be conserved even in patients with many breast tumors
Patients with multiple tumors in a breast could avoid mastectomy, given those tumors could be removed, leaving enough breast tissue, as per a study on over 200 women. Such patients can instead undergo a lumpectomy, which is a breast-conserving surgery, and whole-breast radiation therapy later. These findings could empower patients with a choice to conserve their breasts.
An endoscopic obesity treatment linked to botulism
WHO was recently notified about five cases of iatrogenic botulism in people who underwent bariatric treatments with botulinum toxin type A injection endoscopically in Turkey. These cases were mild to moderate, with one patient admitted to the ICU. So far, no deaths have been reported. WHO is collaborating with European CDC to investigate these cases and share information.
World Health Organization
Cold snare polypectomy is more beneficial in delaying bleeding
Compared to hot snare polypectomy, cold snare polypectomy was associated with a lower risk of mild and severe delayed post-polypectomy bleeding events, as per a study. Patients who underwent cold snare polypectomy also had shorter polypectomy time and fewer emergency department visits. These findings could help guide managing small colorectal polyps.
Can you cut back on sodium bicarbonate pills in kidney transplant recipients?
Sodium bicarbonate used to correct metabolic acidosis and prevent declining graft function in kidney transplant recipients was found not to affect the decline in eGFR, a surrogate marker for graft function, as per a study. The findings suggest sodium bicarbonate should not be advised to preserve eGFR in transplant recipients with kidney disease and metabolic acidosis.
Bariatric surgeries could raise the risk of death by suicide
A study compared more than 20,000 people who underwent bariatric surgeries and did not get surgeries and found that several weight loss surgeries were linked to lower all-cause mortality in both men and women for decades. However, the rates of death by suicide were remarkably higher in people who underwent surgery than in people in the non-surgical group.
Cutting down on anesthetics can help reduce climate changes
An expert anesthesiologist recommended doctors lower their use of anesthetic gases to fight climate change. He added that no matter how tiny the positive effect of reducing anesthetic gas use, it would add up to the efforts to mitigate global warming. Small changes in such daily practices without affecting patients' comfort could account for 0.1% reduction in carbon emissions.
New York Post
Appendectomy may raise the risk of colorectal cancer
A Chinese study revealed that appendectomy could impact the homeostasis in the gut microbiome in patients, thereby increasing their risk of developing colorectal cancer. Shotgun metagenomic sequencing on faecal samples of patients who underwent appendectomy showed the enrichment of 7 colorectal cancer-promoting bacterial species and the depletion of 5 commensal species.
New guidelines for managing perioperative pain in cannabis users
The ASRA strongly recommends universal screening for cannabinoids for all patients before surgery, postponing surgery for patients with altered mental status due to cannabis intoxication, counselling heavy and frequent cannabis users about the adverse effects of cannabis on postoperative pain management, and educating pregnant women about the dangers of maternal cannabis use.
American Society of Regional Anesthesia and Pain Medicine
Why are some surgeons prescribing opioids to patients' partners?
To avoid the hurdles for acquiring opioids and safety rules for filling opioid prescriptions by the patients themselves, some surgeons are prescribing painkillers to spouses. The rates of opioid prescriptions to spouses increased by 6 times on the days of surgery. The reports did not find any increase in adverse effects in the patients whose spouses got these prescriptions.
Harvard Medical School
Prolonged cold ischemia should not be a reason to reject kidney donation
A retrospective analysis of deceased donor kidney transplantations revealed that primary nonfunction and delayed graft function increased with cold ischemia time. But it had a lower influence than the kidney donor profile index. Data from UNOS suggest that 8.7% of kidneys were discarded to prolonged cold ischemia time, which could have helped people on the waiting list.