Some new twists to one of the most common procedures in US general surgery

Article Abstract:

One of the most common surgical procedures is the repair of an inguinal hernia, which is a protrusion of the intestine through a weakness or defect in the abdominal muscle wall into the inguinal or groin area. Two new techniques were developed to reduce the pain, length of recovery time, and 20 percent recurrence rate often associated with inguinal hernia repair. In the first technique, a cut or incision is made into the abdomen at a site away from the defect. A laparascope, a tube-like instrument that allows one to see into the abdominal cavity, is then inserted through the incision. The hernia is located and closed off with a stapling device. The surgical instruments are then removed, and the incision is sewn shut. The procedure can be performed within 10 to 15 minutes and the patient can be treated on an outpatient basis. Hernias repaired by this method have not recurred within a year after the procedure. The second technique involves making an incision into the abdomen and inserting an artificial mesh into the opening of the hernia. This mesh acts like a plug to seal off the hernia, and is secured in place by growth of structural fibroblastic tissue. Because it is shaped like a triangular paper drinking cup or umbrella, the mesh can accommodate the muscular movements in the intestine.

Innovations, Surgery, Inguinal hernia

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Lipid particles may help solve puzzle regarding genesis of some cardiovascular diseases

Article Abstract:

People who have a small, dense form of low-density lipoprotein (LDL) may benefit more from low-fat diets than those who don't. A high amount of LDL cholesterol in the blood is considered a risk factor for heart disease, and the small, dense form may present an even bigger risk. Sixteen men who had the small, dense LDL experienced a greater reduction in risk following a low-fat diet than did 20 men who had large, buoyant LDL or 24 men whose LDL could assume either form. Lipoprotein a, or Lp(a), may be a risk factor for restenosis after percutaneous transluminal coronary angioplasty (PTCA). Lp(a) is LDL combined with apolipoprotein (a). Fifty patients who experienced restenosis after PTCA were found to have much higher levels of Lp(a) in their blood than patients who did not experience restenosis. Elevated Lp(a) has been found in 45% of black men with documented coronary artery disease but black men with normal coronary arteries had normal levels of Lp(a).

Health aspects, Cardiovascular diseases, Development and progression, Low density lipoproteins, Lipoprotein A

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Image of perfection once the goal - now some women just seek damages

Article Abstract:

The current controversy over silicone breast implants arose not from a lawsuit, but from a regular Food and Drug Administration (FDA) review. Although injectable silicone has never been approved by the FDA, it is routinely used in artificial joints and heart valves, catheters and as a lubricant in intravenous equipment. It is estimated that as many as 2 million women have breast implants, and although there have been many reports in the literature of adverse effects, the implants have never been tested in clinical trials. Many doctors feel that implants are safe, and they deny lawyers' claims that implant manufacturers withheld information from doctors. For now, the FDA requires any woman who wants an implant to participate in a clinical trial, and the agency intends to start a national registry. The FDA and the American Society for Plastic and Reconstructive Surgeons both have toll-free hotlines for women who have questions about breast implants.

Science and technology policy, Ethical aspects, Breast implants, United States. Food and Drug Administration

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