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New prostate surgery not necessarily better: study

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New prostate surgery not necessarily better: study

Men who have less invasive prostate cancer surgery — often done robotically — are more likely to be incontinent and have erectile dysfunction than men who have conventional open surgery, U.S. researchers said on Tuesday.

Many men, especially those who are wealthy and highly educated, favor minimally invasive surgery because they assume the high-tech approach will yield better results, but the evidence on that is mixed, the team reported in the Journal of the American Medical Association.

“We found men undergoing minimally invasive versus open surgery were more likely to have a diagnosis of incontinence and erectile dysfunction,” Dr. Jim Hu of Brigham and Women’s Hospital in Boston said in a telephone briefing.

Hu said use of minimally invasive surgery has taken off since the introduction and heavy marketing of robot-assisted surgery, such as the da Vinci system made by Intuitive Surgical Inc.

The system consists of robotic arms, controlled from a console, that allow surgeons to perform less invasive surgeries. Hospitals advertise the systems as being able to reduce trauma, blood loss, risk of infection, scarring and often pain.

Hu said so far, there have been few studies that compare minimally invasive surgery with open surgery.

To do that, he and colleagues used billing data from the Medicare insurance program for the elderly on procedures done from 2003 to 2007. During that time, use of minimally invasive surgery for prostate cancer increased fivefold.

While both approaches fared equally well as a cancer treatment, they found that men who got the minimally invasive approach had shorter hospital stays, were less likely to need blood transfusions, and had fewer breathing problems after surgery than those who got conventional surgery.

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Surgical Operation surgery

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Surgical Operation surgery

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A patient undergoing coronary artery surgery.

The chest has been opened and the heart exposed. A heart-lung machine will take over the vital job of circulating oxygenated blood to the body while the heart is temporarily stopped.

During this period, blockages in the coronary arteries will be bypassed using sections of vein taken from the patient’s legs.

A patient with ischaemic heart disease is having the blocked coronary artery bypassed using a section of vein taken from her leg.

During the procedure, the circulation of oxygenated blood to the body and brain has been taken over by a heart-lung machine.

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More kids have autism than thought: U.S. study

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More kids have autism than thought: U.S. study

You may have heard the oft-quoted statistic that autism affects 1 in 150 US children. Turns out it’s more like 1 in 91 — and about 1 in 58 boys, according to new figures released Sunday.

That’s an estimated 673,000 US children — or approximately 1 percent of all U.S. kids, the researchers from the U.S. Centers for Disease Control and Prevention, Atlanta, and Harvard Medical School, Boston report in the journal Pediatrics.

Bob Wright, co-founder of the autism advocacy group Autism Speaks, told Reuters Health he’s not at all surprised by the new figures. “We’ve been screaming about the numbers going up; now there is a relatively complete recognition of it.”

“The statistical aspect of autism is just staggering,” he said, and not enough is being done about it. “If we had 1 in 58 boys getting swine flu, the country would be crazy,” Wright said.

Autism is a brain disorder characterized by problems with social interaction, repetitive behavior and other symptoms. People with a mild version called Asperger’s syndrome usually function relatively well in society, although they have problems relating to others. People with the most extreme symptoms may be unable to speak and may also suffer severe mental illness and retardation.

No one knows what causes autism — it’s generally thought to have genetic and environmental triggers — and there is currently no good treatment.

Autism is “an urgent public health concern,” Dr. Ileana Arias, deputy director of CDC, told reporters on a conference call Friday ahead of public release of the data.

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