Surgery News - August 2008 - (Page 2) NEWS SURGERY NEWS • A U G U S T 2 0 0 8 Sensitivity Studied Diabetes • ACS Pushes for Veto Override Pay Cut • from page 1 sensitivity followed a similar trajectory of improvement among 20 diabetic and 107 nondiabetic patients at a point in time between the measurements taken at 40 and 180 days after surgery. Patients who had high insulin resistance and poor insulin sensitivity (HOMA-IR of 2.3 or more) prior to surgery were studied. At baseline, estimates of β-cell sensitivity were lower in the 27 diabetic patients than in the 65 nondiabetic patients in this category. By 40 days after surgery, β-cell sensitivity matched the level of nondiabetic patients. At 1 year, diabetic patients had higher fasting blood glucose levels than did nondiabetic patients. Mean body weight, BMI, and excess body weight were similar between groups at baseline, but at 1 year levels of each measure were lower in diabetic patients. ■ MASSACHUSETTS MEDICAL SCHOOL from page 1 for insulin resistance (HOMAIR) and β cells (HOMA-β). Insulin resistance levels varied widely among 47 type 2 diabetic patients and 172 nondiabetic patients who had LRYGB, including several “type 2 diabetic patients with fairly good insulin sensitivity,” Dr. Perugini said at the annual meeting of the American Society for Metabolic and Bariatric Surgery. Before surgery, the investigators discovered a hyperbolic relationship between insulin sensitivity and β-cell sensitivity in both groups. Type 2 diabetes shifted the relationship between the two factors so that the diabetic patients produced less insulin for each degree of insulin sensitivity than did nondiabetic patients. Among patients with lower levels of insulin resistance (HOMA-IR less than 2.3), β-cell Dr. Richard A. Perugini studied insulin in 219 LRYGB patients. publican senators changed their votes to help pass the bill. The Democrats also racked up an extra vote when Sen. Edward M. Kennedy (D-Mass.) returned to the Senate for the first time since having undergone surgery for a brain tumor in order to help pass the bill. In the final tally, the bill passed 69-30. Days later, President Bush vetoed the bill, but the House and Senate acted quickly to override the veto. The new law, which will give physicians a little more predictability in estimating their Medicare income, was widely praised by physician and patient groups. American College of Surgeons (ACS) officials said that by overriding the president’s veto, Congress avoided a “potential health care disaster.” The override came after much lobbying by ACS members and other physician groups, as well as thousands of calls from ACS Fellows urging their members of Congress to quickly pass the bill. The legislation eliminates the 10.6% payment cut, and it changes how Medicare’s budget neutrality requirement is applied to work values assigned to physician services under Medicare, meaning additional increases in Medicare payments for certain surgical services. However, ACS officials are anxious for members of Congress to resume working on a long-term solution for how to pay physicians under Medicare. “The 18-month reprieve estab- payments across the board. Congress finances the pay inlished by this legislation allows time for physicians, patients, and creases for physicians in part other stakeholders to work to- through controversial cuts to gether and with members of Medicare Advantage plans. OffiCongress to develop a long-term cials at America’s Health Insursolution to this problem,” said ance Plans, which represents the ACS Executive Director Thomas health insurance industry, estimated that the bill will cut nearR. Russell, FACS. He called on all stakeholders ly $14 billion from the Medicare to help develop a solution that Advantage plans over the next 5 will ensure that even deeper cuts years. The inclusion of these are not imposed on physicians cuts in the bill slowed its passage starting in 2010. ACS officials in the Senate and caused Presihave circulated a proposal that dent Bush to veto the legislawould replace the current Sus- tion. ■ tainable Growth Rate (SGR) payment formula ews with a system of six sepMore N t a arate physician service is jus ay! categories—primary and w click a preventive care, other evaluation and management services, major procedures, anesthesia services, imaging and diagnostic services, and minor procedures and all other physician services. Spending targets for each category would be based on the current SGR factors, but would not include the gross domestic product. The new See the system, developed in Exclusive Online Edition conjunction with the at www.facs.org American Osteopathic Association, would allow Go to Periodicals, then policymakers to adjust Surgery News to learn about payments in individual recent developments in techservice areas instead of nology and surgical practice. making cuts to physician SURGERY NEWS Editor in Chief, SURGERY NEWS Lazar J. Greenfield, M.D., FACS ACS Director of Communications Linn Meyer TONY MACIAG/UNIVERSITY SURGERY NEWS EDITORIAL ADVISORY BOARD Anesthesiology: Robert Morell, M.D., Clinical Associate Professor of Anesthesia, Fort Walton Beach Medical Center Bariatric: Myriam J. Curet, M.D., FACS, Professor of Surgery, Stanford University Cardiothoracic: Mark S. Allen, M.D., FACS, Professor of Surgery, Mayo Clinic Cardiothoracic: Fred A. Crawford, Jr., M.D., FACS, Chief, Division of Cardiothoracic Surgery, Medical University of South Carolina Colorectal: Robert Madoff, M.D., FACS, Professor of Surgery, University of Minnesota Endocrine Surgery: Robert Udelsman M.D., FACS, Chairman, Department of Surgery, Yale University Ethics: James W. Jones, M.D., Ph.D., FACS, Visiting Professor of Medicine and Medical Ethics, Baylor University Information Technology: Patricia L. Turner, M.D., FACS, Assistant Professor of Surgery, University of Maryland Minimally Invasive and Gastrointestinal: Gerald M. Fried, M.D., FACS, Professor of Surgery, McGill University Neurological: Hunt Batjer, M.D., FACS, Michael J. Marchese Professor, Northwestern University Obstetrics and Gynecology: William J. Hoskins, M.D., FACS, Executive Director of Surgical Activities, Memorial Sloan-Kettering Cancer Center Ophthalmology: Natalie C. Kerr, M.D., FACS, Chief, Pediatric Ophthalmology Service, University of Tennessee Orthopedic: Mark R. Belsky, M.D., FACS, Chief of Orthopedic Surgery, Newton-Wellesley Hospital Otolaryngology: Mark Weissler, M.D., FACS, J.P. Riddle Distinguished Professor, University of North Carolina Pediatric Surgery: Thomas F. Tracy, Jr., M.D., FACS, Pediatric Surgeon-in-Chief, Hasbro Children's Hospital Plastic Surgery: Linda Phillips, M.D., FACS, Truman G. Blocker Jr., M.D. Distinguished Professor, University of Texas Resident/Associate Society: Ted A. James, M.D., Assistant Professor of Surgery, University of Vermont Surgical Oncology: James P. Neifeld, M.D., FACS, Chairman, Department of Surgery, Virginia Commonwealth University Transplantation: Jeffrey Punch, M.D., FACS, Associate Professor of Surgery, University of Michigan Trauma (Burns and Mass Casualties): Steven E. Wolf, M.D., FACS, Professor of Surgery, University of Texas Trauma and Critical Care: Grace S. Rozycki, M.D., FACS, Professor of Surgery, Emory University Urology: Badrinath R. Konety, M.D., FACS, Vice Chair, Dept. of Urology, University of California at San Francisco Vascular: Linda Harris, M.D., FACS, Associate Professor of Surgery, Millard Fillmore Hospital SURGERY NEWS is the official newspaper of the American College of Surgeons and provides the practicing surgeon with timely and relevant news and commentary about clinical developments and about the impact of health care policy on the profession and on surgical practice today. Content for SURGERY NEWS is provided by International Medical News Group and Elsevier Global Medical News. Content for the NEWS FROM THE COLLEGE is provided by the American College of Surgeons. The ideas and opinions expressed in SURGERY NEWS do not necessarily reflect those of the College or the Publisher. The American College of Surgeons and Elsevier Inc., will not assume responsibility for damages, loss, or claims of any kind arising from or related to the information contained in this publication, including any claims related to the products, drugs, or services mentioned herein. POSTMASTER: Send changes of address (with old mailing label) to Circulation, SURGERY NEWS, 60 B Columbia Rd., 2nd flr., Morristown, NJ 07960. The American College of Surgeons’ headquarters is located at 633 N. Saint Clair St., Chicago, IL 60611-3211. SURGERY NEWS (ISSN 1553-6785) is published monthly for the American College of Surgeons by Elsevier Inc., 60 B Columbia Rd., 2nd flr., Morristown, NJ 07960; 973-290-8200; fax 973-290-8250. OF ELSEVIER SOCIETY NEWS GROUP, A DIVISION OF INTERNATIONAL MEDICAL NEWS GROUP President, IMNG Alan J. Imhoff Director, ESNG Mark Branca Executive Director, Editorial Mary Jo M. Dales Executive Editor, IMNG Denise Fulton Executive Editor, EGMN Kathy Scarbeck Publication Editor Elizabeth Wood Publication Associate Editor Jay C. Cherniak VP, Medical Education Sylvia H. Reitman Senior Director, Marketing and Research Janice Theobald Circulation Analyst Barbara Cavallaro Executive Director, Operations Jim Chicca Director, Production and Manufacturing Yvonne Evans Production Manager Judi Sheffer Creative Director Louise A. Koenig National Account Manager Stephen H. Close, 973-290-8223, fax 973-290-8250, s.close@elsevier.com Classified Sales Manager Danny Wang, 212-6333158, fax 212-633-3820, d.wang@elsevier.com Address Changes: Fax change of address (with old mailing label) to 973-290-8245 or e-mail change to subs@elsevier.com ADVERTISING OFFICES EDITORIAL OFFICES 5635 Fishers Lane, Suite 6000, Rockville, MD 20852, 240-221-4500, fax 240-221-2541. Letters to the Editor: surgerynews@facs.org ©Copyright 2008, by the American College of Surgeons 60 B Columbia Rd., 2nd flr., Morristown, NJ 07960, 973-290-8200, fa http://www.facs.org
Table of Contents Feed for the Digital Edition of Surgery News - August 2008 Surgery News - August 2008 Contents The 20/20 Vision: Making Amends News From the College: Dedicated Effort Opinion: NOTESworthy? Pediatric Surgery: Burn Remedy Surgery News - August 2008 Surgery News - August 2008 - Contents (Page 1) Surgery News - August 2008 - Contents (Page 2) Surgery News - August 2008 - Contents (Page 3) Surgery News - August 2008 - Contents (Page 4) Surgery News - August 2008 - Contents (Page 5) Surgery News - August 2008 - The 20/20 Vision: Making Amends (Page 6) Surgery News - August 2008 - The 20/20 Vision: Making Amends (Page 7) Surgery News - August 2008 - News From the College: Dedicated Effort (Page 8) Surgery News - August 2008 - News From the College: Dedicated Effort (Page 9) Surgery News - August 2008 - News From the College: Dedicated Effort (Page 10) Surgery News - August 2008 - News From the College: Dedicated Effort (Page 11) Surgery News - August 2008 - Opinion: NOTESworthy? (Page 12) Surgery News - August 2008 - Pediatric Surgery: Burn Remedy (Page 13) Surgery News - August 2008 - Pediatric Surgery: Burn Remedy (Page 14) Surgery News - August 2008 - Pediatric Surgery: Burn Remedy (Page 15) Surgery News - August 2008 - Pediatric Surgery: Burn Remedy (Page 16)
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.