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    <recommendedItem id="20100101_19_459"
                     title="Murtha Dead at 77"
                     score="0.011"
                     href="http://www.medpagetoday.com/Washington-Watch/Washington-Watch/tb/18388?impressionId=1265764127480"
                     
      &lt;p&gt;Representative John P. Murtha (D-Pa.), 77, long-time chairman of the House Appropriations Subcommittee on Defense, died yesterday afternoon from complications following a planned laparoscopic cholecystectomy, according to a statement from the congressman&apos;s office.&lt;/p&gt;
&lt;p&gt;He had been admitted to the intensive care unit at Virginia Hospital Center in Arlington on Jan. 31, days after surgeons at the National Naval Medical Center in Bethesda, Md., accidentally nicked his intestine during the operation, according to a report in &lt;em&gt;The Washington Post&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;In that same report, Rep. Bob Brady (D-Pa.), a close friend of Murtha&apos;s, said the congressman developed an infection and fever.&lt;/p&gt;
&lt;p&gt;Citing a request for privacy from the Murtha family and patient privacy laws, a spokesperson for the National Naval Medical Center declined to provide information on the operation.&lt;/p&gt;
&lt;p&gt;In a statement, Virginia Hospital Center said Murtha died &quot;despite aggressive critical care interventions.&quot;&lt;/p&gt;


  &lt;p&gt;Mark Malangoni, MD, surgeon-in-chief at MetroHealth Medical Center in Cleveland, told &lt;em&gt;MedPage Today&lt;/em&gt; that serious complications, including bowel damage and death, are not common following cholecystectomy. More complicated patients, such as the obese and diabetics, have a greater risk of complications and of a switch to an open procedure.&lt;/p&gt;
    &lt;p&gt;Death is extremely rare in healthy individuals, occurring in no more than one per 1,000 patients, according to the American College of Surgeons (ACS).
    &lt;p&gt;More common, but still infrequent, are bleeding and leakage of bile, both of which can be treated fairly easily, said Malangoni, a regent of the ACS.&lt;/p&gt;


&lt;p&gt;When the bowel is damaged, as reportedly occurred in Murtha&apos;s case, it typically occurs in two ways -- either from a sharp injury when the trocars used for a laparoscopic procedure are inserted or from a cautery burn.
    &lt;p&gt;Both types of injury can go unnoticed by the surgeon and may not become apparent for days after the operation, Malangoni said.&lt;p&gt;
    &lt;p&gt;Although he did not know the details of Murtha&apos;s case, Malangoni said a patient would usually be admitted right away, at least overnight, if the surgeon realized that an injury had occurred. The procedure likely would have switched from a laparoscopic one to an open one as well.&lt;/p&gt;


&lt;p&gt;A 2009 Cochrane Review comparing laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis found no difference in mortality in 38 trials. No patients died in the laparoscopic group and only 0.09% died in the open group.&lt;/p&gt;
&lt;p&gt;Severe complications were reported in 2.2% of the laparoscopic patients and 6.8% of the open patients.&lt;/p&gt;


 &lt;p&gt;Malangoni said most surgeons become experienced with performing laparoscopic cholecystectomies before completing their residency; most will perform 40 or 50 by the end of training.&lt;p&gt;
    &lt;p&gt;&quot;It is a very common operation, so once out into practice, most general surgeons are doing dozens of these each year,&quot; he said. &quot;So your experience comes about pretty quickly.&quot;
    &lt;p&gt;It is unclear how much experience Murtha&apos;s surgeon had.&lt;/p&gt;

&lt;p&gt;Murtha had recently become the longest serving member of Congress in Pennsylvania state history.&lt;/p&gt;
&lt;p&gt;First elected in 1974, Murtha, a former Marine, was the first Vietnam War combat veteran to serve in Congress, and he served as an advocate for the military throughout his career. He was also a prominent critic of the Iraq War.&lt;/p&gt;
&lt;p&gt;Murtha is survived by his wife, Joyce, and three children.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_226"
                     title="ASCO GI: Blood Test Detects Colorectal Cancer"
                     score="-0.003"
                     href="http://www.medpagetoday.com/MeetingCoverage/ASCOGI/tb/18079?impressionId=1265764127480"
                     
      &lt;p&gt;ORLANDO  --  A novel blood test that measures CD24 protein levels may detect early colorectal cancer and precancerous adenomas, researchers found.&lt;/p&gt;
&lt;p&gt;The investigational assay had 78.4%% sensitivity and 86.8% specificity for distinguishing patients with colorectal adenoma or cancer from healthy controls in a study led by Sarah Kraus, PhD, of Tel Aviv Souraski Medical Center in Israel.&lt;/p&gt;
&lt;p&gt;Further validation for the biomarker would be needed before considering clinical use in surveillance, they cautioned here at the ASCO Gastrointestinal Cancers Symposium.&lt;/p&gt;
&lt;p&gt;But the results were exciting and could represent &quot;a very significant advance,&quot; commented Robert P. Sticca, MD, of the University of North Dakota in Grand Forks.&lt;/p&gt;
&lt;p&gt;&quot;It looks like it may be a very reliable marker for not only the early detection of colon cancer and even precancerous conditions, but also could be used for follow-up for patients who previously had cancer for recurrence,&quot; he said as moderator of a press briefing at which the results were discussed.&lt;/p&gt;
&lt;p&gt;Colorectal cancer screening is effective, with early detection and treatment shown to improve survival.&lt;/p&gt;
&lt;p&gt;However, colorectal cancer is often diagnosed at a late stage with poor prognosis, in part because of &lt;a href=&quot;http://www.medpagetoday.com/Gastroenterology/ColonCancer/10115&quot; mce_href=&quot;http://www.medpagetoday.com/Gastroenterology/ColonCancer/10115&quot; target=&quot;_blank&quot;&gt;poor uptake of colonoscopy&lt;/a&gt;, Kraus said at the press briefing.&lt;/p&gt;
&lt;p&gt;Unfortunately, there are no sufficiently accurate blood-based screening tests, he noted, although there have been &lt;a href=&quot;http://www.medpagetoday.com/MeetingCoverage/ECCO-ESMO/16057&quot; mce_href=&quot;http://www.medpagetoday.com/MeetingCoverage/ECCO-ESMO/16057&quot; target=&quot;_blank&quot;&gt;attempts&lt;/a&gt; to develop them.&lt;/p&gt;
&lt;p&gt;Her group had previously found that the CD24 protein  --  expressed on the cell surface, where it plays a role in cell adhesion and metastasis  --  was associated with development of colorectal cancer in a gene expression study.&lt;/p&gt;
&lt;p&gt;So, with two independent cohorts, they tested whether CD24 could be a good biomarker for colorectal cancer.&lt;/p&gt;
&lt;p&gt;The first cohort included 63 patients with colorectal cancer, 19 with adenoma, and 68 controls with a clean bill of health on colonoscopy. Of these 150 individuals, 143 were externally evaluated by a blinded investigator.&lt;/p&gt;
&lt;p&gt;CD24 expression was nearly six-fold higher among adenoma and colorectal cancer cases than among controls, a significant difference. Levels were similar between the cancer and adenoma groups.&lt;/p&gt;
&lt;p&gt;The second cohort included 73 subjects: 38 normal controls, 24 with colorectal adenoma, and 11 with colorectal cancer.&lt;/p&gt;
&lt;p&gt;The test could distinguish colorectal cancer cases from controls with &quot;relatively high&quot; sensitivity and specificity (92.3% and 83.8%, respectively), Kraus said.&lt;/p&gt;
&lt;p&gt;Its performance in detecting adenoma versus normal colonoscopy results was lower, 75.0% sensitivity and 89.2% specificity.&lt;/p&gt;
&lt;p&gt;Kraus said her group is now testing this CD24 approach in a larger sample and developing an enzyme-linked immunosorbent assay (ELISA) that could be more widely used.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The researchers reported no conflicts of interest.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
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