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Journal and News Scan
May 21, 2015
Submitted by: Mark Ferguson
This prospective observational study followed 111 patients for 3 years after laparoscopic repair of a type III paraesophageal hernia. QOL improved at all postoperative time intervals from 28.5 preop to about 10. The radiographic recurrence rate was 27% at 1 year. Hernias involving most of the stomach were more likely to recur than smaller hernias.
May 20, 2015
Submitted by: Mark Ferguson
A pooled analysis of outcomes from two randomized trials involving SBRT or surgery for operable patients with clinical early stage NSCLC was performed. The number of patients was small (58 total) and the follow-up was a median of 35-40 mos. Overall 3-year survival was better in the SBRT group (95% vs 79%; p=0.037) whereas recurrence free survival did not differ between the groups. Grade 4 complications or death occurred in 48% of surgical patients (1 mortality) and in none of the SBRT patients.
May 20, 2015
Submitted by: Philip McElnay
This retrospective review compared outcomes for re-do minimally invasive mitral valve operations vs re-do sternotomy in mitral valve operations. The authors demonstrate a similar MV-repair rate in the two groups but a significantly lower bypass and cross-clamp time in the minimally invasive group. Working within the confines of a retrospective study the authors have produced a very interesting paper.
May 19, 2015
Submitted by: Mark Ferguson
Pts with suspected lung cancer underwent sampling of normal-appearingbronchial epithelial cells in the main bronchi, unrelated to the suspected tumor. Gene expression was analyzed and classified. Classification for cancer was about 75% accurate.
May 19, 2015
Submitted by: Mark Ferguson
The question in this review was whether patients who experience tension pneumothorax differ in presentation depending on whether they are breathing spontaneously or are on positive pressure ventilation. Assisted ventilation was more often associated with hypoxia, hypotension, and cardiac arrest. These adverse clinical signs frequently arose within minutes of initial clinical presentation in the assisted ventilation cohort.
May 19, 2015
Submitted by: Mark Ferguson
Competence-based rather than time-based surgical education will likely become the norm in the next decade. The authors reviewed current methods for assessing technical competence in trainees. No clear definition of technical competence was evident. Instruments used for assessment were originally designed to assess skill rather than competence. The field is ripe for additional research.
May 18, 2015
Submitted by: CTSNet Staff
Filmed at the 2012 Dallas-Leipzig Valve meeting, Patrick McCarthy delivers a presentation on the management of left atrial appendage.
May 18, 2015
Submitted by: CTSNet Staff
A recent picture of a junior doctor asleep while at work in a Monterrey, Mexico hospital has sparked an online conversation about the importance of sleep for doctors. The picture was taken and posted by a blogger, who wrote, "We are aware that this is a tiring job but doctors are obliged to do their work." Doctors have responded on twitter with the hashtag #YoTambienMeDormi ("I've also fallen asleep"), posting pictures and stories about the necessity of taking short naps while working long shifts.
May 17, 2015
Submitted by: J. Rafael Sadaba
The question of whether digoxin increases the risk of death in patients with atrial fibrillation (AF) or congestive heart failure (CHF) continues to be a matter of debate. The authors of this manuscript attempt to find an answer with a meta-analysis and systematic review of the literature. Overall, the analysis comprises data from 235.047 AF patients and 91.379 patients with CHF. The results indicate that digoxin therapy is associated with an increased mortality risk in these patients, particularly in those treated for AF.
May 17, 2015
Submitted by: Lisa Brown
The most recent WHO classification for lung adenocarcinoma is based on the predominant histologic subtype in the resected tumor. Several studies have validated the use of this classification system for prognostic purposes, but predicting response to adjuvant chemotherapy has not yet been tested. The goal of this study was to determine whether this classification can be used to predict benefit from adjuvant chemotherapy in patients who have undergone complete surgical resection. The Lung Adjuvant Cisplatin Evalutaion Biomarker (LACE-Bio) collabortive group formed a large cohort of patients from four adjuvant chemotherapy clinical trials (n=552 for this study). Two groups were compared: acinar/papillary (n=247) and micropapillary/solid (n=305). Patients in the micropapillary/solid subgroup had a significant benefit from adjuvant chemotherapy in terms of disease-free survival, whereas patients in the acinar/papillary subgroup did not.