ALERT!
This site is not optimized for Internet Explorer 8 (or older).
Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.
Journal and News Scan
February 24, 2015
Submitted by: Mark Ferguson
This study evaluated potential safety concerns of using NSAIDS in combination with antithrombotic agents 30 days or more after MI. The population studied was comprised of nearly 62,000 Danish patients. Use of NSAIDs at any time doubled the risk of a bleeding episode and increased the risk of a major cardiovascular event by 40%. The NSAIDs risks were present even after short-term NSAIDS use.
February 24, 2015
Submitted by: Joseph Basha
This is an excellent summary of the pros and cons of LAA occlusion for stroke prevention in non valvular AF. The authors consider the evidence for both, and expand on the limitations of some of the cited studies' designs and the lack of a registry. As is well established, a registry could be useful in determining long term efficacy such as is found in the The Transcatheter Valve Therapy registry for surveillance of transcatheter aortic valve replacement.
February 24, 2015
Submitted by: Joseph Basha
Resently confronted with the problem of plasma leakage out of the gas exhaust port of the oxygenator, necessesatatting changing of the oxygenator several times in 48 hours. We noted that the the plasma in the discarded oxygenator that had seperated was milky white in color and we checked for hyperlipidemia which was affirmed. In addition, propofol was being used and the patient had elevated glucose levels. An insulin drip was started and the propofol replaced with versed. The subsequent oxygenator survived 6 hours and hte next over 24 hours indicating improvment. Measured lipid levels wer also lower.
Believeing that the root couse was the hyperlipidemia but not having confirmation of this, I contacted an engineering friend that works with these types of hollow fibers. He subsequently forwarded me this article.
The investigators, under experimental conditions, created plasma leakage in the hollowfiber oxygenators and conclude that the absorbtion of phospholipids leads to the formation of a hydrophilic layer over the surface of the membrane which is hydrophobic leading to plasma leakage.
February 22, 2015
Submitted by: J. Rafael Sadaba
This manuscript reports on data from the UK registry from 2007 to 2012 including 3980 TAVI procedures and a 6 year follow up. The authors carry out a good analysis of trends, risk factors for mortality and results. They found little change in the characteristics of patients treated in the UK by TAVI from 2007 to 2012. Pre-procedural atrial fibrillation was strongly associated with later mortality. Patients who could be treated by the femoral route had a lower mortality than those for whom an alternative route was needed. Unadjusted survival for the direct aortic and the transapical approach were similar at 1 to 2 years. Surgical femoral approaches were used in about 11% in 2007 to 2009, but in later years it increased to about 20%. No difference in outcomes was identified according to need for pacing, or the presence of pre-procedural LBBB. The presence of post procedural aortic regurgitation (moderate or severe) was associated with lower long term survival on multivariate analysis at 1 and 2 years. There was a low incidence of procedural stroke, but it had the strongest independent association with early and late mortality.
February 21, 2015
Submitted by: Mark Ferguson
A survey involving the general public identified opinions regarding lung cancer. Most felt it was related to smoking and lifestyle, was a serious cancer, and involved major treatments. The participants underestimated cure rates for early stage disease (52% survival) and overestimated overall survival (32% survival).
February 21, 2015
Submitted by: Mark Ferguson
Indications for postoperative radiation therapy (PORT) for resected lung cancer are unclear. This study evaluated outcomes from the National Cancer Data Base 2004-2006, including 2115 patients resected with pathologic N2 NSCLC, of whom 918 (43%) received PORT. PORT was associated with better median survival (42 vs 38 mos, p=0.048) and was associated with improved survival on multivariable analysis.
February 21, 2015
Submitted by: Mark Ferguson
SEER outcomes from 1973-2010 were evaluated, including a total of over 947,000 pts, of whom only 441 had atypical carcinoid tumors of the lung. 69% were women and 87% were white. 20% had stage IV disease at diagnosis. 78% of the patients underwent resection. 3-year survival was 85% for N0, 69% for N1-2, and 26% for stage IV.
February 21, 2015
Submitted by: Arie Blitz
The meta-analysis by Kowalewski et al found that implantable gentamicin collagen sponges significantly reduced the incidence of sternal wound infections by nearly 40%.
February 21, 2015
Submitted by: Mark Ferguson
Beautiful video. The background music is also beautiful, but I think something with more of a beat would have been appropriate.
February 16, 2015
Submitted by: Marcelo Jimenez
Usually patients with prior cancer are excluded in lung cancer trials, but the impact on survival in lung cancer is not known. In a cohort of 102929 patients older than 65 with stage IV lung cancer, a propensity score analysis were performed and found that patients with prior cancer had better survival (all-cause and lung cancer-specific). Therefore these patients with prior cancer should be considered candidates for clinical trials for advanced lung cancer.