Journal and News Scan

Patients who were nonadherent to participating in cancer screening tests experienced increased mortality from noncancer causes. It is hypothesized that such patients are also noncompliant with general medical care recommendations, and that such noncompliance represents a behavioral phenotype.

Malignant pleural effusions (MPE) affect up to 15% of all patients with cancer, and in the last few years several well-designed randomized clinical trials have been published. In this position paper, members from both the European Respiratory Society and the European Association for Cardio-Thoracic Surgery summarize the available evidence, focusing on six topics: (1) symptomatic MPE, (2) MPE with trapped lung, (3) loculated MPE, (4) factors predicting prognosis, (5) timing of oncological therapy and definitive fluid management, and (6) histological diagnosis versus cytology.

On December 20, 2018, the US Food and Drug Administration (FDA) issued a new warning against the use of fluoroquinolones in patients with connective tissue disorders and those predisposed to aortic disease.

The FDA indicates that fluoroquinolones, a commonly prescribed class of antibiotics (including Avelox, Cipro, Factive, Levaquin, and Ofloxacin), should not be used in certain patients with aortic aneurysm/dissection and those who are at higher risks for developing aortic aneurysms and dissections, such as patients with connective tissue disorders, hypertension, peripheral atherosclerotic vascular diseases, and the elderly. A review of several recent studies shows that people who have taken a fluoroquinolone are twice as likely to develop an aortic aneurysm or dissection than those who have not taken one of these drugs. FDA has also required a new warning about this risk to be added to the labeling of these medications.

Kiener and colleagues evaluated survival for patients receiving either an arterial or atrial switch operation for d-transposition of the great arteries. The authors evaluated operation data from the Pediatric Cardiac Care Consortium between 1982 and 1991, finding better 20-year overall transplant-free survival for arterial switch operations than for atrial switch (82.1% versus 76.3%) despite the fact that in-hospital mortality was higher for arterial switch (21.6% versus 12.9%).