Journal and News Scan

Patient Care

A teenager suffered a “boy band-induced pneumothorax” at a One Direction concert, and the case was recently reported in the Journal of Emergency Medicine.

At the 48^th Union World Conference on Lung Health in Guadalajara, México, the United Nations and its partners launched an initiative to combat zoonotic tuberculosis.

Read a summary of presentations on percutaneous mitral valve techniques from the 2017 PCR London Valves meeting in the UK.

Drugs and Devices

In an interview with Nature, the executive director of the European Medicines Agency talks about the effect that the agency’s impending move from London could have on its operations.

The US Food and Drug Administration (FDA) will temporarily allow imports of intravenous saline to avoid shortages as Puerto Rico, which manufactures about 10% of medical products consumed in the US, continues recovering from the devastation caused by Hurricane Maria.

The US FDA approved a magnet-tipped catheter device for correcting pediatric esophageal atresia without open surgery.

Research, Trials, and Funding

Researchers from Uganda, the US, and France find that prophylactic penicillin might be helpful for children with mild latent rheumatic heart disease.

Two studies published in JAMA Cardiology and the European Heart Journal suggest that low mitochondrial DNA copy number might indicate increased risk of cardiac events.

A new protocol from a multidisciplinary team at Johns Hopkins University in Baltimore, US, aims to reduce the incidence of acute kidney injury after cardiac surgery.

Researchers at Harvard University in Boston, US, used “lung-on-a-chip” tissue models to study NSCLC adenocarcinoma cells. Mechanical forces, applied to these model lungs to mimic breathing, reduced cancer cell growth and invasion and influenced anti-cancer drug efficacy.

The authors report on the design and use of a growth-accommodating device that may have a variety of pediatric applications, including valve annuloplasty. The device consists of a biodegradable core and a tubular braided sleeve (woven much like a 'finger trap' toy). After implantation, the core—which constrains the length of the device—degrades so as to allow the annuloplasty to enlarge gradually over time. Thus, the device 'grows' with the child. The authors further present validation of the device in a swine model.

The free full text is available.

In this retrospective study, the long-term survival benefits of multiple arterial coronary grafting were evaluated among over 20,000 patients in British Columbia by comparing outcomes to those of L IMA + SVG.    Multiple arterial grafting was associated with decreased mortality (HR 0.79) and decreased revascularization rates (HR 0.74).  The incidences of MI and heart failure were also reduced (HR 0.63 and 0.79, respectively).

The authors, using a decision analysis model, compared the cost-effectiveness (over one year) of three different strategies for preventing Staphylococcus aureus infections in patients undergoing CABG in the U.S.  The three strategies were as follows:

• Universal decolonization with mupirocin, chlorhexidine, and vancomycin in all patients undergoing CABG
• Targeted decolonization with mupirocin, chlorhexidine, and vancomycin only in patients who are S aureus carriers
• No decolonization in any patients

Findings:  Universal decolonization is the most cost-effective strategy in >91% of simulations in this model.  Annually in the US, universal decolonization is predicted to lead to $102 million in cost savings, while targeted decolonization is predicted to lead to $45 million in cost savings.