Journal and News Scan

This is an expert summary of the evidence for thymectomy in nonthymomatous myasthenia gravis, titled Thymectomy and myasthenia gravis: A history of surgical passion and scientific excellence.

It really suggests that this operation is the standard of care for these patients if they are ACh-positive and young and MGFA II or above.

An editorial on what will be soon required from papers sent to the Circulation group of periodicals, and probably soon to all reputable biomedical journals. Bolli advances that the internal and external validity of manuscripts has space for improvement!

At the  Annual Meeting of the SCTS in Belfast,  Catherine Fowler gave a moving talk about how her father died of a missed aortic dissection.

Catherine’s sister, Caroline has started a petition that will call on the UK parliament to implement a policy to improve diagnosis and raise awareness of aortic dissection in the NHS. If successful, this may help other countries to implement such polices internationally. It is open for anyone worldwide to put their name to this petition if you agree that the diagnosis of aortic dissection in our Hospitals needs improving. 

Click on the link above if you want to give your support to this. 

Here is their story : 

In 2015, our father Tim Fleming suddenly became very unwell, presenting all of the classic symptoms of Aortic Dissection; severe and sudden onset of pain in his back, chest and abdomen. Sadly, it appears to us that all of the markers and indicators were missed. The correct diagnosis of an Aortic Dissection was not made when Dad initially presented to A&E. Dad paid the ultimate price with his life.

This petition is an urgent call to parliament for the implementation of a robust policy, diagnostics and awareness for Aortic Dissection within the NHS.

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"Think Aorta" is a campaign to lower the unacceptable high rate of misdiagnosed Aortic Dissections in Accident and Emergency Departments and GP Surgeries across the UK and Ireland.

Aortic dissection is the most common life-threatening disorder affecting the aorta. It occurs when a tear inside of the aorta causes blood to flow between the layers of the wall of the aorta. Early diagnosis and treatment is critical for survival.Aortic Dissection can quickly lead to a painful and frightening death as a result of reduced blood flow to the heart or rupture of the aorta.

A&E medical staff must immediately rule out Aortic Dissection. It is a known fast killer where the death rate increases 1% for each hour that diagnosis and surgical repair are delayed, therefore advanced medical care is needed immediately.

Aortic Dissection IS one of the top deadly three chest pain entities and very often mimics a heart attack. ECG and chest x-rays are routinely used to diagnose heart attack but cannot rule out Aortic Dissection, as both can appear normal in a patient with a life-threatening Aortic Dissection.

A&E health care professionals and medical staff MUST remain suspicious at all times - until aortic dissection is ruled out.

The condition, "Aortic Dissection" is well documented since the early 18th Century.  But AORTIC DISSECTION continues to be misdiagnosed by our A&E medical professionals and GP’s despite well established treatment guidelines but where no medical policy exists.

The rate of misdiagnosed Aortic Dissection is unacceptably high.

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TIME FOR CHANGE

This is an urgent call for the government to implement the following actions across the NHS in the UK and Ireland:

1. POLICY - The introduction of policy and guidelines for timely identification and treatment of Aortic Dissection for emergency services and A&E departments across the NHS.

2. DIAGNOSTICS - The implementation across the NHS of consistent, routine emergency diagnostics for Aortic Dissection – once a heart attack is ruled-out, doctors should routinely check for Aortic Dissection.

3. EDUCATION - Training, awareness and education for our medical professionals to ensure rapid, consistent adoption of the identified best practice.

4. PROCESS - Organisation of emergency cardiac surgical services so that patients with aortic dissection are always treated by surgeons with the appropriate experience.

PLEASE SIGN THIS PETITION TO STOP THE MISDIAGNOSIS OF THIS KILLER

“Think Aorta” Timely detection and treatment of Aortic Dissection will save lives. 

This petition will be delivered to:

• UK Secretary of State for Health
  Rt Hon. Jeremy Hunt MP
• Irish Minister for Health
  Mr Simon Harris

Many of the adverse events that occur in hospitals are a result of human error.  The authors describe a system for use in the OR that collects and collates intraoperative data feeds, including patient and OR team physiological parameters, audiovisual content, and environmental factors.  The data are analyzed to assist in proactive assessment of risks, support root cause analyses, facilitate team training, assess efficiency, and help in evaluation of surgical technology.  This technologica approach may reflect our work environment in the future.