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Journal and News Scan
This retrospective analysis of patients admitted emergently for acute MI, heart failure, or cardiac arrest examined 30-day mortality for admissions during periods when cardiologists were attending national meetings vs admissions immediately surrounding the meeting dates. Mortality for each condition was lower during meeting dates than during non-meeting dates. High risk pts admitted for AMI during meeting dates had a lower incidence of PCI without any change in mortality.
A fictional paper authored by Simpsons characters Edna Krabappel and Maggie Simpson, as well as someone called Kim Jong Fun (who we can only imagine is a slightly more approachable relative of North Korea’s leader) has just been accepted into two scientific journals.
Titled “Fuzzy Homogeneous Configurations”, the article makes absolutely no sense and is made up entirely of a random string of words, but both the Journal of Computational Intelligence and Electronic Systems, and the Aperito Journal of NanoScience Technology have agreed to publish it.
Don’t worry, you didn’t miss the episode where Ms Krabappel and Maggie got their PhDs - the paper was created as a hoax set out to expose predatory journals, as Joseph Stromberg reports for Vox. And it clearly worked.
These predatory journals spam thousands of scientists and - for a fee - will publish literally anything. They usually claim that the papers they accept are peer reviewed, but, as this example clearly demonstrates, that’s not the case.
Still, many young researchers desperate to build up their profile are unfortunately duped by them.
In an attempt to raise awareness about these scam journals, US engineer Alex Smolyanitsky recently created this completely incoherent “scientific” paper using a random text generator
A $400,000 grant from the MacArthur Foundation will be used to create a database of retractions from scientific journals, extending the work done by Adam Marcus and AHCJ Vice President Ivan Oransky on their Retraction Watch blog.
The grant was awarded to the Center for Scientific Integrity, a nonprofit organization set up by Marcus and Oransky.
The two journalists founded and run Retraction Watch, the independent blog that covers retractions. Oransky explains in a blog post they are only able to cover about two-thirds of new retractions.
This randomized trial in New Zealand assigned smokers who wished to quit to either nicotrine replacement therapy or cytisine therapy. At 1 mon more patients reported continuous abstinence from cigarettes in the cytisine group than in the nicotine replacement group (40% vs 31%). Cytisine was more effective at 1 week, 2 mos, and 6 mos. Cytisine was superior to nicotine replacement in women and was non-inferior in men. Self-reported adverse events were more common in the cytisine group.
Hemodilution on CPB is a hotly debated topic. Today, transfusion management programs have emerged as a way to reduce the need for allogeneic RBC transfusions but debate over what the safest lowest hematocrit is for cardiac surgery patients persists. What I found most interesting about this article is that is suggests that women tolerate a lower hematocrit than males. Is this a hormonal protective process or are women pre-conditioned to tolerating lower hematocrits? Certainly for me it has put what I have always practiced into question. Much work has been done with both lowest hematocrit levels and the deleterious effects of transfusions. I will be eager to see new data regarding this controversial topic as it emerges.
The CardioWest Total Artificial Heart (CW-TAH) is a pneumatically driven pump that completely replaces the patient’s native ventricles orthotopically. The device weighs 160 g and consists of two artificial ventricles, four Medtronic Hall tilting disk valves, two membranes, and two drivelines tunneled through the skin, which connect the ventricles to an external console generating pulsatile flow (1). At maximum stroke volume (close to 70 mL), it delivers a cardiac output between seven and nine litres per minute. Variations in cardiac output are determined by variations in venous return and peripheral resistance linked to the patient’s position and level of physical activity (2). The CW-TAH is indicated for use in patients with refractory cardiac failure as a bridge to transplantation, and when used for this indication, improves survival to transplant (3). Portable drivers have been approved in both Europe and the United States to allow stable patients to be discharged home while awaiting their transplant (4).
- Slepian MJ, Smith RG, Copeland JG. The Syncardia CardioWest Total Artificial Heart. In: Baughman KL, Baumgartner WA. eds. Treatment of Advanced Heart Disease. New York, NY: Taylor and Francis Group, 2006:473.
- Bellotto F, Compostella L, Agostoni P, et al. Peripheral adaptation mechanisms in physical training and cardiac rehabilitation: the case of a patient supported by a CardioWest total artificial heart. J Card Fail 2011;17:670-5. [PubMed]
- Copeland JG, Smith RG, Arabia FA, et al. Cardiac replacement with a total artificial heart as a bridge to transplantation. N Engl J Med 2004;351:859-67. [PubMed]
- Jaroszewski DE, Anderson EM, Pierce CN, et al. The SynCardia freedom driver: a portable driver for discharge home with the total artificial heart. J Heart Lung Transplant 2011;30:844-5. [PubMed]
This publication by the University of Louisville group provides an excellent comparative analysis of the outcomes after continuous-flow (CF) vs. pulsatile flow (PF) LVADs. Although the outcomes after CF LVAD implantation are clearly superior than those of PF LVADs, there are certainly unique morbidities after CF LVAD implantation. The authors argue that these differential outcomes beg the question: Should pulsatility algorithms be introduced in all contemporary CF LVADs?
We are in the wrong specialty !!
In this manuscript, the authors report on a retrospective study looking at the progression of aortic stenosis (AS) in 1558 patients with mild, moderate and severe AS and preserved left ventricular function. They conclude that the progression of severity depends significantly on the severity of the AS at baseline. Although the average rate of progression in AS mean gradient is slower than previously reported, a significant proportion of patients were observed to progress to higher grades of severity or AVR within the recommended time frames for echocardiographic follow-up. In this model, few clinical variables were associated with significantly accelerated progression: in patients with mild AS only age and gender and in patients with moderate AS renal disease and hyperlipidemia beyond age and gender.
In this Duke study, all CF LVAD implantations during the 2005 to 2013 era were analyzed, and those patients who underwent CF LVAD implantation and later replacement were reviewed. Two groups of patients were compared: those undergoing VAD replacement via a resternotomy approach (n=20) and those undergoing VAD replacement via a nonsternotomy approach (n=22). After VAD replacement, the latter group exhibited improved survival and reduced morbidity as compared to the former. Hence, it may be preferable to replace LVADs via a nonsternotomy approach if concomitant cardiac conditions do not need to be addressed.