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Journal and News Scan

Source: Science Translational Medicine
Author(s): Chun Gwon Park, Christina A. Hartl, Daniela Schmid, Ellese M. Carmona, Hye-Jung Kim, Michael S. Goldberg

Surgery for cancer is known to suppress immune response and facilitate the development of metastases.  In this study in mice, a scaffold designed to release agonists of innate immunity over time was placed in the bed of resected tumors.  The treatment reduced local recurrence and improved survival. 

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Maximilian Luehr, Sven Peterss, Andreas Zierer, Davide Pacini, Christian D Etz, Malakh Lal Shrestha, Konstantinos Tsagakis, Bartosz Rylski, Giampiero Esposito, Klaus Kallenbach, Ruggero De Paulis, Paul P Urbanski

Of 1,232 patients who underwent elective arch repairs at 11 European aortic centers, 155 were selected and their surgical outcomes were analyzed retrospectively. Approximately 13% of patients suffered an aortic event, and 85% of them needed reoperation. Multivariate analysis found older age at reoperation to be the only independent risk factor for in-hospital mortality.

Source: Annals of Surgery
Author(s): Luca Gianotti, Roberto Biffi, Marta Sandini, Daniele Marrelli, Andrea Vignali, Riccardo Caccialanza, Jacopo Viganò, Annarita Sabbatini, Giulio Di Mare, Mario Alessiani, Francesco Antomarchi, Maria Grazia Valsecchi, Davide P Bernasconi

One of the more contentious issues in Enhanced Recovery After Surgery (ERAS) programs is the role of preoperative carbohydrate loading.  This randomized trial demonstrated less need for insulin for treating serum glucose >180 mg/dl in the carbohydrate-loading group compared to the placebo group (2.4% versus 16.0%; RR 0.15; p<0.001) with no change in the frequency of postoperative infection.

Source: Annals of Surgery
Author(s): Yanik J. Bababekov, Sahael M. Stapleton, Jessica L. Mueller, Zhi Ven Fong, David C. Chang

A brief, informative, and helpful article.  It highlights alarming reports that 80% to 90% of "negative" randomized controlled trials in surgery are not adequately powered to reliably declare a negative outcome.

Source: The Thoracic and Cardiovascular Surgeon
Author(s): Alper Kepez, Bulent Mutlu, Ashok Paudel, Cigdem Ileri, Halil Atas, Bedrettin Yildizeli

Kepez and colleagues retrospectively evaluated the incidence of coronary artery-pulmonary artery collaterals in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Of 83 patients with CTEPH who underwent coronary angiography prior to pulmonary endarterectomy, collaterals were found definitively in 15 patients (18.1%) and were probable in an additional 4 patients (4.8 %). The presence of coronary artery-pulmonary artery collaterals was associated with higher pulmonary artery pressure, higher pulmonary vascular resistance, and a greater reduction in pulmonary vascular resistance following surgery.

Source: Society for Cardiothoracic Surgery in Great Britain and Ireland
Author(s): Sukumaran Nai on behalf of the MiniStern Trial Investigators.

A medium-size RCT comparing full sternotomy to limited sternotomy for conventional aortic valve replacement, presented at the SCTS Annual Meeting in Glasgow. The 7-10% one year attrition rate seems quite disappointing, and will most probably be discussed. We will await the full paper to see what was the learning curve for the innovative approach.

Please scroll to page 14 in the link provided to read the presentation summary.

Source: Dental Hypotheses
Author(s): Jafar Kolahi, Saber Khazaei

A hijacked journal is a legitimate scientific journal that offers print-only version, for which a bogus website has been created by a malicious third party fake publisher for the purpose of fraudulently offering research scientists the chance to rapidly publish their paper online with publication fee. Journal hijackers are dominant in analyzing the behaviors of researchers and journalism worldwide. They find the email addresses of authors from the websites of commercial and non-peer-reviewed journals. During last few years, more than one hundred of hijacked journals have been observed. They charge a fee, but your article does not get published and you will not get a medline indexed citation. 

Source: BMJ Heart
Author(s): Arturo Evangelista, Pastora Gallego, Francisco Calvo-Iglesias, Javier Bermejo, Juan Robledo-Carmona, Violeta Sánchez, Daniel Saura, Roman Arnold, Amelia Carro, Giuliana Maldonado, Augusto Sao-Avilés, Gisela Teixidó, Laura Galian, José Rodríguez-Palomares, David García-Dorado

The authors studied 852 adults with bicuspid aortic valves.  The prevelance of three morphotypes was tallied.  Relative fusion rates were: RL 72.9%, RN 24.1% and LN 3%.  Additionally, 18.3% had no raphe.  Aortic regurgitation was unrelated to morphotype.  Aortic stenosis was more common in the RN fusion group and in the presence of a raphe.  Seventy-six percent had ascending aortic dilation unrelated to morphotype but associated with valve dysfunction.  Aortic root dilation was present in 34% and was more commonly associated with male sex and aortic regurgitation.

Source: New England Journal of Medicine
Author(s): Felicity Lee, Paul Maggiore, Kevin Chung

Read the amazing story of the 44-year-old nurse who got acute chest pain in a remote area of Australia. He was the only clinican in the area, so he took his own ECG, diagnosed his acute MI, and cannulated and thrombolysed himself!

They make them tough in Australia.

Source: News from around the web.
Author(s): Claire Vernon

Patient Care

Some Syrian refugee children have received surgery for congenital heart defects in Jordan, however many refugees in need of complex medical care are unable to receive such care.

A hospital in Philadelphia, Pennsylvania, is working to increase the rate of patient referral for cardiac rehab after surgery.

Several Rwandan heart patients will receive surgical treatment as part of a free surgery camp at King Faisal Hospital in Kigali, Rwanda, an initiative sponsored by the Rwandan Ministry of Health, King Faisal Hospital, and the non-profit organization Team Heart.


Drugs and Devices

The US Food and Drug Administration took the first formal step toward a major policy change that would reduce the amount of nicotine allowed in cigarettes.

The UK Medicines and Healthcare Products Regulatory Agency announced plans to review anticoagulant usage after a study published in the BMJ suggested increased risk for atrial fibrillation patients with chronic kidney disease.


Research, Trials, and Funding

Japanese researchers have received approval from Osaka University to test the ability of iPS cell-derived sheets of cardiac muscle to treat ischemic cardiomyopathy. The team must now gain approval from the Japanese Health, Labor, and Welfare Ministry.

Researchers from the US and Canada find that COPD patients selected for lung transplant have better survival than one would expect based on their BODE score, potentially because the transplant qualification process reduces comorbid conditions that are unrelated to lung function in this group of patients.

Early studies on wearable devices for atrial fibrillation screening were presented at the recent meeting of the American College of Cardiology, but the findings don’t yet address whether the increased screening results in improved patient outcomes.