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Journal and News Scan

Source: The New England Journal of Medicine
Author(s): Holger Thiele, Ibrahim Akin, Marcus Sandri, Georg Fuernau, Suzanne de Waha, Roza Meyer-Saraei, Peter Nordbeck, Tobias Geisler, Ulf Landmesser, Carsten Skurk, Andreas Fach, Harald Lapp, Jan J. Piek, Marko Noc, Tomaž Goslar, Stephan B. Felix, Lars S. Maier,Janina Stepinska, Keith Oldroyd, Pranas Serpytis, Gilles Montalescot, , Olivier Barthelemy, Kurt Huber, Stephan Windecker, Stefano Savonitto, Patrizia Torremante, Christiaan Vrints, Steffen Schneider, Steffen Desch, Uwe Zeymer, for the CULPRIT-SHOCK Investigators

Interesting to read the mortality and renal morbidity of PCI after serious MI. The choice of dual primary outcome may have been an afterhought....

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Narain Moorjani, Michael Lewis, Rajesh Shah, Sion Barnard, Tim Graham, Sridhar Rathinam

Moorjani and colleagues describe the implementation of a simulation-based training program for cardiothoracic surgical trainees in the UK and Ireland, which included 10 courses during the six-year training program. Attendance of the courses lead to increases in self-confidence and perceived self-competency among trainees, and board examination pass rates after course attendance increased significantly.

Commentary articles from Jonathan Nesbitt and Paul Hendry consider the success of the program and the possibility of implementing similar training programs elsewhere.

Source: Psychological Science
Author(s): Daniel K Walco, Jane L Risen

The authors demonstrate that, even when we rationally understand which of two choices is more likely to pay off, up to half of us will rely on gut feelings instead.  

Source: The Annals of Thoracic Surgery
Author(s): Lisa S. Foley, David A. Fullerton, Joshua Mares, Mitchell Sungelo, Michael J. Weyant, Joseph C. Cleveland Jr., T. Brett Reece

Erythropoietin (EPO) signaling is an important component of neuroprotection in ischemic reperfusion injury following aortic surgery. EPO also induces hematopoiesis, a fact that has limited its clinical usefulness for treating spinal cord ischemia after aortic surgery. Foley and colleagues tested whether a particular EPO receptor subtype, a heterodimer with the interleukin beta common receptor (βcR), was sufficient for EPO treatment to preserve the viability of oxygen and glucose deprived mouse spinal cord neurons in culture. Their findings suggest that βcR presents a specific target for treating spinal cord ischemia while avoiding hematopoietic side effects.

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

Patient Care

A baby in the UK has surgery to put her ectopic heart back inside her chest.

The first open-heart surgery at a district-level hospital is performed in Vietnam, as surgeons at the Thủ Đức District Hospital in Ho Chi Minh City closed an atrial septal defect in a young man.

Nestle Health Sciences is launching a patient education website to promote awareness of its nutritional drink designed for patients undergoing major elective surgery.

Three people received new organs when surgeons at the Cleveland Clinic in Abu Dhabi, UAE, performed the country’s first cadaver heart and kidney transplant.

 

Drugs and Devices

The American Hospital Association wants increased oversight on the cybersecurity of medical devices.

Boston Scientific has delayed the reintroduction of its voluntarily-recalled LOTUS Edge Aortic Valve, which had been expected in early 2018. They will provide more information on the valve’s status in February 2018.

 

Research, Trials, and Funding

Research published in JAMA Psychiatry investigated the association between congenital cardiac malformations and use of attention-deficit/hyperactivity disorder drugs during pregnancy.

The REMOVE Trial will test CytoSorb, an extracorporeal blood purification therapy, for preventing vasodilatory shock in patients with infective endocarditis; the trial will be funded by the German Federal Ministry of Education and Research.

Researchers at Washington University School of Medicine in St Louis, Missouri, have used entirely noninvasive cardiac radiation to treat five patients with ventricular tachycardia.

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Lorraine D. Cornwell, Alfredo E. Echeverria, Jason Samuelian, Jessica Mayor, Roberto F. Casal, Faisal G. Bakaeen, Shuab Omer, Ourania Preventza, Weiyuan Mai, George Chen, Katherine H. Simpson, Drew Moghanaki, Angela W. Zhu

Using propensity score matching, patients with clinical stage I NSCLC who underwent either VATS lobectomy or stereotactic body radiotherapy (SBRT) were compared for long-term outcomes.  Among 37 matched pairs, tumor control at 3 years was twice as good for surgery (p=.0038),  cancer-specific survival was 15 percentage points better for surgery (p=.055), and overall survival and recurrence-free survival were superior for surgery (p<.005 for both).  SBRT was an independent predictor of recurrence and poorer survival .

Source: The Annals of Thoracic Surgery
Author(s): Billie-Jean Martin, Kandice Mah, Luke Eckersley, Joyce Harder, Charissa Pockett, Daryl Schantz, John Dyck, Mohammed Al Aklabi, Ivan M. Rebeyka, David B. Ross

Martin and colleagues analyzed in-hospital complications, transplant-free survival, and long-term reintervention for patients receiving a Fontan operation over 20 years, with a specific focus on differences between patients with and without hypoplastic left heart syndrome (HLHS). The authors found that patients with HLHS were more likely to require intervention for atrioventricular valve regurgitation but not for Fontan failure. Ten-year overall and transplant-free survival were also the same for patients with and without HLHS.

Source: MedPage Today
Author(s): F. Perry Wilson

As many will recall, world chess champion Garry Kasparov was defeated by IBM's Deep Blue computer in 1997.  Now machine-learning algorithms have bested trained pathologists in differentiating between benign and malignant changes in sentinel lymph nodes in breast cancer patients.  We can expect to see increasing involvement of AI in pathology as well as other fields in medicine in the future.

See also:  https://jamanetwork.com/journals/jama/fullarticle/2665774

 

Source: MedPage Today
Author(s): Mark L Fuerst

Liquid biopsies have long held promise for diagnosis, treatment selection, and surveillance of lung cancer patients.  This articles summarizes results of two studies involving highly precise measurement of tumor mutational burden.  A burden of 16-fold or greater was associated with improved overall survival with immunotherapy (atezolizumab) compared to standard chemotherapy (docetaxel) in two prospective studies. Additional trials are ongoing.

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

Patient Care

US states that implemented policies for screening newborns for critical congenital heart disease have seen reductions in infant cardiac deaths compared to states that didn’t implement screening.

Jimmy Kimmel’s infant son, whose medical care has been in the spotlight as part of the US healthcare debate, is recovering from his second heart surgery.

The man who received the first locally-developed mechanical heart valve in India, the TTK-Chitra valve, celebrates 27 years with his mechanical valve.

Surgeons in New York City remove a tennis ball-sized tumor from a man’s heart.

 

Drugs and Devices

The US Food and Drug Administration announced new guidance on 3D-printed medical devices.

A transcatheter device for mitral regurgitation that is anchored entirely in the left atrium was awarded Best Technology Parade Presentation at the International Conference for Innovations in Cardiovascular Interventions in Tel Aviv, Israel.

Edwards Lifesciences has purchased Harpoon Medical, including its mitral valve repair device that is expected to receive CE mark approval soon.

 

Research, Trials, and Funding

Adding atezolizumab, an anti-PD-L1 immunotherapy, to an antiangiogenic biologic drug and chemotherapy delayed progression of non-small cell lung cancer regardless of PD-L1 expression, in an early report from the phase III IMpower150 trial.

Former US National Football League athletes were found to have a higher incidence of an ascending aorta over 4 cm wide than similarly aged men who were not professional athletes.

Apple and Stanford University have launched the Apple Heart Study, which uses an app linked to the Apple Watch to monitor participants for irregular heart rhythms.

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