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Journal and News Scan
February 18, 2016
Submitted by: Mark Ferguson
The authors studied the rate of publication of completed clinical trials performed in academic medical centers in the US. Among over 4,300 such trials, only 36% were published within 2 years of completion, and only 66% were ultimately published at any time. There was considerable variation in publication rates among institutions.
February 18, 2016
Submitted by: Mark Ferguson
The authors studied the relationship of outcomes after non-cardiac surgery to blood transfusion among over 7,300 patients. Patients with significant bleeding were excluded. Patients were stratified according to the occurence of postoperative MI and the nadir hematocrit value (20-24%, 24-27%, 27-30%). The outcome was 30-day mortality. In the no-transfusion group, mortality increased as nadir hematocrit decreased. In patients with an MI, mortality was lower in the low hematocrit patients who received a transfusion. In patients without an MI, mortality was increased for patients in the high hematocrit group who received a transfusion. In patients with stable cardiovascular status postoperatively, a restrictive transfusion policy is appropriate. Those who have cardiovascular instability or MI may require a different transfusion strategy.
February 18, 2016
Submitted by: Mark Ferguson
The authors studied outcomes after endovascular AAA aneurysm repair (EVAR) to assess whether ongoing aortic remodeling related to systemic inflammatory disease (SID) contributes to an increased incidence of endoleak. 65% of 79 treated patients had systemic inflammatory disease. Major complication rates were increased 7-fold in the group with SID. This group also experienced a 2.5-fold greater incidence of endoleaks and a 2-fold greater rate of late sac expansion. More interventions were required in the SID group.
February 18, 2016
Submitted by: Mark Ferguson
Over 1400 patients with asymptomatic severe carotid stenosis were randomized to with carotid stenting or endarterectomy. The endpoints were the composite of death, stroke, or acute MI within 30 days, or ipsilateral stroke. Stenting was non-inferior to endarterectomy. The rate of the composite endpoint was 3.8% vs 3.4% (stent vs surgery). At 30 days to 5 years, freedom from ipsilateral stroke was 97.8% vs 97.3%. Cumulative stroke-free survival rates were 93.1% and 94.7%.
February 10, 2016
Submitted by: Joel Dunning
NHS England is evaluating a series of operations in the UK. One of the procedures it is looking at is Pectus Excavatum surgery.
At the moment the proposal is to ban all pectus surgery in the UK funded by the NHS. This document is currently available for 25 more days for public consultation and to obtain the views of the public and profession widely.
There are only around 200 of these operations conducted per year in the UK and therefore we believe that the money saved will be minimal.
However the benefit to patients of Pectus surgery, many patients of which are teenagers or adolescents we believe is very large in terms of their confidence and ability to face the world.
These patients are also often not able to afford the money to fund this operation as they are not yet earning.
If you also believe in Pectus Excavatum as a good operation, and you would like us to help preserve this in the UK then please sign this signature and send this on to others.
you are also able to send a personal view to NHS england as well as see all their documents here :
https://www.engage.england.nhs.uk/consultation/clinical-commissioning-wa...
Many thanks for your Help
The UK thoracic Surgery community
February 9, 2016
Submitted by: CTSNet Staff
This article analyzes the amount of lung function loss in 31 patients who underwent bilateral metastasectomy for pulmonary metastases.
February 6, 2016
Submitted by: Joel Dunning
NHS england carries out a series of consultations to guide national policy. Their recommendations are usually completely binding and result in policy change across the whole of the UK. Hospitals are unable to carry out operations for which they withdraw NHS funding.
The current NHS England evaluation for robotic thoracic surgery concludes :
Robotic surgery requires expensive equipment, which represents a capital cost as well as the cost of consumables. Currently providers are reimbursed for robotic assisted surgery through the national prices, with a separate additional payment for the cost of the robotic consumables.
NHS England has concluded that there is not sufficient evidence to support a proposal for the routine commissioning of robotic assisted lung resection for primary lung cancer.
It is open for 30 days of evaluation before they make the final decision. Anyone can respond to their document, so please do respond if you want to influence this decision
Further information can be found here.
https://www.engage.england.nhs.uk/consultation/clinical-commissioning-wave2
February 5, 2016
Submitted by: Aristotle Protopapas
A useful reference tool for all colleagues interested in research and biomedical publishing
February 2, 2016
Submitted by: Aristotle Protopapas
This randomized trial (NEAT-HFpEF) of 110 subjects (59 placebos) disproves, by clinical and biological markers, the utility of nitrates for exercise tolerance. This is a subset of cardiac failure patients we are likely to encounter in general cardiothoracic surgical practice.
February 1, 2016
Submitted by: Mark Ferguson
A retrospective analysis of patients suffering blunt cardiac injury was performed to identify factors associated with mortality. Death was not associated with abnormal ECG or the site or number of bone fractures. Mortality was related to hypotension, elevated lactate, and elevated troponins.