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Journal and News Scan

Source: Multimedia Manual of Cardiothoracic Surgery
Author(s): Alan D.L. Sihoe*, Michael K.Y. Hsin and Peter S.Y. Yu

this is a video and article decribing the technique for bullectomy and pleural abrasion using the original drain as a port and 2 3mm ports.

 

Source: New England Journal of Medicine
Author(s): Tommaso Sanna, Hans-Christoph Diener, Rod S. Passman, Vincenzo Di Lazzaro, Richard A. Bernstein, Carlos A. Morillo, Marilyn Mollman Rymer, Vincent Thijs, Tyson Rogers, Frank Beckers, Kate Lindborg, and Johannes Brachmann, for the CRYSTAL AF Investigators

The cause of ischemic stroke remains elusive in up to 20-40% of cases.  In patients with cryptogenic stroke, 8.9% of patients with long term monitoring using an insertable cardiac monitor were found to an episode of atrial fibrillation, which may have implications in therapy.

Source: Heart
Author(s): Abdel-Wahab M, Zahn R, Gerckens U, Linke A, Sievert H, Schäfer U, Kahlert P, Hambrecht R, Sack S, Hoffmann E, Senges J, Schneider S, Richardt G; on behalf of the German TAVI Registry Investigators

In this study the authors use data from 1432 patients included in the German TAVI registry to identify variables which predict poor outcome in patients left with more than mild aortic regurgitation (AR) following TAVI.  The Medtronic Core Valve prosthesis had been used in the great majority of the procedures. 1-year follow up data was available in 92% of the patients. Of these patients, 201 (15.2%) were found to have significant AR. Using Cox regression analysis, only more than mild pre-existing mitral regurgitation and pulmonary hypertension were identified as independent predictors of 1-year mortality .

Source: Annals of Oncology
Author(s): A. G. Pallis, C. Gridelli, U. Wedding, C. Faivre-Finn, G. Veronesi, M. Jaklitsch, A. Luciani, and M. O'Brien

Although lung cancer is common in the elderly population, little information specific to this population is available to inform healthcare practitioners.  The EORTC, in collaboration with the International Society of Geriatric Oncology, released a concensus statement in 2010 on this topic.  Since then a number of related studies have been published.  The current publication is an update on the 2010 statement that includes new recommendations for treatment, data on patient preferences, and concepts regarding geriatric assessment.

Source: Journal of Clinical Oncology
Author(s): Joshua A. Roth, Sean D Sullivan, Arliene Ravelo, Joanna Sanderson, Scott David Ramsey

In this study presented by Dr. Joshua A. Roth recently at the ASCO meeting, they used a model to forecast the 5-year results of implementation of a screening program (as suggest the NLST, age older than  55 with at least 30 pack-years of smoking history) in comparison to no screening program. They modeled various scenarios involving faster and slower diffusion of the program. The number of lung cancer detected at the localize stage will raise from 15% to 32% with 54900 of new lung cancer diagnoses, but the cost of this advantage will exceed 9.3 $ billion.

Source: Journal of Thoracic Oncology
Author(s): Hayes, Sara A.; Huang, James; Plodkowski, Andrew J.; Katzen, Janine; Zheng, Junting; Moskowitz, Chaya S.; Ginsberg, Michelle S.

Predictors of resectability on preoperative CT were evaluated in 133 pts undergoing resection for thymoma over a 13 year period in a single institution.  60% of pts were Masaoka stage I or II.  17% of pts had an incomplete resection.  On multivariate analysis, pleural nodularity and the degree of abutment of adjacent vessels predicted incomplete resection. 

Source: Journal of Thoracic Oncology
Author(s): Safieddine, Najib; Liu, Geoffrey; Cuningham, Kris; Ming, Tsao; Hwang, David; Brade, Anthony; Bezjak, Andrea; Fischer, Stefan; Xu, Wei; Azad, Sassan; Cypel, Marcelo; Darling, Gail; Yasufuku, Kazu; Pierre, Andrew; de Perrot, Marc; Waddell, Tom; Keshavjee, Shaf

This single institution study evaluated prognostic factors in 262 pts undergoing thymectomy for thymic tumors over a 25-year period.  The majority of tumors were Masaoka stage II and the most common histology was WHO type B.  15 year survival was 91%.  Recurrence was related to Masaoka stage and tumor size.

Source: Journal of Gastrointestinal Surgery
Author(s): Kazuhiko Sakamoto, Masaaki Oka, Shigehumi Yoshino, Shoichi Hazama, Shigeru Takeda, Kiyoshi Yoshimura, Naoko Okayama, Yuji Hinoda

This prospective study evaluated the relationship of inflammatory gene polymorphisms and postoperative pneumonia after esophagectomy in 120 pts.  One genotype for IL-10 was significantly associated with reduced postoperative serum IL-10 levels and an increased rate of postoperative pneumonia.  IL-10 polymorphism was an independent predictor of pneumonia.

Source: SCTS Ionescu University 2014
Author(s): One of a series of lectures from the Ionescu SCTS University available for free at http://173.45.225.219/categories/scts-edinburgh-2104

This lecture documents the lack of conclusive evidence for LA appendage occlusion. 

This is one of a series of lectures given on management of the Left Atrial appendage at the SCTS University 2014 so click below to see several others including talks by many eminent speakers including Jim Cox 

 

http://173.45.225.219/categories/scts-edinburgh-2104

 

 

Source: New England Journal of Medicine
Author(s): William D. Chey, Lynn Webster, Mark Sostek, Jaakko Lappalainen, Peter N. Barker, and Jan Tack

In two double blind trials involving nearly 1400 pts being treated with opiods for non-cancer pain and experiencing constipation, oral naloxegol was compared to placebo with the primary outcome being spontaneous bowel activity.  Naloxegol was superior to placebo overall and in the subgroup of patients who had failed to respond to laxatives.  Pain scores did not differ, indicating that the oral opiod receptor antagonist did not interfere with pain management.

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