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Journal and News Scan

Source: New England Journal of Medicine
Author(s): Gerard A. Silvestri, Anil Vachani, Duncan Whitney, Michael Elashoff, Kate Porta Smith, J. Scott Ferguson, Ed Parsons, Nandita Mitra, Jerome Brody, Marc E. Lenburg and Avrum Spira for the AEGIS Study Team

Pts with suspected lung cancer underwent sampling of normal-appearingbronchial epithelial cells in the main bronchi, unrelated to the suspected tumor.  Gene expression was analyzed and classified.  Classification for cancer was about 75% accurate. 

Source: Annals of Surgery
Author(s): Roberts, Derek J.; Leigh-Smith, Simon; Faris, Peter D.; Blackmore, Christopher; Ball, Chad G.; Robertson, Helen Lee; Dixon, Elijah; James, Matthew T.; Kirkpatrick, Andrew W.; Kortbeek, John B.; Stelfox, Henry T.

The question in this review was whether patients who experience tension pneumothorax differ in presentation depending on whether they are breathing spontaneously or are on positive pressure ventilation.  Assisted ventilation was more often associated with hypoxia, hypotension, and cardiac arrest.  These adverse clinical signs frequently arose within minutes of initial clinical presentation in the assisted ventilation cohort.

Source: Annals of Surgery
Author(s): Szasz, Peter; Louridas, Marisa; Harris, Kenneth A.; Aggarwal, Rajesh MD; Grantcharov, Teodor P.

Competence-based rather than time-based surgical education will likely become the norm in the next decade.  The authors reviewed current methods for assessing technical competence in trainees.  No clear definition of technical competence was evident.  Instruments used for assessment were originally designed to assess skill rather than competence.  The field is ripe for additional research.

Source: VuMedi
Author(s): Patrick McCarthy

Filmed at the 2012 Dallas-Leipzig Valve meeting, Patrick McCarthy delivers a presentation on the management of left atrial appendage. 

Source: BBC Trending
Author(s): Gabriela Torres

A recent picture of a junior doctor asleep while at work in a Monterrey, Mexico hospital has sparked an online conversation about the importance of sleep for doctors. The picture was taken and posted by a blogger, who wrote, "We are aware that this is a tiring job but doctors are obliged to do their work." Doctors have responded on twitter with the hashtag #YoTambienMeDormi ("I've also fallen asleep"), posting pictures and stories about the necessity of taking short naps while working long shifts. 

Source: European Heart Journal
Author(s): Vamos M, Erath JW, Hohnloser SH.

The question of whether digoxin increases the risk of death in patients with atrial fibrillation (AF) or congestive heart failure (CHF) continues to be a matter of debate. The authors of this manuscript attempt to find an answer with a meta-analysis and systematic review of the literature. Overall, the analysis comprises data from 235.047 AF patients and 91.379 patients with CHF. The results indicate that digoxin therapy is associated with an increased mortality risk in these patients, particularly in those treated for AF.

Source: Journal of Clinical Oncology
Author(s): MIng-Sound Tsao, Sophie Marguet, Gwenael Le Teuff, Sylvie Lantuejoul, Frances A. Shepherd, Lesley Seymour, Robert Kratzke, Stephen L. Graziano, Helmut H. Popper, Rafael Rosell, Jean-Yves Douillard, Thierry Le-Chevalier, Jean-Pierre Pignon, Jean-Charles Soria, and Elisabeth M. Brambilla

The most recent WHO classification for lung adenocarcinoma is based on the predominant histologic subtype in the resected tumor. Several studies have validated the use of this classification system for  prognostic purposes, but predicting response to adjuvant chemotherapy has not yet been tested. The goal of this study was to determine whether this classification can be used to predict benefit from adjuvant chemotherapy in patients who have undergone complete surgical resection. The Lung Adjuvant Cisplatin Evalutaion Biomarker (LACE-Bio) collabortive group formed a large cohort of patients from four adjuvant chemotherapy clinical trials (n=552 for this study).  Two groups were compared: acinar/papillary (n=247) and micropapillary/solid (n=305). Patients in the micropapillary/solid subgroup had a significant benefit from adjuvant chemotherapy in terms of disease-free survival, whereas patients in the acinar/papillary subgroup did not.

Source: Journal of the National Cancer Institute
Author(s): Maartje van der Schaaf, Asif Johar, Bas Wijnhoven, Pernilla Lagergren and Jesper Lagergren

In this population-based cohort study with 1044 patients who underwent esophagectomy for esophageal cancer between 1987 and 2010 in Sweden, the researchers found that a higher number of lymph nodes removed did not affect mortality in any specific stage.

Source: Dallas Morning News
Author(s): Matt Wixon

Nick Albus had transposition correction as a child and had to have a second operation in 2013. Now he is pushing to get in the state champoinships at 100m. Read his story here. 

Source: JACC Cardiovascular Interventions
Author(s): Kamperidis V, van Rosendael PJ, de Weger A, Katsanos S, Regeer M, van der Kley F, Mertens B, Sianos G, Ajmone Marsan N, Bax JJ, Delgado V.

In this manuscript the authors describe their findings in an observational study of patients undergoing either aortic valve replacement with a “sutureless” aortic valve bioprosthesis (Medtronic’s 3f Enable) or transcatheter aortic valve implantation (TAVI) with either an Edwards Sapiens XT or Medtronic CoreValve prosthesis, comparing functional and clinical outcomes. Propensity score matching (80 patients) was performed to control  selection bias.The findings suggest that transcatheter bioprostheses have a better hemodynamic profile than the 3f Enable valve in terms of effective orifice area index and mean transvalvular pressure gradient. However, aortic regurgitation was present more often after TAVI. The sutureless bioprosthesis was independently associated with patient-prosthesis mismatch at discharge. Nevertheless, these hemodynamic differences had no impact on the mid-term survival of the patients.

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