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Journal and News Scan

Source: JAMA Internal Medicine
Author(s): Edward F. Patz Jr; Paul Pinsky; Constantine Gatsonis; JoRean D. Sicks; Barnett S. Kramer; Martin C. Tammemägi; Caroline Chiles; William C. Black; Denise R. Aberle; for the NLST Overdiagnosis Manuscript Writing Team

This study examined the rate of overdiagnosis (detection rate of indolent tumors) of lung cancer in the NLST.  They found that 18% of all lung cancers detected were of the indolent type, and nearly 79% of the bronchioalveolar cancers were likely indolent. 

Source: Annals of Thoracic Surgery
Author(s): John M. Stulak, Salil Deo, John Schirger, Keith D. Aaronson,Soon J. Park, Lyle D. Joyce, Richard C. Daly, Francis D. Pagani

This study of 389 pts receiving a continuous flow LVAD evaluated the risk of thromoembolic (TE)complications associated with preop AF.   TE occured in 25% of pts; freedom from TE at 2 years was 46% in those with AF and 72% in those without AF (p<0.001).  AF did not affect late survival.

Source: Annals of Thoracic Surgery
Author(s): Surgery Claude A. Beaty, Kara A. Haggerty, Madeline G. Moser, Timothy J. George,Chase W. Robinson, George J. Arnaoutakis, Glenn J. Whitman

This behavioral modification study covered 6 months at a single institution during which 144 pts underwent 510 transfusion events.  Cardiac surgeons agreed on a Hgb cutoff value of 8 as an indication for transfusion (massive transfusions were excluded).  Surgeons received weekly feedback as to their practice patterns.  Compared to baseline, feedback resulted in a 63% reduction in transfusions and an increase in single transfusions from 77% to 90%.   

Source: Gizmodo
Author(s): Ashley Feinberg

Researchers at Tsinghua University in Beijing have taken a potentially wildly complicated problem and come up with a (relatively) simple solution by injecting the heart with gallium, a chemically stable metal that melts at about 85 degrees Fahrenheit. In other words, it has no problems flowing through the labyrinthine vessels of the heart.

Source: JAMA Internal Medicine
Author(s): Ilke Sipahi; M. Hakan Akay; Sinan Dagdelen; Arie Blitz; Cem Alhan

This meta-analysis compared outcomes of PCI vs CABG in patients with multivessel disease, evaluating studies that were not individually powered to detect survival differences. 6 RTC including 6055 pts were analyzed. Significant benefits for CABG were associated with overall mortality, MI, and the need for revascularization.

Source: Journal of the American College of Cardiology
Author(s): Sadat U, Usman A, Gillard JH, Boyle JR.

The use of pharmaceutical strategies to prevent contrast-induced acute kidney injury continues to be an unresolved matter. In this manuscript the authors describe their findings of a systematic review with a meta-analysis on the prevention of this type of injury with ascorbic acid. They conclude that ascorbic acid appears to be nephro-protective against contrast-induced acute kidney injury.

Source: Journal of Thoracic Oncology
Author(s): Collaud, Stéphane; Waddell, Thomas K.; Yasufuku, Kazuhiro; Pierre, Andrew F.; Darling, Gail E.; Cypel, Marcelo; Rampersaud, Yoga R.; Lewis, Stephen J.; Shepherd, Frances A.; Leighl, Natasha B.; Cho, John; Bezjak, Andrea; Tsao, Ming Sound; Keshavjee, Shaf; de Perrot, Marc

This article describes outcomes of en bloc resection of superior sulcus tumors invading the spine in 48 pts from multiple centers operated on during a 22 year period. Most pts received induction chemotherapy and radiation therapy. Complete resection was achieved in 88%, and 5-year survival was 61%. Surgical mortality was 6%. The primary determinant of survival was complete response to induction therapy.

Source: Annals of Thoracic Surgery
Author(s): Javariah Siddiqui, Christian P. Brizard, Igor E. Konstantinov, John Galati, Gavin Wheaton, Michael Cheung, Stephen Horton, Yves d'Udekem

Bicuspid AV repair was performed in 146 pts over a period of 34 years; the primary indication was stenosis. Survival at 20 yrs was 88%. Freedom from reintervention at 18 yrs was 43%. 30 additional pts without reintervention had moderate to severe stenosis or moderate regurgitation at last follow-up.

Source: Annals of Thoracic Surgery
Author(s): Ho Young Hwang, Kwang Ree Cho, Ki-Bong Kim

The patency and clinical outcomes of the right internal thoracic artery (RITA) and right gastroepiploic artery (RGEA) as Y-grafts to the LIMA in situ were evaluated in 443 pts using propensity score matching. Graft patency, overall survival, and freedom from reintervention rates were similar for the two groups.

Source: Annals of Thoracic Surgery
Author(s): Bing-sheng Sun, Yue Li, Zhen-fa Zhang, Jian You, Chang-li Wang

Osteopontin (OPN) influences metastatic behavior of tumors through binding to CD44v6 and integrin. The authors in this study assessed OPN and CD44v6 expression in 159 NSCLC pts and evaluated survival. The combination of markers stratified overall and disease-free survival, especially in stage I pts. Overall survival for [OPN- AND CD44v6-] pts was 64.4%, for [OPN+ OR CD44v6+] was 49.1%, and for [OPN+ AND CD44v6+] was 16.4%.