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Journal and News Scan
December 19, 2014
Submitted by: Joel Dunning
A $400,000 grant from the MacArthur Foundation will be used to create a database of retractions from scientific journals, extending the work done by Adam Marcus and AHCJ Vice President Ivan Oransky on their Retraction Watch blog.
The grant was awarded to the Center for Scientific Integrity, a nonprofit organization set up by Marcus and Oransky.
The two journalists founded and run Retraction Watch, the independent blog that covers retractions. Oransky explains in a blog post they are only able to cover about two-thirds of new retractions.
December 18, 2014
Submitted by: Mark Ferguson
This randomized trial in New Zealand assigned smokers who wished to quit to either nicotrine replacement therapy or cytisine therapy. At 1 mon more patients reported continuous abstinence from cigarettes in the cytisine group than in the nicotine replacement group (40% vs 31%). Cytisine was more effective at 1 week, 2 mos, and 6 mos. Cytisine was superior to nicotine replacement in women and was non-inferior in men. Self-reported adverse events were more common in the cytisine group.
December 17, 2014
Submitted by: Joseph Basha
Hemodilution on CPB is a hotly debated topic. Today, transfusion management programs have emerged as a way to reduce the need for allogeneic RBC transfusions but debate over what the safest lowest hematocrit is for cardiac surgery patients persists. What I found most interesting about this article is that is suggests that women tolerate a lower hematocrit than males. Is this a hormonal protective process or are women pre-conditioned to tolerating lower hematocrits? Certainly for me it has put what I have always practiced into question. Much work has been done with both lowest hematocrit levels and the deleterious effects of transfusions. I will be eager to see new data regarding this controversial topic as it emerges.
December 15, 2014
Submitted by: Joel Dunning
The CardioWest Total Artificial Heart (CW-TAH) is a pneumatically driven pump that completely replaces the patient’s native ventricles orthotopically. The device weighs 160 g and consists of two artificial ventricles, four Medtronic Hall tilting disk valves, two membranes, and two drivelines tunneled through the skin, which connect the ventricles to an external console generating pulsatile flow (1). At maximum stroke volume (close to 70 mL), it delivers a cardiac output between seven and nine litres per minute. Variations in cardiac output are determined by variations in venous return and peripheral resistance linked to the patient’s position and level of physical activity (2). The CW-TAH is indicated for use in patients with refractory cardiac failure as a bridge to transplantation, and when used for this indication, improves survival to transplant (3). Portable drivers have been approved in both Europe and the United States to allow stable patients to be discharged home while awaiting their transplant (4).
- Slepian MJ, Smith RG, Copeland JG. The Syncardia CardioWest Total Artificial Heart. In: Baughman KL, Baumgartner WA. eds. Treatment of Advanced Heart Disease. New York, NY: Taylor and Francis Group, 2006:473.
- Bellotto F, Compostella L, Agostoni P, et al. Peripheral adaptation mechanisms in physical training and cardiac rehabilitation: the case of a patient supported by a CardioWest total artificial heart. J Card Fail 2011;17:670-5. [PubMed]
- Copeland JG, Smith RG, Arabia FA, et al. Cardiac replacement with a total artificial heart as a bridge to transplantation. N Engl J Med 2004;351:859-67. [PubMed]
- Jaroszewski DE, Anderson EM, Pierce CN, et al. The SynCardia freedom driver: a portable driver for discharge home with the total artificial heart. J Heart Lung Transplant 2011;30:844-5. [PubMed]
December 13, 2014
Submitted by: Arie Blitz
This publication by the University of Louisville group provides an excellent comparative analysis of the outcomes after continuous-flow (CF) vs. pulsatile flow (PF) LVADs. Although the outcomes after CF LVAD implantation are clearly superior than those of PF LVADs, there are certainly unique morbidities after CF LVAD implantation. The authors argue that these differential outcomes beg the question: Should pulsatility algorithms be introduced in all contemporary CF LVADs?
December 13, 2014
Submitted by: Joel Dunning
We are in the wrong specialty !!
December 11, 2014
Submitted by: J. Rafael Sadaba
In this manuscript, the authors report on a retrospective study looking at the progression of aortic stenosis (AS) in 1558 patients with mild, moderate and severe AS and preserved left ventricular function. They conclude that the progression of severity depends significantly on the severity of the AS at baseline. Although the average rate of progression in AS mean gradient is slower than previously reported, a significant proportion of patients were observed to progress to higher grades of severity or AVR within the recommended time frames for echocardiographic follow-up. In this model, few clinical variables were associated with significantly accelerated progression: in patients with mild AS only age and gender and in patients with moderate AS renal disease and hyperlipidemia beyond age and gender.
December 11, 2014
Submitted by: Arie Blitz
In this Duke study, all CF LVAD implantations during the 2005 to 2013 era were analyzed, and those patients who underwent CF LVAD implantation and later replacement were reviewed. Two groups of patients were compared: those undergoing VAD replacement via a resternotomy approach (n=20) and those undergoing VAD replacement via a nonsternotomy approach (n=22). After VAD replacement, the latter group exhibited improved survival and reduced morbidity as compared to the former. Hence, it may be preferable to replace LVADs via a nonsternotomy approach if concomitant cardiac conditions do not need to be addressed.
December 11, 2014
Submitted by: Arie Blitz
Provocative study that analyzes lower body perfusion in a porcine model during cardiopulmonary bypass with an actuated IABP in place to effect pulsatile perfusion. Parameters of distal perfusion including measurement of pressures and microsphere perfusion indicate that flow distal to the balloon pump may be impaired.
December 10, 2014
Submitted by: Marcelo Jimenez
This interesting article summarizes the evidence from clinical, radiologic and pathologic investigations that lung cancer, specifically adenocarcinoma, may metastasize through the airways, defined as discontinuous spread of cancer cells from the primary tumor through the airways to adjacent or distant lung parenchyma. The presence of persistent or growing centrilobular nodules on CT images may be considered suspicious for aerogenous spread in patients with primary lung adenocarcinoma. This form of intrapulmonary metastasis would have significant implications in treatment and adds new opportunities in lung cancer research.