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Journal and News Scan

Source: Journal of Clinical Oncology
Author(s): J-S Ryu, HJ Ryu, S-N Lee, A Memon, S-K Lee, H-S Nam, H-J Kim, K-H Lee, J-H Cho, S-S Hwang

The authors evaluated the impact of small (<10mm) pleural effusion on outcomes in patients with NSCLC.  Of over 2000 pts, minimal PE was present in 13%.  It was more common in patients with more advanced stages.  Minimal PE was associated with decreased median survival (7.7 vs 17.7 mos) after adjustment for other prognostic variables.  The impact on outcomes was greater for earlier stages of disease.

Source: Journal of the American College of Cardiology
Author(s): Makkar RR, Jilaihawi H, Mack M, Chakravarty T, Cohen DJ, Cheng W, Fontana GP, Bavaria JE, Thourani VH, Herrmann HC, Pichard A, Kapadia S, Babaliaros V, Whisenant BK, Kodali SK, Williams M, Trento A, Smith CR, Teirstein PS, Cohen MG, Xu K, Tuzcu EM, Webb JG, Leon MB.
In this manuscript the authors analyse data from the cohort B (inoperable patients) of the PARTNER trial in order to compare outcomes in two groups of patients, those inoperable for technical reasons and those inoperable for clinical reasons. Patients deemed inoperable for technical reasons had a lower risk profile. Two-year mortality and quality of life was significantly better in this group.
Source: American Journal of Cardiology
Author(s): Costopoulos C, Latib A, Maisano F, Testa L, Bedogni F, Buchanan L, Naganuma T, Sticchi A, Sato K, Miyazaki T, Figini F, Giannini F, Taramasso M, Naim C, Carlino M, Chieffo A, Montorfano M, Alfieri O, Colombo A.
There have been some concerns about outcomes of TAVI in patients with bicuspid aortic valves (BAV). In this retrospective study, outcomes after TAVI in 21 patients with BAVs were compared with those in 447 patients with tricuspid aortic valves (TAV). Device success was lower and 30-day mortality was higher in BAV patients. There was no significant difference between groups in terms of 30-day composite safety end point, postprocedural aortic regurgitation or in 12-month cardiovascular mortality.
Source: Journal of Nuclear Medicine
Author(s): ZB Zeliadt, ET Loggers, CG Slatore, DH Au, PL Herbert, GJ Klein, LG Kessler, LM Backhus

During the period 1997-2009, nearly 3,000 military veterans with NSCLC were evaluated regarding the utility of PET in staging their cancers.  PET use increased in frequency during the study period from 9% to 91%.  PET reduced the chance of unnecessary surgery by nearly 50%. 

Source: Journal of Clinical Oncology
Author(s): G Sozzi, M Boeri, M Rossi, C Verri, P Suatoni, F Bravi, L Roz, D Conte, M Grassi, N Sverzellati, A Marchiano, E Negri, C La Vecchia, U Pastornio

In an effort to provide diagnostic information complementary to radiographic screening for lung cancer, the authors evaluated the diagnostic performance of plasma mRNA.  The mRNA signature classifier demonstrated 87% sensitivity and 81% specificity, with a negative predictive value of 99%.  In contrast, low dose CT had a sensitivity of 79% and a specificity of 81%.  Combining the mRNA signature classifier and low dose CT resulted in a 5-fold decrease in false positive findings based on CT alone.

Source: Annals of Thoracic Surgery
Author(s): Nathan M. Mollberg, Carrie Bennette, Eric Howell, Leah Backhus, Beth Devine, Mark K. Ferguson

LVI is thought to be an adverse prognostic indicator of survival in patients with NSCLC.  This review quantified the relationship of LVI and survival.  The unadjusted effect of LVI for recurrence-free survival was HR=3.63 and for overall survival was HR=2.38.  After adjustment for covarates, these HRs were 2.52 and 1.81, both highly significant. 

Author(s): list25
From plane crashes to lightning strikes these are the 25 things that are statistically most likely to kill you.
Source: Journal of the American Medical Association
Author(s): Christopher Vinden; Danielle M. Nash; Jagadish Rangrej; Salimah Z. Shariff; Stephanie N. Dixon; Arsh K. Jain; Amit X. Garg
The debate between surgeon sleep deprivation and performance continues. This study looked at complications from laparoscopoic cholecystectomies (n=94,183) in surgeons who operateed the night before and found no difference in outcomes. Although lap cholecystectomies don't translate to cardiothoracic surgery, some of the discussion points apply. Also, there is an excellent editorial accompanied the article written by Michael Zinner and Julie Ann Freischlag.
Source: Circulation
Author(s): Van Belle E, Juthier F, Susen S, Vincentelli A, Iung B, Dallongeville J, Eltchaninoff H, Laskar M, Leprince P, Lievre M, Banfi C, Auffray JL, Delhaye C, Donzeau-Gouge P, Chevreul K, Fajadet J, Leguerrier A, Prat A, Gilard M, Teiger E; for the FRANCE 2 Investigators.
In this study, the authors evaluate the relevance of post-procedural-aortic-regurgitation (AR) following transcatheter aortic valve replacement (TAVR) in patients included in the FRANCE 2 registry. They compare outcomes and risk factors for post-procedural AR in balloon expandable (BE) and self-expandable (SE) prosthesis. Not surprisingly, post-procedural AR was significantly more frequent in SE than in BE prosthesis. Post-procedural AR ≥2 was a predictor of 1-year mortality. Risk factors for post-procedural AR were identified for BE and SE prosthesis.
Source: Journal of the American College of Cardiology
Author(s): Rick A. Nishimura; Catherine M. Otto; Robert O. Bonow; Blase A. Carabello; John P. Erwin; Robert A. Guyton; Patrick T. O’Gara; Carlos E. Ruiz; Nikolaos J. Skubas; Paul Sorajja; Thoralf M. Sundt; James D. Thomas
The new AHA/ACC Guideline for the management of patients with valvular heart disease. This version is a complete update of the 2008 version and provides up-to-date guidance implementing the new developments in valvular heart disease.