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Journal and News Scan
Within a year after a diagnosis of lung cancer the suicide rate for such patients is 6 times higher than in the general population. This is among the greatest increases in the risk of suicide among all cancer diagnoses.
Malignant pleural effusions (MPE) affect up to 15% of all patients with cancer, and in the last few years several well-designed randomized clinical trials have been published. In this position paper, members from both the European Respiratory Society and the European Association for Cardio-Thoracic Surgery summarize the available evidence, focusing on six topics: (1) symptomatic MPE, (2) MPE with trapped lung, (3) loculated MPE, (4) factors predicting prognosis, (5) timing of oncological therapy and definitive fluid management, and (6) histological diagnosis versus cytology.
Edwards Lifesciences announced that the SAPIEN 3 Ultra system has received US Food and Drug Administration approval for transcatheter aortic valve replacement in severe, symptomatic aortic stenosis patients who are determined to be at intermediate or greater risk of open-heart surgery.
On December 20, 2018, the US Food and Drug Administration (FDA) issued a new warning against the use of fluoroquinolones in patients with connective tissue disorders and those predisposed to aortic disease.
The FDA indicates that fluoroquinolones, a commonly prescribed class of antibiotics (including Avelox, Cipro, Factive, Levaquin, and Ofloxacin), should not be used in certain patients with aortic aneurysm/dissection and those who are at higher risks for developing aortic aneurysms and dissections, such as patients with connective tissue disorders, hypertension, peripheral atherosclerotic vascular diseases, and the elderly. A review of several recent studies shows that people who have taken a fluoroquinolone are twice as likely to develop an aortic aneurysm or dissection than those who have not taken one of these drugs. FDA has also required a new warning about this risk to be added to the labeling of these medications.
The world breaks everyone and afterward many are strong at the broken places. But those that will not break it kills. It kills the very good and the very gentle and the very brave impartially. If you are none of these you can be sure it will kill you too but there will be no special hurry.
Kiener and colleagues evaluated survival for patients receiving either an arterial or atrial switch operation for d-transposition of the great arteries. The authors evaluated operation data from the Pediatric Cardiac Care Consortium between 1982 and 1991, finding better 20-year overall transplant-free survival for arterial switch operations than for atrial switch (82.1% versus 76.3%) despite the fact that in-hospital mortality was higher for arterial switch (21.6% versus 12.9%).
Loger and colleagues implanted transcatheter prostheses in the mitral valve position in 33 pigs. Valve performance and heart function were analyzed for both supra-annular and subvalvular fixation. The supra-annular valve deployment was associated with a low degree of paravalvular leakage and was well-tolerated in the hearts, resulting in excellent three-month outcomes for these animals.
A randomized controlled trial coauthored by the Editor-in-Chief of the host periodical on the risk management of multivessel diabetic coronopathy.
Borracci and colleagues evaluated the incidence of acute kidney injury (AKI) in 418 patients during in-hospital care after cardiac surgery. The authors found AKI in 17.5 % of patients when considering the worst kidney function measurement in the postoperative period compared to 4.5 % of patients when only considering kidney function at discharge. Transient AKI did not affect in-hospital outcomes independently of the patient’s preoperative renal function.
Stanifer and colleagues present a contemporary analysis of tracheal surgery in the US with the goal of identifying predictors of major morbidity and mortality. Tracheal resections reported in The Society of Thoracic Surgeons General Thoracic Surgery Database between 2002 and 2016 were included in this analysis. The cervical approach was the most commonly used, and benign disease was the indication 75% of the time. Centers performing fewer than four resections per year had higher combined morbidity and mortality than centers performing at least four per year.