The Annals of thoracic surgery
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We determined the effect of human lung fibroblasts (LFs) in metastatic lesion formation in a four-dimensional (4D) lung cancer model. ⋯ The secreted factor from LFs grown on the 4D model inhibits the formation of metastatic lesions. The 4D model may be used to determine the role of different components of the tumor's microenvironment in metastatic lesion formation, and this secreted factor may provide a novel therapy for treatment of cancer metastasis.
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Comparative Study
Comparison of Two National Databases for General Thoracic Surgery.
Improving the quality of surgical care through accurate measurement of outcomes is an important endeavor. The purpose of this study was to compare data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and The Society of Thoracic Surgeons (STS) general thoracic surgery database to determine if a sampling technique (ACS NSQIP) is as effective and accurate as the comprehensive technique (STS database). ⋯ Databases built on partial sampling that do not capture all patients, such as the ACS NSQIP, may be useful for global analyses, but fall short of providing a foundation for meaningful quality improvement initiatives when analyzing data for specific thoracic surgical operations. These results highlight the utility and importance of complete databases such as the STSDB. National comparisons of clinical outcomes for thoracic surgical procedures should be interpreted with caution when using partial databases.
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Multicenter Study
Quality-Cost Relationship in Congenital Heart Surgery.
There is an increasing focus on optimizing health care quality and reducing costs. The care of children undergoing heart surgery requires significant investment of resources, and it remains unclear how costs of care relate to quality. We evaluated this relationship across a multicenter cohort. ⋯ Lowest cost hospitals generally deliver the highest quality care for children undergoing heart surgery, although there is some variation in this relationship. This information is important in the design of initiatives aiming to optimize health care value in this population.
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Prolonged air leaks may result in increased morbidity and mortality. Endobronchial valves have been used as a nonoperative treatment. We evaluated the efficacy of endobronchial valves at achieving chest tube removal and hospital discharge for air leaks resulting from varied etiologies. ⋯ Challenging air leaks often occur in medically compromised patients. They may persist despite multiple interventions. Endobronchial valves offer minimally invasive management. Time to chest tube removal and length of stay are variable, frequently because of clinical status and underlying disease.