European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 2013
Accuracy, calibration and clinical performance of the new EuroSCORE II risk stratification system.
The European System for Cardiac Operative Risk Evaluation (EuroSCORE) has been used for many years since its introduction in 1999. Recently, a new EuroSCORE (EuroSCORE II) has been developed to update the previous version. The EuroSCORE II includes some different predictors and/or introduces a new classification of the already existing predictors. This study presents a validation series for the EuroSCORE II compared with the previous additive and the logistic EuroSCORE and with the Age, Creatinine and Ejection Fraction (ACEF) score. ⋯ The EuroSCORE II represents a useful update of the previous EuroSCORE version, with a much better clinical performance and the same good level of accuracy. It is possible that for the risk stratification of very high-risk patients, other factors (rare but associated with a mortality rate >50%) should be included in the future models.
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Eur J Cardiothorac Surg · Jan 2013
The North American view: the perspective of the American Association for Thoracic Surgeons.
The American Association for Thoracic Surgeons (AATS) is a small, selective organization focused on scholarship in thoracic surgery, complementing the Society of Thoracic Surgeon's focus on practice issues impacting all practicing surgeons. AATS works to improve the academic quality of North American and International meetings and symposia and focuses specific lobbying efforts on improving National Institutes of Health funding for thoracic surgeons. We need to embrace new technologies and incorporate them into our training programmes, and to cultivate the creativity necessary for innovation. It is necessary to make residents and medical students more aware of the virtues of a career in our specialty and focus less on making the training process more attractive for its own sake.
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Eur J Cardiothorac Surg · Jan 2013
Limited resection for clinical Stage IA non-small-cell lung cancers based on a standardized-uptake value index.
In a previous study, we found that a standardized-uptake value (SUV) index obtained from positron emission tomography (PET)/computed tomography (CT) data was significantly correlated with prognosis in patients with pathological Stage I lung adenocarcinoma. However, this value has not been studied in early stage lung cancer patients undergoing limited resection. In this study, we investigated if an SUV index could be used to identify patients with clinical Stage IA lung cancers that were appropriate for limited resection. ⋯ In clinical Stage IA lung cancer patients, the SUV index was a significant predictive marker for recurrence. Patients with SUV indices <1.0 were less likely to have a recurrence. Thus, clinical Stage IA patients with SUV indices <1.0 should be candidates for limited resection.
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Eur J Cardiothorac Surg · Jan 2013
Right vertical infra-axillary mini-incision for repair of simple congenital heart defects: a matched-pair analysis.
To evaluate the efficacy and safety of the right vertical infra-axillary mini-incision (RVAI) used for the repair of simple congenital heart defects. ⋯ The RVAI surgical approach to simple congenital heart defects was a safe procedure and could be performed with excellent cosmetic and clinical outcomes. It provided a good alternative to the standard MSI for simple congenital heart defects.
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Eur J Cardiothorac Surg · Jan 2013
Persistent post-surgical pain following anterior thoracotomy for lung cancer: a cross-sectional study of prevalence, characteristics and interference with functioning.
Most studies of persistent post-surgical pain following thoracic surgery have focused on classic posterolateral thoracotomy in mixed surgical populations without systematic assessment of disease recurrence and other potential sources of pain. The purpose of this study was to examine patterns in the prevalence of persistent post-surgical pain following lung cancer surgery and to quantitatively assess the characteristics of persistent post-surgical pain and associated sensory changes. ⋯ Persistent post-surgical pain following anterior thoracotomy was prevalent in 19% (95% CI: 15-23%) of lung cancer patients for up to 10 years postoperatively. Future preventive strategies should focus on the role of intraoperative nerve damage, including the potentially protective role of anterior thoracotomy.