The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2018
Integration of simulation components enhances team training in cardiac surgery.
Simulation in resident medical education has traditionally focused on isolated components of a surgical procedure. We hypothesized that incorporating an interdisciplinary team into a high-fidelity simulation laboratory would enhance the modeling of real-world challenges during cardiac surgery. ⋯ This simulation strategy integrates components from each discipline involved in successful completion of a cardiac surgical procedure. Our findings highlight the importance of team training as a valuable component in the residency curriculum.
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J. Thorac. Cardiovasc. Surg. · Jun 2018
CommentGenetic variants in cytokine signaling pathways and clinical outcomes in early-stage lung cancer patients.
The purpose of this study was to explore the role of single nucleotide polymorphisms (SNPs) in cytokine signaling genes and to compare them with clinical outcomes in surgical patients with non-small cell lung cancer (NSCLC). ⋯ Genetic variants in cytokine signaling pathways were associated with clinical outcomes in NSCLC patients treated with surgery individually and cumulatively. Further studies are necessary to elucidate our findings and translate them into the clinical setting.
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J. Thorac. Cardiovasc. Surg. · Jun 2018
Initial surgical experience following implementation of lung cancer screening at an urban safety net hospital.
Safety net hospitals provide care mostly to low-income, uninsured, and vulnerable populations, in whom delays in cancer screening are established barriers. Socioeconomic barriers might pose important challenges to the success of a lung cancer screening program at a safety net hospital. We aimed to determine screening follow-up compliance, rates of diagnostic and treatment procedures, and the rate of cancer diagnosis in patients classified as category 4 by the Lung CT Screening Reporting and Data System (Lung-RADS 4). ⋯ Implementation of a multidisciplinary lung cancer screening program at a safety net hospital is feasible. Compliance with follow-up and interventional recommendations in Lung-RADS 4 patients was high despite anticipated social challenges. Overall diagnostic and surgical resection rates and interventions for noncancer diagnosis were low in our initial experience.
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J. Thorac. Cardiovasc. Surg. · Jun 2018
Early fundoplication is associated with slower decline in lung function after lung transplantation in patients with gastroesophageal reflux disease.
Gastroesophageal reflux disease (GERD) is prevalent after lung transplantation. Fundoplication slows lung function decline in patients with GERD, but the optimal timing of fundoplication is unknown. ⋯ In this study, patients with early fundoplication had a higher FEV1 5 years after lung transplantation. Early fundoplication might protect against GERD-induced lung damage in lung transplant recipients with GERD.
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J. Thorac. Cardiovasc. Surg. · Jun 2018
Donor tissue-specific exosome profiling enables noninvasive monitoring of acute rejection in mouse allogeneic heart transplantation.
In heart transplantation, there is a critical need for development of biomarkers to noninvasively monitor cardiac allografts for immunologic rejection or injury. Exosomes are tissue-specific nanovesicles released into circulation by many cell types. Their profiles are dynamic, reflecting conditional changes imposed on their tissue counterparts. We proposed that a transplanted heart releases donor-specific exosomes into the recipient's circulation that are conditionally altered during immunologic rejection. We investigated this novel concept in a rodent heterotopic heart transplantation model. ⋯ Transplant heart exosome profiling enables noninvasive monitoring of early acute rejection with high accuracy. Translation of this concept to clinical settings might enable development of a novel biomarker platform for allograft monitoring in transplantation diagnostics.