Research News from BJS - Specialist centres increase chance of surviving abdominal aortic aneurysm surgery
People with abdominal aortic aneurysms stand a better chance of surviving if they are operated on at hospitals that see large numbers of these patients than if they are treated at smaller regional hospitals with fewer such patients.
This finding is supported by two papers published in this month’s BJS. Both pieces of research were led by Peter Holt, who works at St George’s Hospital, London.
“Our research adds to the evidence that concentrating surgical resources in large centres of excellence can provide great benefit to patients. A bad outcome in this type of surgery is death, and specialist centres are best placed to prevent it,” says Mr Holt.
An aortic aneurysm occurs when the muscle wall of the main artery that runs vertically through the body (the aortic artery) weakens and the artery bulges out irreversibly due to the blood pressure inside pushing out on the weakened segment. The wall can become extremely weak and the resulting bulge very large. If not repaired surgically, it is liable to tear (rupture) and cause catastrophic bleeding, which is fatal in 80% of cases as many patients never make it to a hospital.
The first paper reports an epidemiological study of UK data from 2000 to 2005 that investigated the outcomes of surgery on 112,545 patients. This showed that specialist centres dealing with more than 32 cases a year generate better outcomes than regional centres with lower caseloads. If the patient came in with a ruptured aneurysm the chance of survival was equally low in both regional and specialist centres.
The second paper reports a meta-analysis and systematic review that identified data, mainly from the USA, from 26 separate studies, which together involved over 350,000 patients. Peter Holt and his team concluded that a centre needed to be performing surgery on at least 43 abdominal aortic aneurysms before it could provide significantly greater chances of success. In this study, the benefit was present for non-ruptured and ruptured aneurysms alike.
“We believe that patients should be sent to centres that have a high volume of these cases and a proven track-record of high rates of success,” says Holt.
Jennifer Beal | alfa
The most recent press releases about innovation >>>
Die letzten 5 Focus-News des innovations-reports im Überblick:
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
New technique promises tunable laser devices
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...