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.
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In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
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