Assessing Providers' knowledge about and barriers to lung cancer screening.

Objective: Low dose computed tomography (LDCT) for lung cancer screening (LCS) is underutilized despite its demonstrated mortality benefit compared to chest radiography. Our study aimed to assess knowledge about LCS and barriers to ordering LDCT from the viewpoint of primary care and pulmonology providers in academic and community settings.

Methods: Providers of various specialties (pulmonology, family medicine, internal medicine, geriatric medicine) who were practicing in Southern California and provided care to patients aged 50 or more were asked to complete a 10-minute survey to assess knowledge about LCS criteria, and barriers to the use of LDCT scan screening.

Scoring Tool to Predict Need for Early Video-Assisted Thoracoscopic Surgery (VATS) After Pediatric Trauma.

Background: No widely used stratification tool exists to predict which pediatric trauma patients may require a video-assisted thoracoscopic surgery (VATS). We sought to develop a novel VATS-In-Pediatrics (VIP) score to predict the need for early VATS (within 72 h of admission) for pediatric trauma patients.

Methods: The pediatric 2017-2020 Trauma Quality Improvement Program database was used and divided into two sets (derivation set using 2017-2019 data and validation set using 2020 data).

A Systematic Review of Short-Term Outcomes of Minimally Invasive Thoracoscopic Surgery for Lung Cancer after Neoadjuvant Systemic Therapy.

Background: Minimally invasive surgeries for non-small cell lung cancers (NSCLCs) such as video-assisted thoracoscopic surgeries (VATSs) and robotic-assisted thoracoscopic surgeries (RATSs) have become standard of care for patients needing surgical resection in early stages. The role for neoadjuvant systemic therapy has increased with patients receiving neoadjuvant systemic chemotherapy and immunotherapy. However, there has been some equipoise over the intraoperative and overall outcomes for these patients.

Elastofibroma Dorsi: Case Series of a Rare Chest Wall Pseudotumor.

Background: Elastofibroma dorsi (EFD) is a pseudotumor of the thoracic wall that can be difficult to diagnose due to its rarity. Prompt recognition can limit unnecessary workup and expedite treatment. This study retrospectively analyzed patients with a diagnosis of EFD, discussing clinical presentations and surgical outcomes.

Dawn of a New Normal: Resident and Faculty Attitudes in Adopting Virtual Conferences and Education.

Background: The COVID-19 pandemic has dramatically changed education in medical residencies with the need to transition to a virtual format. The objective of this study is to assess the adoption of a virtual format for grand rounds, M&M, and education of the surgical department.

Method: A 25 question online survey was developed using Qualtrics and distributed to faculty and resident physicians in the Department of Surgery from March to April 2021.

Controversies in Lung Cancer: Heterogeneity in Treatment Recommendations for Stage III NSCLC According to Disease Burden and Oncogenic Driver Alterations.

Introduction: Therapeutic options for stage III non-small-cell lung cancer (NSCLC) consist of definitive chemoradiation, surgery combined with neoadjuvant/adjuvant chemotherapy, and trimodality therapy. More recently, biologically driven systemic therapy options, including immunotherapy and targeted therapy, have become increasingly available.

Methods: A customized, case-based survey was designed and distributed to members of the International Association for the Study of Lung Cancer (IASLC) to determine practice habits and preferences for NSCLC patients with stage III disease and N2 to N3 nodal involvement.

Long-term assessment of efficacy with a novel Thoracic Survivorship Program for patients with lung cancer.

Objective: We developed a novel, nurse practitioner-run Thoracic Survivorship Program to aid in long-term follow-up. Patients with non-small cell lung cancer who were disease-free at least 1 year after resection could be referred to the Thoracic Survivorship Program by their surgeon. Our objectives were to summarize follow-up compliance and assess long-term outcomes between Thoracic Survivorship Program enrollment and non-Thoracic Survivorship Program.

How Effective Is Neoadjuvant Therapy Followed by Surgery for Pathologic Single-Station N2 Non-Small Cell Lung Cancer?

The optimal treatment strategy for pathologic single-station N2 (pN2a1) non-small cell lung cancer (NSCLC)-surgery first followed by adjuvant treatment (SF) or neoadjuvant therapy followed by surgery (NS)-remains unclear. We compared disease-free survival (DFS) and overall survival (OS) after NS versus SF for pN2a1 NSCLC. We retrospectively identified patients with pN2a1 NSCLC resected between 2000 and 2018.

Postoperative surgical trainee opioid prescribing practices (POST-OPP): A national survey.

Background: Increasing opioid-related deaths have heightened focus on combating the opioid epidemic. The impact of surgical trainees on opioid-related deaths is unclear, and there is little data examining the association between trainee pain management education and opioid prescribing practices.

Methods: An anonymous, online survey was distributed to members of the Resident and Associate Society of the American College of Surgeons.

Correction to: Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA.

The following disclaimer is missing from the original article.

Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA.

Background: Projections based on regulations curtailing asbestos use in the USA suggest that peak incidence of pleural mesothelioma would occur between 2000 and 2005 and then decline. We analyzed the National Cancer Database (NCDB) to assess current trends in disease incidence, patient demographics, cancer treatment, and survival.

Methods: The NCDB was queried to identify patients diagnosed with pleural mesothelioma from 2004 through 2014.

The Bigger Picture: Picking the Right Soap Box-Is it Possible to Connect with Different Audience Targets (Practitioners and Patients) from the Same Platform?

The use of Internet and social media has skyrocketed in the past decade. It did not take long until physicians realized that they could use social media as a tool for communication with patients and colleagues. Since then use of social media has exploded and the information that has become available for physicians and their patients is remarkable.

Bariatric surgery may reduce the risk of Alzheimer's diseases through GLP-1 mediated neuroprotective effects.

Obesity and diabetes are associated with deficits in multiple neurocognitive domains and increased risk for dementia. Over the last two decades, there has been a significant increase in bariatric and metabolic surgery worldwide, driven by rising intertwined pandemics of obesity and diabetes, along with improvement in surgical techniques. Patients undergoing bariatric surgery achieve a significant decrease in their excess weight and a multitude of sequela associated with obesity, diabetes, and metabolic syndrome.

A Multi-institutional Comparison of Perioperative Outcomes of Robotic and Open Pancreaticoduodenectomy.

Objectives: Limited data exist comparing robotic and open approaches to pancreaticoduodenectomy (PD). We performed a multicenter comparison of perioperative outcomes of robotic PD (RPD) and open PD (OPD).

Methods: Perioperative data for patients who underwent postlearning curve PD at 8 centers (8/2011-1/2015) were assessed.

A model for predicting prolonged length of stay in patients undergoing anatomical lung resection: a National Surgical Quality Improvement Program (NSQIP) database study.

Objectives: There are currently no studies that have specifically delineated the risk factors for a prolonged length of hospitalization in patients undergoing anatomical lung resection. Knowing these risk factors is important in terms of risk stratification and improving outcomes in the high-risk population. The goal of this study was to identify risk factors associated with a prolonged length of stay (≥14 days) in patients undergoing an anatomical lung resection and to further create a model for predicting the probability of a prolonged length of stay in these patients.

The Natural History of Operable Non-Small Cell Lung Cancer in the National Cancer Database.

Background: The survival of untreated non-small cell lung cancer (NSCLC), or the natural history, is an important perspective for patients considering resection for NSCLC. The National Cancer Database (NCDB) allows untreated NSCLC patients who were recommended to undergo surgical resection (ie, "operable") to be identified. The survival of untreated NSCLC patients in the NCDB was studied to determine the natural history of operable NSCLC.

Sigmoid volvulus in a patient with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS): a rare occurrence.

Mitochondrial diseases are rare and devastating, with a wide spectrum of clinical presentations and systemic symptoms. The majority of the published literature focuses on the neuromuscular manifestations and genetic components of this mitochondrial cytopathy, however, cardiac, renal, endocrine and gastrointestinal manifestations may also be present. The authors report a case detailing a 56-year-old woman's final hospitalisation from the gastrointestinal sequelae of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) (Co Q10 deficiency variant).

Cardiovascular Complications Following Thoracic Surgery.

Cardiovascular events after thoracic surgery can result in increased morbidity, mortality, length of stay, and increased overall cost. The prevention of postoperative cardiovascular complications is an area of intense study, and the body of evidence guiding clinicians continues to grow. Early diagnosis and management of cardiovascular events can minimize the consequences of these complications.

Timing of heparin and thrombus formation in donor lungs after cardiac death.

Background: Heparin is routinely administered to brain-dead donors before cardiac arrest, although it is not universally allowed for donation after cardiac death (DCD) donors due to concerns that death may be hastened. The lack of heparin may lead to thrombosis and compromised graft function. We evaluated the impact of timing of heparin administration and thrombi formation in a DCD pig model.

Pediatric donor lungs for adult transplant recipients: feasibility and outcomes.

Background: There is a limited experience using pediatric organs for adult lung transplantation (LTx), with size matching the major concern. We reviewed our experience transplanting pediatric donor lungs into adult recipients with endpoints of post-LTx complications and overall patient survival.

Methods: From 2/1990 to 12/2007, 609 adults underwent primary LTx at our institution.