Do We Need Basic Research in Cardiac Surgery?

2016 ◽  
Vol 66 (01) ◽  
pp. 002-006 ◽  
Author(s):  
Christian Schlensak ◽  
David Schibilsky ◽  
Gloria Faerber ◽  
Torsten Doenst
Keyword(s):  
Cardiac Surgery ◽  
Clinical Practice ◽  
Basic Science ◽  
Basic Research ◽  
Daily Practice ◽  
Western Blots ◽  
Daily Work ◽  
Chain Reactions ◽  
Polymerase Chain Reactions ◽  
Cardiac Surgeons

Thinking about the daily practice of cardiac surgery, genetically altered mouse models, polymerase chain reactions, western blots, and other laboratory tools are the last that comes to mind. It is, therefore, not surprising that the pursuit of such basic science activities by practicing surgeons and those in training is often limited. However, there is an innate connection between these two seemingly different disciplines. To address and visualize this connection, we propose the following three hypotheses. First, cardiac surgery would not be at its present level of expertise without fundamental contributions of basic science. Second, without practicing cardiac surgeons performing basic research and translating their results to clinical practice next to their daily work, our ability to care for cardiac surgery patients would be poorer. Third, basic science training for those aiming to become practicing cardiac surgeons improves their ability to properly care for their patients. Finally, we will discuss some potentially even unexpected implications for our currently changing daily clinical practice.

Air Embolism on Cardiopulmonary Bypass

2019 ◽  
pp. 160-165
Author(s):  
Aaron Hudson ◽  
Ryan Hood
Keyword(s):  
Cardiac Surgery ◽  
Clinical Practice ◽  
Cardiopulmonary Bypass ◽  
Sudden Death ◽  
Air Embolism ◽  
Cardiac Surgical Procedures ◽  
Daily Basis ◽  
Team Members ◽  
Cardiac Surgeons ◽  
Almost All

The danger associated with air embolism in cardiac surgery has been well established for over 125 years. In the first volume of Annals of Surgery, published in 1885, long preceding the era of cardiac surgery and the use of extracorporeal circulatory techniques, Dr. Nicholas Senn alluded to the ensuing calamity caused by air embolism: “I intend on this occasion to call your attention to one of the most dreaded and, I may add, one of the most uncontrollable causes of sudden death—I allude to air-embolism.”1,2 Since the advent of modern cardiac surgery, much attention has been focused on the prevention of air embolism by cardiac surgeons, anesthesiologists, and perfusionists alike. Indeed, all three team members are critically responsible for the safe conduct of thousands of cardiac surgical procedures occurring on a daily basis worldwide. While the morbidity and mortality of massive air embolism is exceedingly high, most believe that with appropriate training and unwavering vigilance during clinical practice, almost all massive air emboli can be prevented.3

scholarly journals A successful story of translational orthodontic research: Micro-osteoperforation-from experiments to clinical practice

2017 ◽  
Vol 7 ◽  
pp. 6-11 ◽  
Author(s):  
Michelle Yuching Chou ◽  
Mani Alikhani
Keyword(s):  
Clinical Practice ◽  
Translational Research ◽  
Clinical Application ◽  
Clinical Studies ◽  
Basic Science ◽  
Scientific Evidence ◽  
Science Research ◽  
Daily Practice ◽  
Research Projects ◽  
Basic Science Research

The gap between basic science research and clinical application has long existed and therefore translational research has emerged in recent years to bridge such gap. Consortium for Translational Orthodontic Research (CTOR) was established with missions to integrate resources from different entities and to provide a platform for interdisciplinary groups who share the same vision to exchange ideas and inspire innovations. During its short existence, CTOR has successfully carried out several research projects which led to various innovations. Micro-osteoperforation is by far one of the most successful examples of translational research in the orthodontic field. It exemplifies how translational research can benefit scientists, clinicians, and patients. In this article, the process of its development, the rationale and scientific evidence from animal and clinical studies, and how it can be applied in daily practice will be depicted.

scholarly journals Physicians’ learning in the workplace: use of informal feedback cues in daily practice

2019 ◽  
Author(s):  
Carolin Sehlbach ◽  
Pim W Teunissen ◽  
Erik W Driessen ◽  
Sharon Mitchell ◽  
Gernot GU Rohde ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Daily Practice ◽  
Learning Opportunities ◽  
Outpatient Setting ◽  
Constructivist Grounded Theory ◽  
Adaptive Expertise ◽  
Structured Interviews ◽  
Daily Work ◽  
Patient Interactions ◽  
Informal Feedback

ABSTRACTPurposeWe expect physicians to be lifelong learners. Learning from clinical practice is an important potential source for that learning. To support physicians in this process, a better understanding of how they learn in clinical practice is necessary. This study investigates how physicians use informal feedback as learning cues to adjust their communication from interactions with patients in the outpatient setting.MethodsTo understand physicians’ use of informal feedback, we combined non-participant ethnographic observations with semi-structured interviews. We enrolled 10 respiratory physicians and observed 100 physician-patient interactions at one academic and one non-academic hospital in the Netherlands. Data collection and analysis were performed iteratively according to the principles of constructivist grounded theory. Our conceptual model describes how physicians use cues to reflect on and adjust their communication as well as to further develop their adaptive expertise.ResultsIn addition to vast variations within and across patient encounters, we observed recurring patterns in physicians’ communications in reaction to specific learning cues. Physicians had learnt to recognise and use different cues to adjust their communication in patient encounters. They established a ‘communication repertoire’ based on multiple patient interactions, which many saw as learning opportunities, contributing to the development of adaptive expertise. Our findings show differences in physicians’ sensitivity to recognising learning opportunities in daily practice which was further influenced by contextual, personal and interpersonal factors. Whereas some reported to have little inclination to change, others used critical incidents to fine-tune their communication repertoire, while others constantly reshaped it, seeking learning opportunities in their daily work.ConclusionsThere is a large variation in how physicians use learning cues from daily practice. Learning from daily practice is a collaborative effort and requires a culture that promotes lifelong learning. Raising physicians’ awareness of experiences as potential learning opportunities might enhance their development of adaptive expertise.

scholarly journals Whole-genome resequencing reveals candidate mutations for pig prolificacy

2017 ◽  
Vol 284 (1869) ◽  
pp. 20172437 ◽  
Author(s):  
Wen-Ting Li ◽  
Meng-Meng Zhang ◽  
Qi-Gang Li ◽  
Hui Tang ◽  
Li-Fan Zhang ◽  
...  
Keyword(s):  
Phenotypic Diversity ◽  
Western Blots ◽  
Chain Reactions ◽  
Polymerase Chain Reactions ◽  
Protein Receptor ◽  
Morphogenetic Protein ◽  
Trait Locus ◽  
Morphological Differences ◽  
Whole Genome Resequencing

Changes in pig fertility have occurred as a result of domestication, but are not understood at the level of genetic variation. To identify variations potentially responsible for prolificacy, we sequenced the genomes of the highly prolific Taihu pig breed and four control breeds. Genes involved in embryogenesis and morphogenesis were targeted in the Taihu pig, consistent with the morphological differences observed between the Taihu pig and others during pregnancy. Additionally, excessive functional non-coding mutations have been specifically fixed or nearly fixed in the Taihu pig. We focused attention on an oestrogen response element (ERE) within the first intron of the bone morphogenetic protein receptor type-1B gene ( BMPR1B ) that overlaps with a known quantitative trait locus (QTL) for pig fecundity. Using 242 pigs from 30 different breeds, we confirmed that the genotype of the ERE was nearly fixed in the Taihu pig. ERE function was assessed by luciferase assays, examination of histological sections, chromatin immunoprecipitation, quantitative polymerase chain reactions, and western blots. The results suggest that the ERE may control pig prolificacy via the cis-regulation of BMPR1B expression. This study provides new insight into changes in reproductive performance and highlights the role of non-coding mutations in generating phenotypic diversity between breeds.

scholarly journals Investigation of Lethal Concurrent Outbreak of Chlamydiosis and Pigeon Circovirus in a Zoo

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1654
Author(s):  
Wei-Tao Chen ◽  
Chin-Ann Teng ◽  
Cheng-Hsin Shih ◽  
Wei-Hsiang Huang ◽  
Yi-Fan Jiang ◽  
...  
Keyword(s):  
Disease Outbreaks ◽  
Chlamydia Psittaci ◽  
Bursa Of Fabricius ◽  
Chain Reactions ◽  
Renal Epithelium ◽  
Polymerase Chain Reactions ◽  
Transmission Electron ◽  
Intracytoplasmic Inclusion Bodies ◽  
Polymerase Chain ◽  
Streptopelia Orientalis

During the spring, an outbreak of sudden death involving 58 birds occurred in a zoo. Histopathological examinations revealed variable numbers of intracytoplasmic basophilic microorganisms in the macrophages, hepatocytes, and renal epithelium of most birds, along with occasional botryoid intracytoplasmic inclusion bodies within histiocytes in the bursa of Fabricius. Based on the results of histopathological examinations, immunohistochemical staining, transmission electron microscopy, and polymerase chain reactions, genotype B Chlamydia psittaci infection concurrent with pigeon circovirus (PiCV) was diagnosed. A retrospective survey, including two years before the outbreak and the outbreak year, of C. psittaci and PiCV infections of dead birds in the aviaries, revealed that the outbreak was an independent episode. The findings of this study indicate that concurrent infection with C. psittaci and PiCV might lead to lethal outbreaks of chlamydiosis, particularly Streptopelia orientalis. In addition, persistently monitoring both pathogens and identifying potential PiCV carriers or transmitters might also help prevent lethal disease outbreaks.

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