Medical Journal Content Continues Rapid Growth

Medical journal content continues to expand at a rapid rate. This is promising for the future of innovation and patient care but challenging for clinicians and scientists. We feature new journals, new social media platforms, educational advertisements, illuminating Letters to the Editor and enlightening Author Replies, Podcasts, Visual Abstracts, and Infographics. This is a developmental time for medical journal publication.     

Internet and Social Media Contribute to Medical Research Journal Growth

In 2010, our editorial team wrote about the Internet’s inarguable role in overloading information on our readers. In this editorial, we reflect on insights gained, mostly in the past decade, regarding the Internet and social media. Medical and surgical information online is easy to obtain, but it varies from platform to platform, is low in quality and reliability, and overestimates the public’s ability to decipher the information. Physicians do not use social media enough, or well. Social media can engage patients and can inform patients about the quality of medical and surgical information online. Physicians, themselves, can provide reliable information that informs patients and eases their minds. Physician-authors can use social media to develop communities with shared interests in research; members of these communities can post research findings and highlight the publications in which they find them. Discussion of research online increases the likelihood that it will be cited. It is no surprise that the Internet and social media have contributed to the growth of Arthroscopy; Arthroscopy Techniques; and Arthroscopy, Sports Medicine, and Rehabilitation.     

A comparison of the in vivo performance of the 19-mm St. Jude Medical Hemodynamic Plus and 21-mm standard valve

BACKGROUND: In the present study we analyzed the in vivo performance of the 19-mm St. Jude Medical Hemodynamic Plus aortic prosthesis (19HP), evaluated the midterm performance of 19HP in the aortic position, and compared the implantability and hemodynamic characteristics of this valve with those of the 21-mm standard St. Jude Medical valve (21SD) in adult patients with aortic stenosis and a narrowed aortic annulus. METHODS: From February 1994 to December 1999, 60 patients who underwent isolated aortic valve replacement with either the 19HP (n = 31) or the 21SD (n = 29) were studied. Comparison between the two models included analysis of early and late mortality and morbidity. Pre- and postoperative echocardiography was performed in all patients to evaluate and compare the hemodynamic performance of both prosthetic valves. The postoperative serum lactic dehydrogenase activity was measured in both groups of patients as an indicator of hemolysis. RESULTS: The mean body surface area was 1.46 +/- 0.16 m2 in the 19HP group and 1.49 +/- 0.13 m2 in the 21SD group (p = 0.1577). Other than female dominance in the 19HP group, there was no statistically significant difference between the two groups in terms of preoperative variables (age, preoperative pressure gradients, and New York Heart Association functional class). The average postoperative peak pressure gradient was 23.3 +/- 10.5 mm Hg in the 19HP group and 27.9 +/- 9.9 mm Hg in the 21SD group (p = 0.0666). There was no hospital death in either group. Six-year follow-up was completed in both groups of patients. Late death occurred in 1 patient in the 19HP group (1.09% per patient-year). Actuarial survival at 6 years was 92.3% +/- 7.4% in the 19HP group, and 100% in the 21SD group (p = 0.33). The linearized complication rate was 1.09% per patient-year and 1.02% per patient-year for thromboembolism, and 1.09% per patient-year and 1.02% per patient-year for anticoagulant-related hemorrhage in the 19HP group and the 21SD group, respectively. Freedom from all complications at 6 years did not show any significant difference between the two groups (p = 0.54). Although left ventricular mass indices decreased significantly after aortic valve replacement in both groups (19HP group, p = 0.0002; 21SD group, p = 0.0006), there were no significant differences in the two indices between the groups after aortic valve replacement (p = 0.999). There was no significant difference in the lactic dehydrogenase level between the two groups (p = 0.4915). CONCLUSIONS: In vivo hemodynamic performance of the 19HP valve as well as the early and intermediate clinical outcome up to 6 years was satisfactory and corresponded closely to that of the 21SD valve in adult patients. The 19-mm Hemodynamic Plus model can be recommended in patients with a measured 19-mm annulus and this valve will minimize the need for the aortic annular enlargement procedure.     

Unmasking MASC: Bringing to Light the Unique Morphologic, Immunohistochemical and Genetic Features of the Newly Recognized Mammary Analogue Secretory Carcinoma of Salivary Glands

Mammary analogue secretory carcinoma (MASC) is a recently described salivary gland neoplasm that is characterized by its striking morphologic and molecular similarities to secretory carcinoma of the breast. This review highlights the characteristic clinical, histologic, immunophenotypic, and molecular features of MASC, and draws attention to the differential diagnosis of this increasingly recognized tumor.     

Quest for professionalism: a biography of the North American Medical and Surgical Journal (1826-31)

This is the biography of a deceased medical journal, the North American Medical and Surgical Journal, born in 1826 in Philadelphia. It was a publication of the Philadelphia Chapter of the Kappa Lambda Society. In the prospectus of the North American Medical and Surgical Journal the promoters observed that a well-conducted journal would achieve the object of elevating the medical profession to its legitimate rank which up to that time had been the recipient of low public opinion. The Journal hoped to inculcate 'a higher standard of excellence not merely in the professional or ministrative but also in the ethical relations and duties of physicians'. After several successful and productive years it passed into history in October 1831, the victim of financial difficulty.