Objective: To investigate the association between periodontitis and mortality from all causes in a prospective study in a homogenous group of 60-to 70-yearold West European men. Methodology: A representative sample of 1400 dentate men, (mean age 63.8, SD 3.0 years), drawn from the population of Northern Ireland, had a comprehensive periodontal examination between 2001 and 2003. Men were divided into thirds on the basis of their mean periodontal attachment loss (PAL). The primary endpoint, death from any cause, was analysed using Kaplan-Meier survival plots and Cox's proportional hazards model. Results: In total, 152 (10.9%) of the men died during a mean follow-up of 8.9 (SD 0.7) years; 37 (7.9%) men in the third with the lowest PAL (<1.8 mm) died compared with 73 (15.7%) in the third with the highest PAL (>2.6 mm). The unadjusted hazard ratio (HR) for death in the men with the highest level of PAL compared with those with the lowest PAL was 2.11 (95% CI 1.42-3.14), p < 0.0001. After adjustment for confounding variables (age, smoking, hypertension, BMI, diabetes, cholesterol, education, marital status and previous history of a cardiovascular event) the HR was 1.57 (1.04-2.36), p = 0.03. Conclusion: The European men in this prospective cohort study with the most severe loss of periodontal attachment were at an increased risk of death compared with those with the lowest loss of periodontal attachment.

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Coronary heart disease (CHD) remains the global leading cause of death and morbidity (Lozano et al., 2012). Although CHD mortality has declined in the United Kingdom (UK) (Bhatnagar et al., 2016), the burden of multimorbidity and comorbidity in patients with incident non-fatal CHD has increased (Tran et al., 2018). In the UK, CHD prevalence is around 3% in England and 4% in Scotland, Wales and Northern Ireland (Bhatnagar et al., 2016). Epidemiological studies have helped identify a range of what are now considered classic risk factors for cardiovascular disease (including CHD) such as age, smoking, hypertension and hypercholesteraemia (Yusuf et al., 2001). Identification of such risk factors has led to the development of riskprediction algorithms and established cardiovascular risk models for men and women (Lloyd-Jones Donald, 2010). These conventional risk factors, however, cannot fully explain excess cardiovascular risk, with at least 25% of all future events occurring in individuals with only one of the classical risk factors (Vilahur et al., 2014).

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'In patients with resectable non-small-cell lung cancer, is video-assisted thoracoscopic segmentectomy a suitable alternative to thoracotomy and segmentectomy in terms of morbidity and equivalence of resection?' Altogether 232 papers were found as a result of the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Only one study compared the survival rates of video-assisted thoracoscopic surgery (VATS) and open surgery and found no significant difference in overall (P = 0.605) and disease-free (P = 0.996) survival between these groups. The mean length of hospital stay was reported as shorter following VATS when compared with open surgery in all of the studies looking at this outcome. The greatest difference in length of hospital stay reported was 4.8 days (VATS 3.5 days and open 8.3 days). The duration of chest tube placement was also universally reported as shorter in patients having VATS procedures when compared with open procedures. Two studies compared the number of lymph nodes that could be sampled when completing this operation by VATS using an open approach and neither found there to be a significant difference between these numbers. Using the evidence collected, we conclude that anatomical segmentectomy performed by VATS is a safe and effective alternative to conventional techniques in the surgical management of non-small-cell lung cancer. We are aware that the current evidence is limited and existing studies all examine small numbers of patients. Unfortunately, at present there is no blinded randomized control trial comparing these two surgical methods. There is also no study comparing the utility of each method for differing anatomical locations of segments. This should be kept in mind when interpreting the results of the studies presented.

Aim The aim was to investigate the role of systemic inflammation in the relationship between periodontitis, edentulism, and all‐cause mortality in a group of men in Northern Ireland aged 58–72 years. Materials and methods A representative sample of 1558 men had a detailed dental examination between 2001 and 2003. The primary end point was death from any cause. Cox's proportional hazards model was used to assess the longitudinal relationship between periodontitis, edentulism, and all‐cause mortality. Accelerated failure time modelling was performed to investigate the mediating role of systemic inflammation. Results Mean age of the men at baseline was 64.3 (standard deviation 2.9) years. During a median follow‐up of 17 years, 500 (32.1%) men died. After adjustment for confounding variables, compared to men with no/mild periodontitis, edentulous men had a hazard ratio for all‐cause mortality of 1.52 (95% confidence interval [CI] 1.16–1.99) p < .01 and for those with severe periodontitis, it was 1.34 (95% CI 1.06–1.70) p = .01. Systemic inflammation accounted only for a minor mediating pathway effect of 10%. Conclusions There was evidence in this group of men that those who were edentulous or had severe periodontitis had a significantly increased risk of all‐cause mortality. Systemic inflammation was not a major explanatory mediator of this association.