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Khairy youngest contributor to New England Journal of Medicine

Thomas Khairy 2020, who attended Selwyn House School from 2013 to 2015, has co-authored an article in the May 7 issue of the New England Journal of Medicine on the risks of infection from using second-hand surgical implants. As one of 22 researchers who contributed to this work, Thomas is now the youngest principal author of any article ever published in the NEJM.
 
Entitled "Infections Associated with Resterilized Pacemakers and Defibrillators,” the article concludes that recycled implants do not present a significantly higher risk of infection than new implants. This is good news for people in developing countries, where new implants are harder to procure.
 
“Thomas has been working on this project for several years with the Montreal Heart Institute,” says Loyola High School, where he now attends. “This was also the focus of his Secondary 3 Loyola Science Fair project, which allowed for more time to work on the material. Thomas won several awards for his project at the time, including the silver medal at the Canada-Wide Science Fair finals.”

Thomas plans to study health sciences at Marianopolis College in the fall

The following is an abstract of the article in the NEJM:

BACKGROUND
Access to pacemakers and defibrillators is problematic in places with limited resources. Resterilization and reuse of implantable cardiac devices obtained post mortem from patients in wealthier nations have been undertaken, but uncertainty around the risk of infection is a concern.

METHODS
A multinational program was initiated in 1983 to provide tested and resterilized pacemakers and defibrillators to underserved nations; a prospective registry was established in 2003. Patients who received reused devices in this program were matched in a 1:3 ratio with control patients who received new devices implanted in Canada. The primary outcome was infection or device-related death, with mortality from other causes modeled as a competing risk.

RESULTS
Resterilized devices were implanted in 1051 patients (mean [±SD] age, 63.2±18.5 years; 43.6% women) in Mexico (36.0%), the Dominican Republic (28.1%), Guatemala (26.6%), and Honduras (9.3%). Overall, 85% received pacemakers and 15% received defibrillators, with one (55.5%), two (38.8%), or three (5.7%) leads. Baseline characteristics did not differ between these patients and the 3153 matched control patients. At 2 years of follow-up, infections had occurred in 21 patients (2.0%) with reused devices and in 38 (1.2%) with new devices (hazard ratio, 1.66; 95% confidence interval, 0.97 to 2.83; P=0.06); there were no device-related deaths. The most common implicated pathogens were Staphylococcus aureus and S. epidermidis.

CONCLUSIONS
Among patients in underserved countries who received a resterilized and reused pacemaker or defibrillator, the incidence of infection or device-related death at 2 years was 2.0%, an incidence that did not differ significantly from that seen among matched control patients with new devices in Canada.
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