J Cardiovasc Surg
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Congenital lobar emphysema is a cause of respiratory distress during infancy that may present a diagnostic problem. Recognition of this entity is rewarding, because excisional therapy is fairly specific and the results are satisfactory. We present two infants aged 7 weeks and 2 days with congenital lobar emphysema who were diagnosed and treated in our institution for the past two years. Published work is reviewed; diagnostic and treatment issues are discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of normothermic versus hypothermic cardiopulmonary bypass on cytokine production and platelet function.
Proinflammatory cytokines and platelets play a key role in the systemic inflammatory response associated with cardiopulmonary bypass (CPB). The aim of this study was to evaluate the effects of both hypothermic and normothermic CPB on platelet activation, cytokine production, as well as their possible correlations. ⋯ Hypothermic CPB is responsible for a greater platelet activation and endothelial dysfunction than normothermic CPB, leading to more profound changes in the hemostatic and inflammatory systems, which, in turn, might be responsible for the higher incidence of postoperative complications reported during hypothermic CPB.
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Scapulothoracic dissociation is an infrequent injury with a potentially devastating outcome. The diagnosis is based on clinical and radiographic findings of forequarter disruption. ⋯ Early recognition of the entity and aggressive treatment are crucial. Outcome is not dependent on management of the arterial injury, but rather on the severity of the neurological deficit.
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Trans-sternal closure of the bronchial stump is an effective procedure to treat bronchopleural fistula after pneumonectomy. The paper reports a modified video-assisted Abruzzini technique that, maintaining the same results, should determine a lower surgical risk. ⋯ The bronchial stump reamputation is achieved by a roticulator endoGIA introduced through the cervicotomy either for the right or left fistulae. The technique proposed might reach the same result as the classic approach with lower surgical risks.
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Video-assisted thoracoscopic surgery (VATS) has been recently utilised in the diagnosis and management of thoracic diseases. In this article we report our series of patients with established indications for VATS treatment. ⋯ VATS is worth considering and has been established as procedure of choice, with exceptional results in various chest diseases such as undiagnosed pleural effusions, recurrent, post-traumatic or complicated spontaneous pneumothorax, stage II empyema, accurate staging for lung cancer in the resection of peripheral solitary pulmonary nodule less than 3 cm, and lung biopsy for pulmonary diffuse disease.