Global reports of myocarditis following COVID-19 vaccination: A systematic review and meta-analysis.

BACKGROUND AND AIMS: Recent media reports of myocarditis after receiving COVID-19 vaccines, particularly the messenger RNA (mRNA) vaccines, are causing public concern. This review summarizes information from published case series and case reports, emphasizing patient and disease characteristics, investigation, and clinical outcomes, to provide a comprehensive picture of the condition. METHODS: A systematic literature search of PubMed and Google scholar was conducted from inception to April 27, 2022. Individuals who develop myocarditis after receiving the COVID-19 vaccine, regardless of the type of vaccine and dose, were included in the study. RESULTS: Sixty-two studies, including 218 cases, participated in the current systematic review. The median age was 29.2 years; 92.2% were male and 7.8% were female. 72.4% of patients received the Pfizer-BioNTech (BNT162b2) vaccine, 23.8% of patients received the Moderna COVID-19 Vaccine (mRNA-1273), and the rest of the 3.5% received other types of COVID-19 vaccine. Furthermore, most myocarditis cases (82.1%) occurred after the second vaccine dose, after a median time interval of 3.5 days. The most frequently reported symptoms were chest pain, myalgia/body aches and fever. Troponin levels were consistently elevated in 98.6% of patients. The admission ECG was abnormal in 88.5% of cases, and the left LVEF was lower than 50% in 21.5% of cases. Most patients (92.6%) resolved symptoms and recovered, and only three patients died. CONCLUSION: These findings may help public health policy to consider myocarditis in the context of the benefits of COVID-19 vaccination.

Prevalence of inter-arm blood pressure difference among young healthy adults: Results from a large cross-sectional study on 3235 participants.

More than 100 years ago, the difference in blood pressure (BP) between arms was first reported. Recent studies have shown that different blood pressure between the right and left arm leads to cardiovascular events. Three thousand and thirty volunteers participated in our cross-sectional study. The sIABP was equal in 163 of 3030 persons (5.37%), dIABP was equal in 222 out of 3030 persons (7.32%), from a total of 792/3030 persons (26.1%) sIAD >10 mmHg, and dIAD > or = 10 mmHg was found in 927 out of 3030 persons (33.5%) in the right arm, and 32.4% in the left arm. In 2692 of 3030 volunteers BP, initially recorded in the dominant hand (right arm), showing sIAD > or = 10 mmHg was found in 943 (37.1%) volunteers, and when the first measurement was done in 338 left-handed volunteers it showed sIAD > or = 10 mmHg in 112 of 338 (34.1%), P < .001; 95% confidence interval for systolic right hand were (115.73: 116.73), and for systolic left hand 95% confidence interval were (113.17:114.15). Furthermore, height, residential area, and heart rate above 90 bpm had a significant effect on IAD (P = . 041, 0.002, <001, respectively). In conclusion, significant inter-arm systolic and diastolic BP differences above (10 mm Hg) is common in the young, healthy population. Hand dominance is a significant consideration while measuring blood pressure. It is mandatory to measure blood pressure in both arms in a sitting position with a stable condition.

Pulmonary hydatid cyst mimicking lung tumor in a heavy smoker patient- Uniportal VATS management.

INTRODUCTION AND IMPORTANCE: Human infection with E. granulosus leads to the development of one or more hydatid cysts located most often in the liver and lungs. However, radiologically and clinically, analysis of atypical or complicated pulmonary hydatid cysts may resemble other types of malignancies. CASE PRESENTATION: Here, we present a 65-year-old man presented with chest pain, loss of appetite, and weight loss for 6 months' duration. The patient was surgically treated for a pulmonary hydatid cyst that mimicked a lung tumor clinically and radiologically. The patient underwent surgery using a uniportal video-assisted thoracoscopic surgery (UVATS) approach. The patient was put on an anti-helminthic drug (Albendazole table 400 mg twice daily for 21 days and 14 days off). He will continue for 3 cycles on this schedule. DISCUSSION: The diagnosis of pulmonary hydatid cyst depends mainly on the imaging procedures supported by appropriate serology and often histopathology. The treatment of choice for the pulmonary hydatid cyst is surgical resection. The uniportal video-assisted thoracoscopic surgery (UVATS) method has been proven to be safe and effective around globally. This includes a shorter surgery time, less pain, less chest tube drainage, and less need for painkillers after the surgery. CONCLUSION: In this report, we present a case of a radiologically and clinically pulmonary hydatid cyst mimicking a lung tumor. In the differential diagnosis of a lung tumor, a pulmonary hydatid cyst should be considered particularly in endemic regions.

Uniportal video-assisted thoracoscopic surgery (UVATS) right lower lobectomy for a giant T4 squamous cell lung tumour.

Video-assisted thoracoscopic surgery (VATS) is one of the unique methods that have revolutionized the discipline of minimally-invasive thoracic surgery in the last two decades. Previously, double-port VATS lobectomy has been used for the resection of T4 tumours. This current case report presents a 68-year-old male that presented with a productive cough of 3 months' duration, associated with fever, chest pain and loss of body weight. He was haemodynamically stable. The patient underwent surgery under general anaesthesia using a uniportal VATS (UVATS) approach. A 2-cm incision was made in the mid-axillary line through the right 5th intercostal space with no rib spreading. The tumour was put into a specimen bag, cut into pieces and then removed via the mouth of the bag using a grasper. After good haemostasis, a single chest drain was placed and the small incision was sutured in layers. The postoperative course was uneventful and no complications were observed. On the 6th day postoperative, the patient was discharged home. This current case demonstrated that UVATS resection for T4 tumours might be a viable approach in the hands of skilled surgeons. It should also provide decreased postoperative pain, faster recovery and shorter hospitalization.

Uniportal Video-assisted Thoracoscopic Surgery (u-VATS) for Management of pulmonary hydatid cyst: A systematic review.

Background and objectives: Hydatid disease of the lung, caused by Echinococcus granulosus, is an unusual parasitic disease. The aim of the current review for managing pulmonary hydatid cysts by uniportal video-assisted thoracoscopic surgery (u-VATS), and their complications, the size of hydatid cyst, length of hospital stay, surgery time, the rate of conversion from u-VATS to thoracotomy or mini-thoracotomy, follow-up, and outcomes. Methods: We conduct the platform searches on the PubMed and Google Scholar electronic databases from inception to January 20, 2022, among patients diagnosed with pulmonary hydatid cyst (PHC) who underwent the u-VATS approach. Results: This systematic review comprised five studies reporting 85 cases of PHC underwent (u-VATS) approach. Most patients were adults. The most common location of pulmonary hydatid cyst was the right lower lobe followed by the left lower lobe. The average size of PHC was 8.41 cm in all studies. The length of hospital stay was 3.85 days. The duration of operation time based on the means of the included studies was 86.19 min for each patient. Furthermore, the overall complication occurred in 9.35% of patients (n = 11) from 85 cases. The most complication was emphysema and prolonged air leak. The recurrence of pulmonary hydatid cyst did not occur in all studies. Conclusion: The feasibility of the video-assisted thoracoscopic surgery (VATS) approach has been proven globally in terms of reducing the overall complication, shorter chest tube duration, shorter surgery time, reduce postoperative pain, shorter chest tube duration, lower chest tube drainage, and less required to pain killers postoperatively.

Uniportal video-assisted thoracoscopic surgery for retained shrapnel in the thoracic cavity: An update surgical approach for removal of foreign body.

Uniportal video-assisted thoracoscopic surgery commonly used for removal of bullet, tumours and foreign bodies in the chest cavity. However, shrapnel fragments related war can injure many organs and life-threatening condition. Furthermore, standard treatment for removal foreign bodies retained in the chest is conventional thoracotomy. Alternatively, single port video-assisted thoracoscopic surgery approach can be used in patients hemodynamically stable. In addition, retained foreign bodies after a penetrating thoracic injury remain challenge for u-VATS surgeons. Here we present A 35-year-old man presented to the emergency department with multiple shells injury associate with right site chest injury. The patient underwent surgery using uniportal video-assisted thoracoscopic surgery u-VATS without spreading of the ribs for removal of a shrapnel retained in the thoracic cavity. The postoperative course was uneventful. On the 2nd day postoperative, the patient was discharged home. The u-VATS approach could be performed by experienced u-VATS surgeons and specialized nurses for this approach. In conclusion, our study revealed that u-VATS is safe, simple and feasible for retained foreign bodies in the thoracic cavity. The u-VATS have many benefits such as decrease postoperative complication, pain and earlier return to work.

Chest wall reconstruction in a young man after high-velocity gunshot using a combination latissimus dorsi flaps and titanium plates: A case report.

Chest trauma, penetrating or blunt, is common in this era of road traffic accidents, terrorism, and hunting in Iraq. During the last decade, many novel surgical procedures and materials were used to reconstruct or stabilize the chest wall to improve integration, maintain the stability of the chest wall, and reduce infections. However, no precise guidelines for managing chest wall diseases are still available to date. Here, we present a 24-year-old male who underwent chest wall reconstruction using a combination of latissimus dorsi flap and titanium plates, which were to cover the chest wall after a high-velocity gunshot. This patient was in shock too, with a lung contusion and massive hemorrhage. The sucking open chest wound lead to grossly disturbed respiratory mechanics. Such patients usually die on the way due to hemodynamic instability. In this particular case, adequate resuscitation and prompt thoracotomy saved the patient's life. This case report is important because, as we already mentioned, thoracic trauma alone is the cause of death in 25% of patients, and in another 25%, it's a contributing factor in a polytrauma death. This amounts to very high mortality. Our patient received a major laceration of the left lung. Our patient had a full recovery from this life-threatening situation.

Life-Threatening Cardiac Tamponade Secondary to COVID-19 Treated with Uniportal Video-Assisted Thoracoscopic Surgery: A Case Report.

BACKGROUND The COVID-19 outbreak emerged in December 2019 in Wuhan, China. COVID-19 is caused by the SARS-CoV-2 coronavirus and mostly affects the respiratory system but can also affect other organs, including the cardiovascular system. Furthermore, the most common cardiac complications include severe left ventricular dysfunction, acute myocardial injury, and arrhythmias. Life-threatening cardiac tamponade and large pericardial effusion are exceedingly rare complications in patients recovered from COVID-19. Previously, this condition was treated with pericardiocentesis, colchicine, and corticosteroids. CASE REPORT We present the case of a 54-year-old man who recovered from a SARS-CoV-2 infection 7 days before presentation and describe a complicated pericardial effusion with life-threatening cardiac tamponade. To the best of our knowledge, this is the first case of pericardial effusion with cardiac tamponade that was successfully treated with single port or uniportal video-assisted thoracoscopic surgery with an excellent outcome. CONCLUSIONS Life-threatening cardiac tamponade with pericardial effusion is an exceedingly rare complication in patients recovered from COVID-19. Generally, patients diagnosed with pericardial effusion undergo a pericardiocentesis procedure. Although there are multiple treatment options for draining pericardial effusion, the recurrence rate with surgical pericardial window formation is the lowest. However, our patient underwent surgery using a uniportal video-assisted thoracoscopic surgery with an excellent outcome.

Uniportal video-assisted thoracoscopic right lower and middle sleeve bilobectomy for a neglected carcinoid tumor.

The bronchial carcinoid (BC) tumor is a neuroendocrine lung tumor that accounts for 1-2% of all lung neoplasia occurrences. However, BC tumors remain rare in the literature. Nowadays, video-assisted thoracoscopic surgery VATS can be safely performed with an excellent clinical outcome. The typical procedure involves three incisions. We assume that performing the same procedures with a single utility incision is possible. This report describes our experience performing sleeve bilobectomy for a neglected carcinoid tumor using a uniportal VATS without spreading of ribs.

Diaphragmatic lipoma; A benign condition necessitating an aggressive management.

INTRODUCTION: Primary diaphragmatic lipoma (PDL) is a very rare condition. The aim of this paper is to report a case of diaphragmatic lipoma presenting as a case of diaphratmatic hernia with a brief literature review. A 73-year-old female presented with chronic dry cough for three month duration. The patient was stable, there was no significant finding on general, chest and abdominal examination. Chest-x-ray showed vague shadow above the left dome of the diaphragm. Computed tomography scan (CT scan) of the chest revealed a round mass with features consistent with either diaphragmatic hernia or malignancy. The patient underwent resection under general anesthesia and histopathological examination confirmed the diagnosis of PDL. CONCLUSION: Although PDL is a benign condition, in most of the time, it needs aggressive management because of the possibility of malignancy or other critical diseases.