Cardiac surgeons between apprehension and ethical duty in the COVID-19 pandemic.

BACKGROUND: Cardiothoracic surgeons are facing a big challenge in their surgical practice in the era of the COVID-19 pandemic. The attitude towards performing surgery is influenced by the pandemic. Setting special recommendations for safe cardiothoracic surgery is of extreme importance. METHODS: This was an observational cross-sectional survey that included 77 Egyptian cardiothoracic surgeons. The survey consisted of a self-administered constructed questionnaire with six sections, and was delivered as a Google Forms questionnaire (https://www.google.com/forms/about) that was sent to individuals via social networks and email. RESULTS: More than 80% of Egyptian cardiothoracic surgeons believe they and their patients are at risk. Out of all participants, none had actually been infected with COVID-19 but 26% had encountered a positive COVID-19 person in their surgical team. Although 51% were testing patients before surgery, they reported 9 confirmed cases postoperatively. Computed tomography was the most recommended investigation prior to surgery (by 69%). Most had postponed elective surgeries and only one-third of all surgeons recommended performing elective surgeries cautiously with pretesting for COVID-19 and maximizing protective measures, while more than 40% recommended not performing high-risk elective surgeries. CONCLUSION: We are committed to the safety of our patients, ourselves, our staff, and our families. Planning for the new phase of reopening, whether total reopening or step-by-step reopening, should carefully consider how we should utilize our resources, respect social distancing, and prevent exposure to untested patients or health workers who might turn out to be an undetected positive case.

Laryngo-Tracheo-Bronchial Foreign Bodies in Children: Clinical Presentations and Complications.

INTRODUCTION: Foreign-body (FB) aspiration in the airway of children is a life-threatening clinical situation responsible for many deaths each year. The aim of this study was to evaluate the different clinical presentations, methods of diagnosis, types and complications of FB inhalation in the pediatric age group. MATERIALS AND METHODS: The study included patients who presented with a definitive or suspicious history of FB aspiration. Detailed data for each patient were recorded concerning the age, sex, nature and site of the FB, presenting symptoms and signs, and radiological findings. RESULTS: Fifty-six patients were enrolled in this study. The age of patients ranged from 6 months to 14 years, with a mean age of 4.5 years. Sixty percent of patients were under 3 years of age. The time interval between aspiration of foreign body and onset of diagnosis ranged from 2 hours to 5 months. Thirty-four (60.7%) patients had normal chest X-ray findings, while opaque FB was seen in eight patients (14.3%). Signs of bronchitis were seen in five patients (9%), while pneumonia and atelectasis were seen in six (10.7%) and three cases (5.3%), respectively. CONCLUSION: FB aspiration is a life-threatening clinical situation, with children <3 years of age being most commonly affected. FB aspiration must be considered a matter of emergency, especially in the case of organic FBs. This study aimed to increase the awareness of laryngo-tracheo-bronchial FBs, as early diagnosis and management decrease the incidence of complications and make removal of aspirated FB easier.