Twenty years experience in oncologic surgery for primary cardiac tumors

Introduction. Primary cardiac tumors are uncommon in cardiac surgery. To investigate the clinical presentation, surgical results and long-term follow-up we retrospectively analyzed our experience in the treatment of primary cardiac tumors. Patients and methods. Ninety-one patients with primary cardiac tumors underwent surgery in our department in the last 20 years. Fifthy-one patients were female, the mean age was 62,2 years. Sixty-three had myxomas, 22 had papillary fibroelastoma, 4 had malignant neoformations and 2 had other benign tumors. Results. All myxomas, fibroelastomas and angiomyolipoma were radically removed. Only a palliative treatment was possible in malignant disease. In-hospital mortality was 1.2%. The mean follow-up time was 78.5 months. Three patients had recurrence of myxoma, all patients with malignant disease dead during the follow-up. Discussion. Primary benign cardiac tumors can be treated with low morbidity and mortality. The follow-up demonstrates that radical surgery is curative in case of benign tumors. The prognosis of malignant tumors is still poor. Palliative procedures have small impact on survival in these patients

Sialadenoma papilliferum of the bronchus: a rare tumour of salivary gland origin

Sialadenoma papilliferum is a benign salivary tumour which rarely occurs in the bronchial tree. Up to now, only four cases of pulmonary papillary sialadenoma have been reported in the  literature.We discuss the case of a male patient with an accidental finding of a middle lobe nodule. The patient underwent a minimally invasive anatomical resection of the lobe to remove the lesion; the postoperative course was regular, and he was healthy at the last follow-up

Validated Prognostic Scores to Predict Outcomes in ECLS-Bridged Patients to Lung Transplantation

Selection of patients who may benefit from extracorporeal life support (ECLS) as a bridge to lung transplant (LTx) is crucial. The aim was to assess if validated prognostic scores could help in selecting patients who may benefit from ECLS-bridging predicting their outcomes. Clinical data of patients successfully ECLS-bridged to LTx from 2009 to 2021 were collected from two European centers. For each patient, we calculated Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score III (SAPS III), Acute Physiology and Chronic Health Evaluation II (APACHE II), before placing ECLS support, and then correlated with outcome. Median values of SOFA, SAPS III, and APACHE II were 5 (IQR 3-9), 57 (IQR 47.5-65), and 21 (IQR 15-26). In-hospital, 30 and 90 days mortality were 21%, 14%, and 22%. SOFA, SAPS III, and APACHE II were analyzed as predictors of in-hospital, 30 and 90 days mortality (SOFA C-Index: 0.67, 0.78, 0.72; SAPS III C-index: 0.48, 0.45, 0.51; APACHE II C-Index: 0.49, 0.45, 0.52). For SOFA, the score with the best performance, a value ≥9 was identified to be the optimal cut-off for the prediction of the outcomes of interest. SOFA may be considered an adequate predictor in these patients, helping clinical decision-making. More specific and simplified scores for this population are necessary

Responsabilidad social universitaria en Maracaibo, Venezuela

This article aims to analyze university social responsibility in Maracaibo, Venezuela. The work is based on the postulates of Rodriguez (2010), De la Cuesta (2011) and the Ministry of Education in Spain (2011), among others. It is a descriptive, field study. The population consisted of authorities from five universities, one (1) public and four (4) private, located in Maracaibo, who were accessed through a questionnaire composed of thirty-two (32) closed items. The instrument was validated by experts in the university management field. To determine the questionnaire’s reliability, the test-retest method was applied, obtaining a 0.94 coefficient. To analyze data, the arithmetic mean or average was used. Results indicate that the universities under study exhibit a social responsibility model with an instrumental, entrepreneurial tendency, where knowledge is seen as the main asset available for society’s use. However, a greater integration of these higher education institutions with their stakeholders is required.  El presente artículo tiene como objetivo analizar la responsabilidad social universitaria en Maracaibo, Venezuela. El trabajo se sustenta en los postulados de Rodríguez (2010), De la Cuesta (2011), el Ministerio de Educación de España (2011), entre otros. El estudio fue descriptivo, de campo. La población estuvo conformada por autoridades de cinco (5) universidades, una (1) pública y cuatro (4) privadas ubicadas en Maracaibo, a las cuales se accedió mediante un cuestionario compuesto por treinta y dos (32) ítems cerrados. El instrumento fue validado por expertos en el ámbito de la gerencia universitaria. Para determinar la confiabilidad del cuestionario se aplicó el método test-retest, obteniéndose un coeficiente de 0,94. Para analizar los datos se utilizó el promedio aritmético o media. Los resultados indican que las universidades estudiadas exhiben un modelo de responsabilidad social de tendencia empresarial instrumental, donde el conocimiento se perfila como el principal activo disponible para su uso por la sociedad, pero se requiere una mayor integración de las instituciones de educación superior con sus stakeholders. &nbsp

Early and long-term Results of pulmonary resection for non-small-cell lung cancer in patients over 75 years of age: A multi-institutional study

none8noOBJECTIVES: Older lung cancer patients with multiple morbidities are increasingly referred to thoracic surgery departments. The aim of this multicenter study was to analyse the prognostic factors for in-hospital morbidity and mortality and to elucidate the predictors of long-term survival and oncological outcomes. METHODS: We identified 319 patients aged ≥ 75 years who underwent intended curative lung resection for lung cancer in three different thoracic surgery departments between January 2000 and December 2010. RESULTS: Seventy-one patients underwent limited resection, 202 had lobectomy, 16 had bilobectomy and 30 had pneumonectomy. The in-hospital mortality was 6.6%. Chronic renal failure, low respiratory reserve and pneumonectomy were predictors of in-hospital mortality. The mean follow-up time was 3.9 years, ranging from 1 month to 10.4 years. The disease-free survivals at 1, 3 and 5 years were 82, 60 and 47%, respectively. The overall survivals at 1, 3 and 5 years were 86, 59 and 38%, respectively. The long-term overall survival was negatively influenced by pneumonectomy, extended resection, N(1-2) subgroups and pathological TNM stage. CONCLUSIONS: Nowadays, we can consider surgery a safe and justifiable option for elderly patients. Careful preoperative work-up and selection are mandatory to gain satisfactory results. Good long-term results were achieved in elderly patients with early stage who underwent lobar or sublobar lung resection. The role of surgery or other alternative therapies, in patients with advanced stages, extensive nodal involvement and/or requiring extensive surgical resection for curative intent, is still unclear and further studies are certainly needed.openDell'Amore, Andrea; Monteverde, Marco; Martucci, Nicola; Sanna, Stefano; Caroli, Guido; Stella, Franco; Dell'Amore, Davide; Rocco, GaetanoDell'Amore, Andrea; Monteverde, Marco; Martucci, Nicola; Sanna, Stefano; Caroli, Guido; Stella, Franco; Dell'Amore, Davide; Rocco, Gaetan

Physiotherapy for Patients on Awake Extracorporeal Membrane Oxygenation: A Systematic Review

Abstract BACKGROUND AND PURPOSE: Extracorporeal membrane oxygenation (ECMO) is used as temporary life support in subjects with potentially reversible respiratory/cardiac failure. The principal purpose of this review was to assess the characteristics and potential advantages of physiotherapeutic interventions in subjects on awake ECMO support. METHODS: Seven databases were interrogated: we searched titles, abstracts and keywords using the Medical Subject Headings terms 'extracorporeal membrane oxygenation' and 'rehabilitation' linked with the Boolean operator 'AND'. RESULTS AND CONCLUSION: In total, 216 citations were retrieved. Nine citations satisfied our inclusion criteria and were subjected to full-text analysis. The numbers of patients enrolled in the included studies (most of which were case series) were low (n = 52). We found no prospective studies or randomized controlled trials. Overall, subjects on awake ECMO usually received a combination of passive and active physiotherapy, and most achieved an acceptable degree of autonomy after treatment. Emerging research in the field affords preliminary evidence supporting the safety of early mobilization and ambulation in patients on awake veno-venous ECMO support

Preoperative physiotherapy in subjects with idiopathic pulmonary fibrosis qualified for lung transplantation: Implications on hospital length of stay and clinical outcomes

Background: Lung transplantation (LTx) candidates with chronic disease are more prone to exercise limitations. Preoperative physiotherapy (PP) can improve exercise tolerance, which in some patients, is severely impaired, often leaving them housebound. The aim of this study was to answer this question: In patients with idiopathic pulmonary fibrosis (IPF) qualifying for LTx, is PP effective in improving postoperative outcomes and reducing length of stay (LOS) after transplantation? Methods: Six major databases were searched up to December 2015. We did not apply limits to publication date, date, gender, or language. Citations were accepted if they discussed preoperative physiotherapeutic treatment in patients with IPF waiting for LTx. Results: After the full texts were read, three papers met the inclusion criteria and were included. All of these papers had an observational design. In total, 55 subjects with IPF and awaiting LTx were observed. Conclusions: The effectiveness of PP in improving postoperative outcomes and reducing LOS following LTx remains unclear, although it appears to benefit IPF patients who qualify for LTx by improving their health status, physical activity levels, and respiratory-related symptoms

Right tracheal sleeve pneumonectomy for complex pulmonary aspergilloma in a patient with diffuse large B-cell lymphoma

Tracheal sleeve pneumonectomy consists of en bloc resection of the lung, main bronchus plus a section of the carina and its subsequent anastomosis with the remaining main-stem bronchus. We present the unique case of a 56-year-old patient, who underwent tracheal sleeve pneumonectomy for a complex pulmonary aspergilloma invading almost the entire right lung up to the carina