Urban thoracic trauma: diagnosis and initial treatment of non-cardiac injuries in adults.

This comprehensive review aims to delineate the prevailing non-cardiac thoracic injuries occurring in urban environments following initial on-site treatment and subsequent admission to hospital emergency departments. Our study involved a rigorous search within the PubMed database, employing key phrases and their combinations, including "thoracic injury," "thoracic trauma," "haemothorax," "lung contusion," "traumatic pneumothorax," "rib fractures," and "flail chest." We focused on original research articles and reviews. Non-cardiac thoracic injuries exhibit a high prevalence, often affecting poly-trauma patients, and contributing to up to 35% of polytrauma-related fatalities. Furthermore, severe thoracic injuries can result in a substantial 5% mortality rate. This review provides insights into clinical entities such as lung contusion, traumatic haemothorax, pneumothorax, rib fractures, and sternal fractures. Thoracic injuries represent a frequent and significant clinical concern for emergency department physicians and thoracic surgeons, warranting thorough understanding and timely intervention

Between Air and Artery: A History of Cardiopulmonary Bypass and the Rise of Modern Cardiac Surgery

Cardiopulmonary bypass (CPB) is one of the most groundbreaking medical innovations in history, enabling safe and effective heart surgery by temporarily replacing the function of the heart and lungs. This review starts with ancient concepts of cardiopulmonary function and then traces the evolution of CPB through important physiological and anatomical discoveries, culminating in the development of the modern heart–lung machine. In addition to examining the contributions of significant figures like Galen, Ibn al-Nafis, William Harvey, and John Gibbon, we also examine the ethical and technical challenges faced in the early days of open heart surgery. Modern developments are also discussed, such as miniature extracorporeal systems, off-pump surgical techniques, and the increasing importance of extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS), while the evolving role of perfusionists in diverse cardiac teams and the variations in global access to CPB technology are also given special attention. We look at recent advancements in CPB, including customized methods, nanotechnology, artificial intelligence-guided perfusion, and organ-on-chip testing, emphasizing CPB’s enduring significance as a technological milestone and a living example of the cooperation of science, medicine, and human inventiveness because it bridges the gap between the past and the future

Opening the Sacred Chamber: The Cultural and Ethical Odyssey of Cardiac Surgery

Cardiac surgery, now a routine medical intervention, was once deemed unthinkable—not merely due to technical limitations, but because of deep-seated cultural, religious, and philosophical prohibitions. This article traces the historical and ethical trajectory of the human heart from a sacred, inviolable symbol of the soul to a surgically accessible organ. Through an interdisciplinary lens that integrates medical history, anthropology, theology, and contemporary bioethics, we examine how shifts in metaphysical belief, technological progress, and moral reasoning gradually legitimized cardiac intervention. From ancient Egyptian funerary rites and classical cardiocentric models to medieval religious taboos and Enlightenment redefinitions of the body, the heart’s transformation reflects broader changes in how humanity conceives life, death, and identity. The emergence of modern cardiac surgery, especially heart transplantation and extracorporeal technologies, raised new ethical dilemmas, challenging the boundaries between tissue and meaning, biology and personhood. This study argues that despite its clinical secularization, the heart retains a unique symbolic gravity that continues to shape public perception and professional responsibility. In the age of precision medicine, cardiac surgery remains not only a technical act but an existential gesture—a transgression that demands both scientific mastery and moral reverence