The impact of previous COVID-19 pneumonia on postoperative outcomes and complications in coronary artery bypass grafting.

Background: This study aimed to provide nuanced insights in managing patients with a history of coronavirus disease 2019 (COVID-19) pneumonia undergoing coronary artery bypass grafting. Methods: This retrospective cohort study involved 168 patients (131 males, 37 females; mean age: 61.2±9.7 years; range, 51 to 72 years) undergoing isolated coronary artery bypass grafting surgery between December 2021 and December 2023. The study examined factors such as age, sex, comorbidities, blood test results, vaccination status, operative parameters, and postoperative complications. Patients' health records were reviewed to confirm the presence of previous COVID-19 pneumonia and vaccination status. Patients were divided into two groups based on their history of COVID-19 pneumonia: Group 1 included 140 who had not been diagnosed with COVID-19 pneumonia, and Group 2 included 28 patients who had a documented history of COVID-19 pneumonia. Postoperative pulmonary complications, including atelectasis, pleural effusion, acute respiratory distress syndrome, and pneumonia, were noted. Results: Patients with a history of COVID-19 pneumonia (Group 2, n=28) demonstrated significantly higher seropositivity for COVID-19 (89.3% vs. 29.3%, p=0.001) compared to those without a history (Group 1, n=140). Although pulmonary complications were higher in Group 2 (17.9% vs. 3.6%, p=0.013), postoperative mortality rates did not differ significantly between the groups. Pleural effusion was markedly higher in Group 2 (14.3% vs. 2.1%, p=0.015). Vaccination did not significantly affect perioperative and postoperative outcomes, except for a minor difference in postoperative drainage volume. Conclusion: This study highlights the impact of prior COVID-19 pneumonia on postoperative outcomes in coronary artery bypass grafting patients. Although there was a rise in pulmonary complications, the mortality rates stayed similar among individuals with and without a prior history of COVID-19 pneumonia. Vaccination did not significantly influence outcomes, emphasizing the need for further research with larger cohorts to validate and expand upon these findings.

Effect of Varying Recovery Duration on Postactivation Potentiation of Explosive Jump and Short Sprint in Elite Young Soccer Players.

ABSTRACT: Köklü, Y, Köklü, Ö, Isikdemir, E, and Alemdaroglu, U. Effect of varying recovery duration on postactivation potentiation of explosive jump and short sprint in elite young soccer players. J Strength Cond Res 36(2): 534-539, 2022-The purpose of this study was to investigate the effects of postactivation potentiation (PAP) on vertical jump and sprint performances with different recovery durations. Twelve elite young soccer players (average age: 17.0 ± 0.6 years; body mass: 67.0 ± 5.4 kg; height: 175.0 ± 3.5 cm) voluntarily performed countermovement jump (CMJ) and 30-m sprints (with 10-m split times) under unloaded and 4 different recovery duration conditions (R1: 1 minute, R2: 2 minutes, R3: 3 minutes, and R4: 4 minutes) after a set of 3 repetitions of half-squat exercises at 90% of 1-repetition maximum. Electromyographic assessments of both limbs' vastus lateralis (VL) and semitendinosus (ST) muscle activity were also made during the tests. Vertical jump height, sprint time, and VL and ST muscle activity root mean square (RMS) values were analyzed. The results show that players demonstrated significantly better CMJ, 10-, and 30-m sprint performances in the R4 condition compared with the unloaded condition (p < 0.05). The players also showed significantly higher RMS values for VL and ST muscle activity in the CMJ and 30-m test performances for both legs in the R4 condition compared with the unloaded, R1, R2, and R3 conditions (p < 0.05). According to these results, if sports scientists and coaches desire to increase the PAP effect after heavy resistance training, 4 minutes of recovery time instead of 1, 2, or 3 minutes for CMJ, 10-, and 30-m sprint performances is recommended.

Repair of calcified left ventricular pseudoaneurysm of long duration.

Cardiac pseudoaneurysm is a contained rupture of the myocardium limited by pericardial adhesions or the epicardial wall. Cardiac pseudoaneurysm may cause sudden death with a mortality of 30-45% in the first year, mostly resulting from rupture. Coronal and axial T2-weighted magnetic resonance images of a 65-year-old male patient admitted with dyspnoea, coughing and chest pain, present for the last 10 days, revealed a large pseudoaneursym of the left ventricle. Coronary bypass and left ventricular restoration operation was performed. The patient was eventlessly discharged 8 days after operation. He is in NYHA Class I 21 months postoperatively. The interval between myocardial insult and establishment of diagnosis is unknown in our patient. This is a patient whose left ventricular rupture had been contained for a very long time, possibly years, because a heavily calcified thick pseudoaneurysm wall was encountered during operation, making this case rare in the literature.

When is transthoracic approach indicated in retrosternal goiters?

PURPOSE: It is critical to differentiate among pathologies of substernal thyroid gland diseases because surgical approaches (i.e., median sternotomy or thoracotomy) might also include a cervical incision. The aim of this study was to analyze the features of patients with goiter who underwent a thyroidectomy via a cervical incision and a median sternotomy or thoracotomy. METHODS: We reviewed 9 cases of thyroid disease in patients undergoing thoracic incisions with or without a cervical incision for varying indications between March 2003 and Jun 2009 were reviewed. Thyroidal masses were removed via a median sternotomy in six patients and thoracotomy in three patients. Split median sternotomy combining thoracotomy was performed in 1 patient. Cervical incision was added in all patients. RESULTS: Pathologic examination revealed multinodular goiter in 5 patients, thyroid carcinoma in 3, and reidel thyroiditis in 1. All patients were extubated in the early postoperative period. There was no postoperative mortality or morbidity. The mean hospital stay was 8.6 days (range, 4-11 days), and mean follow-up was 24.3 months (range, 4-39 months). CONCLUSIONS: We recommend the use of transthoracic approaches, such as median sternotomy and thoracotomy for retrosternal goiter for surgical exposure, because they provide a wide exposure and facilitate removal of the mass. By using median sternotomy and thoracotomy, we can avoid catastrophic results, such as hemorrhage, as well as completely remove malignancies.