A Successful Case of Cardiac Arrest due to Acute Myocarditis with COVID-19: 120 Minutes on Manual Cardiopulmonary Resuscitation then Veno-Arterial Extracorporeal Membrane Oxygenation.

Acute myocarditis is one of the common complications of coronavirus disease 2019 (COVID-19) with a relatively high case fatality. Here reported is a fulminant case of a 42-year-old previously healthy woman with cardiogenic shock and refractory cardiac arrest due to COVID-19-induced myocarditis who received veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) after 120 minutes of cardiopulmonary resuscitation (CPR). This is the first adult case of cardiac arrest due to COVID-19-induced myocarditis supported by ECMO that fully recovered with normal neurological functions. The success of the treatment course with full recovery emphasized the potential role of ECMO in treating these patients.

Massive lung necrosis due to microwave ablation in an octogenarian required urgent lobectomy.

We present a rare complication of microwave ablation (MWA) in a male patient in his 80s. His massive pulmonary necrosis and tension pneumothorax required urgent surgery. However, the damage to the lung tissue was too large, deep and fragile. We failed to suture or conduct wedge resection on the lung lesion, so, left upper lobectomy was necessary. Therefore, we suggest that it is probably possible to reduce the frequency and time threshold when performing MWA for the elderly with comorbidities.

Coronary Sinus Rupture Due to Blunt Cardiac Trauma.

We present a very rare case of devastating blunt cardiac trauma with large right atrial rupture, contusion of the right atrioventricular groove, and coronary sinus tear. Surgical repair was successfully performed by urgently establishing cardiopulmonary bypass via the femoral vein and artery simultaneously with a median sternotomy. (Level of Difficulty: Intermediate.).

An Initial 5-Year Single-Center Experience of 365 Patients Undergoing the Video-Assisted Thoracoscopic Surgery for Nuss Procedure for Pectus Excavatum in Resource-Scare Setting.

Background: Little is known about video-assisted thoracoscopic surgery in the Nuss procedure (VATS-NUSS) and its postoperative outcomes in the resource-scarce conditions in clinical practice such as Vietnam. Available evidence in the literature was mostly reported from large institutions in developed countries. Hence, this study was conducted to review our initial large single-center experience in the use of the VATS-NUSS for patients with pectus excavatum (PE) within 5 years. Methods: Data from 365 consecutive PE patients between January 2015 and December 2019 who were surgically treated with VATS-NUSS were retrospectively analyzed. Results: Of 365 patients, median age at operation was 15.61 ± 3.73 years (range = 5-27 years), most being child and adolescent. Three hundred nine patients (84.65%) were male. PE was commonly detected at puberty (n = 328, 89.9%). Postoperatively, early complications consisted of pneumothorax (n = 5, 1.37%), pleural bleeding/pleural fluid (n = 2, 0.55%), pleural hematoma (n = 1, 0.27%), pneumonia (n = 1, 0.27%), surgical wound infection (n = 1, 0.27%), incision fluid accumulation (n = 3, 0.82%), metal bar infection (n = 1, 0.27%), atelectasis (n = 3, 0.82%), and fever (n = 8, 2.19%). Late complications included surgical wound infection (n = 2, 0.55%), metal bar deviation (n = 5, 1.37%), metal bar allergy (n = 10, 2.74%), recurrent PE (n = 2, 0.55%), and persistent PE (n = 5, 1.37%). No deaths occurred. In 175 patients (47.95%) experiencing bar removal, mean operative time for bar removal was 34.09 ± 10.61 min, and the length of hospitalization following bar removal was 2.4 ± 1.34 days; the most frequent complication was pneumothorax (n = 19, 10.85%). One wound infection and one incision fluid accumulation happened following bar removal. Favorable midterm to long-term postoperative outcomes were achieved. Conclusions: From the beginning of the Vietnamese surgeons' experience, VATS-NUSS application obtained favorable outcomes with minimizing the occurrence of serious intraoperative and postoperative complications. Current rare evidence enables to give a real picture in the application, modification, and development of VATS-NUSS in the countries having similar resource-scarce conditions.

Antibiotic and antiparasitic residues in surface water of urban rivers in the Red River Delta (Hanoi, Vietnam): concentrations, profiles, source estimation, and risk assessment.

Antibiotic residues and antimicrobial resistance in surface water are issues of global concern, especially in developing countries. In this study, the occurrence of seven antibiotics and one antiparasitic agent was determined in surface water samples collected from four rivers running through Hanoi urban area in the Red River Delta, northern Vietnam. The pharmaceuticals in water samples were analyzed by solid-phase extraction combined with liquid chromatography-tandem mass spectrometry method. The concentrations of pharmaceuticals in our samples ranged from 3050 to 16,700 (median 7800) ng/L, which were generally higher than levels found in river water from many other locations in the world. Amoxicillin, oxfendazole, and lincomycin were the most dominant and frequently detected compounds (detection rate 100%), which together accounted for 76 ± 14% of total concentrations. Sulfacetamide and sulfamethoxazole were detected at moderate concentrations in more than two-thirds of the analyzed samples. The remaining antibiotics (i.e., azithromycin, ciprofloxacin, and ofloxacin) were found at lower detection frequency and concentrations. Antibiotic concentrations in the water samples were not significantly different between the investigated rivers. Meanwhile, levels of pharmaceuticals in the samples collected in February 2020 were higher than those found in the remaining samples, largely due to the sharp decrease in sulfamethoxazole and azithromycin concentrations of the samples collected in March and April. Considerable ecological risks of antibiotics in surface water were estimated for some compounds such as amoxicillin, ciprofloxacin, and ofloxacin.