Surgical lung biopsy for suspected interstitial lung disease with video-assisted thoracoscopic surgery is safe, providing exact histological and disease specific diagnosis for tailoring treatment.

Background: Surgical lung biopsy (SLB) is required for diagnosis in patients with suspected interstitial lung disease (ILD) if other less invasive diagnostic methods are non-conclusive. We evaluated the outcome of SLB by using centralized databases in a whole-nation patient-cohort.

Methods: A population-based retrospective study on 68 consecutive patients (mean age 58 years, 58.

Responding to discontinuities in product-based service supply chains in the COVID-19 pandemic: Towards transilience.

Purpose: In this study, we identify and characterise how organisations have responded, in ways ranging from restoration to radical change, to discontinuities in their product-based service (PBS) supply chains during the COVID-19 pandemic.

Design/methodology/approach: Following a theoretical approach that integrates transilience and panarchy theory as a response strategy in PBS supply chains, our qualitative study involved collecting data through 19 semi-structured interviews at six manufacturing firms during the first 6 months of the COVID-19 pandemic (i.e.

Respiratory function and CT abnormalities among survivors of COVID-19 pneumonia: a nationwide follow-up study.

Introduction: Considering the pulmonary burden caused by acute COVID-19, questions remain of respiratory consequences after recovery. The aim of the study was to describe respiratory function of COVID-19 pneumonia survivors at mid-term follow-up (median 68 days) and assess whether impairments were predicted by acute illness severity or residual CT abnormalities.

Methods: Residents of Iceland that had COVID-19 and oxygen saturation ≤94% from 28 February 2020 to 30 April 2021 were offered a clinical follow-up visit with an interview, a 6 min walk test (6MWT), spirometry with gas exchange measurement and chest CT.

[Parenchymal lung changes on CT in patients with coronavirus disease 2019 (COVID-19)].

Introduction Infections due to COVID-19 can lead to life threatening pneumonia. Accompanying severe disease are more prominent pulmonary changes on Computed Tomography (CT) scan of the chest. The goal of this study was to describe pulmonary CT changes during acute COVID-19 and at follow up and whether the extent of changes correlate with severity of illness, demographics or other risk factors.

Assessing the inequalities in access to online delivery services and the way COVID-19 pandemic affects marginalization.

This paper discusses the importance of incorporating online home delivery services (OHDS) into the concept of accessibility and marginalization. The authors propose a method to quantify access to OHDS and assess levels of inequalities in access to OHDS using data from OHDS providers in the pharmaceutical and food sectors, as well as from transport operators delivering parcels. The Västra Götaland Region in the West coast of Sweden is used as a case study.

[Smoking is associated with health risks even when cessation is before the age of 30 years].

It is broadly believed that smokers who have ceased to smoke before the age of 30 years, have no excess health risk compared with never-smokers. As summarised in this review, large, prospective cohort studies show, that this holds true regarding all-cause mortality for men, whereas the risk of dying remains slightly elevated for women, who quit smoking early. The risk of lung cancer also remains elevated.

Exploring power shifts as an enabler for a strengthened patient role in quality improvements: a Swedish survey study.

Objectives: This study examined the relationship between professionals' perceptions of a strengthened role for the patient and of patient involvement in quality improvement (QI) and whether professionals' experiences in improvement science were a moderator on such a relationship.

Design: From a predominantly close-ended, 44-item questionnaire, 4 questions specifically concerning professionals' perception on patient involvement in QI were analysed.

Setting: Three Swedish regions.

Suprapubic catheter placement through ileal mesentery causes mechanical small bowel obstruction six years later in a female patient with turners syndrome.

Percutaneous suprapubic cystostomy (SPC) is a procedure performed to manage urinary retention when urethral catheterization is contraindicated or to improve the quality of life in cases such as neurogenic bladder. Although a simple procedure, it is associated with serious complications, increasing the morbidity and mortality. This case study demonstrates a delayed presentation of small bowel obstruction caused by a suprapubic catheter traversing through the ileal mesentery in a patient with no prior bowel surgeries.

[Visits of patients with exertional rhabdomyolysis to the Emergency Department at Landspítali, The National University Hospital of Iceland in the years 2008-2012].

Introduction: Overexertion and too much training are among the -multiple etiologies of rhabdomyolysis. Creatine kinase (CK) and myo-globine, released from skeletal muscle cells, are useful for diagnosis and follow-up. Acute kidney injury is a serious complication of myoglobinemia.

Using cognitive task analysis to identify critical decisions in the laparoscopic environment.

Objective: The aim of this study was to identify the critical decisions surgeons need to make regarding laparoscopic surgery, the information these decisions are based on, the strategies employed by surgeons to reach their objectives, and the difficulties experienced by novices.

Background: Laparoscopic training focuses on the development of technical skills. However, successful surgical outcomes are also dependent on appropriate decisions made during surgery, which are influenced by critical cues and the use of appropriate strategies.

Prognosis of metastatic carcinoma of the lung in the bevacizumab era: comparison between the major histologic types of lung cancer.

Background: In October 2006, bevacizumab was approved for treatment for patients with metastatic non-small-cell lung cancer other than squamous carcinoma. Our hypothesis was that the change in survival after approval of bevacizumab for metastatic adenocarcinoma would show differences from that of small-cell carcinoma and squamous carcinoma.

Methods: Data was obtained from the National Cancer Institute Surveillance Epidemiology and End Results (SEER) registry for patients with lung cancer diagnosed between January 2004 and November 2007.

Nottingham grades of lobular carcinoma lack the prognostic implications they bear for ductal carcinoma.

Background: Invasive lobular cancer (L) differs clinically and morphologically from invasive ductal cancer (D); differences notwithstanding, Nottingham grades are provided in both. This study compared 22,719 lobular carcinomas with 201,517 ductal carcinomas, dividing them into the grades: well differentiated (W), moderately differentiated (M), poorly differentiated (P), and ungraded to see if differences between comparable grades of lobular and ductal cancer were uniform, consistent with the notion the grading system provides similar information for both cancer subtypes.

Methods: The Surveillance, Epidemiology and End Results (SEER) database was used to limn relationships among grades, as respects proportions of patients with T3 tumors and nodal metastases, as well as cancer-specific survival.

Chylothorax after coronary artery bypass grafting.

Injuries to the thoracic duct and its tributaries resulting in chylothorax have been described after almost any thoracic, mediastinal, cardiac, and neck surgery. Although it remains one of the rarest complications after coronary artery bypass grafting (CABG), evidence suggests that its frequency is underestimated. New treatment options make it paramount to understand the etiology, pathophysiology, and natural course of this complication.

Lung metastasis 21 years after initial diagnosis of osteosarcoma: a case report.

Introduction: To the best of our knowledge, this case report describes the longest disease-free interval between primary diagnosis and metastatic recurrence of an osteosarcoma.

Case Presentation: A 35-year-old Caucasian American man presented with asymptomatic lung metastases 21 years after being diagnosed and treated for lower extremity osteosarcoma. He underwent curative lung resection, but 2 years thereafter developed metastatic disease in the scapula and tibia and, after resection and chemotherapy, is in remission 1 year later.

Best poster award: accuracy of surgery residents' interpretation of computed tomography scans in trauma.

Background: We evaluated the accuracy of surgery residents in interpreting computed axial tomography (CT) scans of trauma patients as compared with attending radiologists.

Methods: Residents listed injuries they identified on initial CT scans of trauma patients in a time-stamped computerized system before the official report becoming available. Head, chest, and abdomen/pelvis CT scans were included.

Prescribing of Controlled Substances for Non-Patients in the Educational Setting: Review of the Ethical, Legal, and Moral Dilemma for Residents.

Prescription drug abuse is an enormous problem in modern society. Studies have shown that it results in more injuries and deaths to Americans than all illegal drugs combined.1 In this review, the author discusses the prescribing of controlled substances by residents as it relates to intercollegial and other non-patient workplace encounters.

Proximal left subclavian artery aneurysms: a case report and review of the literature.

Aneurysms of the proximal subclavian artery are extremely rare. A 39-year-old female with an incidental finding of a small proximal left subclavian artery aneurysm at its origin from the aortic arch is described. This was an incidental finding during workup for chest pain.

Anterior mediastinal herniation of the transverse colon after an omental flap transposition.

Poststernotomy mediastinitis continues to be an infrequent but serious complication after cardiac surgery. We present a case of a 59-year-old man who developed a deep sternal wound infection after an emergency cardiac surgery. Omental transposition flap was used to cover the sternal defect.

Laparoscopic greater omentum harvesting with split-thickness skin grafting for sternal wound dehiscence.

Sternal wound dehiscence is a serious complication occasionally requiring soft tissue coverage. The greater omentum typically has been used as a last resort because of the underlying morbidity from a laparotomy. We present a case in which a laparoscopically created omental flap with subsequent split-thickness skin grafting was used to correct a large soft tissue defect that occurred after sternal wound dehiscence developed.

An ethanol protocol to prevent alcohol withdrawal syndrome.

Background: Alcohol withdrawal syndrome (AWS) occurs in dependent patients during the initial period of sudden onset abstinence. It is usually manifested by mild symptoms such as disorientation, agitation, and tachycardia, but, if untreated, can lead to severe confusion, seizures, and even cardiovascular collapse. Prevention of AWS has been shown to improve morbidity and mortality and shorten hospital and ICU stays.

Isolated chyle duct injury in blunt trauma.

We present a case of a patient sustaining an isolated injury to the right main branch of the cysterna chyli due to a high-speed motor vehicle accident. A 42-year-old man presented after a high-speed collision. CT revealed a collection of hypodense fluid in the gallbladder fossa, which was the clue to take him to the OR.