Outcomes of Lung Transplantation in Coal Workers Pneumoconiosis: Analysis of UNOS Database.

Background: Coal worker's pneumoconiosis (CWP) poses a significant burden on affected individuals and is associated with increased morbidity and mortality. Lung transplantation (LT) is the only effective treatment for this progressive and fatal lung disease. This study aims to evaluate the outcomes of patients who have undergone LT for primary diagnosis of CWP.

A Subtle Adversary: Mycobacterium avium-intracellulare Infection of the Surgical Site Years After Bilateral Lung Transplantation.

 complex is a nontuberculous that has been associated with a wide range of infections, including the skin and soft tissues, central nervous system, and pulmonary system. We discuss the case of a 66-year-old male with a history of coal worker's pneumoconiosis who had undergone a bilateral lung transplant eight years prior and presented with drainage from his right chest incision site. He underwent operative exploration and drainage of the wound.

Cavity induced modulation of intramolecular vibrational energy flow pathways.

Recent experiments in polariton chemistry indicate that reaction rates can be significantly enhanced or suppressed inside an optical cavity. One possible explanation for the rate modulation involves the cavity mode altering the intramolecular vibrational energy redistribution (IVR) pathways by coupling to specific molecular vibrations in the vibrational strong coupling (VSC) regime. However, the mechanism for such a cavity-mediated modulation of IVR is yet to be understood.

Long-Term Outcomes of Endovascular Repair of Thoracic Aortic Aneurysms.

The thoracic aorta is a dynamic structure composed of the aortic root, ascending aorta, aortic arch, and descending aorta. It is subject to the pressure and volume of the cardiac cycle and susceptible to atherosclerotic and aneurysmal changes. With these changes, the risk for acute aortic syndromes increases, thus creating the impetus for earlier interventions.

Anti-Thymocyte Globulin as a Therapy for Chronic Lung Allograft Dysfunction: A Single-Center Experience.

Introduction: Anti-thymocyte globulin (ATG) is a polyclonal antibody formulation which has been used as a second-line therapy for chronic lung allograft dysfunction (CLAD). Limited data exist evaluating its efficacy; however, several single-center retrospective studies have variably demonstrated either improvement or stabilization of spirometry parameters after administration of ATG. ATG has been in use at UT Southwestern for treatment of CLAD since at least 2010; here, we seek to evaluate the effectiveness of this intervention at our center.

Pulmonary Embolism in Donor Lungs-Incidence and Management.

In efforts to decrease the mortality on the waiting list for lung transplantation, alternatives to increase the donor pool have been explored. Caution must be used when accepting donor lungs with pulmonary embolism (PE), as prior evidence has shown mixed results after transplantation of donor lungs with PE. However, the mere diagnosis of PE on imaging should not be the sole reason for the exclusion of these donors for transplant, and they should be reviewed as any other donor.

Pulmonary Embolism Following Lung Transplantation: Prevention and Management.

Thromboembolic events are the third leading cardiovascular diagnosis following stroke and myocardial infarction. In the United States, 300,000 to 600,000 people per year are diagnosed with venous thromboembolism, either deep venous thrombosis or pulmonary embolism (PE). Of those patients, thousands die from PE despite heightened vigilance and improved therapies.

Dynamical Tunneling in More than Two Degrees of Freedom.

Recent progress towards understanding the mechanism of dynamical tunneling in Hamiltonian systems with three or more degrees of freedom (DoF) is reviewed. In contrast to systems with two degrees of freedom, the three or more degrees of freedom case presents several challenges. Specifically, in higher-dimensional phase spaces, multiple mechanisms for classical transport have significant implications for the evolution of initial quantum states.

Caught in the Act: A Recurrent Tamponade After Coronary Artery Bypass Grafting With Culprit Lesion Identified on Computed Tomography Angiogram.

Delayed cardiac tamponade after cardiac surgery is a rare complication with significant diagnostic challenges. The recurrence of cardiac tamponade physiology after initial intervention creates another degree of difficulty in the management of already medically complex patients. We present the case of a 65-year-old male who underwent four-vessel coronary artery bypass grafting that was complicated by the delayed presentation of cardiac tamponade requiring mediastinal exploration.

Phase space perspective on a model for isomerization in an optical cavity.

Explanation for the modification of rates and mechanism of reactions carried out in optical cavities still eludes us. Several studies indicate that the cavity-mediated changes in the nature of vibrational energy flow within a molecule may play a significant role. Here, we study a model polaritonic system, proposed and analyzed earlier by Fischer et al.

Right Coronary Artery Button Pseudoaneurysm After the Modified Bentall Procedure.

Anastomoses of the coronary buttons are the Achilles' heel of the modified Bentall procedure (MBP) for the repair of the aortic root and ascending aorta. We present a rare case of post-MBP right coronary artery button pseudoaneurysm in a 30-year-old man. The contained leak, attributed to a pseudoknot in the polypropylene suture, was visualized via computed tomography angiography and transesophageal echocardiogram and repaired under deep hypothermic circulatory arrest.

A call to action in thoracic transplant surgical training.

Thoracic organ recovery and implantation is increasing in complexity. Simultaneously the logistic burden and associated cost is rising. An electronic survey distributed to the surgical directors of thoracic transplant programs in the United States indicated dissatisfaction amongst 72% of respondents with current procurement training and 85% of respondents favored a process for certification in thoracic organ transplantation.

The value of COPE therapy in the perioperative care of heart failure patients receiving left ventricular assist device implantation.

Purpose: This pilot study implemented Creating Opportunities for Personal Empowerment (COPE), a cognitive behavioral therapy (CBT) intervention, in the perioperative care of patients with advanced heart failure awaiting left ventricular assist device (LVAD) implantation.

Methods: Using a quasi-experimental study design, the patients were screened for anxiety and depression using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) screening tools. If patients scored 5 or greater on either tool, they received COPE.

Bilateral Lung Transplantation in Kartagener's Syndrome and Situs Inversus.

Kartagener's syndrome (KS) is a genetic disorder and a subgroup of primary ciliary dyskinesia characterized by situs inversus, chronic sinusitis and bronchiectasis. Patients with KS can develop severe bronchiectasis with end-stage lung disease due to recurrent pulmonary infections. Lung transplantation is a treatment option with good outcomes reported in the literature.

Diffuse Coronary Vasospasm After Mitral Valve Replacement, Maze Procedure, and Tricuspid Valve Repair.

Coronary vasospasm is a known complication after coronary artery bypass grafting surgery but has rarely been described in non-coronary cardiac operations. We report the case of a 51-year-old male with nonischemic cardiomyopathy and paroxysmal atrial fibrillation. He presented with severe mitral and tricuspid regurgitation and was taken for mitral valve replacement, tricuspid valve repair, and Maze procedure.

Pathophysiology and Management of Heart Failure in the Elderly.

The population of elderly adults is increasing globally. It has been projected that the population of adults aged 65 years will increase by approximately 80% by 2050 in the United States. Similarly, the elderly population is rising in other countries; a notable example being Japan where approximately 30% of the population are aged above 65 years.

Diagnosis and Management of Aortic Valvular Disease in the Elderly.

Aortic valvular disease, including aortic stenosis and aortic regurgitation, is increasingly common with age. Due to the aging population, more elderly patients are presenting with aortic valve pathology and expectations for prompt diagnosis and efficacious treatment. The current paradigm for aortic valve disease is based on surgical or interventional therapy.

Dissociation dynamics of a diatomic molecule in an optical cavity.

We study the dissociation dynamics of a diatomic molecule, modeled as a Morse oscillator, coupled to an optical cavity. A marked suppression of the dissociation probability, both classical and quantum, is observed for cavity frequencies significantly below the fundamental transition frequency of the molecule. We show that the suppression in the probability is due to the nonlinearity of the dipole function.

Extracorporeal Membrane Oxygenation to Facilitate Chemotherapy-Moving the Goalposts!

Extracorporeal membrane oxygenation (ECMO) is a lifesaving intervention in critically ill patients with cardiorespiratory failure. ECMO in patients with cancer is generally contraindicated not only to conserve precious resources and properly direct use but also due to a multitude of associated physiological derangements in these subsets of patients. ECMO in patients with disseminated cancer is an automatic rule-out except for anecdotal reports.

Giant ventral hernia following left ventricular assist device bridge to heart transplantation.

Ventral hernias following left ventricular assist device (LVAD) placement are rare. With the improvement in technology, and miniaturization of devices associated with intrapericardial placement, these complications have largely been abolished. The mere presence of a large ventral hernia should not exclude recipients from being candidates for orthotopic heart transplantation.