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Bronchiolitis obliterans syndrome (BOS) is the main and late chronic complication after lung transplantation. It remains a major impediment to long-term outcome. Unfortunately, the survival rate of lung transplant recipients lags behind that of other organ transplant recipients, and BOS accounts for more than 30% of all mortality after the third year following lung transplantation. Most recent studies suggest that immune injury is the main pathogenic event in small airway obliteration and the development of BOS. Early detection of BOS is possible as well as essential because prompt initiation of treatment may halt the progress of the disease and the development of chronic graft failure. Current treatment of BOS is disappointing despite advances in surgical techniques and improvements in immunosuppressive therapies. Therefore, a clear understanding of the pathogenesis of BOS plays a major role in the search for new and effective therapeutic strategies for better long-term survival and quality of life after lung transplantation.

Introduction: Acute kidney injury (AKI) is a term used to describe when the kidney loses its function rapidly. And it’s associated with an increase in the level of serum creatinine by 0.5 to 1mg/dL. It can be diagnosed by a plethora of criteria such as the Kidney Disease Improving Global Outcomes (KDIGO) and the Risk, Injury, Failure, Loss, End-stage (RIFLE) criteria. Cardiac surgery-associated AKI (CSA-AKI) is the most prevalent complication in patients following cardiac surgery and is also linked to increased mortality and morbidity rates. In addition, exogenous and endogenous toxins, ischemia and reperfusion, inflammation, oxidative stress, metabolic factors, and neurohormonal activation may all play a role in the development of CSA-AKI. All these factors may be active at varying time intervals and with different degrees of intensity, or may function simultaneously. Methods: In late 2019, a retrospective study was conducted by reviewing the health data of patients who underwent coronary artery bypass graft (CABG), valvular repairs, and other open cardiac surgeries at the King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, between November 2014 and June 2019. Information was obtained from the Hospital information system, Jeddah, Saudi Arabia. Of the 159 patients who underwent open-heart surgery at KAUH, 126 (79.2%) were male and 33 (20.8%) were female. Patients below 15 years of age and those with poor renal function prior to open cardiac surgery were excluded. The KDIGO criteria were used to diagnose AKI for our patients. Results: In this study, 34% of the patients experienced AKI after open cardiac surgery, and the most frequent risk factor encountered was diabetes mellitus (DM), which was present in 97 (61%) patients, followed by angina pectoris in 93 (58.5%) patients. Hypertension was identified in 85 (53.5%) and acute myocardial infarction in 82 (51.6%) patients. There were only two (1.3%) patients with known cases of chronic obstructive lung disease (COPD). Of the surgeries, 131 (82.4%) were classified as elective and 28 (17.6%) were urgent. Conclusion: The most common risk factor associated with AKI following open-heart surgery is DM, followed by angina pectoris. However, further studies are required to investigate all the cardiac procedures.

BACKGROUNDPectus carinatum is a congenital chest wall deformity characterized by protrusion of the sternum and adjacent costal cartilages. Multiple treatment options are available for correction of pectus carinatum.OBJECTIVEWe report our initial experience with first-line treatment using a custom fitted dynamic compression orthosis.DESIGNProspective evaluation of all patients seen between November 2013 and December 2014.SETTINGUniversity hospital.PATIENTS AND METHODSThe treatment protocol for patients who had pressure for initial correction ≤7.5 psi included a custom-fitted and adjusted dynamic compression orthosis and frequent clinic visits. Patient satisfaction was assessed after 12 months.MAIN OUTCOME MEASURESPatient satisfaction score.RESULTSEighteen patients (17 male and 1 female) (age: mean, 15.5 y; range, 10–23 y) completed treatment or continued in the study. Mean pressure for initial correction was 4.5 psi (range, 2.2–7.3 psi), bracing time was 12.8 hours/day (range, 8–24 h/d), and satisfaction score was 3 (scale: no correction, 0; complete correction, 4). There was complete correction in 7 patients (39%), remarkable improvement in 5 patients (28%), minimal improvement in 3 patients (17%), and no correction in 3 patients (17%). There were no major complications.CONCLUSIONTreatment with dynamic compression orthosis for chondrogladiolar pectus carinatum provided favorable outcomes in compliant patients. We recommend this as first-line treatment for this condition.LIMITATIONSNo objective findings. Satisfaction scores are subjective. We recommend chest CT for follow up and use of a radiological tool for comparison.

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The addition of nitroglycerin to cardioplegia did not show any benefit, either quantitatively or qualitatively, for optimizing coronary artery bypass grafting targets.

Introduction: Lung transplant is the preferred treatment for several end-stage pulmonary diseases. The first successful human lung transplant was performed by the Toronto Group in 1983 [1]. Objectives: This article discusses our initial experience with single and double lung transplant. Study Design: A retrospective analysis was done on 11 consecutive lung transplants for end-stage pulmonary diseases performed at our institution between 2008 and 2010. Materials and Methods: Major indications were idiopathic pulmonary fibrosis (n = 6), bronchiectasis (n = 2), primary pulmonary hypertension (n = 1), lymphangioleiomyomatosis (n = 1), and scleroderma (n = 1). Results: Two patients (18.2%) died within 30 days of surgery. One- and 2-year survival rates for the recipients were 81.8% and 72.7%. Sepsis caused the deaths of 2 recipients. Conclusions: Although sepsis and chronic rejection limit the benefits, lung transplant gives many patients with end-stage pulmonary disease the ability for a better quality of life

The use of MUF after CPB can produce an immediate improvement in lung compliance and gas exchange capacity, which may effectively minimize pulmonary dysfunction postbiventricular repair of congenital heart disease. However, these improvements are not sustained for the first 6 h postoperatively and do not reduce the duration of postoperative intubation, ICU stay, or total hospital stay.