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Article ; Online: An unexpected case of thoracic necrotising fasciitis.

Alzetani, Sarah / Harden, Stephen / Alzetani, Aiman

BMJ case reports

2024 Volume 17, Issue 1

Abstract: Necrotising fasciitis (NF) is a life-threatening bacterial infection characterised by rapid tissue destruction, which can have severe consequences if not recognised early and treated promptly. It is most commonly caused by group A streptococcus entering ... ...

Abstract	Necrotising fasciitis (NF) is a life-threatening bacterial infection characterised by rapid tissue destruction, which can have severe consequences if not recognised early and treated promptly. It is most commonly caused by group A streptococcus entering the body through breaks in the skin. This case report describes a patient who presented with systemic signs of infection, including right axillary pain, following a recent intramuscular injection. Clinical examination and radiological findings were consistent with NF, and surgical exploration confirmed the diagnosis of thoracic NF. The patient underwent extensive surgical debridement, intensive care management and subsequent reconstructive surgery. This report highlights the importance of early recognition of NF and that this condition is not limited to the limbs but may also affect the torso. It employs consideration of all portals of potential bacterial entry that may prompt a differential of NF through thorough history taking. This case encourages healthcare professionals to maintain awareness of skin infections as a potential though rare complication of procedures such as injections hence the continued value of aseptic techniques to minimise risk. Finally, it emphasises that prompt diagnosis, appropriate antibiotic therapy and immediate surgical intervention remain crucial in managing NF and improving patient outcomes.
MeSH term(s)	Humans ; Fasciitis, Necrotizing/diagnosis ; Fasciitis, Necrotizing/surgery ; Debridement/methods ; Streptococcus pyogenes ; Plastic Surgery Procedures ; Extremities/surgery ; Anti-Bacterial Agents/therapeutic use
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2024-01-31
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2023-257946
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Three Dimensional Modelling in the Optimisation of Chest Wall Resection and Reconstruction Following Metastatic Breast Cancer.

Ahmed, Hanad / Khan, Mansoor / Alzetani, Aiman

European journal of breast health

2022 Volume 18, Issue 3, Page(s) 286–288

Abstract: Two-dimensional computed tomography scans no longer offer the level of detail that many surgeons desire for more accurate and precise surgical intervention. Computed tomography image reconstruction into three dimensional (3D) virtual models with ... ...

Abstract	Two-dimensional computed tomography scans no longer offer the level of detail that many surgeons desire for more accurate and precise surgical intervention. Computed tomography image reconstruction into three dimensional (3D) virtual models with interactive capability is providing an enhanced understanding of the patient's anatomy and pathology allowing the surgeon to create tailored intraoperative plans, minimizing complications and maximizing the intended therapeutic outcome. In this case report we demonstrate the use of 3D image reconstruction software in the management of a 36-year-old female with metastatic breast cancer affecting the chest wall.
Language	English
Publishing date	2022-07-01
Publishing country	Turkey
Document type	Case Reports
ISSN	2587-0831
ISSN	2587-0831
DOI	10.4274/ejbh.galenos.2022.2022-3-6
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Article: Chest Wall Silicone Granuloma Following Ruptured Silicone Breast Implant Causes Giant Chest Wall Abscess and Osteomyelitis: The First Report.

Ahmed, Hanad / Tamburrini, Alessandro / Khan, Mansoor / Alzetani, Aiman

European journal of breast health

2021 Volume 17, Issue 4, Page(s) 383–385

Abstract: Silicone breast implant ruptures have been widely reported in the literature. Granuloma formation is a known complication of such ruptures with reported sites including the axillae, limbs, chest wall muscles, and internal organs, such as the lungs and ... ...

Abstract	Silicone breast implant ruptures have been widely reported in the literature. Granuloma formation is a known complication of such ruptures with reported sites including the axillae, limbs, chest wall muscles, and internal organs, such as the lungs and the liver. To the best of our knowledge, there are no reported cases of a silicone granuloma causing osteomyelitis of the sternum and multiple ribs in the absence of infection. We therefore report on the case of an 81-year-old patient who presented with an anterior chest wall discharging sinus tract on the background of a ruptured silicone breast implant. We raise awareness about the potentially devastating complications resulting from a ruptured silicone implant with relevance to cardiothoracic practice.
Language	English
Publishing date	2021-10-04
Publishing country	Turkey
Document type	Case Reports
ISSN	2587-0831
ISSN	2587-0831
DOI	10.4274/ejbh.galenos.2020.5971
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Article ; Online: Antibiotic-loaded Bone Cement in the Management of Neosternal Osteomyelitis.

Ahmed, Hanad / Badran, Abdul / Tilley, Simon / Alzetani, Aiman

The Annals of thoracic surgery

2021 Volume 114, Issue 3, Page(s) e209–e211

Abstract: Antibiotic-loaded bone cement is an alternative treatment option that can be used in the surgical management of osteomyelitis requiring bone resection and reconstruction. Current literature provides a focus on its use within the orthopedic patient group ... ...

Abstract	Antibiotic-loaded bone cement is an alternative treatment option that can be used in the surgical management of osteomyelitis requiring bone resection and reconstruction. Current literature provides a focus on its use within the orthopedic patient group with scarce literature surrounding the cardiothoracic patient demographic. We hereby demonstrate the use of an antibiotic-loaded bone cement in the definitive management of neosternal osteomyelitis and nonunion, avoiding the need for further complex autografting and internal fixation.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Bone Cements ; Fracture Fixation, Internal ; Humans ; Osteomyelitis/drug therapy ; Osteomyelitis/surgery
Chemical Substances	Anti-Bacterial Agents ; Bone Cements
Language	English
Publishing date	2021-12-24
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2021.11.050
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Zs.A 252: Show issues

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Jg. 1995 - 2021: Lesesall (1.OG)
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Article ; Online: Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry.

Buttery, S C / Lewis, A / Alzetani, A / Bolton, C E / Curtis, K J / Dodd, J W / Habib, A M / Hussain, A / Havelock, T / Jordan, S / Kallis, C / Kemp, S V / Kirk, A / Lawson, R A / Mahadeva, R / Munavvar, M / Naidu, B / Rathinam, S / Shackcloth, M /

Shah, P L / Tenconi, S / Hopkinson, N S

BMJ open respiratory research

2024 Volume 11, Issue 1

Abstract: Introduction: Lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement can produce substantial benefits in appropriately selected people with emphysema. The UK Lung Volume Reduction (UKLVR) registry is a national multicentre ... ...

Abstract	Introduction: Lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement can produce substantial benefits in appropriately selected people with emphysema. The UK Lung Volume Reduction (UKLVR) registry is a national multicentre observational study set up to support quality standards and assess outcomes from LVR procedures at specialist centres across the UK. Methods: Data were analysed for all patients undergoing an LVR procedure (LVRS/EBV) who were recruited into the study at participating centres between January 2017 and June 2022, including; disease severity and risk assessment, compliance with guidelines for selection, procedural complications and survival to February 2023. Results: Data on 541 patients from 14 participating centres were analysed. Baseline disease severity was similar in patients who had surgery n=244 (44.9%), or EBV placement n=219 (40.9%), for example, forced expiratory volume in 1 s (FEV
MeSH term(s)	Humans ; Male ; Emphysema ; Lung/surgery ; Pneumonectomy/adverse effects ; Pneumonectomy/methods ; Pulmonary Emphysema/surgery ; Registries ; United Kingdom ; Female
Language	English
Publishing date	2024-02-29
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2736454-9
ISSN	2052-4439 ; 2052-4439
ISSN (online)	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2023-002092
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Article ; Online: LKB1 depletion-mediated epithelial-mesenchymal transition induces fibroblast activation in lung fibrosis.

Xu, Zijian / Davies, Elizabeth R / Yao, Liudi / Zhou, Yilu / Li, Juanjuan / Alzetani, Aiman / Marshall, Ben G / Hancock, David / Wallis, Tim / Downward, Julian / Ewing, Rob M / Davies, Donna E / Jones, Mark G / Wang, Yihua

Genes & diseases

2024 Volume 11, Issue 3, Page(s) 101065

Abstract: The factors that determine fibrosis progression or normal tissue repair are largely unknown. We previously demonstrated that autophagy inhibition-mediated epithelial-mesenchymal transition (EMT) in human alveolar epithelial type II (ATII) cells augments ... ...

Abstract	The factors that determine fibrosis progression or normal tissue repair are largely unknown. We previously demonstrated that autophagy inhibition-mediated epithelial-mesenchymal transition (EMT) in human alveolar epithelial type II (ATII) cells augments local myofibroblast differentiation in pulmonary fibrosis by paracrine signalling. Here, we report that liver kinase B1 (LKB1) inactivation in ATII cells inhibits autophagy and induces EMT as a consequence. In IPF lungs, this is caused by downregulation of
Language	English
Publishing date	2024-01-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2821806-1
ISSN	2352-3042 ; 2352-3042
ISSN (online)	2352-3042
ISSN	2352-3042
DOI	10.1016/j.gendis.2023.06.034
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Article: Tracheal leiomyoma mimicking asthma for over 20 years.

Harrison, Oliver J / Jackson, Mark / Shaw, Emily / Alzetani, Aiman

Journal of surgical case reports

2020 Volume 2020, Issue 9, Page(s) rjaa323

Abstract: Benign tracheal tumours have an incidence of 1 in 1,000,000, of which leiomyomas represent only 1%. We report a case of tracheal leiomyoma masquerading as asthma for over 20 years. A 48-year-old man presented aged 26 years with asthma symptoms ... ...

Abstract	Benign tracheal tumours have an incidence of 1 in 1,000,000, of which leiomyomas represent only 1%. We report a case of tracheal leiomyoma masquerading as asthma for over 20 years. A 48-year-old man presented aged 26 years with asthma symptoms unresponsive to treatments and an obstructive spirometry pattern. Symptoms were not particularly troubling but suddenly exacerbated 22 years later. Flow-volume studies were consistent with upper airway obstruction. Computed tomography chest revealed a 2.3 cm mass arising from the posterior aspect of the trachea 2 cm above the carina. Bronchoscopic resection was performed using a Nd:YAG laser. Histology confirmed leiomyoma. Follow-up after 6 weeks revealed complete resolution of symptoms with normal spirometry. Tracheal masses should be considered in any patient with atypical asthma. A flow-volume loop may provide a clue to diagnosis and bronchoscopic laser resection is a minimally invasive treatment option.
Language	English
Publishing date	2020-09-23
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjaa323
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Article ; Online: Image-guided combined ablation and resection in thoracic surgery for the treatment of multiple pulmonary metastases: A preliminary case series.

Harrison, Oliver J / Sarvananthan, Sajiram / Tamburrini, Alessandro / Peebles, Charles / Alzetani, Aiman

JTCVS techniques

2021 Volume 9, Page(s) 156–162

Abstract: Objectives: To demonstrate the feasibility and preliminary outcomes of a novel hybrid technique combining percutaneous microwave ablation and wire-assisted wedge resection for patients with multiple pulmonary metastases using intraoperative imaging.: ... ...

Abstract	Objectives: To demonstrate the feasibility and preliminary outcomes of a novel hybrid technique combining percutaneous microwave ablation and wire-assisted wedge resection for patients with multiple pulmonary metastases using intraoperative imaging. Methods: We describe our technique and present a retrospective case series of 4 patients undergoing iCART at our institution between August 2018 and January 2020. Procedures were performed in a hybrid operating suite using the ARTIS Pheno cone beam computerized tomography scanner (Siemens Healthineers, Erlangen, German). Patient information included past history of malignancy as well as lesion size, depth, location, and histology result. Surgical complications and length of stay were also recorded. Results: Five procedures were performed on 4 patients during the study period. One patient underwent bilateral procedures 4 weeks apart. All patients underwent at least 1 ablation and 1 wedge resection during the combined procedure. Patient ages ranged from 40 to 66 years and the majority (75%) were men. All had a past history of cancer. Lesions were treated in every lobe. Size and depth ranged from 6 to 24 mm and 21 to 33 mm, respectively, for ablated nodules and 5 to 27 mm and 0 to 22 mm, respectively, for the wedge resected nodules. Three procedures were completed uniportal and operative time ranged from 51 to 210 minutes. All cases sustained <10 mL blood loss. There were 2 intraoperative pneumothorax, 1 prevented successful completion of the ablation. One patient required a prolonged period of postoperative physiotherapy and was discharged on day 6. The other patients were discharged on postoperative day 2 or 3. All 5 histology specimens confirmed metastatic disease. Conclusions: Our hybrid approach provides a minimally invasive and comprehensive personalized therapy for patients with multiple pulmonary metastases under a single general anesthetic. It provides histology-based diagnosis whilst minimizing lung tissue loss and eliminating the need for transfer from radiology to operating theatre. Emergence of ablation as a treatment for stage 1 non-small cell lung cancer and the expansion of lung cancer screening may widen the application of iCART in the future.
Language	English
Publishing date	2021-03-13
Publishing country	United States
Document type	Journal Article
ISSN	2666-2507
ISSN (online)	2666-2507
DOI	10.1016/j.xjtc.2021.03.013
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Article ; Online: Endobronchial Valves in the Management of Persistent Air Leak in Coronavirus Disease 2019.

Ahmed, Hanad / Badran, Abdul / Tamburrini, Alessandro / Kattach, Hassan / Veres, Lukacs / Alzetani, Aiman

The Annals of thoracic surgery

2021 Volume 113, Issue 1, Page(s) e1–e3

Abstract: Pneumothorax and persistent air leak are documented complications of severe acute respiratory syndrome coronavirus 2 infection. Patients who fall into this category are often poor candidates for invasive thoracic surgical intervention. Endobronchial ... ...

Abstract	Pneumothorax and persistent air leak are documented complications of severe acute respiratory syndrome coronavirus 2 infection. Patients who fall into this category are often poor candidates for invasive thoracic surgical intervention. Endobronchial valves offer an effective and less invasive treatment option and can successfully treat persistent air leak and support the weaning of patients with severe acute respiratory syndrome coronavirus 2 pneumonia off ventilation.
MeSH term(s)	COVID-19/complications ; Humans ; Male ; Middle Aged ; Pneumothorax/etiology ; Pneumothorax/surgery ; Prostheses and Implants
Language	English
Publishing date	2021-09-04
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2021.08.011
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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Ambulatory chest drainage with advanced nurse practitioner-led follow-up facilitates early discharge after thoracic surgery.

Harrison, Oliver J / Vilar Alvarez, Maria Elena / Snow, Victoria / Tamburrini, Alessandro / Woo, Edwin / Veres, Lukacs / Chamberlain, Martin H / Alzetani, Aiman

General thoracic and cardiovascular surgery

2022 Volume 71, Issue 3, Page(s) 182–188

Abstract: Objectives: To demonstrate the safety and feasibility of advanced nurse practitioner-led (ANP-led) outpatient follow-up after discharge with ambulatory chest drains for prolonged air leak and excessive fluid drainage.: Methods: Patients discharged ... ...

Abstract	Objectives: To demonstrate the safety and feasibility of advanced nurse practitioner-led (ANP-led) outpatient follow-up after discharge with ambulatory chest drains for prolonged air leak and excessive fluid drainage. Methods: Patients discharged with ambulatory chest drains between January 2017 and December 2019 were retrospectively reviewed. Discharge criteria included air leak < 200 ml/min or fluid drainage > 100 ml/24 h on a digital drain. Patients were reviewed weekly in the clinic by ANPs, a highly skilled cohort of nurses with physician support available. Outcomes included length of stay, duration of air or fluid leak and complications. Results: Two-hundred patients were included, amounting to 368 clinic episodes. The median age was 68 ± 13 years and 119 (60%) were male. 112 (56%) patients underwent anatomical lung resection (total anatomical lung resections during the study period = 917) equating to a discharge with ambulatory chest drain rate of 12.2% in this group. The median length of stay was 6 ± 3 days and 176 (88%) patients were discharged with air leak versus 24 (12%) with excessive fluid drainage. The median time to drain removal was 12 ± 11 days. Complications occurred in 16 patients (8%) and 12 (6%) required readmission. An estimated 2075 inpatient days were saved over the study period equating to an annual cost saving of £123,167 (US$149,032) per annum. Conclusions: Patients with air leak or excessive fluid drainage can safely be discharged with ambulatory chest drains, allowing them to return to their familiar home environment safely and quickly. ANP-led clinics are a robust and cost-effective follow-up strategy and are associated with a low complication rate.
MeSH term(s)	Humans ; Male ; Middle Aged ; Aged ; Aged, 80 and over ; Female ; Patient Discharge ; Pneumonectomy/adverse effects ; Follow-Up Studies ; Thoracic Surgery ; Retrospective Studies ; Drainage/adverse effects ; Chest Tubes ; Length of Stay
Language	English
Publishing date	2022-10-10
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2376888-5
ISSN	1863-6713 ; 1863-6705
ISSN (online)	1863-6713
ISSN	1863-6705
DOI	10.1007/s11748-022-01873-9
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