Objectives: To determine the risk factors of spontaneous pneumothorax (SP) in Kuwait. Subjects and Methods: From January 2002 through December 2003, 254 consecutive cases with a diagnosis of SP were reviewed. Analyses of pneumothorax rates by age, sex, smoking, body mass index (BMI) and climatic conditions were evaluated. Results: Of the 254 patients, 242 (95%) were male and 12 (5%) were female; a larger proportion of 180 (88%) were Kuwaitis and 74 (12%) were expatriates. Two hundred and eight (82%) episodes were regarded as primary SP and 46 (18%) as secondary SP. The mean age was 24.5 ± 5.8 years for primary SP and 45.7 ± 14.5 years for secondary SP. One hundred and ninety-six (77%) individuals were current smokers. BMI in primary and secondary SP was 19.3 and 22.4, respectively (p < 0.001). There was no relationship between SP and climatic conditions (a rise or fall in temperature, humidity or atmospheric pressure). However, a slight increase in SP occurred in July, probably the hottest month in Kuwait. Conclusions: The data indicate that the most important risk factors of SP in Kuwait are smoking, low BMI and the male gender.

The use of ambulatory pleural catheters for managing malignant pleural effusion is a safe and effective strategy. It has only minor complications that are related to prolonged drainage. We feel that this strategy should be considered the first choice option for these patients.

Despite aiming for the same target pump flow, periodic limitations of venous return to the pump resulted in a significant reduction in average flow delivered to the patient by Mini-CPB. Less haemodilution compensated for this reduction, so that the average oxygen delivery was the same. The association between oxygen delivery and postoperative change in plasma creatinine was evident in both groups. Further work to understand whether there is a particular cohort of patients who benefit (or are put at risk) by one method of CPB vs the other is warranted.

Objective: To assess the incidence and to identify the possible associated risk factors for postoperative pulmonary complications after major lung resection. Subjects and Methods:One hundred and sixty-eight consecutive patients undergoing major lung resection for benign and malignant lung disease over a 3-year period were included in the study. Preoperative assessment clinical parameters, intraoperative and postoperative events were recorded. Pulmonary complications were noted according to a precise definition. The risk of complications associated with age, comorbidity, forced vital capacity (FVC), blood transfusion and extended operation was evaluated using logistic regression analysis. Results: The mean age of the patients was 47.1 years (range 16–80 years), 137 (77%) patients underwent lobectomy, 23 (14%) pneumonectomy, and 15 (9%) bilobectomy. Forty-six (27%) patients developed postoperative pulmonary complications and 2 (1.1%) died within 30 days following the operation. Age ≧65 years (OR 3.7, 95% CI: 1.5–8.6, p = 0.002), the presence of comorbid cardiopulmonary disease (OR 0.2, 95% CI: 0.1–0.5, p = 0.001), FVC <50% (OR 0.2, 95% CI: 0.1–0.8, p = 0.02), blood transfusion (OR 0.2, 95% CI: 0.1–0.4, p = 0.0001), and extended operation (OR 0.2, 95% CI: 0.07–0.6, p = 0.005) were the identified factors associated with the development of postoperative pulmonary complications, which necessitated an increased length of hospital stay. Conclusion: Postoperative pulmonary complications are more likely to develop in patients with age ≧65 years with comorbid cardiopulmonary disease, FVC <50%, blood transfusion, and extended operation.

We conclude that high intensity focused ultrasound ablation for atrial fibrillation using the Epicor system is safe and effective for surgical patients with paroxysmal AF. The persistent and LSP AF results suggest that alternative ablation strategies should be considered for these patients.