Video 1 Uniportal robotic-assisted thoracic surgery lung-sparing carinal sleeve resection and reconstruction. Authors: Diego Gonzalez-Rivas, Rawand A. Essa, Natalia Motas, Akif Turna, Mugurel L. Bosinceanu, Veronica Manolache

More than 100 years ago, the difference in blood pressure (BP) between arms was first reported. Recent studies have shown that different blood pressure between the right and left arm leads to cardiovascular events. Three thousand and thirty volunteers participated in our cross-sectional study. The sIABP was equal in 163 of 3030 persons (5.37%), dIABP was equal in 222 out of 3030 persons (7.32%), from a total of 792/3030 persons (26.1%) sIAD >10 mmHg, and dIAD > or = 10 mmHg was found in 927 out of 3030 persons (33.5%) in the right arm, and 32.4% in the left arm. In 2692 of 3030 volunteers BP, initially recorded in the dominant hand (right arm), showing sIAD > or = 10 mmHg was found in 943 (37.1%) volunteers, and when the first measurement was done in 338 left-handed volunteers it showed sIAD > or = 10 mmHg in 112 of 338 (34.1%), P < .001; 95% confidence interval for systolic right hand were (115.73: 116.73), and for systolic left hand 95% confidence interval were (113.17:114.15). Furthermore, height, residential area, and heart rate above 90 bpm had a significant effect on IAD (P = . 041, 0.002, <001, respectively). In conclusion, significant inter-arm systolic and diastolic BP differences above (10 mm Hg) is common in the young, healthy population. Hand dominance is a significant consideration while measuring blood pressure. It is mandatory to measure blood pressure in both arms in a sitting position with a stable condition.

Arterial thrombosis is rarely reported in relation to COVID-19 patients. It occurs mostly in critical patients especially those with acute respiratory distress syndrome and patients in intensive care units. The cause of arterial thrombosis is mostly related to a cytokine storm. However, limited studies are available regarding arterial thrombosis in COVID-19 disease. Here, we present a case of lower limb ischemia in a moderately symptomatic COVID-19 patient in Iraq within three days after recovery from COVID-19. The patient presented with severe right lower limb pain, forefoot, cyanosed toes, and lower limb ischemia was diagnosed by physical examination and ultrasound. The patient was successfully treated by anticoagulant drugs. Our case alerts healthcare workers that they need to be more cautious of life threatening COVID-19 complications in order to begin early and effective preventive measures.

Background and aims Concerns have been raised recently about takotsubo cardiomyopathy after receiving COVID-19 vaccines, particularly the messenger RNA (mRNA) vaccines. The goal of this study was to compile case reports in order to provide a comprehensive overview of takotsubo cardiomyopathy associated with COVID-19 vaccines. Methods From inception until March 10, 2022, a systematic literature search was conducted in PubMed and Google Scholar. The study included individuals who developed cardiac takotsubo cardiomyopathy as a result of receiving COVID-19 vaccinations, regardless of the type of vaccine or dose. Results Eight studies, including 8 cases, participated in the current systematic review. The median age was 61.6 years; 87.5% were female, while 12.5% were male. 75% of the patients received the mRNA COVID-19 vaccines, while 25% received other types. In addition, takotsubo cardiomyopathy occurred in 62.5% of patients after receiving the first dose and another 25% after the second dose of COVID-19 vaccines. Moreover, the mean number of days to the onset of symptoms was 2.62 days. All cases had an elevated troponin test and abnormal ECG findings. The left ventricular ejection fraction (LVEF) was above 50% among all cases. In terms of the average length of stay in the hospital, 62.5% stayed for 10.2 days, and all cases recovered from their symptoms. Conclusion Takotsubo (stress) cardiomyopathy complications that are associated with COVID-19 vaccination are rare, they can be life-threatening. Chest pain should be considered an alarming symptom, especially in those who had received a second dose of the vaccine in the last 3 days. For diagnosis, CK-MB and troponin are better biomarkers to confirm myocarditis than CRP, ESR, and NT-proBNP. All of cases completely recovered.

Introduction and importance: Mucoepidermoid carcinoma (MEC) is an extremely rare type of lung cancer, accounting for approximately 0.2–0.4 % of all lung cancers. It typically presents as a central airway lesion, with symptoms such as cough, hemoptysis, bronchitis, wheezing, fever, chest pain, and clubbing of the fingers. Histologically similar to tumors in major salivary glands, it mostly arises from small salivary glands that line the tracheobronchial tree. Case presentation: We have reported a rare case of intrabronchial mucoepidermoid carcinoma that extended extra-bronchially in a 25-year-old female presenting with hemoptysis for 10 days associated with mild cough and wheezing. A computerized tomography (CT) scan revealed a 3.5 cm lesion in the right upper bronchus, and fiber optic bronchoscopy confirmed an intrabronchial lesion. We performed right sleeve lobectomy via a novel Uniportal video-assisted thoracoscopic surgery (U-VATS) approach. Discussion: Since Mucoepidermoid carcinoma (MEC) frequently manifests with vague symptoms, diagnosing it when it spreads from extra-bronchial intrabronchial can be difficult and uncommon. The typical histology of Mucoepidermoid carcinoma (MEC) composed of varying 3 cell types, but the histology of our case was single cell type and it was diagnosed by genetic analysis in another advanced hospital. The effectiveness and safety of Uniportal video-assisted thoracoscopic surgery (UVATS) have been acknowledged globally. Shorter surgical times, less pain, and a decreased requirement for extensive chest tube drainage are all linked to this technique. Conclusion: This case illustrates how a young woman's intrabronchial mucoepidermoid carcinoma was successfully treated with a sleeve lobectomy performed via Uniportal video-assisted thoracoscopic surgery (VATS). Highlights: