SARS-CoV-2 During Abdominal Operations: Are Surgeons at Risk?

Background: The safety of surgery in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients remains unclear. On the basis of data from other viral diseases, it has been assumed that coronavirus disease 2019 (COVID-19) has the potential risk of transmission during surgery. The presence of the virus within the peritoneal fluid and the peritoneal tissues is not known.

Chronic giardiasis: a rare cause of exocrine pancreatic insufficiency.

Exocrine pancreatic insufficiency (EPI) is a major cause of maldigestion/malabsorption syndromes. It is routinely diagnosed in clinical practice with the use of faecal elastase 1 levels, and pancreatic enzyme replacement therapy continues to be the mainstay of treatment. Numerous primary pancreatic and extrapancreatic causes for EPI have been established.

Methadone, QTc prolongation and torsades de pointes: Current concepts, management and a hidden twist in the tale?

Methadone is a drug that has found widespread utility in the management of opioid addiction and pain. Along with its popularity, methadone has also earned an infamous reputation for causing prolongation of the QT interval and an increased risk of torsades de pointes. In this article we will give a brief overview of the long QT syndromes, followed by an in-depth look at the current pathophysiologic mechanisms of methadone induced QT prolongation, a review of the existing literature and the current concepts regarding the prevention and management of methadone induced torsades de pointes.

Spontaneous coronary artery dissection causing acute myocardial infarction in a 62-year-old postmenopausal woman without co-morbidities: a case report.

Introduction: Spontaneous coronary artery dissection is an important yet rare cause of acute coronary syndrome. The available literature shows a higher risk factor for women, notably during pregnancy and puerperium. The incidence in postmenopausal women is exceedingly rare, and is more commonly seen in association with concurrent predisposing factors.

Simultaneous very late stent thrombosis in multiple coronary arteries.

We report 2 noteworthy cases of very late stent thrombosis presenting as ST-segment-elevation myocardial infarction, with vastly different manifestations. Both patients were women who had histories of multivessel percutaneous coronary intervention with first-generation sirolimus-eluting stents, in 2005 and 2006. On the more recent occasions reported here, one underwent successful multivessel primary percutaneous coronary intervention, while the other underwent successful multivessel "plain old balloon angioplasty.

Clopidogrel and genetic testing: is it necessary for everyone?

Clopidogrel is a widely used antiplatelet agent to treat and prevent a variety of atherothrombotic diseases. More than a decade after its initial Food and Drug Administration approval, studies have emerged raising concerns regarding its possible reduced efficacy in patients who have impaired conversion of clopidogrel to its active metabolite (ie, poor metabolizers). Research has implicated genetic variations in the CYP2C19 isozyme as at least partly responsible for the variable antiplatelet response seen with clopidogrel.

Linagliptin: the newest dipeptidyl peptidase-4 inhibitor for type 2 diabetes mellitus.

Dipeptidyl peptidase-4 (DPP-4) inhibitors are some of the newest medications in our armamentarium for the management of type 2 diabetes mellitus. Through inhibition of the DPP-4 enzyme, these agents increase the amount of circulating incretin hormones, leading to an increase in insulin release and a suppression of glucagon secretion. Linagliptin is the third DPP-4 inhibitor approved by the Food and Drug Administration in the United States.

Sirolimus-eluting coronary stents: novel devices for the management of coronary artery disease.

Despite major technological advances in the practice of percutaneous coronary intervention, restenosis of the treated arteries remains a challenge for many interventional cardiologists. Sirolimus is a macrolide antibiotic with potent antifungal, immunosuppressive, and antimitotic activities. Sirolimus inhibits in-stent restenosis via 2 major mechanisms of action: by blocking the process of neointimal hyperplasia by inhibiting smooth muscle cell proliferation and by inhibiting inflammatory cell activity.

Significance of inducible nitric oxide synthase in acute myocarditis caused by Trypanosoma cruzi (Tulahuen strain).

Chagas' disease, caused by Trypanosoma cruzi, is associated with myocarditis and expression of myocardial cytokines and inducible nitric oxide synthase (NOS2). To assess the functional significance of NOS2 in murine Chagas' disease, we infected NOS2 knockout (NOS2(-/-)) and C57BL/6x129sv (wild type) mice with the Tulahuen strain of T. cruzi.

Post cardiopulmonary bypass bleeding: an introductory review.

Cardiac surgery requiring cardiopulmonary bypass (CPB) has increased in both number and safety over the past four decades. Postoperative bleeding continues to be a major cause of perioperative morbidity. The reported incidence varies from 4-32%.

Anomalous inferior vena cava associated with horseshoe kidneys.

Two cases are presented in which anomalies of the inferior vena cava were associated with horseshoe kidneys. Radiological demonstration of such combined variation is rare, only one case of duplicated inferior vena cava with horseshoe kidney having been found in the literature. The embryological basis for these anomalies is reviewed.

Amniorrhexis lowers the incidence of positive cultures for group B streptococci.

Objective: Our purpose was to determine the effect of amniorrhexis on cultures for group B streptococci.

Study Design: Intrapartum vaginal cultures for group B streptococci were obtained before and after rupture of membranes in 166 women; in addition, rectal cultures were obtained from the last 35 patients.

Results: Before rupture of membranes 49 of 166 (30%) of the vaginal cultures were positive for group B streptococci; only 28 of 166 (17%) remained positive after rupture of membranes (p = 0.

Mechanism of antihypertensive action of dilevalol compared with that of "cardioselective" beta-blocking agents.

The hemodynamic effects of dilevalol, a nonselective beta-adrenergic blocking agent with vasodilating properties, were evaluated in 34 hypertensive patients and compared with those of the "cardioselective" beta blockers atenolol and metoprolol in 21 patients. Hemodynamic measurements were obtained at baseline, after acute treatment (first dose) with dilevalol (400 mg) and atenolol (50 mg) or metoprolol (100 mg), and again after subchronic treatment with these agents. After both acute and subchronic treatment (mean daily dose 1,042 mg), dilevalol significantly reduced mean arterial pressure (MAP, p less than 0.