Clinical, virological, imaging and pathological findings in a SARS CoV-2antibody positive cat

This paper reports a presumptive severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection in a cat. A cat with respiratory disease living with three individuals with coronavirus disease 2019 showed bilateral ground-glass opacities in the lung on X-ray and computed tomography. The clinical swabs were negative for SARS-CoV-2 RNA, but the serum was positive for SARS-CoV-2 antibodies. Interstitial pneumonia and prominent type 2 pneumocyte hyperplasia were noted on histopathology. Respiratory tissues were negative for SARS-CoV-2 RNA or antigen, but the cat was positive for feline parvovirus DNA. In conclusion, the respiratory disease and associated pathology in this cat could have been due to exposure to SARS-CoV-2.

The effect of single incision laparoscopic cholecystectomy on systemic oxidative stress: a prospective clinical trial

PURPOSE: Single incision laparoscopic cholecystectomy (SILC) has become a more frequently performed method for benign gallbladder diseases all over the world. The effects of SILC technique on oxidative stress have not been well documented. The aim of this study was to evaluate the effect of laparoscopic cholecystectomy techniques on systemic oxidative stress by using ischemia modified albumin (IMA). METHODS: In total, 70 patients who had been diagnosed with benign gallbladder pathology were enrolled for this prospective study. Twenty-one patients underwent SILC and 49 patients underwent laparoscopic cholecystectomy (LC). All operations were performed under a standard anesthesia protocol. Serum IMA levels were analysed before operation, 45 minutes and 24 hours after operation. RESULTS: Demographics and preoperative characteristics of the patients were similiar in each group. The mean duration of operation was 37.5 ± 12.5 and 44.6 ± 14.3 minutes in LC and SILC group, respectively. In both groups, there was no statistically significant difference in hospital stay, operative time, or conversion to open surgery. Operative technique did not effect the 45th minute and 24th hour IMA levels. However, prolonged operative time (>30 minutes) caused an early increase in the level of IMA. Twenty-fourth hour IMA levels were not different. CONCLUSION: SILC is an effective and safe surgical prosedure for benign gallbladder diseases. Independent of the surgical technique for cholecystectomy, the prolonged operative time could increase the tissue ischemia.

effectiveness of trendelenburg positioning on the cross-sectional area of the right internal jugular vein in obese patients

Trendelenburg positioning is a common approach used during internal jugular vein [IJV] cannulation. No evidence indicates that Trendelenburg positioning significantly increases the crosssectional area [CSA] of the IJV in obese patients. The primary aim of this study was to determine the effectiveness of Trendelenburg positioning on the CSA of the right internal jugular vein assessed with ultrasound measurement in obese patients. Forty American Society of Anesthesiologists II patients with body mass index >/= 30 kg/m[2] undergoing various elective surgeries under general endotracheal anesthesia were enrolled. Ultrasound images of the right IJV were obtained in a transverse orientation at the cricoid level. We measured the CSA of the right IJV two different conditions in a sealed envelope were applied in random order: State 0, table flat [no tilt], with the patients in the supine position, and State T, in which the operating table was tilted 20[degree] to the Trendelenburg position. The change in the CSA of the IJV from the supine to the Trendelenburg position [1.80 cm[2] vs 2.08cm[2]] was not significantly different. The CSA was paradoxically decreased in 10 of 36 patients when the position changed from State 0 to State T. Trendelenburg positioning does not significantly increase the mean CSA of the right IJV in obese patients. In fact, in some patients, this position decreases the CSA. The use of the Trendelenburg position for IJV cannulation in obese patients can no longer be supported

Effect of laparoscopic cholecystectomy techniques on postoperative pain: a prospective randomized study / 대한외과학회지

PURPOSE: Minimally invasive surgical technics have benefits such as decreased pain, reduced surgical trauma, and increased potential to perform as day case surgery, and cost benefit. The primary aim of this prospective, randomized, controlled study was to compare the effects of single incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC) procedures regarding postoperative pain. METHODS: Ninety adult patients undergoing elective laparoscopic cholecystectomy were included in the study. Patients were randomized to either SILC or CLC. Patient characteristics, postoperative abdominal and shoulder pain scores, rescue analgesic use, and intraoperative and early postoperative complications were recorded. RESULTS: A total of 83 patients completed the study. Patient characteristics, postoperative abdominal and shoulder pain scores and rescue analgesic requirement were similar between each group except with the lower abdominal pain score in CLC group at 30th minute (P = 0.04). Wound infection was seen in 1 patient in each group. Nausea occurred in 13 of 43 patients (30%) in the SILC group and 8 of 40 patients (20%) in the CLC group (P > 0.05). Despite ondansetron treatment, 6 patients in SILC group and 7 patients in CLC group vomited (P > 0.05). CONCLUSION: In conclusion, in patients undergoing laparoscopic surgery, SILC or CLC techniques does not influence the postoperative pain and analgesic medication requirements. Our results also suggest that all laparoscopy patients suffer moderate and/or severe abdominal pain and nearly half of these patients also suffer from some form of shoulder pain.

Specimen index may be a predictive factor for recurrence after primary closure of pilonidal disease / 대한외과학회지

PURPOSE: The aim of the present study was to evaluate the predictive value of volume of the specimen/body mass index (VS/BMI) ratio for recurrence after surgical therapy of pilonidal disease. METHODS: Ninety-eight patients with primary pilonidal disease were enrolled in this study. The VS/BMI ratio was calculated for each patient. This ratio was defined as the specimen index (SI). VS, BMI and SI were evaluated to determine whether there is a relationship between these parameters and recurrence of pilonidal disease. In addition, the predictive ability of SI for recurrence was analyzed by receiver operating characteristic (ROC) curve. RESULTS: VS and SI were found to be higher in patients with recurrence. ROC curve analysis showed that VS and SI are predictive factors for recurrence in patients treated with primary closure, nevertheless our new index had higher sensitivity and specificity than VS (sensitivity 85.7% vs 71.4% and specificity 90.7% vs 85.1%, respectively). The cut-off level for the greatest sensitivity and specificity for SI was 1.29. CONCLUSION: Recurrence is higher in patients with high VS regardless of the operation method. SI may be a predictive value in patients treated with primary closure.