Human subcutaneous dirofilariasis caused by Dirofilaria immitis in a Greek adult

Human dirofilariasis is a zoonotic infection caused by worms of the genus Dirofilaria. Most reported cases involve Dirofilaria repens, and D. immitis infection has been rarely reported. Canines act as a reservoir for the infection, while human infections are sporadic. Human dirofilariasis has been widely reported in South Europe; however, the worldwide distribution constantly changes. We herein report an extremely rare case of subcutaneous trunk dirofilariasis in a 45-year-old immunosuppressed woman, caused by D. immitis. The parasitic infection was detected using ultrasonography. The infection was confirmed by a polymerase chain reaction-based method and was attributed to D. immitis

Granisetron versus tropisetron in the prevention of postoperative nausea and vomiting after total thyroidectomy

Postoperative nausea and vomiting [PONV] are frequently encountered after thyroidectomy. For PONV prevention, selective serotonin 5-hydroxytryptamine type 3 [5-HT [3]] receptor antagonists are considered one of the first-line therapy. We report on the efficiency of granisetron and tropisetron, with that of placebo on the prevention of PONV in patients undergoing total thyroidectomy. One hundred twenty-seven patients were divided into three groups and randomized to receive intravenously, prior to induction of anesthesia, tropisetron 5 mg, or granisetron 3 mg, or normal saline. All patients received additionally 0.625 mg droperidol. All episodes of postoperative PONV during the first 24 h after surgery were evaluated. Nausea visual analogue scale [VAS] score was lower in tropisetron and granisetron groups than the control group at all measurements [P<0.01] except for the 8-h measurement for tropisetron [P=0.075]. Moreover, granisetron performed better than tropisetron [P<0.011 at 4 h and P<0.01 at all other points of time] apart from the 2-h measurement. Vomiting occurred in 22.2%, 27.5%, and 37.5% in granisetron, tropisetron, and control groups, respectively [P=0.43]. The combination of the 5-HT[3] antagonists with droperidol given before induction of anesthesia is well tolerated and superior to droperidol alone in preventing nausea but not vomiting after total thyroidectomy

Combined general-epidural anesthesia with continuous postoperative epidural analgesia preserves sigmoid colon perfusion in elective infrarenal aortic aneurysm repair

In elective open infrarenal aortic aneurysm repair the use of epidural anesthesia and analgesia may preserve splanchnic perfusion. The aim of this study was to investigate the effects of epidural anesthesia on gut perfusion with gastrointestinal tonometry in patients undergoing aortic reconstructive surgery. Thirty patients, scheduled to undergo an elective infrarenal abdominal aortic reconstructive procedure were randomized in two groups: the epidural anesthesia group [Group A, n=16] and the control group [Group B, n=14]. After induction of anesthesia, a transanally inserted sigmoid tonometer was placed for the measurement of sigmoid and gastric intramucosal CO[2] levels and the calculation of regional-arterial Co[2] difference [deltaP CO[2]]. Additional measurements included mean arterial pressure [MAP], cardiac output [CO], systemic vascular resistance [SVR], and arterial lactate levels. There were no significant intra- and inter-group differences for MAP, CO, SVR, and arterial lactate levels. Sigmoid pH and PCO[2] increased in both the groups, but this increase was significantly higher in Group B, 20 min after aortic clamping and 10 min after aortic declamping. Patients receiving epidural anesthesia during abdominal aortic reconstruction appear to have less severe disturbances of sigmoid perfusion compared with patients not receiving epidural anesthesia. Further studies are needed to verify these results