DNAs prepared from chagasic patients' sera were amplified by the polymerase chain reaction using oligonucleotide primers which anneal specifically to a highly repetitive sequence of Trypanosoma cruzi nuclear DNA. Samples from both acutely and chronically infected patients yielded positive results by this method. No significant difference was observed when either whole blood or serum samples of the patients were used. These results indicate that serum instead of whole-blood samples could be used for polymerase chain reaction-based detection of T. cruzi in field studies without the need of applying any special chemical treatment to the specimens. This would represent a considerable advantage due to the easier handling and transportation of serum as compared with whole-blood samples, especially in tropical climates.
Wepresent an adult case of mumps brainstem encephalitis. He was successfully treated with steroid pulse therapy and recovered completely except for persistent dysuria. He had not been vaccinated and had no history of acute mumps infection. Weconsider that encephalitis in this case was caused by a reversible autoimmuneprocess triggered by mumps infection. Weemphasize the usefulness of pulse therapy for the treatment of somecases of mumps brainstem encephalitis in addition to the importance of mumpsvaccination to prevent such a severe complication as encephalitis.
Herein we present a case of laparoscopic cholecystectomy in a patient who was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The patient was a 56-year-old man with acute cholecystitis. During preoperative workup, he was revealed to be SARS-CoV-2-positive, but without any signs of pneumonia. As treatment of acute cholecystitis was complicated by asymptomatic coronavirus disease 2019 (COVID-19), nonoperative management with antibiotics was initiated. However, his condition deteriorated to gangrenous cholecystitis and obstructive cholangitis on the 8 th day of symptom onset. A multidisciplinary team discussed the treatment and perioperative risk mitigation strategy against viral transmission. After sharing information and simulation of preventive measures, laparoscopic cholecystectomy and C-tube drainage were performed on the 11 th day of symptom onset, when we thought that infectiousness should have declined significantly. During surgery, protective measures against surgical smoke were applied using pneumoperitoneum devices equipped with an ultralow particulate air filter. We report our experience of perioperative risk mitigation strategies in laparoscopic surgery for a patient who was positive for SARS-CoV-2.
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