scholarly journals The Association between Vaccination and Autoimmunity

2021 ◽  
Vol 5 (2) ◽  
pp. RV9-RV13
Author(s):  
Meenakshi Chopra ◽  
Yagyeshwar Malhotra ◽  
Varsha Sharma ◽  
Sourav Chandra Bidyasagar Bal

Vaccines are one of the prime preventive measures against infectious diseases. Administration of vaccination may lead to significant autoimmune manifestations. There is a vast literature on autoimmune issues associated with vaccines including animal and in-vitro studies, case reports and case series. Contrary to this, epidemiological research work does not report this association. This review on the potential association between vaccines and the development of autoimmune diseases is based on currently available scientific literature. We conclude that vaccines have a very positive impact on human health. Further research is required to clarify the association between vaccines and autoimmune conditions and also the detailed mechanisms behind this.

Author(s):  
Harshil Bhatt

Abstract Purpose of Review Breastfeeding is beneficial to both the newborn and the mother. During the COVID-19 pandemic, concerns have been raised on whether the SARS-CoV-2 virus could be transmitted from COVID-19 positive mother to the newborn through breastmilk. The purpose of this review is to examine the available evidence on the risks of transmission of infection from COVID-19 mothers to their newborns through breastfeeding. Recent Findings Data is very limited in this regard, with only a few smaller case series, and case reports have been published so far. In most of the studies, breastmilk samples from COVID-19 mothers tested negative for the virus. In the case reports where the virus was detected in breastmilk and the infants were diagnosed with COVID-19, it remained unclear whether the disease was transmitted through breastmilk or direct contact or through delivery. Another hypothesis is that the viral antibodies could pass to the newborn passively through breastmilk of COVID-19 positive mothers and give immunity to the child, but data is minimal. Summary Based on the currently available limited evidence and recognizing the benefits of breastfeeding, it may be concluded that if the health of the mother and her newborn allows, direct breastfeeding or extracted breastmilk should be encouraged by the healthcare providers after a careful discussion of the risks of vertical transmission to the mother and her family. Preventive measures should be taken by COVID-19 mothers to prevent droplet transmission of infection to the infants while breastfeeding.


2015 ◽  
Vol 129 (5) ◽  
pp. 410-415 ◽  
Author(s):  
I Syed ◽  
V S Sunkaraneni

AbstractBackground:There are currently no guidelines in the UK for the specific management of hereditary haemorrhagic telangiectasia related epistaxis. The authors aimed to review the literature and provide an algorithm for the management of hereditary haemorrhagic telangiectasia related epistaxis.Method:The Medline and Embase databases were interrogated on 15 November 2013 using the search items ‘hereditary haemorrhagic telangiectasia’ (title), ‘epistaxis’ (title) and ‘treatment’ (title and abstract), and limiting the search to articles published in English.Results:A total of 46 publications were identified, comprising 1 systematic review, 2 randomised, controlled trials, 27 case series, 9 case reports, 4 questionnaire studies and 3in vitrostudies.Conclusion:There is a lack of high-level evidence for the use of many of the available treatments for the specific management of epistaxis in hereditary haemorrhagic telangiectasia. Current management should be based on a multidisciplinary team approach involving both a hereditary haemorrhagic telangiectasia physician and an ENT surgeon, especially when systemic therapy is being considered. The suggested treatment algorithm considers that the severity of epistaxis merits intervention at different levels of the treatment ladder. The patient should be assessed using a reproducible validated assessment tool, for example an epistaxis severity score, to guide treatment. More research is required, particularly in the investigation of topical agents targeting the development and fragility of telangiectasiae in hereditary haemorrhagic telangiectasia.


Author(s):  
Michael Joshua Hendrix ◽  
Lindsey Larson ◽  
Adriana M Rauseo ◽  
Sasinuch Rutjanawech ◽  
Alexander D Franklin ◽  
...  

Abstract Background Itraconazole is the preferred azole for histoplasmosis in the current Infectious Diseases Society of America guidelines. Voriconazole is increasingly used as treatment for histoplasmosis; it has in-vitro activity against Histoplasma capsulatum and has shown success in case reports and small case series but may have a lower barrier to resistance. No comparative studies have been published. Methods We constructed a single-center retrospective cohort of adult patients diagnosed with histoplasmosis from 2002 to 2017. Individual charts were reviewed to gather clinical information including demographics, clinical features, immune status, treatments, and mortality. Patients were categorized based on initial choice of azole, either as initial treatment or as step-down therapy from amphotericin B. Initial therapies with other azoles were excluded. Mortality was compared using a multivariable Cox proportional hazards with Heaviside function at 42 days. Results We identified 261 cases of histoplasmosis from 2002 to 2017. After excluding patients not treated with itraconazole or voriconazole, 194 patients remained. 175 (90%) patients received itraconazole and 19 (10%) received voriconazole. There were no significant demographic differences between patient populations receiving either azole as their initial azole treatment. Death at 180 days occurred in 41 patients (23.4%) in the itraconazole group and 6 patients (31.6%) in the voriconazole group. Patients on voriconazole had a statistically significant increase in mortality during the first 42 days after initiation of treatment when compared to patients receiving itraconazole (HR 4.30 [95% CI 1.3-13.9, p 0.015]) when controlled for other risk factors. Conclusion Voriconazole in histoplasmosis was associated with increased mortality in the first 42 days compared to itraconazole.


Author(s):  
Fahima A. Begum ◽  
Tiffanie-Marie Borg ◽  
Hamed Mazoochy ◽  
Nima Heidari

Objectives: The aim of this study is to review the available literature addressing the safety and efficacy of antiseptics in surgical wounds. The different antiseptic solutions, irrigation volumes, time scales and delivery methods have been compared so that evidence-based recommendations on antiseptic use in orthopaedic, foot and ankle surgical procedures can be proposed. Methods: A literature search was performed using the online databases Medline and EMBase to identify in-vitro and in-vivo studies pertaining to antiseptic use in an orthopaedic context. Terms including antiseptic, irrigation fluid, bacitracin, hydrogen peroxide, povidone-iodine and chlorhexidine were searched. Literature published in English from inception to July 2020 in which the full text was accessible was considered for inclusion. Cellular and animal studies were included on the basis that authors analysed antiseptic efficacy and/or toxic effect of antiseptic on cells present in orthopaedic wounds. Clinical studies that met the criteria for inclusion in this review assessed antiseptic use in a surgical context, with a focus on foot and ankle procedures.         These included case reports, case series, case control, prospective and retrospective studies as well as randomised controlled trials. Studies were categorised as in-vitro, animal and human studies. Twenty-three, eleven and forty-four studies were identified as in-vitro, animal and       human studies respectively. These have been summarised and presented herein in a narrative format. Results: There is strong evidence that skin preparation with antiseptics before orthopaedic procedures reduces the risk of post-operative infection. Conclusion: Routine prophylactic intra-operative antiseptic use should be performed with caution as they increase the risk of local and systemic complications. However, there is strong evidence supporting the use of antiseptics pre-operatively when preparing the skin. Determining the best antiseptic preparation remains a matter of debate since a single agent or solution is not effective against all organisms. Further research is therefore needed to assess the efficacy of antiseptics in prevention and treatment of infections.


Author(s):  
Roberta Lopes de Castro Martinelli ◽  
Reinaldo Jordão Gusmão ◽  
María Paz Moya Daza ◽  
Irene Queiroz Marchesan ◽  
Giédre Berretin-Felix

This work aims to describe the profile of scientific production referring to ankyloglossia. For this an investigation was carried out by searching for scientific articles indexed in the electronic databases LILACS and PUBMED. For the bibliometric review, the data referring to the year of publication, type of study and level of evidence were examined and tabulated. The data were discussed on the quantitative and representative values optics. The first results allowed to analyzic 651 published studies were analyzed. Most of the research on tongue tie found correspond to descriptive studies and case series (49.31%), followed by case reports, in vitro research, in animals and literature review (24.27%), cohort and cases and controls (11.98%), specialist opinion (11.68%), randomized clinical trials (1.54%) and systematic reviews (1.22%). Few studies addressed complications during or after lingual frenulum release surgery. In conclusion Scientific production on ankyloglossia has shown an increasing increase in the last 28 years, with studies with evidence levels 1, 2 and 3 being published, whose main focus was the performance of surgery to release the lingual frenulum.


1996 ◽  
Vol 30 (6) ◽  
pp. 644-655 ◽  
Author(s):  
Denise M Coleman ◽  
H William Kelly ◽  
Bennie C Mcwilliams ◽  
Annette Pérez ◽  
Marc M Perreault

Objective To provide an overview of aerosol drug delivery during mechanical ventilation in the pediatric and adult populations. Data Sources Published articles and abstracts identified in a MEDLINE search (1984–July 1994) were reviewed. Study Selection All articles and abstracts found, including review articles, in vivo and in vitro studies, case reports, and case series pertaining to issues involving aerosol delivery during mechanical ventilation, were reviewed. No predetermined selection criteria were used to exclude studies. Data Extraction Percent delivery of the starting dose to either the patients or the various in vitro lung models, as well as each variable possibly affecting delivery for each study, were tabulated for each study reviewed. Data Synthesis The delivery of therapeutic aerosols to endotracheally intubated and mechanically ventilated patients presents a unique challenge for healthcare providers. Delivery can be affected by the diameter of the endotracheal tube and ventilator circuitry, type of ventilator, ventilator modes, type of delivery device, and how the delivery device is operated and introduced into the ventilator circuitry. The drug being aerosolized may behave differently from one delivery system to another. The proper operation of each device requires attention to positioning in the ventilator circuit as well as the mode of ventilation. Conclusions No apparent advantage exists for metered-dose inhalers with a large-volume adapter over jet nebulizers, as each method of delivery is capable of similar efficiency (5–15%). Sufficient attention to detail, including the use of an efficient nebulizer and/or adapter and proper placement and operating method, is required to provide optimal delivery. For bronchodilator administration, careful monitoring of outcomes will provide the most optimal dosing schedule.


2021 ◽  
Vol 30 (03) ◽  
pp. 219-227
Author(s):  
Muhammad Haider Amin Malik ◽  
◽  
Nazia Yazdanie

OBJECTIVE: To review the periodontal considerations associated with removable partial denture therapy. METHODOLOGY: Using a MEDLINE search, for "removable partial dentures periodontal", a total of 712 papers from peer-reviewed journals came in results. The MEDLINE search was made more specific by applying filters to the key phrase with other key words such as "periodontal evaluation"(140), "direct retainers"(77), "non-surgical periodontal"(8), "surgical periodontal"(180), "plaque"(249), "periodontal indices"(112), "tooth mobility,"(180) "periodontal maintenance,"(60) "splinting,"(198) and "split major connector"(2). Both in vivo and in vitro studies on the Perio-prosthodontic aspects of RPD treatment were included in the study pool whereas case Series and case reports were excluded. RESULT: A total of 1206 studies were collected from the search engine. After applying the exclusion criteria and filtering the duplicates a total of 95 studies were included for the narrative review. CONCLUSIONS: Out of all the factors, recall and oral and denture hygiene have the utmost importance. KEYWORDS: Perio-prosthodontics, removable partial denture, periodontal indices.


2021 ◽  
Author(s):  
Aqsa Mumtaz ◽  
Larabe Farrukh ◽  
Tawseef Dar ◽  
Hamza Naveed ◽  
Saad Siddique ◽  
...  

Abstract In scientific literature, silicone embolization syndrome has been well described and multiple presentations have been delineated. The use of non-medical injections of silicone has become very popular with the public in general, in particular with certain groups that are highly focused on their physical image. Local effects including tissue necrosis, foreign body giant cell reaction, and community-acquired infection have been commonly recorded. Distal effects suggesting an embolic phenomenon can present as regional lymphadenopathy, granulomatous hepatitis, interstitial nephritis, and other acute systemic illnesses. But pulmonary and neurologic sequelae especially warrant emergency attention and can be fatal, if not identified immediately. Pulmonary manifestation can sometimes easily mimic bilateral pneumonia, especially if there is no suspicion for illicit silicone use, which was the case with our patients. The injected subcutaneous silicone migrated rapidly from the interstitial subcutaneous tissue into the general bloodstream resulting in systemic silicone embolization. An analysis of the presented case in conjunction with a review of the pertinent medical literature, including relevant case reports revealed the common clinicopathological manifestations of silicon embolism.


2017 ◽  
Vol 94 (8) ◽  
pp. 574-577 ◽  
Author(s):  
Nicola Thorley ◽  
Jonathan Ross

ObjectivesTrichomoniasis, caused by Trichomonas vaginalis (TV), is the most common curable sexually transmitted infection worldwide. Current guidance in the UK is to treat TV with a nitroimidazole antibiotic. The high prevalence of TV, high rate of antibiotic resistance and limited tolerability to nitroimidazoles suggest that alternative treatment regimens are needed. Intravaginal boric acid (BA) has been used safely for the treatment of candida vulvovaginitis and bacterial vaginosis, and in vitro studies suggest BA is active against TV. We review the evidence for the efficacy of BA in patients with TV.MethodsMEDLINE, EMBASE, CINAHL, AMED, HMIC and BNI and Grey literature databases, The Cochrane Library, Trial Registers, conference abstracts and proceedings were searched. Inclusion criteria were women aged 16 years or over with microbiological confirmation of TV infection and using BA as treatment. There were no restrictions on language, publication date or study design. The in vitro evidence for BA activity against TV was also reviewed.ResultsNo randomised controlled trials or case series were found. Four case reports demonstrated TV clearance with BA using a variety of dose regimens (dose 600 mg alternate nights to 600 mg two times per day; duration 1–5 months). In vitro studies suggest that BA has activity against TV which is independent of its effect on pH.DiscussionFurther evaluation of BA for the treatment of uncomplicated TV is required, but it may be useful when therapeutic options are limited. If shown to be safe and effective, intravaginal BA might provide a well-tolerated alternative anti-infective treatment which reduces community exposure to systemic antibiotics.


Spectrum ◽  
2020 ◽  
Author(s):  
Chester Lau ◽  
Ran Zhao ◽  
Dilini Vethanayagam

Background: While the Public Health Agency of Canada notes 19 cases from May 2019 to February 2020 relating to e-cigarette or vaping product use-associated lung injury (EVALI) in Canada, there are likely many more unreported cases, including non-hospitalized and asymptomatic cases. E-cigarette use or vaping exposes users to numerous aerosolized chemical species, some of which have proven to be deleterious to health. These chemical species can include vitamin E acetate (VEA), flavourants, base / solvents (propylene glycol or vegetable glycerin), psychoactive substances, pesticides, endotoxins, metals, and pyrolysis by-products from e-cigarette heating coils. Objectives: We aim to review current findings related to EVALI from the standpoint of known chemical species currently used in vaping products. We specifically examine the toxicological profiles of these chemical species and the mechanisms through which they cause lung injury. Methods: A comprehensive literature search was performed with MEDLINE for EVALI-related human studies that were published between January 1, 2010, and May 15, 2020. This search strategy identified 832 case reports, case series, clinical trials, and in-vitro laboratory studies. From this group, 71 records were examined in greater detail. Results and Conclusions: Although the chemical composition and toxicology of vaping products have largely been characterized, the physiological effects of the chemical interactions between various constituents of vaping products and the generation of new species remain inconclusive. Given the rapid increase in the popularity of vaping and e-cigarettes, there is a need for further research. Developing a comprehensive understanding of the chronic health effects of vaping through randomized controlled trials and physiological studies is prudent and necessary to reduce the long-term impacts on users and the health care system.


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