scholarly journals COVID-19 Vaccine-Related Thrombosis: A Systematic Review and Exploratory Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Clio Bilotta ◽  
Giulio Perrone ◽  
Valeria Adelfio ◽  
Giovanni Francesco Spatola ◽  
Maria Laura Uzzo ◽  
...  

IntroductionThe World Health Organization declared the coronavirus disease 2019 (COVID-19) pandemic on March 11, 2020. Two vaccine types were developed using two different technologies: viral vectors and mRNA. Thrombosis is one of the most severe and atypical adverse effects of vaccines. This study aimed to analyze published cases of thrombosis after COVID-19 vaccinations to identify patients’ features, potential pathophysiological mechanisms, timing of appearance of the adverse events, and other critical issues.Materials and MethodsWe performed a systematic electronic search of scientific articles regarding COVID-19 vaccine-related thrombosis and its complications on the PubMed (MEDLINE) database and through manual searches. We selected 10 out of 50 articles from February 1 to May 5, 2021 and performed a descriptive analysis of the adverse events caused by the mRNA-based Pfizer and Moderna vaccines and the adenovirus-based AstraZeneca vaccine.ResultsIn the articles on the Pfizer and Moderna vaccines, the sample consisted of three male patients with age heterogeneity. The time from vaccination to admission was ≤3 days in all cases; all patients presented signs of petechiae/purpura at admission, with a low platelet count. In the studies on the AstraZeneca vaccine, the sample consisted of 58 individuals with a high age heterogeneity and a high female prevalence. Symptoms appeared around the ninth day, and headache was the most common symptom. The platelet count was below the lower limit of the normal range. All patients except one were positive for PF4 antibodies. The cerebral venous sinus was the most affected site. Death was the most prevalent outcome in all studies, except for one study in which most of the patients remained alive.DiscussionVaccine-induced thrombotic thrombocytopenia (VITT) is an unknown nosological phenomenon secondary to inoculation with the COVID-19 vaccine. Several hypotheses have been formulated regarding its physiopathological mechanism. Recent studies have assumed a mechanism that is assimilable to heparin-induced thrombocytopenia, with protagonist antibodies against the PF4–polyanion complex. Viral DNA has a negative charge and can bind to PF4, causing VITT. New experimental studies have assumed that thrombosis is related to a soluble adenoviral protein spike variant, originating from splicing events, which cause important endothelial inflammatory events, and binding to endothelial cells expressing ACE2.ConclusionFurther studies are needed to better identify VITT’s pathophysiological mechanisms and genetic, demographic, or clinical predisposition of high-risk patients, to investigate the correlation of VITT with the different vaccine types, and to test the significance of the findings.

2014 ◽  
Vol 31 (1) ◽  
pp. 107-114
Author(s):  
Renato Salviato Fajardo ◽  
Adriana Cristina Zavanelli ◽  
Eliene Ferreira Botasim ◽  
Glaucia de Souza Barboza

To improve mental health services, the World Health Organization proposes an epidemiological approach" based on the constant screening of existing research, and aimed at continuous improvement of psychological treatment rather than strict application of prescribed techniques. This study provides an epidemiological survey conducted at the psychology ward of the municipal Ambulatório de Saúde Mental in Birigui, São Paulo, Brazil. Data from 180 patients in psychotherapeutic care were collected, and subsequent descriptive analysis showed that the population consisted predominantly of adults (82.8% of total) and females (81.0%). Depressive disorder was the most common symptom (61.1%), and the majority of the participants (72.2%) received psychological treatment for the first time. The data presented in this paper can assist mental health professionals in selecting appropriate treatment by creating a profile of patients.


2020 ◽  
Vol 16 ◽  
Author(s):  
Nitigya Sambyal ◽  
Poonam Saini ◽  
Rupali Syal

Background and Introduction: Diabetes mellitus is a metabolic disorder that has emerged as a serious public health issue worldwide. According to the World Health Organization (WHO), without interventions, the number of diabetic incidences is expected to be at least 629 million by 2045. Uncontrolled diabetes gradually leads to progressive damage to eyes, heart, kidneys, blood vessels and nerves. Method: The paper presents a critical review of existing statistical and Artificial Intelligence (AI) based machine learning techniques with respect to DM complications namely retinopathy, neuropathy and nephropathy. The statistical and machine learning analytic techniques are used to structure the subsequent content review. Result: It has been inferred that statistical analysis can help only in inferential and descriptive analysis whereas, AI based machine learning models can even provide actionable prediction models for faster and accurate diagnose of complications associated with DM. Conclusion: The integration of AI based analytics techniques like machine learning and deep learning in clinical medicine will result in improved disease management through faster disease detection and cost reduction for disease treatment.


Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 113
Author(s):  
Oumar Bassoum ◽  
Mouhamadou Faly Ba ◽  
Ndèye Marème Sougou ◽  
Djibril Fall ◽  
Adama Faye

Introduction: Data on drug use in paediatrics are scarce in Senegal. The objective of this study was to assess the prescribing indicators in a paediatric population seen in an outpatient consultation at a Health Centre in Dakar, Senegal. Methods: A retrospective and analytical study was conducted. The study population consisted of prescriptions for children aged 0 to 14 years who were seen in ambulatory consultation between 1 June and 30 November 2019. The sample size was 600 prescriptions. The systematic survey was then conducted. Five prescription indicators recommended by the World Health Organization were calculated. The R software was used for descriptive analysis, bivariate analysis and binomial logistic regression. Results: The average number of drugs per prescription was 2.56. The proportion of drugs prescribed under the International Nonproprietary Name (INN) was 18.9%, while the proportion of drugs on the National Essential Medicines List (NEML) was 41.3%. The proportions of prescriptions with at least one antibiotic and one injectable product were 41.5% and 1.3%, respectively. Conclusions: This study showed that prescribing habits were inadequate. Thus, it would be necessary to move towards continuing training of prescribers in the wise use of medicines.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Natasha F. Sabur ◽  
Mantaj S. Brar ◽  
Lisa Wu ◽  
Sarah K. Brode

Abstract Background The World Health Organization recommends intravenous amikacin for the treatment of MDR-TB at a dose of 15 mg/kg. However, higher doses are associated with significant toxicity. Methods Patients with MDR-TB treated at our institution receive amikacin at 8–10 mg/kg, with dose adjustment based on therapeutic drug monitoring. We conducted a retrospective cohort study of patients with MDR-TB who received amikacin between 2010 and 2016. Results Forty-nine patients were included in the study. The median starting dose of amikacin was 8.9 mg/kg (IQR 8, 10), and target therapeutic drug levels were achieved at a median of 12 days (IQR 5, 26). The median duration of amikacin treatment was 7.2 months (IQR 5.7, 8), and median time to sputum culture conversion was 1 month (IQR 1,2). Six patients (12.2%) experienced hearing loss based on formal audiometry testing (95% CI 4.6–24.8%); 22.2% had subjective hearing loss (95% CI 11.2–37.1%) and 31.9% subjective tinnitus (95% CI 19.1–47.1%). Ten patients (23%) had a significant rise in serum creatinine (95% CI 11.8–38.6%), but only 5 patients had a GFR < 60 at treatment completion. 84% of patients had a successful treatment outcome (95% CI 84–99%). Conclusions Low dose amikacin is associated with relatively low rates of aminoglycoside-related adverse events. We hypothesize that low-dose amikacin can be used as a safe and effective treatment for MDR-TB in situations where an adequate regimen cannot be constructed with Group A and B drugs, and where careful monitoring for adverse events is feasible.


2017 ◽  
Vol 9 (2) ◽  
pp. 23-28
Author(s):  
Krishna Bahadur Thapa ◽  
Namrata KC ◽  
T Koirala ◽  
A Bhatttarai

Background: Dengue virus is now classified as a major global health threat by the World Health Organization. Bleeding is a common complication and is one of the most feared. There is an increase incidence in the adult population, hence, the focus of this study.Objectives: To determine the incidence of bleeding and the factors that influence its development among patients admitted with dengue fever at Fatima Medical Center, Phillipines from January 2009 to December 2011.Methods: This is a case control study using chart review. The incidence of bleeding is calculated using risk ratio. Factors affecting bleeding are determined using chi square for qualitative variables and T-test or ANOVA for quantitative variables. Simultaneous determination of factors association with bleeding will be analyzed using multiple logistic regression. Level of significance will be set at alpha = 0.05.Results: The female sex is significantly more prone to develop bleeding (p=0.044). There is no significant increase in bleeding in patients who have co-morbidities (p=0.447). In every one unit increase in WBC (1 x 109) the odds of bleeding decrease by 15%. For every one unit increase in hematocrit the odds of bleeding decreases by 6.8%. For every one unit increase in platelet count the odds of bleeding decreases by 3% that is every 10 unit increase in platelet count the odds of bleeding decrease by 22.9%.Conclusions: Female sex, a low initial WBC and platelet count will increase a patient’s propensity to develop bleeding.Journal of Gandaki Medical College Volume, 09, Number 2, July December  2016, page: 23-28


Author(s):  
E. K. Mgbe ◽  
C. G. Mgbe ◽  
S. N. Ezeofor ◽  
J. F. Etiki

Background: The world is experiencing a global corona virus (COVID-19) pandemic. As of 9th June 2020, over 7 million confirmed cases of coronavirus disease (COVID-19) and more than 400,000 deaths had been reported in more than 30 countries of the world according to World Health Organization. Aim: We aimed to assess the knowledge, attitudes, and vulnerability perception of Enugu state residents during the coronavirus outbreak in order to facilitate better health care outcomes. Methodology: A prospective Web-based cross-sectional survey was designed for this study which was conducted in March 2020 among Enugu state residents. The obtained data were coded, validated, and analyzed using Statistical Package for the Social Sciences SPSS software, version 24. Descriptive analysis was applied to calculate the frequencies and proportions and Chi-Square Test was also used. A preliminary phase was conducted to assess the validity and reliability of the questionnaire before its use.  Results: The study showed that significant number (99.6%) of the respondents had heard about Covid-19 and the most stated source of knowledge was social media (57.6%), followed by Newspaper and television shows (50.2%) while the least was from General Practitioner (GP) (8.9%). There was over 75% agreement with, and practice, of all known covid precautionary measures and less than 35% responses for wrong claims and practices about covid -19. Conclusion: The overall knowledge, attitude, and perception are high in Enugu state population although few still has background combined superstitious believes. Social media and internet are the highest used facility for acquisition of knowledge and information in Enugu, Nigeria.


2019 ◽  
Vol 56 (1) ◽  
pp. 84 ◽  
Author(s):  
Padmapriya Ramanujam ◽  
Saravanan Poorni ◽  
Manali Ramakrishnan Srinivasan ◽  
Nivedhitha Malli Sureshbabu

The prevalence of oral diseases is increasing and is becoming a major concern in the society. Treatment without prevention is simply unsustainable. One such preventable disease is dental caries. Several strategies for caries prevention have been developed over the years. Bacteriotherapy is one potential method. With better understanding on the importance of a well balanced oral microbial environment for maintaining good dental health, probiotics has gained great momentum in dentistry. The World Health Organization along with the Food and Agriculture Organisation of the United Nations defined probiotics as “Live microorganisms which when administered in adequate amounts confer a health benefit on the host”. Several probiotic strains have been identified for caries prevention through various experimental studies. However, identifying the right vehicle for administration of probiotics on everyday basis is the need of the hour. Toothpastes, mouthrinses, powders, tablets, lozenges, chewing gums are some probiotic vehicles that have been studied. This paper would throw light on the microbial strains, mechanism of action, forms and future for probiotics in caries prevention.


Author(s):  
Mohamed A. A. Mahdy ◽  
Waleed Younis ◽  
Zamzam Ewaida

A novel coronavirus has been reported as the causative pathogen of the Coronavirus disease 2019 (COVID-19) outbreak in Wuhan city, China in December 2019. Due to the rapid spread of the virus worldwide, it has been announced as a pandemic by the World Health Organization (WHO). Hospitalized patients in Wuhan were associated with the Huanan seafood wholesale market where live animals, such as poultry, bats, snakes, frogs, rabbits, marmots, and hedgehogs are sold in that market which suggests a possible zoonotic infection. It was suggested that bat is the natural host of SARS-CoV-2, but the intermediate host is still unclear. It is essential to identify the potential intermediate host to interrupt the transmission chain of the virus. Pangolin is a highly suspected candidate as an intermediate host for SARS-CoV-2. Recently, SARS-CoV-2 infection has been reported in cats, dogs, tigers, and lions. More recently SARS-CoV-2 infection affected minks severely and zoonotic transfer with a variant SARS-CoV-2 strain evidenced in Denmark, Netherlands, USA, and Spain suggesting animal-to-human and animal-to-animal transmission within mink farms. Furthermore, experimental studies documented the susceptibility of different animal species to SARS-CoV-2, such as mice, golden hamsters, cats, ferrets, non-human primates, and treeshrews. It is also essential to know the possibility of infection for other animal species. This short review aims to provide an overview on the relation between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and animals.


2019 ◽  
Vol 36 (11) ◽  
pp. 947-954 ◽  
Author(s):  
Danielle Zweers ◽  
Alexander de Graeff ◽  
Jette Duijn ◽  
Everlien de Graaf ◽  
Petronella O. Witteveen ◽  
...  

Introduction: Anxiety is a common symptom in the palliative phase, and symptom management depends on the competencies of individual professionals. This study aims to get insight into the needs of anxious hospice patients with advanced cancer regarding support. Method: Semi-structured interviews were performed in admitted hospice patients with cancer. Patients admitted from May 2017 till May 2018 were eligible whether or not they were anxious. Interviews were analyzed and coded within predefined topics. Results: Fourteen patients were included: 10 females, median age 71, and median World Health Organization performance score 3. Most patients were highly educated. Thirteen patients were interviewed within 6 months before death. Information, open communication, sense of control, safety, adequate symptom management, and respect for patients’ coping strategy were the 6 main expressed needs. Conclusion: Assessing patients’ needs regarding anxiety provided important angles where health-care professionals can make a difference in order to support anxious patients in their final stage of life to realize tailored palliative care. Future research should focus on the development of a systematic approach for health-care professionals to manage anxiety in daily care of terminal patients.


2019 ◽  
Vol 54 (6) ◽  
pp. 1901522 ◽  
Author(s):  
Sergey Borisov ◽  
Edvardas Danila ◽  
Andrei Maryandyshev ◽  
Margareth Dalcolmo ◽  
Skaidrius Miliauskas ◽  
...  

The World Health Organization (WHO) recommends that countries implement pharmacovigilance and collect information on active drug safety monitoring (aDSM) and management of adverse events.The aim of this prospective study was to evaluate the frequency and severity of adverse events to anti-tuberculosis (TB) drugs in a cohort of consecutive TB patients treated with new (i.e. bedaquiline, delamanid) and repurposed (i.e. clofazimine, linezolid) drugs, based on the WHO aDSM project. Adverse events were collected prospectively after attribution to a specific drug together with demographic, bacteriological, radiological and clinical information at diagnosis and during therapy. This interim analysis included patients who completed or were still on treatment at time of data collection.Globally, 45 centres from 26 countries/regions reported 658 patients (68.7% male, 4.4% HIV co-infected) treated as follows: 87.7% with bedaquiline, 18.4% with delamanid (6.1% with both), 81.5% with linezolid and 32.4% with clofazimine. Overall, 504 adverse event episodes were reported: 447 (88.7%) were classified as minor (grade 1–2) and 57 (11.3%) as serious (grade 3–5). The majority of the 57 serious adverse events reported by 55 patients (51 out of 57, 89.5%) ultimately resolved. Among patients reporting serious adverse events, some drugs held responsible were discontinued: bedaquiline in 0.35% (two out of 577), delamanid in 0.8% (one out of 121), linezolid in 1.9% (10 out of 536) and clofazimine in 1.4% (three out of 213) of patients. Serious adverse events were reported in 6.9% (nine out of 131) of patients treated with amikacin, 0.4% (one out of 221) with ethionamide/prothionamide, 2.8% (15 out of 536) with linezolid and 1.8% (eight out of 498) with cycloserine/terizidone.The aDSM study provided valuable information, but implementation needs scaling-up to support patient-centred care.


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