Case Report: Associated Ocular Adverse Reactions With Inactivated COVID-19 Vaccine in China

The vaccine is still the best clinical measure for effective prevention and control of coronavirus disease 2019 (COVID-19). The vaccine-associated ocular adverse reactions should be noted in detail among the medical community. We reported twelve eyes of 9 patients presented at the Department of Ophthalmology, Qilu Hospital of Shandong University from March to August 2021 with ocular complaints following COVID-19 vaccination. The main inclusion criterion was the development of ocular symptoms within 14 days after receiving a dose of an inactivated COVID-19 vaccine. The mean (SD) age was 44.7 ± 16.5 years (range, 19–78 years), among which seven (77.8%) cases were women. The mean time of ocular adverse events was 7.1 days (range, 1–14 days) after receiving the inactivated COVID-19 vaccine. One patient was diagnosed with choroiditis, 1 with uveitis, 4 with keratitis, 1 with scleritis, 1 with acute retinal necrosis, and 1 with iridocyclitis. Although the causal relationship between vaccines and ocular adverse events cannot be established from this case series report, physicians should pay attention to the ocular adverse reactions following the COVID-19 vaccine administration.

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Ocular adverse events associated with immune checkpoint inhibitors: a novel multidisciplinary management algorithm

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835921992989 ◽

2021 ◽

Vol 13 ◽

pp. 175883592199298

Author(s):

Orthi Shahzad ◽

Nicola Thompson ◽

Gerry Clare ◽

Sarah Welsh ◽

Erika Damato ◽

...

Keyword(s):

Adverse Events ◽

Checkpoint Inhibitors ◽

Case Reports ◽

Case Series ◽

Simple Algorithm ◽

Cancer Therapeutics ◽

Management Algorithm ◽

Ocular Symptoms ◽

Systemic Corticosteroids ◽

Permanent Loss

Ocular immune-related adverse events (IrAEs) associated with use of checkpoint inhibitors (CPIs) in cancer therapeutics are relatively rare, occurring in approximately 1% of treated patients. Recognition and early intervention are essential because the degree of tissue damage may be disproportionate to the symptoms, and lack of appropriate treatment risks permanent loss of vision. International guidelines on managing ocular IrAEs provide limited advice only. Importantly, local interventions can be effective and may avoid the need for systemic corticosteroids, thereby permitting the continuation of CPIs. We present a single institution case series of eight affected patients managed by our multidisciplinary team. Consistent with previously published series and case reports, we identified anterior uveitis as the most common ocular IrAE associated with CPIs requiring intervention. Based on our experience, as well as published guidance, we generated a simple algorithm to assist clinicians efficiently manage patients developing ocular symptoms during treatment with CPIs. In addition, we make recommendations for optimising treatment of uveitis and address implications for ongoing CPI therapy.

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Management of Advanced Medullary Thyroid Carcinoma with Vandetanib: Case Series

Endocrinology and Disorders ◽

10.31579/2640-1045/065 ◽

2021 ◽

Vol 5 (1) ◽

pp. 01-07

Author(s):

Andrés Flórez R

Keyword(s):

Partial Response ◽

Adverse Events ◽

Thyroid Carcinoma ◽

Medullary Thyroid Carcinoma ◽

Stable Disease ◽

Case Series ◽

Medullary Thyroid ◽

The Mean ◽

Grade 3

Objective: To describe the tumor response and adverse events in patients with advanced medullary thyroid carcinoma (MTC) treated with vandetanib at the National Cancer Institute in Bogotá, Colombia. Materials and Methods: Case series including five patients with advanced MTC treated with vandetanib from April 2011 to August 2018 and a minimum follow-up of 6 months. Results: 5 patients met the inclusion criteria, including 3 women. The mean age was 49 years. A total of 4 patients underwent total thyroidectomy prior to starting vandetanib. The main indication for vandetanib was progression of liver metastasis (4 patients). Regarding treatment response, 3 patients presented stable disease, 1 patient showed partial response, and 1 had disease progression. The mean treatment duration was 16.5 months. Grade 3 or 4 adverse events were observed in three patients, 1 with diarrhea, 1 with hypertension, and 1 with rash. All symptoms improved with dose reduction or temporary suspension of vandetanib. Conclusions: The management of advanced MTC with vandetanib allows for prolonged disease control (stable disease or partial response). Although adverse events are frequent, most are mild and severe cases are manageable.

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Apheresis-Adverse Events in Man and Machine Individualities

Faridpur Medical College Journal ◽

10.3329/fmcj.v14i1.46162 ◽

2020 ◽

Vol 14 (1) ◽

pp. 27-30

Author(s):

Md Ashraful Hoque ◽

Kashfia Islam ◽

Selina Akter

Keyword(s):

Adverse Reaction ◽

Adverse Events ◽

Adverse Reactions ◽

Key Factors ◽

Serious Adverse Events ◽

Female Ratio ◽

The Mean ◽

Male To Female ◽

Citrate Toxicity ◽

Common Adverse Reaction

Adverse events due to platelet pheresis are not unheard of citrate related reactions being the most common. Most of these events are mild and self limiting. The current study describes adverse events in platelet pheresis using modern apheresis systems. This prospective study included 1455 platelet pheresis procedures done from July 2016 to December 2017. Procedures were performed on Hemonetics MCS+, Trima Accel and Cobe spectra cell separators. The endpoint of each procedure was a yield of 3 × 1011 platelets (PLTs) per unit. Donor adverse reaction if any was managed, reported, and documented. The median age of donors was 31 years with male to female ratio of 13:1. The median body surface area and body mass index were 1.64 m2 and 22.4 kg/m2, respectively. The mean PLT count of donors was 199.8 × 103/uL with a mean hemoglobin value of 13.6 g/dl. ACD infusion was significantly more in the Hemonetics MCS+, (P< 0.01). Donation time was least with the Trima compared to Hemonetics MCS+ (P< 0.01) and Cobe (P< 0.001). Total whole blood volume processed was higher in Hemonetics MCS+, (P< 0.01). Paresthesia due to citrate toxicity was the most common adverse reaction (65.3%), and vascular injury was observed in only five donors. The overall incidence of adverse reaction was 3.4%. Serious adverse events were not observed. The modern generation apheresis machines are more donors friendly and cause less adverse reactions compared to the older versions. Good donor screening, optimized donor physiognomic and hematological values and skilled operators are the key factors in reaction reduction by apheresis. Faridpur Med. Coll. J. Jan 2019;14(1): 27-30

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Safety review of 42 cases of COVID-19 treated with low-dose chloroquine

10.21203/rs.3.rs-22918/v1 ◽

2020 ◽

Author(s):

Bo Zhou ◽

Jing Zhang ◽

Yanqing Liu ◽

Wenxin Hong ◽

Fengbi Jian ◽

...

Keyword(s):

Clinical Trial ◽

Adverse Events ◽

Adverse Reactions ◽

Low Dose ◽

Information Management System ◽

Controlled Clinical Trial ◽

Global Pandemic ◽

High Incidence ◽

The Mean ◽

Grade 3

Abstract BackgroundCoronavirus Disease 2019 (COVID-19) has become a global pandemic and caused over one hundred thousand death. Chloroquine (CQ) and hydroxychloroquine (HCQ) were recommended for off-label use in the treatment of COVID-19 in some countries despite their unclear benefit. However, the toxicity of these agents has been ignored, so the investigation of their safety in the treatment of COVID-19 is crucial for providing a reference for the rational use. MethodsThe medical records obtained from the information management system of Guangzhou Eighth People’s Hospital were reviewed to extract data about patients who received chloroquine phosphate tablets for COVID-19 treatment from January 20th to March 5th, 2020. The data were assessed to determine the correlation of adverse reaction with chloroquine phosphate based on Chinese CFDA standards as well as the severity of adverse events based on American CTCAE5.0 standard, and evaluate the safety of this medication.ResultsA total of 42 patients (23 males and 19 females, average 42.19±14.29 years old) with COVID-19 were treated with low-dose chloroquine phosphate (oral, 500 mg, once per day). Totally 18 patients（42.86%）experienced 20 adverse events. The mean duration of CQ administration was 6.57 days (SD, 3.16 days; range: 1 day to 16 days) and 52.4% received CQ for 7 to 9 days. The adverse events occurred within 6–8 days of treatment. For the 20 adverse events, 19 were not higher than grade 2 and only one was grade 3 because of the severely limited self-care ability in one patient. The most common adverse events were related to the digestive, circulatory, hepatic, and nervous systems.ConclusionOral chloroquine phosphate tablets resulted in a high incidence of adverse reactions. In the clinical trial of chloroquine phosphate for COVID-19 treatment, it should be used under pharmaceutical care; timely evaluation of the drug safety during the treatment process is necessary and a randomized controlled clinical trial should be conducted.

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Injection Laryngoplasty for Children with Unilateral Vocal Fold Paralysis: Procedural Limitations and Swallow Outcomes

Otolaryngology ◽

10.1177/0194599818813002 ◽

2018 ◽

Vol 160 (3) ◽

pp. 540-545 ◽

Cited By ~ 2

Author(s):

Kara D. Meister ◽

April Johnson ◽

Douglas R. Sidell

Keyword(s):

Adverse Events ◽

Vocal Fold ◽

Pediatric Population ◽

Case Series ◽

Study Data ◽

Injection Laryngoplasty ◽

Swallow Study ◽

Vocal Fold Immobility ◽

The Mean ◽

Room Time

Objective Vocal fold immobility with resultant dysphagia is a known cause of morbidity in the pediatric population. Herein we evaluate the efficacy and adverse events of injection laryngoplasty in children. Study Design Case series with chart review. Setting Tertiary academic children’s hospital. Subjects and Methods Patients <12 years of age with unilateral vocal fold immobility, dysphagia, and objective swallow study data were included. Primary outcome measures included perioperative adverse events and the ability to advance the diet, as defined by initiation of oral feeds or reduction in thickener following postoperative swallow study. Results The mean age of the cohort (N = 41) was 43.83 months (range, 0.5-144 months), and 46.3% of patients were <18 months old. Perioperative adverse events included increased oxygen requirement (n = 3), prolonged operating room time secondary to tenuous cardiopulmonary status (n = 2), and postoperative readmission within 30 days (n = 1). A total of 63.63% (n = 21 of 33) of patients safely advanced their diet following objective improvement on swallow study. Patients undergoing injection laryngoplasty ≤6 months of the onset of vocal fold immobility were more likely to advance their diet following surgery. Conclusion Injection laryngoplasty has the potential to advance or initiate an oral diet for children with vocal fold immobility, including those in the first months of life. It is relatively free of adverse events, but certain limitations in the pediatric population must be considered. Preoperative characteristics, including timing of injection and premorbidity diet, may guide clinicians in predicting those patients most likely to advance their diet following injection laryngoplasty.

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Fixed Dental Prosthesis on 4.2 mm Length Rough Implants: A Case Series Report after an Average Loading Time of 33 Months

Journal of Oral Implants ◽

10.1155/2015/390974 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Yves Reingewirtz ◽

Henri Tenenbaum

Keyword(s):

Case Series ◽

Limiting Factors ◽

Good Reliability ◽

Fixed Dental Prosthesis ◽

Short Implants ◽

Case Series Report ◽

Natural Teeth ◽

The Mean ◽

Attachment Level ◽

Series Report

Aim. Several limiting factors encourage the clinician to use short implants. Among those, the presence of limiting anatomical elements and the simplification of surgical procedures are particularly significant. The goal of this study is to analyse the opportunity to extend the use of short implants to extrashort implants with a length less than 5 mm (ESI). Materials and Methods. Seven patients (3 women, 4 men; mean age 60.4 years) received extrashort implants (Straumann Implant, Palatal Orthosystem, length 4.2 mm, diameter 4.1 or 4.8 mm) in severe resorbed edentulous posterior areas. The implants were incorporated in partially fixed dentures. The osseous stability and the attachment level were recorded after a loading period of 22 to 54 months. Results. The results demonstrated a success rate of 100%, stability in the osseous level surrounding implants (mean annual mesial and distal loss of 0.026 mm and 0.105 mm, resp.), and no significant differences in the mean attachment depth between extrashort implants and contralateral teeth or implants (3.7 mm versus 3.55 mm, SD = 0.87). Splinting ESI with natural teeth resulted in significantly more bone resorption than with other implants (P=0.001). Conclusion. This exploratory study on the use of extrashort implants demonstrated good reliability over a loading period of 22 to 54 months.

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Traditional Chinese Medicine in Cancer Care: A Review of Case Series Published in the Chinese Literature

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/751046 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 27

Author(s):

Guoyan Yang ◽

Xun Li ◽

Xiaoli Li ◽

Lu Wang ◽

Jia Li ◽

...

Keyword(s):

Chinese Medicine ◽

Traditional Chinese Medicine ◽

Adverse Reactions ◽

Chinese Literature ◽

Herbal Medicines ◽

Case Series ◽

Point Of View ◽

Syndrome Differentiation ◽

Case Series Report ◽

Series Report

Traditional Chinese medicine (TCM) has been widely used in cancer in China. Case series report a series of cases exposed to a certain intervention. To understand the current situation of case series of TCM for cancer, we performed this review. We included case series of cancer patients treated with TCM therapy. Electronic searches were conducted in four main Chinese databases until February 2011. A total of 1,217 reports of case series (92,945 patients) were included. The top five types of cancer were lung cancer, liver cancer, stomach cancer, leukemia, and esophageal cancer. Leukopenia and hiccup treated by TCM were the most common adverse reactions after surgery or induced by chemo/radiotherapy. More than half of the patients were treated with TCM therapies alone. The application of herbal medicines especially formula based on syndrome differentiation was highly prevalent, and the typical administration route was oral usage. 1,182 reports were published in a structured format. The quantity of TCM case series for cancer treatment is substantial. Further studies should focus on the most common types of cancer and the most frequently applied TCM therapies. We presented a recommendation from the methodological point of view for the format of reporting.

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1418Adverse effects of spironolactone in long-term treatment of resistant arterial hypertension

European Heart Journal ◽

10.1093/eurheartj/ehz748.0065 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

J Vaclavik ◽

L Jelinek ◽

J Jarkovsky ◽

K Benesova ◽

D Tavacova ◽

...

Keyword(s):

Adverse Effects ◽

Adverse Events ◽

Arterial Hypertension ◽

Adverse Reactions ◽

Term Treatment ◽

Kaplan Meier ◽

Long Term Treatment ◽

The Mean ◽

Resistant Arterial Hypertension

Abstract Background Spironolactone is recommended as a fourth line antihypertensive drug by current hypertension guidelines. This drug had relatively few adverse effects in short term clinical trials, but data about their occurrence during long-term treatment of resistant hypertension are scarce. Purpose To evaluate the occurrence and type of adverse effects of spironolactone during long-term treatment and their possible clinical and laboratory predictors. Methods We prospectively followed 274 patients with resistant arterial hypertension who started treatment with spironolactone between September 2007 and December 2016. The duration of spironolactone use, its dose, the incidence of adverse events, blood pressure, and laboratory findings were recorded at baseline and during the last clinical examination. Results Patients were followed for an average of 35 (± 29) months, the mean dose of spironolactone was 27.5 mg/day. Adverse effects occurred in 72 patients (26.3%) and in 61 (84.7%) lead to discontinuation of spironolactone. The most common adverse reactions were gynaecomastia (30.6%), hyperkalaemia (30.6%) and symptomatic hypotension (26.4%). The mean duration of spironolactone treatment before their occurrence was 25 (± 27) months. According to the Kaplan-Meier curve, the median for the incidence of adverse events would be 97 months (91.5–102.5 months), i.e. 50% of patients could be treated with no adverse events for more than 8 years. Adverse events were more common in the elderly (hazard ratio – HR 1.38, P=0.007), patients with higher baseline serum creatinine (HR 1.12, P=0.035) and patients taking angiotensin receptor blockers (HR 1.65, P=0.040). Kaplan-Meier estimate – adverse events Conclusion During long-term treatment of resistant hypertension with spironolactone, more than a quarter of patients experience adverse reactions that usually require discontinuation of spironolactone. Acknowledgement/Funding Supported by the grants of Palacký University in Olomouc Nr. IGA_LF_2016_038 and IGA_LF_2017_029.

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Continuous interscalene catheters for ambulatory shoulder surgery provide effective intraoperative and early postoperative analgesia in adolescent patients

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine ◽

10.1136/jisakos-2020-000433 ◽

2020 ◽

Vol 5 (4) ◽

pp. 208-212

Author(s):

Erica Holland ◽

Daniel Low ◽

Viviana Bompadre ◽

Michael Saper

Keyword(s):

Adverse Events ◽

Postoperative Analgesia ◽

Insertion Site ◽

Case Series ◽

Shoulder Surgery ◽

Opioid Consumption ◽

Opioid Use ◽

Pain Scores ◽

Adolescent Patients ◽

The Mean

ObjectivesTo review the analgesic efficacy (by means of pain scores and opioid consumption) and adverse events after interscalene catheter (ISC) placement for ambulatory shoulder surgery in a series of adolescent patients.MethodsA retrospective review was performed of 36 patients who underwent ISC placement. Intraoperative and postoperative data regarding block placement, opioid consumption and pain scores were recorded. Via telephone, patients were assessed on postoperative days (PODs) 1-3 for pain scores, oxycodone use, global satisfaction and adverse effects of treatment.ResultsThe mean age was 15.4±1.8 years. The average time of ISC placement was 11.8±3.8 min. The mean postanaesthesia care unit maximum pain score was 1.6±2.4 with four patients who received rescue intravenous morphine. Mean pain scores for POD 1- 3 at rest were 2.5±2.3, 2.1±1.5 and 1.8±1.6, respectively. Mean number of doses of oxycodone on POD 1–3 were 1.1±1.4, 1.5±1.8 and 0.7±1.3, respectively. Satisfaction was reported in 94% of patients and 97% would have the catheter again. Adverse events included two accidental catheter removals at the end of the procedure or in the recovery unit, one catheter replacement at the end of surgery due to dislodgement, two early catheter removals on POD 2 because of dressing failure and insertion site discomfort, three cases of Horner’s Syndrome and one patient with transient ipsilateral facial numbness on POD 3.ConclusionThe use of ISCs in adolescent ambulatory shoulder surgery is beneficial, providing effective intraoperative and early postoperative analgesia as evidenced by low pain scores and minimal opioid use. Their routine use should be considered as they minimise perioperative opioid use with minimal adverse events.Level of evidenceLevel IV, case series.

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The Influence of Decentration on Higher-Order Aberrations in Artisan Aphakic Intraocular Lens Implantation Eyes

Journal of Ophthalmology ◽

10.1155/2020/7601524 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Aizhu Miao ◽

Min Zhang ◽

Tianhui Chen ◽

Yi Lu

Keyword(s):

Intraocular Lens ◽

Case Series ◽

Higher Order ◽

Intraocular Lens Implantation ◽

Retrospective Case ◽

Higher Order Aberrations ◽

Vision Science ◽

Department Of Ophthalmology ◽

Lens Implantation ◽

The Mean

Purpose. To characterize the influence of decentration on higher-order aberrations of Artisan aphakic intraocular lens implantation eyes. Setting. Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China. Design. Retrospective case series. Methods. Twenty-three eyes of 18 patients were retrospectively examined. Location of the IOL was imaged using a slit-lamp, and decentration (the distance from the center of a pupil to the geometric center of the IOL) was measured using the AutoCAD 2007 software. Ocular and internal higher-order aberrations were measured using the wavefront analyzer KR-1W (Topcon) and their correlation with decentration were analyzed. Coma, spherical, 3rd-, 4th-order, trefoil, tetrafoil aberrations, ocular, and internal higher-order aberrations were calculated for a 4.0 mm pupil diameter. Results. The mean age of patients was 33.6 ± 21.4 years (ranging from 7 to 72 years). The mean follow-up period was 28.2 ± 10.5 months (ranging from 12 to 52 months). The mean postoperative best-corrected visual acuity (BCVA) was 0.19 ± 0.19 logMAR (range −0.18–0.52). The mean decentration was 0.57 ± 0.28 mm (range 0.15–1.21 mm). There was no correlation between Artisan IOL decentration and ocular higher-order aberrations, internal higher-order aberrations, coma, spherical, 3rd-, 4th-order, trefoil, and tetrafoil aberrations, respectively. There was a positive correlation between Artisan IOL decentration and 2nd-astig aberrations when 2nd-astig aberrations were less than 0.1. Conclusions. The position of Artisan IOLs showed slight decentration and the amounts of decentration were not large enough to influence higher-order aberrations.

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