Short term safety of booster immunization with BNT162b2 mRNA COVID-19 vaccine in healthcare workers

This study demonstrated good short-term safety profile after a third dose of BNT162b2 vaccine among HCWs. There were more frequent local reactions and less systemic reactions compared to the second dose. HCW's who reported reactions had higher pre-booster titer of anti-S1 antibodies compared to those reported no reactions.

Unusual Reactions to Hymenoptera Stings: Current Knowledge and Unmet Needs in the Pediatric Population

Hymenoptera stings are generally well-tolerated and usually cause limited local reactions, characterized by self-resolving erythema and edema associated with pain. However, Hymenoptera stings can induce immediate and delayed hypersensitivity reactions. In addition to these manifestations, unusual reactions to Hymenoptera stings have been reported. The latter are defined as unusual because of their atypical characteristics. They may differ from classical hypersensitivity reactions due to the stings' particular localization and the unusual involvement of one or more specific organs. Although unusual reactions to Hymenoptera stings are infrequent, it is essential for clinicians to know the possible related clinical manifestations. Here, we review the available literature and propose a diagnostic and management algorithm. At present, there are no defined guidelines for most of the unusual reactions to Hymenoptera stings, which should be managed in a tailored way according to the specifical clinical manifestations presented by the patients. Further studies are needed to better define these conditions and the underlying pathogenetic mechanisms to improve the diagnostic and therapeutic approach.

Multi- Factor etiopathogenesis of gastric and duodenal peptic ulcer disease

Gastric and duodenal peptic ulcer disease is a multifactorial pathology, in the etiopathogenesis of which the general and local reactions of the body to external and internal risk factors play a role. Psychoemotional stress is the main cause of the pathology of nervous and humoral regulation (general reaction), and the local reaction is expressed in a violation of the ratio between the factors of aggression and protection factors in the mucous membrane of the stomach and / or duodenum. The combined action of these components leads to the formation of an ulcerative defect.

Diphtheria

Diphtheria is caused by toxin-producing bacteria, Corynebacterium diphtheriae, and less frequently by one of two other, zoonotic, Corynebacteria. Diphtheria toxin destroys tissue, which builds up in the throat and tonsils, making breathing and swallowing almost impossible. The bacteria are transmitted by respiratory droplets, by direct physical contact with skin lesions, via secretions from infected patients, or contaminated materials. Clinically, tonsillitis, pharyngitis, laryngitis, and skin infections (wound infection; ulcers) appear; diphtheria once was a terrible killer of young children. Antibiotics (penicillin, erythromycin, others) are used to eradicate the bacteria; for respiratory infections, diphtheria antitoxin is used to neutralize circulating toxins and reduce/prevent complications like myocarditis, neuritis (nerve palsies). Case fatality rates of up to 10% have been reported during diphtheria outbreaks, and are even higher in settings where diphtheria antitoxin is unavailable. Diphtheria vaccines consist of inactivated toxins, called toxoids, and are available in combinations with other antigens such as tetanus, pertussis, and others. These combinations are usually well-tolerated, local reactions are the most frequently observed side effects. Efficacy studies are not available but various observational studies consistently indicate high vaccine effectiveness between 87% and 96%.

Bee sting leading to stroke: a case report and review of the literature

In India, bee stings are very common, seen mainly in farmers and honey collectors. Usually, it presents with local reactions and anaphylaxis. It rarely requires urgent hospitalisation. Other major complications seen are acute renal failure, intravascular coagulation, rhabdomyolysis and acute pulmonary oedema. Stroke as a presentation is uncommon. We report a case of a 45-year-old man presenting with right-sided hemiplegia and aphasia due to multiple bee stings. Diffusion MRI showed left middle cerebral artery territory hyperacute infarct.

Photodynamic reparative skin regeneration using application of photosensitizer gel based on chlorin e6

The results of a study of the clinical effectiveness of the correction of involutional changes in the skin by the method of photodynamic therapy (PDT) with the use of a photosensitizer gel (PS), the active substance of which is the trismeglumine salt of chlorin e6, are presented. The data of fluorescence spectroscopy for monitoring the level of PS fluorescence in order to determine the optimal time of its exposure are demonstrated. The study of the optimal exposure time involved 80 patients with different skin phototypes. The study of the effectiveness of PDT involved 42 patients aged 44–68 years with signs of chrono- and photoaging. The PDT procedure was performed by irradiating the entire surface treated with the PS with a power density of 100 mW/cm2, a light dose of 120–140 J/cm2, a laser radiation wavelength of 660 nm, and a light beam area of 400–800 cm2. It was found that exposure to PS for 10–20 min gives the highest fluorescence and does not depend on the skin phototype. The clinical effect of PDT was achieved in 85.7% of patients; there were no negative subjective sensations. Moisture metrics increased on the skin of the face by 53%, reaching the control values in young healthy volunteers, on the skin of the hands - by 64%. Elastometry indicators on the skin of the face and hands increased by 19% and 16%, respectively. Thus, the PDT procedure with PS based on chlorin e6 is an effective method for correcting involutional changes in the skin, leads to a pronounced clinical effect, improves the parameters of skin moisture measurement and elastometry, and passes without undesirable local reactions. Optical coherence tomography showed an increase in collagen ordering.

Production of a Plasma Derived Universal Antivenom against All Elapid Neurotoxic Snake Venoms

Snakebite envenoming has killed about 138000 people and maimed 400,000 victims annually. WHO has designated this medical problem as one of the most neglected tropical diseases for which effective, affordable antivenoms (AVs) are urgently needed. Production of potent AV against neurotoxic venoms was difficult and was thought to be due to the low immunogenicity of the postsynaptic neurotoxins (PSNT) which cause death in the victims. However, it was showed that the use of ineffective adjuvant in the immunization of horse was the root cause. The highly effective Freund adjuvant (FA) causes severe local reactions and could not be used. A novel immunization protocol termed ‘low dose low volume multi-site’ was tested and shown to obliterate the local side effect and allow for the safe use of FA in horse. The immunization protocol led to the production of 7 highly potent monovalent AVs, and 2 potent polyvalent AVs, one against 4 neurotoxic venoms and another against 3 hematotoxic venoms. These AVs allow the treatment of snakebite victims without the need to identify the culprit snakes. Furthermore, we have tested a novel immunization strategy using ‘Diverse toxin repertoire’ of 12 Asian elapid toxin fractions. The resulting antiserum effectively neutralized at least 36 elapid venoms of 28 species encompassing 10 genera and from 20 countries on 4 continents, and most likely all the elapid neurotoxic snake venoms. These results indicate that effective universal antivenom against all elapid neurotoxic venoms of the world can be produced and save numerous lives.

Intradermal ChAdOx1 Vaccine Following Two CoronaVac Shots: A Case Report

Inactivated SARS-CoV-2 vaccines are used in many countries with uncertain immunogenicity. Intradermal ChAdOx1 has been proposed as a resource-efficient heterologous third booster shot. A 52-year-old healthy male healthcare professional had received two intramuscular CoronaVac shots on 21 April and 23 May 2021, and volunteered to take a 0.1 mL ChAdOx1 vaccine intradermally on 29 June 2021, with minimal local reactions. The declining IgG levels against spike protein from the two CoronaVac shots increased to higher than 10,000 AU/mL two weeks after the intradermal ChAdOx1. Moreover, the neutralizing antibody increased from 66.77% to almost 100%. A ratio of 6.6:9.7 of IgA:IgG was observed. The 50% pseudovirus neutralization titer (PVNT50) against lentiviral pseudovirus bearing a codon-optimized spike gene (wild type, alpha, beta, and delta) were 1812.42, 822.99, 1025.42, 1347.13, respectively. The SARS-CoV-2-specific T cells to spike protein–peptide pools (532–788 SFU/106 PBMCs) were detected. In conclusion, the antibody and cellular responses to the intradermal ChAdOx1, as a third booster dose in a healthy volunteer who received two intramuscular CoronaVac shots, revealed a dramatic increase in the total antibodies, including IgG, IgA, as well as T cell responses against spike protein. The immune response from intradermal ChAdOx1 should be further investigated in a larger population.

Housing for Refugees in Sweden: Top-Down Governance and its Local Reactions

In this article, we investigate local level reactions to the top-down state steering for the housing of refugees in Sweden. We especially reflect on events after the increased refugee reception in Sweden in 2015 and the introduction of a Settlement Act in 2016 which made it mandatory for municipalities to receive a specific number of refugees and organise accommodation. This has resulted in a wide array of housing situations for refugees concerning standard, costs and temporary solutions. A multi-level governance framework from on central government steering perspective is applied. We argue that the modified legislation can be understood as a change in governance throughout the years — from persuasion to economic incentives and, finally, to coercive methods. Sweden is a country that has distinguished itself as one refraining from particularity and continuing to work towards equality between newcomers and citizens. In relation to recent legal and political developments, we identify a change — a paradoxical change, as governance for the more-equal reception of refugees in Sweden seems to lead to increased inequalities for refugees on the local level.