ANALYSIS OF ADVERSE EVENTS AFTER IMMUNIZATION WITH VACCINES AGAINST Sars-Cov-2

Although the WHO-recommended coronavirus vaccines are safe and effective, vaccines provide new information to healthcare professionals about the extent and nature of adverse reactions to these drugs. The aim of the study is supplementing the available data on adverse reactions of vaccines on the example of the experience of vaccination of the teaching staff of the Cherkasy Medical Academy with vaccines COVISHIELD and COMIRNATY. Information for this study was collected retrospectively through a survey of 72 employees of the Cherkasy Medical Academy who were vaccinated with the COVISHIELD vaccine (first dose); 67 workers vaccinated with AstraZeneca (second dose); 54 workers who were vaccinated with COMIRNATY vaccine (first dose); 52 people vaccinated with this vaccine (second dose). The study confirmed that among the local side effects, the most common were pain at the injection site, among the systemic - fever, weakness, fatigue and drowsiness, headache, muscle pain, chills. Most of the side effects were most pronounced in young people, more often in women than in men.

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.

ESTIMATION OF THE SAFETY OF LOW-INTENSITY LASER RADIATION IN TREATMENT OF PATIENTS WITH PROFESSIONAL POLYNEUROPATHIES OF THE UPPER LIMBS

The inclusion of low-intensity laser radiation in the complex treatment of professional polyneuropathies of the upper extremities, due to its numerous biological effects, contributes to a statistically significant reduction in pain in the hands of patients, and improves the conduction of nerve impulses along the peripheral nerves of the hands. In addition to describing the positive clinical and neurophysiological trends achieved during treatment, the issue of the safety of the developed therapy method is important. The aim of the study is to assess the safety of the proposed method of low-intensity laser therapy (LILT) in patients with professional polyneuropathies of the upper extremities. Material and methods: on the basis of the department of occupational pathology, 116 patients (60 men, 56 women) with occupational polyneuropathies of the upper extremities were treated using LILT. Therapeutic measures were carried out using a semiconductor laser apparatus for red spectrum radiation (650 nm) with fiber-optic light guides for percutaneous therapy "ALP-01-Laton" in the sitting position of patients. Diffuse scattered laser radiation of the red region of the spectrum with an energy illumination of 0.7-1.1 mW / cm2 directly affected the projection area of the exit of the median nerve from the carpal tunnel to the hand. There were 5-10 procedures per course, the energy exposure of laser radiation and the number of sessions were determined individually. Results: To ensure the safety of the therapy, patients were included in the study strictly in accordance with the developed inclusion and non-inclusion criteria. Patients were treated in a specially equipped room with the use of personal protective equipment; safety rules were followed during the operation of the device. During treatment, all 116 patients treated with LILT did not have systemic side effects. A number of patients developed short-term complaints associated with local reactions: short-term tingling sensations and "goose bumps" in the hands, warmth, slight burning sensation, etc. All recorded local side effects occurred directly during LILT-procedures and were completely stopped within 1-5 minutes after their completion. In general, LILT-exposure did not cause serious side effects and was well tolerated by patients. 13.5% of patients noted a decrease in pain in the arms directly during the LILT treatment procedures. Conclusion. The developed method of LILT of professional polyneuropathies of the upper extremities is simple and convenient for use in clinical practice: it is applicable both in a hospital and on an outpatient basis. LILT has a limited list of contraindications, and is generally well tolerated by patients with minimal local side effects.

Side Effects of mRNA-Based and Viral Vector-Based COVID-19 Vaccines among German Healthcare Workers

Background: the increasing number of COVID-19 vaccines available to the public may trigger hesitancy or selectivity towards vaccination. This study aimed to evaluate the post-vaccination side effects of the different vaccines approved in Germany; Methods: a cross-sectional survey-based study was carried out using an online questionnaire validated and tested for a priori reliability. The questionnaire inquired about demographic data, medical and COVID-19-related anamneses, and local, systemic, oral, and skin-related side effects following COVID-19 vaccination; Results: out of the 599 participating healthcare workers, 72.3% were females, and 79.1% received mRNA-based vaccines, while 20.9% received a viral vector-based vaccine. 88.1% of the participants reported at least one side effect. Injection site pain (75.6%) was the most common local side effect, and headache/fatigue (53.6%), muscle pain (33.2%), malaise (25%), chills (23%), and joint pain (21.2%) were the most common systemic side effects. The vast majority (84.9%) of side effects resolved within 1–3 days post-vaccination; Conclusions: the mRNA-based vaccines were associated with a higher prevalence of local side effects (78.3% vs. 70.4%; Sig. = 0.064), while the viral vector-based vaccine was associated with a higher prevalence of systemic side effects (87.2% vs. 61%; Sig. < 0.001). Females and the younger age group were associated with an increased risk of side effects either after mRNA-based or viral vector-based vaccines. The gender- and age-based differences warrant further rigorous investigation and standardized methodology.

Adverse effects of prostaglandin analogues used in ophthalmological practice

Prostaglandin analogues are a class of antihypertensive drugs for glaucoma treatment which are systematically safe but have a sufficiently large number of local side effects. These effects may worsen the quality of life of patients with glaucoma and reducetheir adherence to treatment routines due to physical and psychological discomfort. The review presents literature data and clinical cases fromthe author’s own medical practice.

Side Effects Reported by Jordanian Healthcare Workers Who Received COVID-19 Vaccines

Background Distribution of COVID-19 vaccines has been surrounded by suspicions and rumors making it necessary to provide the public with accurate reports from trustworthy experts such as healthcare professionals. Methods We distributed a questionnaire in Jordan among physicians, dentists and nurses who received a COVID-19 vaccine to explore the side effects (SE) they encountered after the first or the second dose of one of three vaccines namely: AstraZeneca Vaxzevria (AZ), Pfizer-BioNTeck (PB), and SinoPharm (SP) vaccines. Results A total of 409 professionals participated. Approximately 18% and 31% of participants reported no SE after the first dose and second dose, respectively. The remainder had mostly local side effects related to injection site (74%). Systemic side effects in the form of fatigue (52%), myalgia (44%), headache (42%), and fever (35%) prevailed mainly after the first dose. These were significantly associated with AZ vaccine, and age ≤ 45 years (p = 0.000 and 0.01, respectively). No serious SE were reported. Conclusions We can conclude that SE of COVID-19 vaccines distributed in Jordan are within the common range known so far for these vaccines. Further studies are needed to include larger sample size and longer follow-up period to monitor possible serious and long-term SE of the vaccines.

Efficacy and Safety of COVID-19 Vaccines: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

The current study systematically reviewed, summarized and meta-analyzed the clinical features of the vaccines in clinical trials to provide a better estimate of their efficacy, side effects and immunogenicity. All relevant publications were systematically searched and collected from major databases up to 12 March 2021. A total of 25 RCTs (123 datasets), 58,889 cases that received the COVID-19 vaccine and 46,638 controls who received placebo were included in the meta-analysis. In total, mRNA-based and adenovirus-vectored COVID-19 vaccines had 94.6% (95% CI 0.936–0.954) and 80.2% (95% CI 0.96.4–0.92.7) efficacy in phase II/III RCTs, respectively. Efficacy of the adenovirus-vectored vaccine after the first (97.6%; 95% CI 0.939–0.997) and second (98.2%; 95% CI 0.980–0.984) doses was the highest against receptor-binding domain (RBD) antigen after 3 weeks of injections. The mRNA-based vaccines had the highest level of side effects reported except for diarrhea and arthralgia. Aluminum-adjuvanted vaccines had the lowest systemic and local side effects between vaccines’ adjuvant or without adjuvant, except for injection site redness. The adenovirus-vectored and mRNA-based vaccines for COVID-19 showed the highest efficacy after first and second doses, respectively. The mRNA-based vaccines had higher side effects. Remarkably few experienced extreme adverse effects and all stimulated robust immune responses.

A Quest for a Universal Plasma-Derived Antivenom Against All Elapid Neurotoxic Snake Venoms

This review describes the research aimed at the development of universal antivenom against elapid neurotoxic snake venoms. The antivenoms produced in Thailand in the 1980s were of low potency, especially against the elapid venoms. This was thought to be due to the low immunogenicity of the α-neurotoxins, which are the most lethal toxins in these venoms. Comparisons of various α-neurotoxin conjugates and polymers, and also different immunological adjuvants, showed that the adjuvant used is the major determinant in the antibody response in horses. The potent Freund’s adjuvant was not used due to its severe local side-effect in horses. Therefore, a novel immunization protocol termed ‘low dose, low volume multi-site’ was developed for use in horses. This immunization protocol has led to the production of highly potent monospecific antivenoms against several elapid and viperid venoms, and two potent polyspecific antivenoms, one against 4 neurotoxic and another against 3 hematotoxic venoms. The immunization protocol has also led to other improvements in antivenom production including: several fold increases in antiserum potency, a reduction in the time required to reach therapeutically useful antibody titers, a 90% reduction in the amount of venom used, and 100% of the horses responding to the immunization program. This development is partly responsible for significant decrease in the Thailand’s annual snakebite death toll from a few dozens to mostly nil in recent years. Finally, a simple and novel immunization strategy, using a ‘diverse toxin repertoire’ composed of numerous elapid toxin fractions as immunogen, was proposed and tested. This immunization procedure has resulted in the successful production of a widely paraspecific antiserum against at least 36 neurotoxic venoms of 28 species encompassing 10 genera and from 20 countries on four continents, and possibly against all elapid venoms with α-neurotoxins as the lethal toxins. These results indicate that, with optimizations of the composition of the ‘diverse toxin repertoire’, the immunization scheme and antibody fractionation to increase the antivenom neutralizing potency, an effective universal antivenom against the neurotoxic elapid snakes of the world can be produced.

Evaluation of electrochemotherapy in the management of apocrine gland anal sac adenocarcinomas in dogs: A retrospective study

Background: Electrochemotherapy (ECT) combines the administration of anticancer drugs with the delivery of electric pulses, thus increasing the drug uptake through the cell membranes, resulting in increased efficacy. Aim: The aim of our study was to describe the tolerability and efficacy of ECT alone or in association with other treatment modalities for the management of apocrine gland anal sac adenocarcinoma (AGASAC). Methods: Medical records of dogs with a diagnosis of AGASAC that were treated with ECT alone or in combination with surgery/chemotherapy were retrospectively evaluated. Each dog received 20 mg/m2 of bleomycin intravenously. Based on the clinician’s decision, the primary tumor or tumor bed was also infiltrated with cisplatin at the dose of 0.5 mg/cm2. Trains of permeabilizing biphasic electric pulses were then applied under general anesthesia. Results: Ten dogs were enrolled in the study. Of those 10 dogs, only one received ECT for treatment of microscopic local disease, while in six cases ECT was the only treatment modality. In three dogs, ECT was followed by systemic medical treatment. Six dogs (60%) had a partial response (PR), three dogs (30%) had stable disease, and one dog treated for microscopic disease did not show any sign of local relapse for 305 days after treatment, being still alive and in complete remission at the time of writing this article. The median time to progression was 303 days and the median survival time was 365 days. The treatment was well tolerated and local side effects were minimal. No systemic effects were documented. Conclusion: This preliminary study suggests that ECT may be beneficial for dogs with AGASAC and could be a useful addition to the current therapeutic options in consideration of its low cost, limited toxicity, and ease of administration.