Comparison of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine side effects by age groups

SUMMARY OBJECTIVE: This online survey aims to compare the side effects that may occur after inactivated severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccination by age groups. METHODS: A total of 411 participants aged 18-100 who received inactivated coronavirus disease 2019 vaccine were included in the study. RESULTS: Participants were divided into four groups according to their ages (i.e., 20-35, 36-50, 51-65, and over 65 years old). Vaccine-related side effects were primarily seen in the 20-35 age group and at least in the >65 age group (p<0.001). The most common side effects were pain, redness, swelling, and numbness at the injection site. Fatigue and headache were other common side effects. After vaccination, 3 (0.73%) participants had hypertension, and 1 (0.24%) had an asthma attack and was admitted to the hospital. No severe side effects were observed in any of the patients. The most critical factors determining the development of side effects were female gender and young age. CONCLUSION: According to the results of this study, different types and rates of side effects are seen in all age groups after the inactivated coronavirus disease 2019 vaccine. Since the 20-35 age group and female gender are at risk of side effects, it would be more appropriate to follow up the side effects after vaccination according to gender and age.

Can various complete blood count parameters helpful in preoperative diagnosis of adnexal torsion?

SUMMARY OBJECTIVE: Adnexal torsion is an important gynecological emergency due to nonfrequent but possible adverse reproductive outcomes. There is no specific laboratory marker to support the preoperative diagnosis or that can be used clinically. The aim of this study was to investigate the diagnostic values of platelet, neutrophil, lymphocyte, and red cell markers as an early indicator of ovarian torsion. METHODS: This retrospective study included 28 female patients who were treated surgically for adnexal torsion between August 2010 and July 2020, and 29 control group women. The demographic data and routine hematological values of patients were compared for adnexal torsion prediction. RESULTS: There were no differences between the groups in terms of the platelet count, platelet distribution width, red cell distribution width, and mean platelet volume values, and there were no differences in the demographic data. Statistical differences were found among white blood cell, hemoglobin, hematocrit, neutrophil and lymphocyte counts, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio, and 81.5% sensitivity and 82.1% specificity were identified for neutrophil/lymphocyte ratio 2.45 (area under the curve AUC 0.892; 95%CI 0.808-0.975; p<0.001). Odds ratio for neutrophil/lymphocyte ratio was 2.62 (95%CI 0.861-7.940, p=0.029). CONCLUSION: According to the regression analysis, neutrophil/lymphocyte ratio was found to be the most beneficial among all blood count parameters for the pre-diagnosis of AT.

Tocilizumab for juvenile idiopathic arthritis: a single-center case series

ABSTRACT BACKGROUND: Juvenile idiopathic arthritis (JIA) is the commonest chronic rheumatic disease among children. When not treated effectively, JIA can lead to functional disability, due to joint damage, along with long-term morbidities. OBJECTIVES: To describe the use of tocilizumab therapy for 11 patients with polyarticular JIA (pJIA) and systemic JIA (sJIA) who presented inadequate response or were refractory to disease-modifying anti-rheumatic drugs (DMARDs) and/or other biological therapies; and to evaluate its benefits, safety and tolerability. DESIGN AND SETTING: Observational retrospective case series at a tertiary-level training and research hospital. METHODS: We reviewed the medical records of 11 consecutive patients with JIA who received tocilizumab (anti-IL-6) therapy in our pediatric nephrology and rheumatology outpatient clinic. We analyzed their demographic data, clinical and laboratory findings, treatment response and adverse reactions. We determined the efficacy of tocilizumab treatment using the American College of Rheumatology (ACR) pediatric (Pedi) response criteria, including ACR Pedi 30, 50, 70 and 90 scores. We used the Wilcoxon test to compare measurements before and after treatment. RESULTS: Tocilizumab was given to seven patients with sJIA and four with pJIA (one of the pJIA patients was rheumatoid factor-positive). In most patients, we observed improvement of symptoms, absence of articular and extra-articular inflammation and continued inactive disease. ACR Pedi 30, 50 and 70 scores were achieved by 90.9% of the patients. Five patients showed minor side effects, possibly due to use of tocilizumab. CONCLUSIONS: Tocilizumab therapy should be considered for treating patients with diagnoses of pJIA or sJIA who are resistant to non-biological DMARDs and/or other biological therapies.

Comparison of early and late percutaneous tracheotomies in adult intensive care unit / Comparação de traqueotomia percutânea precoce e tardia em unidade de terapia intensiva para adultos / Comparación de traqueotomía percutánea precoz y tardía en unidad de cuidados intensivos para adultos

Background and objectives: Percutaneous tracheotomy has become a good alternative for patients thought to have prolonged intubation in intensive care units. The most important benefits of tracheotomy are early discharge of the patient from the intensive care unit and shortening of the time spent in the hospital. Prolonged endotracheal intubation has complications such as laryngeal damage, vocal cord paralysis, glottic and subglottic stenosis, infection and tracheal damage. The objective of our study was to evaluate potential advantages of early percutaneous tracheotomy over late percutaneous tracheotomy in intensive care unit. Methods: Percutaneous tracheotomies applied to 158 patients in adult intensive care unit have been analyzed retrospectively. Patients were divided into two groups as early and late tracheotomy according to their endotracheal intubation time before percutaneous tracheotomy. Tracheotomies at the 0–7th days of endotracheal intubation were grouped as early and after the 7th day of endotracheal intubation as late tracheotomies. Patients having infection at the site of tracheotomy, patients with difficult or potential difficult intubation, those under 18 years old, patients with positive end-expiratory pressure above 10 cmH2O and those with bleeding diathesis or platelet count under 50,000 dL−1 were not included in the study. Durations of mechanical ventilation and intensive care stay were noted. Results: There was no statistical difference among the demographic data of the patients. Mechanical ventilation time and time spent in intensive care unit in the group with early tracheotomy was shorter and the difference was statistically significant (p < 0.05). Conclusion: Early tracheotomy shortens mechanical ventilation duration and intensive care unit stay. For that reason we suggest early tracheotomy in patients thought to have prolonged intubation. .

Justificativa e objetivos: A traqueotomia percutânea tornou-se uma boa alternativa para os pacientes com previsão de intubação prolongada em unidades de terapia intensiva. Os benefícios mais importantes da traqueotomia são alta precoce da unidade de terapia intensiva e menos tempo de permanência no hospital. As complicações da intubação intratraqueal prolongada são: lesão da laringe, paralisia das pregas vocais, estenose glótica e subglótica, infecção e lesão traqueal. O objetivo deste estudo foi avaliar as potenciais vantagens da traqueotomia percutânea precoce versus traqueotomia percutânea tardia em unidade de terapia intensiva. Métodos: Traqueotomias percutâneas foram realizadas em 158 pacientes em unidade de terapia intensiva para adultos e analisadas retrospectivamente. Os pacientes foram alocados em dois grupos para traqueotomia precoce e tardia, de acordo com o tempo de intubação intratraqueal antes da traqueotomia percutânea. As traqueotomias consideradas precoces foram realizadas nos dias 0-7 de intubação intratraqueal e as tardias realizadas após o sétimo dia de intubação intratraqueal. Os pacientes com infecção no local da traqueotomia, intubação difícil ou potencialmente difícil, idade inferior a 18 anos, pressão positiva ao final da expiração acima de 10 cmH2O e aqueles com diátese hemorrágica ou contagem de plaquetas em 50.000 dL−1 foram excluídos do estudo. Os tempos de ventilação mecânica e internação em UTI foram registrados. Resultados: Não houve diferença estatística entre os dados demográficos dos pacientes. Os tempos de ventilação mecânica e de internação em unidade de terapia intensiva do grupo traqueotomia precoce foram ...

Introducción y objetivos: La traqueotomía percutánea se ha convertido en una buena alternativa para los pacientes con previsión de intubación prolongada en unidades de cuidados intensivos (UCI). Los beneficios más importantes de la traqueotomía son el alta precoz de la UCI y menos tiempo de permanencia en el hospital. Las complicaciones de la intubación endotraqueal prolongada son: lesión de la laringe, parálisis de las cuerdas vocales, estenosis glótica y subglótica, infección y lesión traqueal. El objetivo de este estudio fue evaluar las potenciales ventajas de la traqueotomía percutánea precoz versus traqueotomía percutánea tardía en la UCI. Métodos: Se realizaron traqueotomías percutáneas en 158 pacientes en la UCI para adultos, siendo analizadas retrospectivamente. Los pacientes fueron divididos en 2 grupos para traqueotomía precoz y tardía, de acuerdo con el tiempo de intubación endotraqueal antes de la traqueotomía percutánea. Las traqueotomías consideradas precoces fueron realizadas en los días 0-7 de intubación endotraqueal, y las tardías, después del séptimo día de intubación endotraqueal. Los pacientes con infección en la región de la traqueotomía, intubación difícil o potencialmente difícil, con una edad inferior a 18 años, presión positiva al final de la espiración por encima de 10 cmH2O y los que tenían diátesis hemorrágica o conteo de plaquetas en 50.000 dl−1 fueron excluidos del estudio. Se registraron los tiempos de ventilación mecánica y de ingreso en la UCI. Resultados: No hubo diferencia estadística entre los datos demográficos de los pacientes. Los tiempos de ventilación mecánica y de ingreso en la UCI del grupo traqueotomía precoz fueron ...