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Heart transplant (HT) patients have a higher risk of severity after SARS-CoV-2 (COVID-19) infection than general population. Serological response to the initial vaccination regimen is lower. The clinical impact of the booster vaccination regimen in HT patients is unknown. The INMU_TC study analyze the immunogenicity after the COVID19 vaccination schedule and the clinical impact in patients with HT in Galicia. : To analyze the clinical events related to COVID-19 infection after receiving the booster dose in a population of patients with CT. Prospective observational study. HT recipients followed in the Galician Health System who had received a booster dose of COVID-19 vaccine according to the regional protocol were consecutively included. Serum anti-SARS-COV2 IgG concentration was determined between 14-30 days after the last vaccination dose. A value ≥33 BAU/ml was considered positive. COVID-19 clinical events were recorded. : We included 275 HT recipients, median age 64.5 years (IQR:55.1-70.7), and 21.8% female. Median time since HT was 7.4 years (IQR:2.5-14.9). Of these, 41 patients (14.9%) had COVID-19 after the booster dose, with an incidence rate of 300.6 per 1000 patient-year. Fourteen patients (34.2% of those infected) required hospital admission, and 4 died from the infection (9.8%). No significant differences were found between infected and non-infected patients after the third dose, except for renal function, more deteriorated in infected patients (creatinine 1.8±1.6 vs 1.4±0.8;p=0.008) and treatment with RAASi (12(29.3%) vs 123(52.6%);p=0.005). There were no significant differences in immunosuppression. A higher percentage of patients with infection, admission, and death had a negative serologic test. Serum concentration of antiSARSCoV2 IgG was lower in infected patients (735.8±895.0 vs 1318.1±847.9;p<0.001) and in patients requiring admission (266.9±581.8 vs 1282±862.2;p<0.001). Patients admitted to ICU and those who died had undetectable titers (<4.81 BAU/ml). HT patients with COVID-19 after the booster vaccine dose had lower serum concentration of anti-SARS-COV2 IgG, being even lower in those who presented a more unfavorable evolution. These data could suggest the importance of monitoring the response to vaccination in these patients in order to evaluate other therapeutic options. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Today, companies choose to display their advertising content on Web pages, using all the resources that technology offers, whether through eye-catching images, animated images, and even videos. The objective is to ensure that the information not only reaches the public but that their ideas travel to target audiences, to people who can potentially consume your products or services. Thus, at present, technology has revolutionized digital marketing, having as greatest exponents of effectiveness to Web pages and social networks, where the information traffic generated by users is analyzed, for example, through trending topics. A clear example that has been observed in 2020 and 2021 were the trends that have shaken the world, such as COVID-19, changing the way any business or organization works, apart from its impact on health. However, brands, apart from seeking empathy with consumers, designed their advertising campaigns to increase their sales. This paper presents an algorithm for the identification and analysis of advertising patterns directed by some brands that have sought to increase their sales successfully, having as a message the awareness of its consumers through displaying content in banners and advertisements, and thus achieve the attention of users. © 2022 Latin American and Caribbean Consortium of Engineering Institutions. All rights reserved.
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Background: The management of acute myeloid leukemia (AML) patients usually requires long inpatient treatments that can affect the limited care facilities, the quality of life, and increases healthcare costs. Additionally, leukemia treating centers in developing countries face limited sources to deliver high-dose chemotherapies as inpatient treatments. Therefore, several reports have established the feasibility and safety of outpatient consolidation. We aimed to implement a high-dose cytarabine outpatient program for AML in a limited-source institution at a public center in Peru.Methods: We conducted a prospective pilot study starting in January 2019 and ending before the COVID-19 Pandemic in March 2020. Eligible patients were ≥ age 14, met inclusion criteria for inpatient induction regimens, were without active infection, and had the following: normal chest x-ray and biochemistry, complete remission after one cycle of 7+3 induction. Logistical requirements included a 3-hours distance residence near the treatment center, caregiver support, trained nursing staff, infusion room capacity, and participation in follow-up. Patients received prophylactic antimicrobials such as oral levofloxacin, fluconazole, and acyclovir and were admitted to the hospital for predetermined complications of therapy (fever, G3-4 toxicity, febrile neutropenia, bleeding or refractory thrombocytopenia). Risk stratification was based on conventional cytogenetics and multiplex PCR using Leukemia.net criteria. Results: Forty-two patients were included during the study period. The median age was 38 years (16-63) and Female/Male ratio 4:3. According to Leukemia.net, 24% were classified as high, 50% intermediate and 26% as low risk group. Including FLT3 mutations in 26% of cases. Twenty-two and 20 subjects received 1-2 and 3-4 cycles of ambulatory HiDAC, respectively. About one-third of cases had emergency admissions during consolidation and 74% complete at least 3 cycles of cytarabine. Only 4 patients underwent sibling-donor allo-SCT. Sixty-four percent experienced relapses, and at 2 years follow-up only 21 subjects were alive. Median OS was 15 months, a better survival was shown among patients who received 3-4 cycles of ambulatory HiDAC (2-year OS 18 vs 23%, p=0.031). Conclusion: Our pilot study shows the feasibility to deliver HiDAC as outpatient consolidation in selected AML cases in a limited setting. Additionally, a high rate of relapses and poor survival was noted in our cohort that requires further consideration. Disclosures: No relevant conflicts of interest to declare.
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TOPIC: Chest Infections TYPE: Fellow Case Reports INTRODUCTION: The recent SARS-CoV-2 pandemic has immensely affected individuals worldwide leading to a serious global emergency. It has the capability to end in post-infection complications and critical outcomes due to significant pro-inflammatory conditions. The role of SARS-CoV-2 in patients with immune disorders, such as sarcoidosis, and the specific interaction between these two diseases remains unclear. Here we present a case of a 65-year-old female with sarcoidosis who got infected with SARS-CoV-2 complicated by pulmonary embolism (PE) and COVID associated pulmonary aspergillosis (CAPA) CASE PRESENTATION: A 60-year-old African American female with a PMH of Sarcoidosis, Chronic thromboembolic pulmonary hypertension (CTEPH) on Riociguat, Macitentan, and Warfarin presented with cough, SOB, and fever for 1-week duration. Upon arrival to the ED, vital signs were significant for tachypnea and hypoxemia. COVID-19 PCR was positive. Initial chest CT revealed bilateral ground-glass opacities (GGOs) with multilobar chronic airspace disease. She was treated with Remdesivir and dexamethasone. During the hospital course, warfarin was held due to supratherapeutic INR. However, before discharge her respiratory parameters decompensated and she required HFNC to maintain her saturation. CT pulmonary angiogram revealed PE in the right distal segmental branch with significant bilateral patchy infiltrates more severe in the distribution of lower lobe suggestive of multilobar pneumonia with bilateral GGOs with crazy paving. Beta galactomannan came back positive and Voriconazole was started empirically with significant improvement in respiratory symptoms. Later fungal culture from sputum confirmed aspergillosis. DISCUSSION: SARS-CoV-2 activates the immune system which results in a release of inflammatory cytokines and leads to cytokine storms. But it remains unknown how the interaction differs in patients with an altered immune system, especially in cases of impairment of the T-cell immunity and granuloma formation, such as sarcoidosis. Some authors suggested that constitutional defects of the regulation of macroautophagy in sarcoidosis could lead to a more severe outcome from the novel SARS-CoV-2 infection. literature review showed that alveolar damage, dysfunctional mucociliary clearance, and altered immune system further facilitates fungal invasion. We, therefore, hypothesize that SARS-CoV-2 in a patient with underlying sarcoidosis may lead to increased risk for pulmonary aspergillosis. CONCLUSIONS: The role of infection from the novel coronavirus in patients having sarcoidosis is still largely unknown however clinicians should be aware that it has the risk of serious complications and clinical deterioration including further destruction of lung architecture, hypervascular response, hypercoagulability, and superinfection like CAPA. REFERENCE #1: https://www.lung.org/lung-health-diseases/lung-disease-lookup/sarcoidosis/learn-about-sarcoidosis REFERENCE #2: https://www.hopkinsmedicine.org/health/conditions-and-diseases/pulmonary-sarcoidosis REFERENCE #3: https://www.nature.com/articles/s41379-020-00661-1#citeas DISCLOSURES: No relevant relationships by Danilo Enriquez, source=Web Response No relevant relationships by SM Hossain, source=Web Response No relevant relationships by Tahmina Jahir, source=Web Response No relevant relationships by Ruby Risal, source=Web Response No relevant relationships by Marie Frances Schmidt, source=Web Response No relevant relationships by Binav Shrestha, source=Web Response No relevant relationships by Sabbena Uppal, source=Web Response
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The ongoing COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global public health crisis. Many reports indicate disappointing results in cancer patients compared to the general population. Therefore, experts in the management of oncohematological malignancies from the National Institute of Neoplastic Diseases, national hospitals and a private clinic in Metropolitan Lima have developed recommendations obtained by consensus to continue with the management of patients with oncohematological neoplasms safely in the face of the pandemic.