A CLINICAL CASE OF A PATIENT WITH MUCOCUTANEOUS AND MUSCULOSKELETAL MANIFESTATIONS AFTER COVID-19 VACCINATION

With the onset of the global pandemic due to the new virus SARS-CoV-2 and the development of vaccines against it, various adverse events have been reported to them. We present a clinical case of a 53-year-old Caucasian woman who presented one week after Pfizer vaccination against SARS-CoV-2 with severe muscle weakness, myalgia in upper and lower extremities, alopecia 2 cm in diameter, and two mucosal ulcerations on lower lip. No deviations from the hematological, biochemical and immunological indicators were found from the laboratory tests carried out. Two weeks later, the patient developed total alopecia on the scalp. Due to the causal relationship with the administered vaccine, the patient was not given a second dose and a diagnosis of Systemic Connective Tissue Disease was not accepted. Six months later, recovery and partial hair growth was observed in the affected areas of the capillitium. Alopecia areata is autoimmune in nature, with literature reporting initial or recurrent alopecia after vaccination. It is important that adverse events after vaccination are properly evaluated in order to choose a proper therapeutic approach. © 2022 Medical Information Center. All rights reserved.

Students’ Attitude to Online Emergency Remote Teaching (ERT) at Nikola Vaptsarov Naval Academy and Faculty of Maritime Studies Split during COVID-19 crisis

COVID-19 pandemic has set new challenges to education systems in the Republic of Bulgaria and in the Republic of Croatia, particularly to higher education systems. In summer semester 2020/2021, emergency remote teaching (ERT) was imposed at Nikola Vaptsarov Naval Academy (NVNA) and at University of Split, Faculty of Maritime Studies (UoS FMS) under the circumstances of the COVID-19 pandemic. As researches related to the students’ satisfaction with learning in digital environment at the beginning of the COVID-19 crisis are very rare in Bulgaria and in Croatia, the aim of the paper is to analyse students’ attitude to the quality of three-month ERT in specialized compulsory navigation courses at NVNA and at UoS FMS. Anonymous survey on students’ attitude was conducted on 154 students majoring in Navigation at NVNA and 98 students majoring in Nautical Studies at UoS FMS. The study revealed that students were generally satisfied with the quality of ERT at NVNA and at UoS FMS. The students’ primary concerns regarding ERT (online/hybrid) in navigation courses included the quality of ERT, difficulties with technology, motivation, as well as time management. This useful information can help both lecturers and faculty managements to adapt their teaching strategies and provide adequate support to the students. MET institutions should support students to build skills and behaviours based on students’ concerns, but also to train and support lecturers to develop and deliver high-quality hybrid courses. Although the study has limited value, it could be used as a reference point for further studies and should encourage MET institutions, as well as maritime administrations, to give strong support to the implementation of hybrid courses in MET. This study could also inspire maritime administrations to conduct pilot projects on hybrid courses introduction in MET, in line with global trends in education and stakeholders’ growing demand for distance learning, without compromising quality of MET. © 2022, Faculty of Maritime Studies. All rights reserved.

Arterial thrombosis: the obscure threat in COVID-19 pandemic victims

INTRODUCTION: SARS-CoV-2 is a novel Coronavirus responsible for the current global pandemic resulting in an escalating number of cases and fatalities worldwide. There is a growing number of reports regarding patients presenting with acute limb ischemia due to thrombosis of all arterial beds. We conducted a literature review to identify and summarize the available data regarding the incidence of COVID-19 induced acute peripheral arterial thrombosis, potential pathophysiological mechanisms, clinical representation, diagnosis, surgical outcomes and limb salvage results. EVIDENCE ACQUISITION: References for this review were identified through searches on PubMed, Ovid Medline, and Embase from December 1, 2019 to March 15, 2021 using relevant terms related to COVID-19. Reference lists of the articles were also searched. Thirty-six publications were deemed relevant for the purpose of this literature review. EVIDENCE SYNTHESIS: An aggressive and timely medical therapy and surgical interventions should be performed to obtain positive treatment outcomes. Nevertheless, the absence of evidence-based protocols remains an obstacle for healthcare providers. Further quality research about SARS-CoV-2 infection with a focus on arterial thrombotic complications are needed to characterize arterial consequences of Coronavirus and to evaluate the necessity of therapeutic anticoagulation in COVID-19 patients with peripheral arterial occlusive disease or thrombophilia. CONCLUSIONS: Healthcare providers should be aware of the manifestations of COVID-19 and a high index of suspicion should be maintained so that all can benefit from evidence of measures that have been found to be effective. Although previous reports also identified COVID-19 patients with limb ischemia, there is limited data on the clinical course and treatment.