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1.
Alergia Astma Immunologia ; 27(2):68-74, 2022.
Article in Polish | EMBASE | ID: covidwho-2030741

ABSTRACT

The Coronaviridae family includes the seven known human coronavi-ruses (HCoV) that cause mild to moderate respiratory infections (HCo-V-229E, HCoV-NL63, HCoV-OC43, HCoV-HKU1) as well as severe illness and death (MERS-CoV, SARS-CoV, SARS-CoV-2). Severe infections in-duce inflammatory responses that are often intensified by host ada-ptive immune pathways. Proinflammatory responses are triggered by CoV entry mediated by host cell surface receptors. Interestingly, four of the seven strains use cell surface metallopeptidases as receptors. The entry receptors for specific coronaviruses are: aminopeptidase N (AP-N), dipeptidyl peptidase 4 (DPP4) and angiotensin-converting enzyme 2 (ACE2) for HCoV-229E, MERS-CoV, SARS-CoV and SARS-CoV2, respectively. In addition, these receptors perform many physiological functions, including the regulation of the circulatory and immune sys-tems. Coronavirus receptors are also highly expressed in human tissues and organs (intestines, kidneys, heart, lungs). Additionally, some cy-tokines, chemokines, and other proteins and immune cells influence the modulation of the expression of coronavirus receptors. This review presents the biological role of receptor proteins in the regulation of human physiological systems, the impact of the immune response on susceptibility to coronavirus infections, and the potential effects of glucocorticosteroids (GCS) and specific allergen immunotherapy (AIT) used in the treatment of asthma and allergy on the suscpetibility to coronaviral infections.

2.
Journal of Emdr Practice and Research ; 16(3):156-168, 2022.
Article in English | Web of Science | ID: covidwho-2005792

ABSTRACT

Recent research has provided new information on the impact of COVID-19 and previous pandemics on the mental health of healthcare professionals (HCP). Several studies have found that HCP are greatly affected by pandemics and may develop anxiety disorders, mood disorders, and posttraumatic stress disorder. The stress caused by the intense working conditions and the fear of contracting and transmitting the virus are major vulnerability factors for these workers, increasing their risk of developing a mental health condition. It is therefore essential to provide appropriate support to this population in order to reduce and avoid the psychological burden of the current pandemic on their mental health. Considering the data previously published on the COVID-19 pandemic and past epidemics, the present article aims to provide an epidemiological review of the psychological impact of a pandemic on healthcare professionals. Furthermore, it examines, from a theoretical perspective, whether EMDR early interventions (EEI) may constitute an effective solution in order to provide psychological support to HCP in hospitals. Lastly, the article will identify various protocols for EEI, which, it argues, should be the approaches of choice for providing early support following a potentially traumatic event.

3.
Transpl Immunol ; 74: 101656, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1967189

ABSTRACT

Advances in immune suppression therapies and desensitization have made possible kidney transplantation regardless of HLA incompatibility. Single antigen bead assay (SAB) is a semi-quantitative estimation of the amount of human leukocyte antigen (HLA) antibodies present in the recipient plasma, and mean fluorescence intensity (MFI) generated gives this rough estimation of the antibodies present in the recipient. Here we present a case of successful kidney transplantation in a patient who expressed DSA with high MFI. A 33-yr-old male, diagnosed with chronic kidney disease (CKD) on regular maintenance hemodialysis, opted for second kidney transplant with his sibling as prospective donor and was referred to the department of Transplant Immunology for histocompatibility testing. Patient had HLA incompatibility with multiple DSA identified by SAB. Patient undergone 20 sessions of plasma exchange till discharge and finally till 6 months graft was functioning well. The authors thus conclude that the option of a high-risk HLA incompatible kidney transplant can be offered to recipients with high MFI DSA, who wish to undergo transplantation for end stage renal disease.


Subject(s)
Kidney Transplantation , Graft Rejection/therapy , Graft Survival , HLA Antigens , Histocompatibility Testing , Humans , Male , Plasma Exchange , Retrospective Studies
4.
Family Medicine and Primary Care Review ; 24(2):163-167, 2022.
Article in English | Scopus | ID: covidwho-1964334

ABSTRACT

Allergen immunotherapy (AIT) is the only casual method of allergy treatment. It is based on regular administration of a gradually increasing dose of an allergen to induce immunological tolerance to a particular sensitising factor. Due to proven efficacy, including preventive effect as well as favourable safety profile, it should be widely applicable, particularly among older children and adolescents. While the number of patients suffering from non-communicable diseases, including allergies, is rising, there is a false im-pression that the impact of infectious diseases can be disregarded. Thanks to prophylactic vaccines, many infectious diseases that used to be a threat to people’s lives have been forgotten. In order to tackle familiar and emerging infectious diseases (such as COVID-19), there is a need to keep in mind vaccinations in all age groups. As allergen immunotherapy and prophylactic vaccines affect the immunologic system, performing both interventions in one patient may raise concerns about safety and effectiveness. However, a large-scale study on this topic has not been performed to date. This article summarises immunological responses occurring after contact with pathogens and allergens as well as describes reactions triggered by prophylactic vaccines and AIT. What is more, possible interference of receiving both a prophylactic vaccine and AIT is discussed. © by Wydawnictwo Continuo.

5.
Shared trauma, shared resilience during a pandemic: Social work in the time of COVID-19 ; : 235-248, 2021.
Article in English | APA PsycInfo | ID: covidwho-1930231

ABSTRACT

The spread of COVID-19 has led to many public health challenges including detrimental mental and physical health outcomes. For an eye movement desensitization and reprocessing (EMDR)-certified therapist who primarily treats a population with an underlying diagnosis of complex posttraumatic stress disorder (C-PTSD), this social phenomenon has presented many ethical and clinical challenges. The continued advancements in technology have promoted a rise in the development and utilization of mobile health applications such as those using EMDR techniques to facilitate the therapeutic process. However, research measuring the efficacy and safety of these applications is limited, particularly for clients who present with complex posttraumatic conditions and associated comorbidities. In this time of collective trauma, virtual EMDR has progressed from an emerging trend to a necessary clinical adaptation. This composite case study illustrates a personal reflection of the adaptation of EMDR to teletherapy in the wake of the COVID-19 pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

6.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927844

ABSTRACT

RATIONALE: Over 400,000 individuals are estimated to have been exposed to the fallout of the World Trade Center (WTC) disaster. The incidence of acquired allergy and lung injury among rescue and cleanup workers exposed to the WTC fallout has been established. Briefly, rescue and cleanup workers exposed to the WTC fallout had a high incidence of allergic hypersensitivity and permanent small airways dysfunction characterized by distal airways narrowing and airway hyperresponsiveness. The current study sought to quantify the utilization of allergy/immunology services among rescue and cleanup workers exposed to the WTC fallout. METHODS: Subjects (N=65) were referred from the WTC Health Program to a multispecialty allergy/immunology and pulmonology clinic for provision of allergy-immunology specialty services. Electronic health records of all subjects were retrospectively reviewed from the date of first referral to March 2020-when routine care was interrupted due to the coronavirus disease 2019 pandemic-to quantify utilization of allergy/immunology and pulmonology services;10 subjects were excluded from analysis due to incomplete health records. RESULTS: On average, time to referral for allergy-immunology services by the WTC Health Program was 15.2 years (SD=1.7). The majority of the subjects were male (89.1%), police officers (67.3%) who never smoked (65.5%) and had no history of allergic or respiratory disease prior to being exposed to the WTC fallout. Most were found to have environmental allergies (83.6%);the most common comorbidities were allergic rhinitis (89.1%), asthma (67.3%), and chronic sinusitis (63.6%). All subjects underwent environmental allergy testing. Most subjects-35 of 55 (63.6%)-were prescribed an epinephrine autoinjector for environmental allergies. Regarding allergic immunotherapy (IT), 33 of 55 (60.0%) received IT;additionally, 7 subjects (12.7%) were determined to be IT candidates but did not receive IT. The most common monoclonal antibody therapy used in this cohort was omalizumab (18.2%). Only 11 (20.0%) and 3 (5.5%) underwent serum IgE and IgG testing, respectively. CONCLUSION: Rescue and cleanup workers referred to a multispecialty allergy/immunology and pulmonology practice from the WTC Health Program not only had a high incidence of acquired allergies to environmental allergens, but the majority were prescribed and epinephrine autoinjector and either received or were candidates to receive allergy immunotherapy. Given that hundreds of thousands of individuals were exposed to the WTC fallout and exposure is an independent risk factor for developing allergic disease, this research may have identified ways we may be falling short in providing allergy/immunology services to exposed individuals.

7.
Italian Journal of Medicine ; 16(SUPPL 1):71, 2022.
Article in English | EMBASE | ID: covidwho-1913011

ABSTRACT

Background and Aim of the study: SARS-CoV2 vaccines may cause immune-mediated reactions with different mechanisms, the main being: immediate and delayed hypersensitivity, dis-immune mechanisms due to Spike protein molecular mimicry and autoimmune pathogenesis. In July 2021 a new Immunology outpatients facility was inaugurated in Cardarelli Hospital - Naples, in order to respond to the increasing demand of immunological consult. Materials and Methods: We accessed our outpatients clinical files by selecting the patients with suspected immune-mediated reaction to SARS-CoV2 vaccines. We reported sex, reaction type, vaccine type, time of onset, duration, treatment, clinical outcome, result of poly-ethylene-glycole (PEG) testing, indication for continuation of vaccine program and, for 'autoimmune-like' reactions, final diagnosis and treatment. Results: Nine women reported hypersensitivity reactions with mRNA vaccines. All the subjects were skin tested for PEG: the test was positive in 5 patients, who were suggested to be vaccinated with desensitization protocol, while the other 4 underwent subsequent doses with previous anti-histamine/steroid treatment. Six patients - 5 women and 1 man - reported 'autoimmune-like' reactions: 3 have been diagnosed for Indifferentiated Connectivitis and 1 for Behcet flare. These data will be updated. Conclusions: The increasing numbers of suspected immune-mediated reactions to vaccines detected in our clinical practice show the need of empower Clinical Immunology facilities in order to improve the safety of the vaccinated population.

8.
Revue Francaise d'Allergologie ; 2022.
Article in English | EMBASE | ID: covidwho-1886064

ABSTRACT

Teleconsultation has been a reimbursed tool for monitoring patients since 2018 but which experienced a phenomenal boom with the COVID crisis of 2020. The National Professional Council of Allergology wanted to survey its members in this regard. 82.1% did not use this tool before the crisis but during it 86.4% of the doctors did it and 66.8% still do it in 2021. The teleconsultation is used mainly for the renewal of an allergen immunotherapy, symptomatic treatments and to announce a biological assessment. One in two allergists find it “interesting” to be able to receive new patients in this way, especially for patients in a medical desert, with a history of drug allergy or chronic urticaria. 57.3% think they save time thanks to teleconsultation. We note that this tool has become a habit of allergists who have known how to appropriate and adapt it to their practice.

10.
Alpha Psychiatry ; 23(3):121-127, 2022.
Article in English | Academic Search Complete | ID: covidwho-1865620

ABSTRACT

Background: This study investigates the effect of the online Eye Movement Desensitization and Reprocessing Recent Traumatic Episode Protocol on posttraumatic stress disorder, anxiety, depression, and burnout symptoms in healthcare workers diagnosed with pandemic- related post-traumatic stress disorder. Methods: The study included healthcare workers who applied to psychiatry outpatient clinics due to the psychiatric symptoms that developed related to the pandemic and who were diagnosed with post-traumatic stress disorder. The Beck Anxiety Inventory, Impact of Event Scale-Revised to evaluate the symptoms of post-traumatic stress disorder (avoidance, intrusion, and hyperarousal), Maslach Burnout Inventory, and Beck Depression Inventory were used for the assessment. The tests were administered 3 times (pre-treatment, post-treatment, and at 1-month follow-up). Results: This study included 14 healthcare workers diagnosed with post-traumatic stress disorder;2 (14.3%) physicians, 2 (14.3%) nurses, 4 (28.6%) other-healthcare workers/medical staff, and 6 (42.8%) other healthcare workers/non-medical staff. There was a significant decrease in Impact of Event Scale-Revised total score, the intrusion and hyper-arousal sub-scores between T1 and T2 (P = .018;P = .005;P = .0005, respectively) and between T1 and T3 (P < .001;P < .001;P < .001, respectively), but there was no difference between T2 and T3 (P = .89). A significant difference was found in repeated measurements of both Beck Depression Inventory [P < .001] and Beck Anxiety Inventory [P < .001] scores. There was a significant difference in emotional exhaustion, one of the subscales of Maslach Burnout Inventory (P = .09). However, there was no significant difference in depersonalization (P = .48) and personal accomplishment (P = .66). Conclusions: Recent Traumatic Episode Protocol appears to be capable of reducing symptoms of anxiety, depression, intrusion, and hyperarousal symptoms of post-traumatic stress disorder and emotional exhaustion when symptoms that developed are related to the pandemic in healthcare workers. [ FROM AUTHOR] Copyright of Alpha Psychiatry is the property of Anatolian Journal of Psychiatry 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.)

11.
Ann Pharmacother ; : 10600280221096883, 2022 May 18.
Article in English | MEDLINE | ID: covidwho-1854676
12.
Journal of the Formosan Medical Association ; 121(5):871-875, 2022.
Article in English | EMBASE | ID: covidwho-1851486
13.
Journal of EMDR Practice & Research ; 16(2):50-60, 2022.
Article in English | Academic Search Complete | ID: covidwho-1833856

ABSTRACT

The intensive care survivor population is increasing. Critical illness can lead to long term psychological distress for a significant proportion of intensive care survivors. This situation has been brought into even starker focus with the impact of COVID-19. Critical illness can lead to long term psychological distress for a significant proportion of intensive care survivors. Risk factors for post-intensive care psychological distress include delirium experiences. This single case study describes the therapeutic process and utility of the Recent-Traumatic Episode Protocol (R-TEP), an eye movement Desensitization and reprocessing (EMDR) therapy protocol for early intervention, with an ICU survivor where therapy was conducted remotely. The treatment provision is unusual in terms of the use of the R-TEP protocol and therapy not being in person. Treatment response was assessed using three standardized measures pre-treatment, post-treatment and at 4-month follow-up, and through qualitative feedback. The advantages of the R-TEP structure are discussed and the need for further research with the ICU survivor population considered. [ FROM AUTHOR] Copyright of Journal of EMDR Practice & Research is the property of Springer Publishing Company, Inc. 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.)

14.
Journal of EMDR Practice & Research ; 16(2):68-75, 2022.
Article in English | Academic Search Complete | ID: covidwho-1833855

ABSTRACT

During the period of the COVID-19 pandemic from the start of 2020 till late 2021, mental health services—seeking and providing—have gone through various changes and adaptations. In this article, we report on eye movement desensitization and reprocessing (EMDR) psychotherapy service providers in India, and how they adapted to the changing circumstances during this time, using a narrative enquiry approach. [ FROM AUTHOR] Copyright of Journal of EMDR Practice & Research is the property of Springer Publishing Company, Inc. 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.)

15.
J Psychosoc Rehabil Ment Health ; : 1-12, 2022 Feb 03.
Article in English | MEDLINE | ID: covidwho-1827536

ABSTRACT

Many eye movement desensitization and reprocessing (EMDR) therapists moved their practice online during COVID-19. We conducted surveys and interviews to understand the implementation and acceptability of online EMDR therapy. From 17 June to 2nd August 2021 an online survey was open to EMDR therapists from the EMDR Association UK & Ireland and EMDR International Association email lists, and, through them, their clients. Questions related to determinants of implementation (for therapists) and acceptability (for clients) of online EMDR. Semi-structured interviews were conducted with a sample of therapist respondents to provide a deeper understanding of survey responses. Survey responses were received from therapists (n = 562) from five continents, and their clients (n = 148). 88% of clients responded as being extremely or very comfortable receiving EMDR therapy online. At the initial point of 'social distancing', 54% of therapists indicated strong or partial reluctance to deliver online EMDR therapy compared to 11% just over one year later. Four fifths of therapists intended to continue offering online therapy after restrictions were lifted. Free-text responses and interview data showed that deprivation and clinical severity could lead to exclusion from online EMDR. Internet connectivity could disrupt sessions, lead to cancellations, or affect the therapy process. Therapists benefited from training in online working. Online EMDR is generally acceptable to therapists and clients, with reservations about digital exclusion, case severity, poor internet connectivity and the need for training. Further research is needed to confirm that online EMDR is clinically non-inferior to in-person working. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40737-022-00260-0.

16.
HLA ; 100(1): 52-58, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1816658

ABSTRACT

The effects of COVID-19 vaccination on alloimmunization and clinical impact in transplant candidates remain largely unknown. In a 61-year-old man who had no donor-specific antibodies (DSA) and was planned to undergo ABO-incompatible kidney transplantation (ABOi KT), DSAs (anti-A24, anti-B51, and anti-Cw14) developed after COVID-19 vaccination. After desensitization therapy, antibody level was further increased, leading to flow cytometric crossmatch-positive status. Donor-specific T cell immunity using interferon-gamma ELISPOT was continuously negative, whereas SARS-CoV-2 specific T cell immunity was intact. After confirming the C1q-negative status of DSA, the patient received ABOi KT. The patient had stable graft function and suppressed alloimmunity up to 2 months after KT. COVID-19 vaccination might relate to alloimmunization in transplant candidates, and desensitization through immune monitoring can help guide transplantation.


Subject(s)
COVID-19 , Kidney Transplantation , Alleles , Antibodies , COVID-19 Vaccines , Flow Cytometry , Graft Rejection , Graft Survival , HLA Antigens , Humans , Living Donors , Male , Middle Aged , SARS-CoV-2 , Vaccination
18.
Medicina (Kaunas) ; 58(4)2022 Apr 03.
Article in English | MEDLINE | ID: covidwho-1810018

ABSTRACT

Dabrafenib and trametinib are two available molecules that have been approved for the treatment of metastatic melanoma with BRAF-V600E or V600K mutations. Their combined therapy has led to long-lasting survival benefits and substantially improved outcomes. Until now, only a few cases of severe hypersensitivity reactions to dabrafenib and vemurafenib have been reported, and even fewer desensitization protocols to these molecules have been documented. We report the case of a 71-year-old female patient with metastatic melanoma harboring a BRAF-V600E mutation undergoing targeted therapy with dabrafenib and trametinib. Two weeks after the initiation of the combined treatment, she developed a hypersensitivity reaction. The cause-effect relationship between dabrafenib and the hypersensitivity reaction was demonstrated twice, when symptoms recurred upon dabrafenib reintroduction. We started a rapid 3-day dabrafenib desensitization protocol, which was well tolerated. When the patient discontinued the drug administration, we decided on a longer protocol that included more steps and more days in order to prevent the occurrence of other hypersensitivity reactions. Our patient tolerated both rapid and slow-going schedules, the first one reaching the final dose within 3 days and the second one reaching the total daily dose within 14 days. Depending on the patient's needs, the severity of the hypersensitivity reaction and the hospital's availability, the doctor may choose either the rapid or slow-going desensitization protocol.


Subject(s)
Melanoma , Neoplasms, Second Primary , Skin Neoplasms , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Female , Humans , Imidazoles , Melanoma/drug therapy , Melanoma/genetics , Mutation , Neoplasm Recurrence, Local/drug therapy , Neoplasms, Second Primary/etiology , Oximes , Proto-Oncogene Proteins B-raf/genetics , Skin Neoplasms/pathology
19.
Int Arch Allergy Immunol ; 183(7): 778-784, 2022.
Article in English | MEDLINE | ID: covidwho-1807742

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has caused a global health crisis. To prevent the disease, the Ministry of Health of Turkey gained approval for the CoronaVac COVID-19 vaccine for emergency use as the first-line. This study aimed to evaluate patients who developed hypersensitivity reactions (HRs) due to the CoronoVac vaccine and to share our experience of administering the second dose of vaccine to these patients. METHODS: The study group included the patients who presented to the Ege University Allergy and Immunology Division between January and May 2021. Demographic data, atopic status, allergic reactions to the first dose of the COVID-19 vaccine and the route of second-dose vaccine administrations were recorded. RESULTS: A total of 7 patients (four healthcare professionals), 6 (86%) of whom were women, with an average age of 53.4 years, were included in the study. The rate of allergic reactions among Ege University health workers was 0.036% (2/5,558). Six of our patients had a history of additional allergic diseases and comorbid diseases. None had any allergic reactions to previous vaccinations and latex allergy. Reactions developed commonly on the skin, as generalized urticaria/angioedema and pruritus. The severity of the reactions was evaluated as mild in 2, moderate in 3, and severe in 2 cases. The second-dose CoronaVac was safely administered by using a gradually increase dose in a total of 6 patients. CONCLUSION: In patients with HRs due to Sinovac in the first dose, the second dose can be safely performed using a gradually increased dose.


Subject(s)
COVID-19 , Latex Hypersensitivity , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Female , Humans , Latex Hypersensitivity/epidemiology , Male , Middle Aged , Pandemics , Vaccination/adverse effects , Vaccines
20.
Health Policy Technol ; : 100625, 2022 Apr 22.
Article in English | MEDLINE | ID: covidwho-1800036
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