Antibody titers of individuals vaccinated for COVID-19: A systematic review.

An important preventive measure to mitigate the COVID-19 pandemic is vaccine implementation. In creating vaccines, evoking neutralizing antibody (NAb) production is the main objective. This review determines and compares the NAb titers produced by COVID-19 vaccine recipients based on the vaccine type and the manner of administration. This review includes published articles on studies with healthy participants with a minimum age of 18 years, without previous infections, and those who were given Emergency Use License (EUL) vaccines from WHO. Bias assessment was performed using the Cochrane Risk of Bias and the Newcastle- Ottawa Scale. In all the studies, 40.82% of the primary doses were viral vector platforms. For booster doses, 50% were mRNA platforms. Messenger RNA (mRNA) vaccines have higher titers as homologous than as heterologous vaccines. However, inactivated vaccines and viral vector vaccines have lower titers as homologous than as heterologous vaccines. Meanwhile, subunit vaccines lack data for their titers. Based on the antibody titers, homologous mRNA vaccines are more viral-protective than their heterologous counterparts. Heterologous inactivated and viral vector vaccines are more protective than homologous combinations, mainly when mRNA is the other type in those heterologous combinations. This is because mRNA vaccines elicit higher immunogenicity compared to other types.

Magnetic Compression Anastomosis (Magnamosis): First-In-Human Trial.

BACKGROUND: Magnetic compression anastomosis (magnamosis) uses a pair of self-centering magnetic Harrison Rings to create an intestinal anastomosis without sutures or staples. We report the first-in-human case series using this unique device. STUDY DESIGN: We conducted a prospective, single-center, first-in-human pilot trial to evaluate the feasibility and safety of creating an intestinal anastomosis using the Magnamosis device. Adult patients requiring any intestinal anastomosis to restore bowel continuity were eligible for inclusion. For each procedure, 1 Harrison Ring was placed in the lumen of each intestinal segment. The rings were brought together and mated, and left to form a side to side, functional end to end anastomosis. Device movement was monitored with serial x-rays until it was passed in the stool. Patients were monitored for adverse effects with routine clinic appointments, as well as questionnaires. RESULTS: Five patients have undergone small bowel anastomosis with the Magnamosis device. All 5 patients had severe systemic disease and underwent complex open urinary reconstruction procedures, with the device used to restore small bowel continuity after isolation of an ileal segment. All devices passed without obstruction or pain. No patients have had any complications related to their anastomosis, including anastomotic leaks, bleeding, or stricture at median follow-up of 13 months. CONCLUSIONS: In this initial case series from the first-in-human trial of the Magnamosis device, the device was successfully placed and effectively formed a side to side, functional end to end small bowel anastomosis in all 5 patients. No patients have had any anastomotic complications at intermediate follow-up.

Combined single-port and endoluminal technique for laparoscopic anterior resection.

OBJECTIVE: To determine the technical feasibility and clinical outcomes of laparoscopic anterior resection using combined single-port and endoluminal technique. METHODS: A single port was placed at the umbilicus. Sigmoid colon was retracted using transabdominal sutures. After adequate mobilization, the colon was stapled distal to the lesion using noncutting endostapler, and the rectum was opened distal to the staple line. The transanal endoscopic operation device was placed transanally and the anvil of a circular stapler was then delivered through the device into the peritoneal cavity. The anvil was placed intraluminally through a colotomy made proximal to the lesion; after this, the colon was transected above the colotomy site. The specimen was next delivered transanally through the transanal endoscopic operation device. Finally, the rectum was closed with endostapler and intracorporeal side-to-end colorectal anastomosis was constructed using the circular stapler. RESULTS: This technique was attempted in an 80-year-old woman with a 3 cm sessile polyp in the distal sigmoid. Laparoscopic anterior resection was arranged as the polyp was not amenable to endoscopic removal. The operative time was 150 minutes. There was no intraoperative complication. The patient was discharged on postoperative day 6, with a maximum pain score of 3. CONCLUSIONS: Laparoscopic anterior resection using this combined single-port and endoluminal technique is feasible for small lesions in the sigmoid colon or upper rectum. The technique avoids multiple trocar incisions and a minilaparotomy for specimen retrieval.

A look at utilization and cancer detection yield of mammography

BACKGROUND: In the Philippines, mammography is frequently requested in the evaluation of patients with breast cancer concern. OBJECTIVES: The general objective was to take a look at the practice of requesting for a mammography in a health care institution and its outcome in terms of cancer detection in patients with non- palpable breast masses. METHODS: A retrospective review of past records from 1994 to 2001 was accomplished. RESULTS: A total of 7,323 mammog-raphies. 192 (3 percent) were done in the 20-29 age group; 966 (13 percent) in 30-39 age group; 2708 (37 percent) in 40-49 age group, 2410 (33 percent) in 50-59 age group and the remaining 1047 (14 percent) in those older than 60 years old. The top three physicians requesting for mammography were obstetrician-gynecologists, 2337 (32 percent); general surgeons, 1348 (18 percent) and internists and family medicine specialists, 806 (10 percent). Normal findings were reported in 4449 (61 percent); benign in 2721 (37 percent), suspicious for cancer without a clinically palpable mass in 99 (1.35 percent) and suspicious for cancer with a palpable breast mass in 52 patients (0.74 percent). A total of 50 patients underwent needle localization biopsy of which 35 had fibrocystic changes (70 percent), 10 had cancer (20 percent) and 5 with indefinite results. CONCLUSION: The overall cancer detection yield for mammography in those without a palpable breast mass, 7271 (7323-52) persons, was extrapolated to be 0.28 percent (20/7271). The authors deemed the information obtained in this study would be useful to the public, health care administrators and health care providers in reviewing the indication and cost-effectiveness of mammography.