Acute myocardial infarction and myocarditis following COVID-19 vaccination.

Emerging reports raise concerns on the potential association between the COVID-19 vaccines and cardiac manifestations. We sought to evaluate cardiac complications associated with COVID-19 vaccination in a pooled analysis from our institution's cohort study and systematic review. Consecutive patients admitted to a tertiary hospital in Singapore between 1 January 2021 and 31 March 2021, with the onset of cardiac manifestations within 14 days following COVID-19 vaccination, were studied. Furthermore, a systematic review was performed, with PubMed, Embase, Research Square, MedRxiv and LitCovid databases accessed from inception up to 29 June 2021. Relevant manuscripts reporting individual patient data on cardiac complications following COVID-19 vaccination were included. Thirty patients were included in the study cohort, with 29 diagnosed with acute myocardial infarction (AMI) and 1 with myocarditis. Five patients developed heart failure, two had cardiogenic shock, three intubated, and one had cardiovascular-related mortality. In the systematic review, 16 studies were included with 41 myocarditis and 6 AMI cases. In the pooled analysis of the study cohort and the systematic review, 35 patients had AMI and 42 had myocarditis. Majority were men, and myocarditis patients were younger than AMI patients. Myocarditis patients tended to present 72 h postvaccination, while AMI patients were older and typically presented 24 h postvaccination. Majority with AMI or myocarditis developed symptoms after the first and second vaccination dose, respectively. This pooled analysis of patients presenting with cardiac manifestations following COVID-19 vaccination highlights the differences between myocarditis and AMI presentations in temporal association with the vaccination.

Disparity in female and Asian representation amongst cardiology journal editorial boards members: a call for empowerment.

BACKGROUND: While progress is evident in gender and ethnic representation in the workplace, this disparity remains prevalent in academic positions. OBJECTIVES: We examined gender and Asian ethnic representation in editorial boards of cardiology journals. METHODS: A cross-sectional analysis was conducted using publicly available data on Cardiology and Cardiovascular medicine journals in the first quartile of the 2020 Scimago Journal & Country Rank indicator. The proportions of female and Asian editorial board members, associate editors and editors-in-chief were assessed. Subgroup analyses were conducted based on the journal's geographical origin, subspecialty and demographic of the editor-in-chief. RESULTS: Seventy-six cardiology journals, involving 8915 editorial board members, were included. Only 19.6% of editorial board members were female, 20.8% Asians and 4.0% Asian females. There were less female representation amongst editors-in-chief (9.9%) compared to associate editors (22.3%). European (18.1%) and North American-based journals (21.1%) had higher female representation compared to Asian-based journals (8.7%). There was lower Asian representation in European (18.1%) and North American-based journals (19.9%) compared to Asian-based journals (72.3%). Females were underrepresented in interventional (14.5%) journals, while Asians were underrepresented in general cardiology (18.3%) and heart failure (18.3%) journals. Journals led by female editors-in-chief had significantly higher female representation compared to male-led ones, while journals with Asian editors-in-chief had greater Asian representation compared to non-Asian led ones. CONCLUSION: This study highlights the female and Asian ethnic underrepresentation in academic roles in cardiology journal editorial boards. Further analysis is needed for other ethnicities, while the community pushes towards gender-balanced and ethnic diversity across editorial boards.

[Stereotactic radiotherapy of intracranial benign tumors]. / Radiothérapie en conditions stéréotaxiques des tumeurs bénignes intracrâniennes.

Stereotactic radiotherapy can be delivered in one fraction or in multiple fractions schedule. It is used in benign tumours such as meningiomas, mainly localized in the base of the skull, for acoustic schwannoma and pituitary tumours. Whatever the tumour, results with the Gamma Knife(®) are the most numerous, but those obtained by linear accelerators, adapted or dedicated, are comparable. The peripheral dose is preferred to the dose delivered to the isocentre. One fraction stereotactic irradiation should be proposed in small lesions and fractionated treatment for tumours larger. Whatever the tumour, the results are satisfactory with a control rate of 90%. However, this value reflects a disparity assessment, radiological stability for meningiomas, radiological stability and preservation of useful hearing in schwannoma and radiological stability and a decrease in hormonal secretions for pituitary adenomas. Overall complication rates are low. In total, the treatment of benign lesions with stereotactic irradiation gives satisfactory results with few complications.

Prophylactic control of post-operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery.

BACKGROUND: The aim of this study was to evaluate the efficacy of ondansetron and ramosetron in the reduction of post-operative nausea and vomiting (PONV) associated with patient-controlled analgesia (PCA) after cardiac surgery. METHODS: A total of 320 patients scheduled for elective cardiac surgery were enrolled. Patients were randomly assigned to one of four treatment regimens (n=80 in each group): no prophylactic antiemetics (group P); intravenous (i.v.) ondansetron 4 mg at the end of surgery and 12 mg added to PCA (group O); i.v. ramosetron 0.3 mg at the end of surgery and no antiemetics added to PCA (group R1); and i.v. ramosetron 0.3 mg at the end of surgery and 0.6 mg added to PCA (group R2). RESULTS: The incidence of PONV during the 48-h post-operative period was lower in groups O (46%), R1 (54%), and R2 (35%) compared with group P (71%, P<0.001). The incidence and severity of nausea were lower in groups O, R1, and R2 than in group P during the 24-h post-operative period, whereas the incidence and severity of nausea during 24-48 h after surgery were lower in groups O and R2, but not in group R1, than in group P. Compared with group P (53%), the frequency of rescue antiemetic usage was significantly lower in groups O (34%) and R2 (29%), but not in group R1 (43%). CONCLUSION: The addition of either ondansetron or ramosetron to PCA can reduce the incidence of PONV during 48 h after cardiac surgery.

A study on the effects of discotheque noise on the hearing of young patrons.

This study aims to find out whether discotheque music affects hearing by exposing 48 young volunteers to discotheque music in discotheque sessions at two discotheques and evaluating their degree of auditory fatigue after exposure. Questionnaire interviews revealed that the majority of them visit discotheques regularly. A higher proportion of those attending the louder discotheque found the music too loud. The prevalence of tinnitus is also higher in those attending the noisier discotheque. The degree of threshold shifts, however, does not appear to be related to the volume of music or auditory fatigue. The noise level exposure was estimated to be 91 dBA to 98 dBA for weekly exposure and 85 dBA to 92 dBA for monthly exposure. To avoid hearing loss, patrons should avoid loud discotheques, or cut down their frequency of visits if they choose to continue patronising them.

Differences in lipopolysaccharide profiles of serologically identical Legionella pneumophila serogroup 6 strains.

Over five years 18 strains of Legionella pneumophila serogroup 6 were isolated in Amsterdam from the hot water supply in three hospitals and from one patient. Immunodiffusion and immunoblot procedures showed that these strains were identical. Profiles of isolated lipopolysaccharides from the 18 strains and the reference serogroup 6 strain were visualised in polyacrylamide gels stained with silver. Four strains from hospital A, isolated in 1982, 1984, and 1985 displayed similar lipopolysaccharide profiles which were different in relative mobility from those of hospitals B and C. Those from hospital B (12 strains isolated in 1983 and 1986) and C (one strain) were similar in relative mobility but different in colour. The strain from a patient with acquired immune deficiency syndrome (AIDS) in hospital A displayed a lipopolysaccharide profile characteristic of hospital A. These reproducible profiles were all different in relative mobility from the reference serogroup 6 strain. They can be used as a marker system in epidemiological surveys of serologically identical serogroup 6 strains. Lipopolysaccharide patterns from strains isolated throughout the years in the same hospital were similar. This suggests an outgrowth from organisms inhabiting the plumbing system rather than reseeding from the Amsterdam mains supply.

Vaginal birth after cesarean section: results of a multicenter study.

Cesarean section is now the most frequently performed major operation in the United States. Nearly one out of every four American babies is delivered by this operation. "Elective repeat" has become the most common indication for cesarean section. Although the safety of vaginal birth after cesarean section has been documented in several recent publications, automatic repeat cesarean section remains the rule in this country. We present one of the largest series of trial of labor ever reported. Of 57,553 live births, 4929 (8.6%) were of women with prior cesarean sections. Among 1776 patients who underwent a trial of labor, 1314 (74%) delivered vaginally. There was no maternal or perinatal mortality related to uterine scar rupture. Thus during the study period 1314 major operations were avoided. We conclude that, for the vast majority of women, allowing a trial of labor is a safe alternative to automatic elective repeat cesarean section.

Comparison of strains of Legionella pneumophila serogroup 1 isolated in four Amsterdam hospitals from patients and hot-water supplies.

Legionella pneumophila serogroup 1 was isolated from patients (14 strains) and hot-water taps (49 strains) in four hospitals in Amsterdam. Precipitation patterns obtained by reaction of heated cell suspensions and rabbit antisera in the double diffusion test revealed antigenic properties of serogroup 1 strains from water unique to each of the four hospitals. By this method similarity could be demonstrated between strains from patients and hot water in three of the four hospitals. No such relationship was present in the fourth hospital, a fact that could be explained by the case histories of the patients. Comparison of strain antigens in the double diffusion test is simple and suitable for epidemiological studies of L. pneumophila.

Antibodies against cell envelope antigens of Yersinia enterocolitica in reactive arthritis and ankylosing spondylitis.

Yersinia enterocolitica is suspected of involvement in the aetiology of reactive arthritis and ankylosing spondylitis. Its two major outer membrane proteins are important targets for IgA and other protein A reactive immunoglobulins in the sera of some patients with these diseases.

Reduction of Rh0(D) sensitization: a cost-effective analysis.

The first American study on the incidence of gestational Rh0(D) sensitization is reported. The authors studied 3995 Rh0(D)-negative pregnancies from a population of 40,319 deliveries at Los Angeles-area Kaiser hospitals between 1976 and 1978. Among these were 61 Rh0(D)-sensitized pregnancies: 38 in women with prior sensitizations, 21 with gestational sensitizations, and 2 postpartum Rh0(D antigen) immune globulin (RhoGAM) failures. The incidence of gestational sensitization was 1.0% (21/2098). Cost-effectiveness of prophylactic RhoGAM post partum, prophylactic RhoGAM at 28 weeks' gestation, and Fetaldex testing post partum was analyzed. Prophylactic RhoGAM at 28 weeks' gestation was the most cost-effective method of further reduction of the Rh0(D) sensitization. All nonsensitized Rh0(D)-negative mothers who delivered Rh0(D)-positive fetuses received RhoGAM.

Postmortem bacteriology of the lung by printculture of frozen tissue. A technique for in situ culture of microorganisms in whole frozen organs.

Lung lobes obtained at necropsy from 100 patients were frozen at -70 degrees C and sectioned as a whole in a sledge microtome as used on complete frozen animals. Prints of freshly cut surfaces were cultured on different solid media in 14 cm Petri dishes. The printcultures showed three patterns of bacterial growth: dense growth in 24%, patchy growth in 43%, and no significant growth in 33%. Forty-two of the 67 positive printcultures showed to or more bacterial species. Besides bacteria known to be pathogens of the lung, streptococci of the viridans group, enterococci, and streptococci of group B were grown, sometimes in pure cultures. The patterns of the printcultures were reproducible in successive sections, and the quantity of the bacterial species could be assessed. Contaminating bacteria on the surface of the lung lobe could be recognised, as these produced colonies restricted to the edges of the print. Because there was no smearing of infecting and contaminating bacteria, printculture offers a method of reference.

Leiomyomatosis peritonealis disseminata associated with pregnancy.

The first reported case in the English literature involving leiomyomatosis peritonealis disseminata (LPD) and a subsequent pregnancy is presented. A review of the literature revealed only 8 previous cases-all of which were treated by tubal ligation or surgical castration. The patient in this report was 22 years of age at the time of diagnosis, the youngest age at which LPD is known to have occurred. The LPD was first noted at primary cesarean section, and 20 months later at a second cesarean section performed at 35 1/2 weeks' gestation, the LPD had advanced to a stage that suggested possible malignancy. All biopsy specimens were subsequently reported as benign LPD.

Purification and identification of turkey immunoglobulin-A.

Turkey immunoglobulin-A (IgA) was isolated from bile, intestinal secretions, and serum by affinity chromatography using monospecific anti-turkey IgA coupled to CNBr-activated Sepharose. The isolated immunoglobulin was antigenically distinct from IgM and IgG. The purity of IgA was demonstrated by immunodiffusion, immunoelectrophoresis, and analytical ultracentrifugation. The predominant forms of polymeric IgA in bile and intestinal secretions had respective So20w values of 16.1 and 15.2. Larger polymers (25-26S) were also present. Two molecular forms (8.5S and 17S) were found in serum. The 8.5S peak was higher than the 17S, indicating a greater concentration of 8.5 S.

Virus-like particles demonstrated by freeze-squeeze technique in acute-phase serum of patients with HBAg-negative hepatitis.

Electromicroscopy of fluid, squeezed from excised and frozen precipitation lines obtained by immunoelectrophoresis in agarose gels of acute-phase sera from patients with HBAg-negative hepatitis, revealed particles of 22, 27, and 31-41 nm. These precipitates and particles were not present in normal human sera and disappeared from the sera of the patients after recovery. These particles were still demonstrable after two years' storage at -20 degrees C.