Thrombocytopenia with and without thrombosis following COVID-19 vaccination: long-term management.

Background: Since administration of COVID-19 vaccines, there has been growing evidence of thrombotic and thrombocytopenic events following vaccination. However, there remains limited data on long-term management of these adverse hematologic events. Key Clinical Question: We report on 9 patients presenting with thrombocytopenia following COVID-19 vaccination, with 4 subsequently diagnosed with vaccine-induced thrombocytopenia and thrombosis (VITT) and 5 with immune thrombocytopenia. Clinical Approach: A retrospective chart review was completed for adults >18 years of age presenting to a tertiary care center with new-onset thrombocytopenia occurring 4 to 42 days following COVID-19 vaccination. Presenting symptoms, laboratory investigations, and response to treatment are described. Conclusion: Two of 4 patients with VITT developed refractory thrombocytopenia successfully treated with intravenous immunoglobulin, corticosteroids, and plasma exchange therapy. Patients with VITT remained on anticoagulation for at least 9 months due to persistently positive diagnostic tests. Four of 5 patients with immune thrombocytopenia received intravenous immunoglobulin and corticosteroids with good recovery. Patients who received a subsequent COVID-19 mRNA vaccine had no adverse hematologic effects.

Structurally integrated fiber optic damage assessment system for composite materials.

Progress toward the development of a fiber optic damage assessment system for composite materials is reported. This system, based on the fracture of embedded optical fibers, has been characterized with respect to the orientation and location of the optical fibers in the composite. Together with a special treatment, these parameters have been tailored to yield a system capable of detecting the threshold of damage for various impacted Kevlar/epoxy panels. The technique has been extended to measure the growth of a damage region which could arise from either impact, manufacturing flaws, or static overloading. The mechanism of optical fiber fracture has also been investigated. In addition, the influence of embedded optical fibers on the tensile and compressive strength of the composite material has been studied. Image enhanced backlighting has been shown to be a powerful and convenient method of assessing internal damage to translucent composite materials.