Adjunct Immune Globulin for Vaccine-Induced Immune Thrombotic Thrombocytopenia.

The use of high-dose intravenous immune globulin (IVIG) plus anticoagulation is recommended for the treatment of vaccine-induced immune thrombotic thrombocytopenia (VITT), a rare side effect of adenoviral vector vaccines against coronavirus disease 2019 (Covid-19). We describe the response to IVIG therapy in three of the first patients in whom VITT was identified in Canada after the receipt of the ChAdOx1 nCoV-19 vaccine. The patients were between the ages of 63 and 72 years; one was female. At the time of this report, Canada had restricted the use of the ChAdOx1 nCoV-19 vaccine to persons who were 55 years of age or older on the basis of reports that VITT had occurred primarily in younger persons. Two of the patients in our study presented with limb-artery thrombosis; the third had cerebral venous and arterial thrombosis. Variable patterns of serum-induced platelet activation were observed in response to heparin and platelet factor 4 (PF4), indicating the heterogeneity of the manifestations of VITT in serum. After the initiation of IVIG, reduced antibody-induced platelet activation in serum was seen in all three patients. (Funded by the Canadian Institutes of Health Research.).

Medication use by middle-aged and older participants of an exercise study: results from the Brain in Motion study.

BACKGROUND: Over the past 50 years, there has been an increase in the utilization of prescribed, over-the-counter (OTC) medications, and natural health products. Although it is known that medication use is common among older persons, accurate data on the patterns of use, including the quantity and type of medications consumed in a generally healthy older population from a Canadian perspective are lacking. In this study, we study the pattern of medication use in a sedentary but otherwise healthy older persons use and determined if there was an association between medication use and aerobic fitness level. METHODS: All participants enrolled in the Brain in Motion study provided the name, formulation, dosage and frequency of any medications they were consuming at the time of their baseline assessment. Maximal aerobic capacity (VO2max) was determined on each participant. RESULTS: Two hundred seventy one participants (mean age 65.9 ± 6.5 years; range 55-92; 54.6% females) were enrolled. Most were taking one or more (1+) prescribed medication (n = 204, 75.3%), 1+ natural health product (n = 221, 81.5%) and/or 1+ over-the-counter (OTC) drug (n = 174, 64.2%). The most commonly used prescribed medications were HMG-CoA reductase inhibitors (statins) (n = 52, 19.2%). The most common natural health product was vitamin D (n = 201, 74.2%). For OTC drugs, non-steroidal anti-inflammatories (n = 82, 30.3%) were the most common. Females were more likely than males to take 1+ OTC medications, as well as supplements. Those over 65 years of age were more likely to consume prescription drugs than their counterparts (p ≤ 0.05). Subjects taking more than two prescribed or OTC medications were less physically fit as determined by their VO2max. The average daily Vitamin D intake was 1896.3 IU per participant. CONCLUSIONS: Medication use was common in otherwise healthy older individuals. Consumption was higher among females and those older than 65 years. Vitamin D intake was over two-fold higher than the recommended 800 IU/day for older persons, but within the tolerable upper intake of 4,000 IU/day. The appropriateness of the high rate of medication use in this generally healthy population deserves further investigation.

Perovskite-type metal oxides exhibiting negligible grain boundary resistance to total electrical conductivity.

In this paper, we report the synthesis, structure and electrical properties of the perovskite-type AZn0.33+xNb0.67-xO3-δ (A = Sr or Ba; 0 ≤ x ≤ 0.08). The investigated compounds were prepared by employing the solid-state (ceramic) reaction using alkaline nitrates, zinc oxide, and niobium oxide at elevated temperatures in air. Powder X-ray diffraction (PXRD) showed the formation of disordered Zn and Nb at the B-sites of space group Pm3̅m with cubic structure and a lattice constant comparable to that of the literature. The AC impedance study showed mainly bulk contribution to the total electrical conductivity over the investigated frequency range of 0.01 Hz to 1 MHz in all the investigated atmospheres even at low temperatures, which is significantly different from that of the well-known perovskite-type B-site ordered BaCa0.33+xNb0.67-xO3-δ and the disordered acceptor-doped BaCeO3. The bulk dielectric constant determined at 500 and 700 °C in air was found to be in the range of 35-100. In air, the isothermal bulk dielectric constant seems to increase with an increasing Zn content, and a similar trend was observed for total electrical conductivity. In dry and wet H2, the electrical conductivity decreases with an increasing Zn content in AZn0.33+xNb0.67-xO3-δ, and the x = 0 member of the Ba compound exhibits the highest total conductivity of 7.2 × 10(-3) S cm(-1) in dry H2 at 800 °C. Both Sr and Ba compounds were found to be stable against the reaction with pure CO2 at 700 °C and H2O at 100 °C for a long period of time. SrZn0.33+xNb0.67-xO3-δ was found to be stable in 30 ppm H2S at 800 °C, while the corresponding Ba compound formed reaction products such as BaS (JCPDS Card 01-0757), BaS2 (JCPDS Card 21-0087), and BaS3 (JCPDS Card 03-0824).