BMI-Associated Anti-Apolipoprotein A-1 Positivity in Healthy Adults after mRNA-Vaccination against COVID-19.

Elevated anti-apolipoprotein A-1 (AAA1) antibody levels associated with cardiovascular risk have been observed in previously SARS-CoV-2-infected or COVID-19-vaccinated individuals. Since patient safety is generally a priority in vaccination, we sought to investigate AAA1 antibody levels in healthy adults after mRNA vaccination. We conducted a prospective cohort study in healthy adult volunteers recruited from military workers of the Transport Air Base in Prague who had received two doses of mRNA vaccines. Anti-apolipoprotein A-1 antibody levels were determined using ELISA from serum samples obtained at three and four time points after the first and second vaccine doses, respectively, within almost 17 weeks of follow-up. The transient AAA1 positivity rate achieved 24.1% (95% confidence interval CI: 15.4-34.7%), i.e., 20 out of 83 participants had at least one positive post-vaccination sample, with a repeat positivity confirmed in only 5 of them. This rate was associated with a BMI > 26 kg/m2, as documented by an adjusted odds ratio of 6.79 (95% CI: 1.53-30.01). In addition, the highest positivity rate of 46.7% (21.3-73.4%) was observed in obese subjects with >30 kg/m2. Since the incidence rate of AAA1 positivity remained unchanged after the first and second vaccine doses, any relationship between AAA1 positivity and mRNA vaccination was inconclusive. The present study showed a transient AAA1 positivity rate associated with overweight or obesity without a proven association with mRNA vaccination.

Rare pulmonary barotrauma after explosive decompression: a case report.

BACKGROUND: Pneumothorax as a consequence of pulmonary barotrauma during explosive decompression military crew training in a hypobaric chamber is an extremely rare and sparsely diagnosed complication. Extensive bilateral tissue damage is even more unexpected. CASE PRESENTATION: A 26-year-old active duty Air Force pilot was performing an explosive decompression simulation from 8000 ft. (2438.4 m) to 25,000 ft. (7620 m) in a 1.5 s interval. The training was interrupted due to the pilot's apparent health complications. After transfer to the emergency department, a CT scan showed bilateral lung barotrauma with emphysema. CONCLUSIONS: The case report shows extensive emphysema and pneumothorax after a rapid decompression done for training purposes. It is a possible but rare complication. The cause remains unclear, with suspicion of a predisposed lung disease.

The effect of hyperbaric oxygen therapy on gene expression: microarray analysis on wound healing.

Background: Hyperbaric oxygen (HBO2) therapy can have a positive effect on wound healing, angiogenesis and blood flow. No prior study has described the effects of HBO2 therapy and gene expression of this process. The goal of our research was to show the effects of HBO2 and its impact at the molecular level on angiogenesis, proliferation, differentiation, oxidative stress, inflammation, and extracellular matrix formation. Live animal subjects were used for simulating the process of wound healing under standard conditions and under the influence of HBO2. Methods: Two experimental groups were created using injured rabbits (N=24), one group (N=12) treated with hyperbaric therapy twice a day and one (N=12) with standard wound care management. Wounds were surgical, uninfected, and in healthy animal test subjects. We compared the whole genomic analysis of the transcriptome with the use of microarray technology at three intervals during treatment. Results: The induction of the wounds in rabbit skin increased expression of hundreds of genes in both treatment groups. The numbers of elevated and decreased genes gradually reduced as the wound healed. Gene expression analysis showed elevated expression of several genes associated with inflammation in both groups of injured animals. Genes connected to the process of angiogenesis, proliferation, differentiation, oxidative stress and extracellular matrix formation were without statistically significant changes. Conclusion: The evidence did not support that HBO2 had any significant effect on gene expression during wound healing. Additionally, there was no evidence to support that there were changes in gene expression in either treatment group.

Inguinal tumorous mass - an uncommon late manifestation of chronic organized hematoma after laparoscopic transabdominal preperitoneal inguinal hernia repair: Two cases report.

BACKGROUND: Hematoma is a common complication following inguinal hernia repair. It is usually diagnosed early after surgical procedure and is spontaneously, or after evacuation, resorbed. Chronic organized hematoma is rare surgery complication, there is no relevant article after laparoscopic hernia repair in literature. CASES PRESENTATION: 62- and 54-year-old men presented a groin palpable tumorous mass several month after uncomplicated laparoscopic transabdominal preperitoneal inguinal hernia repair. Their dominant complaints were mechanical restrictions. The ultrasound showed a solid formation subcutaneously. The removal and histopathology examination confirmed a chronic organized hematoma and at the same time, this ended the patients 'problems. CONCLUSION: Both patients represent uncommon cases of late postoperative difficulties, uncharacteristic localization of chronic organized hematoma and the need for surgical reintervention to exclude neoplasm.

Acute portal vein thrombosis in noncirrhotic patients - different prognoses based on presence of inflammatory markers: a long-term multicenter retrospective analysis.

Background: Portal vein thrombosis (PVT) is a partial or complete thrombotic occlusion of the portal vein and is rare in noncirrhotic patients.Patients and methods: 78 adult patients with noncirrhotic acute PVT without known malignity were evaluated. Patients with initial CRP level 61-149 mg/l were excluded.Results: Patients were divided into two groups - the first one (33 patients) was characterized with signs of inflammation and CRP over 149 mg/l. The second group (45 patients) was without signs of inflammation and CRP level less than 61 mg/l. The frequency of prothrombotic hematologic factors was statistically significantly different in levels of factor VIII and MTHFR 677 C mutation. All patients from both groups underwent the same oncologic and hemato-oncologic screening which was positive in 23 patients (51.1%) in the group without signs of inflammation. In the group of patients with clinical and laboratory signs of inflammation oncologic and hemato-oncologic screening was positive only in 1 patient (3.0%). Complete portal vein recanalization was achieved in 19.2%, partial recanalization in 26.9%.Conclusions: Patients with clinical signs of inflammation and acute PVT have a low risk of malignancy in contrast to patients without signs of inflammation and acute PVT, which have a high risk of oncologic or hemato-oncologic disease. Patients with negative hemato-oncologic screening should be carefully observed over time because we expect they are at higher risk for the development of hemato-oncologic disease, independent from the presence and number of procoagulation risk factors.

Quality evaluation of frozen apheresis red blood cell storage with 21-day postthaw storage in additive solution 3 and saline-adenine-glucose-mannitol: biochemical and chromium-51 recovery measures.

BACKGROUND: The Czech Republic decided to build the frozen red blood cell (RBC) bank for military contingency and civil emergency preparedness. Storage methods were validated with (51)Cr recovery measures out to 21 days postthaw. STUDY DESIGN AND METHODS: A total of 139 apheresis RBC units collected in additive solution (additive solution 3 [AS-3] or saline-adenine-glucose-mannitol [SAG-M]) were obtained from volunteers by double erythrocytapheresis; all were sterilely glycerolized, frozen, stored for at least 30 days at a minimum of -65 degrees C in collection or cryogenic bags, thawed, sterilely deglycerolized, and stored at 4 +/- 2 degrees C for up to 21 days in AS-3 or SAG-M. Units were sampled before storage and after thaw weekly. Metabolic intermediates and (51)Cr recovery measures were obtained to determine the index of therapeutic effectiveness (ITE). RESULTS: Despite losses associated with cryoconservation and eventual transfer to cryogenic bags, 3-week storage with optimum ITE was obtained with frozen storage in primary collection or cryogenic bags and postthaw storage in AS-3. Such cells would pass as acceptable in vitro hematology and biochemistry variables. CONCLUSIONS: A system for frozen RBC storage with 3-week, postthaw, liquid storage has been validated. With commercially available components and automated processing, it is capable of supporting civilian rare blood and emergency and international military combat and peacekeeping support use patterns.

Liver trauma usually means management of multiple injuries: analysis of 78 patients.

The liver is the second most traumatized organ in the abdominal cavity. The authors present a retrospective analysis of a group of 78 patients treated for this injury at one institution. In this group, there were 5 (6.41%) penetrating and 73 (93.59%) blunt trauma injuries. The mean Injury Severity Score (ISS) of the group was 31.6. Isolated liver trauma occurred in only three (3.84%) cases. At the same time, chest injury occurred in 89.84%, head injury occurred in 74.64%, limb injury occurred in 32.05%, and spinal or pelvic injury occurred in 26.92% of patients. Trauma to other intra-abdominal organs was found in 82.97% of patients, and surgical intervention was necessary in 51.06%. The routine use of helical computed tomography with contrast showed a sensitivity of 88.76% and 95.50%, respectively. Liver bleeding resulted in three (3.84%) patient deaths. Overall mortality was 29.48%. The mean period of hospitalization on the intensive care unit was 27.42 days. At present, liver trauma cannot be separated from multiple injuries; morbidity and mortality depend more on the affiliated trauma than on specific liver injury.

A humanitarian mission in southern Iraq: utilization of the 7th Field Hospital of the Army of the Czech Republic--a report on its medical activities and working conditions.

Between April 24 and September 18, 2003, a total of 7,099 outpatient treatments were performed. Between June 3 and September 18, 2003, a total of 124 patients were surgically treated and 209 patients were hospitalized; the hospital recorded 1,239 bed-days, 137 of them in the intensive care unit. A total of 924 X-ray and ultrasound examinations were performed, as well as 10,014 laboratory tests. Local inhabitants accounted for 90.5% of the patients. In their practice, the doctors encountered a very wide spectrum of surgical and nonsurgical diagnoses. Part of the work was to support humanitarian activities, with supplies of humanitarian material, selection of children for specialized cardiosurgical treatment in the Czech Republic, and blood donations. Work in that unstable region was significantly complicated by the extreme climate and the high security risk.

Gunshot liver trauma with disruption of the right hepatic duct managed by surgery, radiology, and endoscopy: a case report.

During the process of treating a complicated gunshot wound of an upper limb, chest, abdomen, and spine, there appeared--sometime after the initial treatment--a necrosis of the right hepatic duct in the bullet path within the liver. Although laparotomy was the life-saving operation during the first and second period, the final diagnosis and solution were based on bypassing the defect, i.e., a combination of a percutaneous and endoscopic approach. The efficiency of this method was also proved by an examination carried out 1 year after the end of the treatment.