Summary of Safety and Efficacy of COVID Vaccination in Patients with Multiple Sclerosis.

BACKGROUND: The SARS-CoV-2 pandemic represents one of the most challenging issues that have recently influenced everyday life in countries all over the world. Understanding the risk of this disease is of high importance in patients with multiple sclerosis (MS) as they represent a vulnerable population through their treatment with disease-modifying therapies (DMTs). Infective episodes may trigger relapses and lead to deterioration of the health condition. SUMMARY: Vaccination is an important preventive measure against infectious diseases. In MS patients, concerns have been raised about the effectiveness of vaccines in patients on various immunomodulatory drugs and about their possible adverse effects including impairment of neurological functions. The objectives of this article were to summarize the current knowledge on immune responses to the COVID-19 vaccines and their safety in MS patients and to provide practical guidance based on the data available to date. KEY MESSAGES: Although MS is not associated with a higher risk of COVID-19, this infection can trigger relapses or pseudo-relapses. Vaccines against SARS-CoV-2 are recommended for all MS patients who are not in the active phase of the disease, despite the fact that there is still a lack of long-term reliable data on the effectiveness and safety of vaccines against COVID-19. Some DMTs can reduce vaccine humoral responses, but might still provide some protection and adequate T-cell response. To optimize the effectiveness of vaccination, the ideal timing of vaccine application and DMTs dosing regimen is crucial.

Assessment of toe brachial index validity in diabetic patients - interim results.

INTRODUCTION: The toe brachial index (TBI) is recommended for the detection of lower extremity arterial disease (LEAD) in case of reduced efficacy of the ankle brachial index (ABI), which most often occurs in diabetics. In this case, TBI is expected to give more accurate results. There are not many studies dealing with the use of TBI specifically in diabetics and the results are different. OBJECTIVE: The purpose of this work is to present the interim results of the study, whose main objective is to assess the validity of TBI in diabetics and to determine whether this method provides improvements over the ABI. METHODS: In the first phase of the study, 42 limbs were examined in 21 patients with type 2 diabetes. ABI was measured using the automatic oscillometric method (ABI OSC) and the manual method using the pencil doppler (ABI DPP). TBI was determined using an automatic plethysmographic method. The reference examination of the arteries of the lower limbs was performed using duplex ultrasonography (DUS). A paired t-test was used to compare the individual TBI and ABI methods. Cut-off points ABI < 0.9; TBI < 0.7; and DUS stenosis > 50 % were used to evaluate validity parameters. RESULTS: The individual ABI and TBI methods gave different results (p < 0.05). In eight limbs of the total number, LEAD was demonstrated using DUS. The best validity parameters were demonstrated by the TBI - sensitivity 0.88; specificity 0.88; positive predictive value 0.64; negative predictive value 0.97, positive likelihood ratio 7.44; negative likelihood ratio 0.14. The ABI method of calculation, that uses lower systolic blood pressure determined from two measurement sites on the ankle as a numerator, had a higher validity parameters. The ABI OSC did not correctly detect a single limb with stenosis > 50 % in this cohort. CONCLUSION: According to the interim results of this work, the TBI was more suitable for the detection of LEAD in diabetics in comparison with ABI.

Education of Adolescents in the Prevention of HIV/AIDS in the Czech Republic.

The number of HIV-positive people in the Czech Republic has trebled over the last decade. An educational programme aimed at the prevention of HIV and STDs in adolescents between 13 and 19 years of age is underway in the Moravian-Silesian Region in the Czech Republic. All schools in the region have been offered the chance to participate in the programme (on a voluntary basis). The programme consists of an educational lecture and a game with interactive elements; the students perform various tasks in groups. An anonymous paired questionnaire (input/output) was used to assess the efficacy of the programme. In order to evaluate the programme efficacy, descriptive statistics, non-parametric Wilcoxon paired test at the level of significance of 5%, and a model of logistic regression for a dichotomous variable were used. A total of 1210 students took part in the programme. The students' knowledge improved, on average, by 15.5%. The highest efficacy was observed in the age group of 13-14-year-olds, where the improvement reached 17.9%. The educational programme was effective in raising awareness about STDs. Due to the observed increase in knowledge especially among the youngest participants (13-14 years old), we recommend aiming further interventions at the youngest age groups.

Vaccines recommended for diabetic patients.

Diabetes mellitus is the name of a group of chronic diseases in which absolute or relative lack of insulin causes hyperglycemia. The hyperglycemic environment causes disorders of the cells of innate immunity, which leads to reduced function of the immune system, and therefore diabetics are more susceptible to infections. Due to immune dysfunction, infections are not only more common, but also more severe and with higher mortality than in people without diabetes. Nevertheless, in diabetics, an adequate immune response to the vaccine is maintained, so it is possible to use one of the most effective options for preventing infections, which is vaccination. When vaccinating diabetics, it is appropriate to prefer inactivated vaccines, the use of which is safe even in immunocompromised persons, of course, while respecting general contraindications. This article is focused on the five most common vaccine-preventable infections, including vaccines that are recommended for diabetics.