Association of Systemic Adverse Reactions and Serum SARS-CoV-2 Spike Protein Antibody Levels after Administration of BNT162b2 mRNA COVID-19 Vaccine.

Objectives The influential factors for anti-severe acute respiratory syndrome coronavirus 2 spike protein antibody (S-ab) levels were assessed after the administration of BNT162b2 mRNA coronavirus disease-2019 (COVID-19) vaccine at short and medium terms. Methods A total of 470 healthcare workers (118 males, mean age 41.0±11.9 years) underwent serum S-ab level measurement at 3 and 8 months after two inoculations of BNT162b2 vaccine given 3 weeks apart, who had no history of COVID-19 were enrolled in this study. The changes and differences after vaccination due to gender and adverse reactions of S-ab were analyzed. Results Systemic adverse reactions incidence (48%) was significantly higher after the second dose than after the first dose (8%). S-ab levels decreased as the age increased (from the 20s to 60s) in both measurements. S-ab level 8 months after the second inoculation [median 476.3 (interquartile range (IQR) 322.4-750.6) U/mL] was significantly lower than that after 3 months [977.5 (637.2-1,409.0) U/mL; p<0.001]. The median decrease rate of S-ab levels in 5 months was 50.3% (IQR 40.3-62.6) and those differences were not observed among all generations. Gender-associated differences in S-ab levels were not observed; however, a significant relationship between higher S-ab levels and the systemic adverse reactions was observed at both measurements. Conclusions The systemic adverse reaction is an independent factor for higher S-ab levels at short and medium terms after BNT162b2 vaccination as demonstrated in our data.

A novel scale predicting postoperative delirium (POD) in patients undergoing cerebrovascular surgery.

PURPOSE: The purpose of this study was to develop and test a scale for predicting POD in patients undergoing cerebrovascular surgery. METHODS: The predictive scale for POD was composed of 32 items reflecting the strongest risk factors as determined by a literature review. The NEECHAM Confusion Scale determined POD onset and severity. RESULTS: Delirium developed in 38 (31.1%) of the 122 patients in our sample. Logistic regression revealed the following risk factors: dehydration, age, disturbance of consciousness, underlying illness, and anxiety or depression. The final scale was weighted by referring to odds ratios. The area under the curve was 0.844 (95% CI=0.766-0.921). The possible total score on this scale was 20 points. A cutoff score of 11 was set for risk of POD (patients scoring over 12 were considered at higher risk). The median score was 8 (range: 4-9) in the non-delirium group and 13 (range: 9-16) in the delirium group (U=499.0; df=120; p<0.001). Scale scores were moderately correlated with delirium duration (ρ=0.532; p<0.001). CONCLUSION: The present scale is a promising a tool for predicting POD but needs to be studied further.

Caring for a Yobiyose-rojin: a comparison of burden on daughters and daughters-in-law.

The issue of "Yobiyose-rojin," elderly parents relocated to the home of one of their children because of the care required by their physical and mental conditions, has been the subject of recent attention in Japan. To determine the effective assistance that caregivers require, the authors compared daughters with daughters-in-law who care for an elderly parent in terms of characteristics and factors that might contribute to the caregiver's burden. Daughters-in-law perceived a much stronger burden although they took care of a less-impaired parent for fewer hours a day than daughters. The results indicated that an appropriate form of support must be carefully chosen based on the identity of the primary caregiver.

[Basic research in supporting the family who provides home care for their elderly people who need medical treatment at home--focusing on "uncomfortableness as judged by the utilization of the external human resource"].

The purpose of this study was to examine the use of external resource by the family caring for the elderly people who need medical treatment at home, and to discuss the methods of family support. An interview and the participatory observation were conducted to each of the 16 families, and the data were analyzed based on the Grounded Theory Approach. "Uncomfortableness as judged by the utilization of external resources" was found as a crucial factor to control the utilization of external human resources. The 3 factors that influenced the degree of uncomfortableness were also clarified. Those findings suggest that it is important to reduce the uncomfortableness stemming from the utilization of external support.