Effectiveness of mRNA-1273 against infection and COVID-19 hospitalization with SARS-CoV-2 Omicron subvariants: BA.1, BA.2, BA.2.12.1, BA.4, and BA.5

Studies have reported reduced natural SARS-CoV-2 infection- and vaccine-induced neutralization against Omicron BA.4/BA.5 compared with earlier Omicron subvariants. We conducted a test-negative case-control study evaluating mRNA-1273 vaccine effectiveness (VE) against infection and hospitalization with Omicron subvariants. The study included 30,809 SARS-CoV-2 positive and 92,427 SARS-CoV-2 negative individuals aged [≥]18 years tested during 1/1/2022-6/30/2022. While 3-dose VE against BA.1 infection was high and waned slowly, VE against BA.2, BA.2.12.1, BA.4, and BA.5 infection was initially moderate to high (61.0%-90.6% 14-30 days post third dose) and waned rapidly. The 4-dose VE against infection with BA.2, BA.2.12.1, and BA.4 ranged between 64.3%-75.7%, and was low (30.8%) against BA.5 14-30 days post fourth dose, disappearing beyond 90 days for all subvariants. The 3-dose VE against hospitalization for BA.1, BA.2, and BA.4/BA.5 was 97.5%, 82.0%, and 72.4%, respectively; 4-dose VE against hospitalization for BA.4/BA.5 was 88.5%. Evaluation of the updated bivalent booster is warranted.

Effectiveness of mRNA-1273 against SARS-CoV-2 omicron and delta variants

SARS-CoV-2 omicron (B.1.1.529) variant is highly transmissible with potential immune escape. We conducted a test-negative case-control study to evaluate mRNA-1273 vaccine effectiveness (VE) against infection and hospitalization with omicron or delta. The large, diverse study population included 26,683 SARS-CoV-2 test-positive cases with variant determined by spike gene status (16% delta, 84% omicron). The 2-dose VE against omicron infection at 14-90 days was 44.0% (95% CI, 35.1-51.6%) but declined quickly. The 3-dose VE was 93.7% (92.2-94.9%) and 86.0% (78.1-91.1%) against delta infection and 71.6% (69.7-73.4%) and 47.4% (40.5-53.5%) against omicron infection at 14-60 days and >60 days, respectively. The 3-dose VE was 29.4% (0.3-50.0%) against omicron infection in immunocompromised individuals. The 3-dose VE against hospitalization with delta or omicron was >99%. Our findings demonstrate high, durable 3-dose VE against delta infection but lower effectiveness against omicron infection, particularly among immunocompromised people. However, 3-dose VE was high against hospitalization with delta or omicron.

A case of Large Aneurysm of the Anterior Ethmoidal Artery Associated with an Anatomically Related Arteriovenous Malformation

The authors report a case of ruptured large saccular aneurysm of anterior ethmoidal artery, ethmoidal artery associated with anatomically related arteriovenous malformation(AVM). The patient was a 49-year-male who presented with severe headache followed by deteriorated consciousness. Computerized tomography and Magnetic resonance imaging revealed intracerebral hemorrhage in left the frontal lobe and intraventricular hemorrhage and contrast enhancing ring-like mass in the frontobasal area. The cerbral angiography showed anterior ethmoidal artery aneurysm with abnormal vascularity in arterial phase. The patient was treated successfully by clipping of the aneurysm and removing of AVM, Among the reference, I have reviewed this paper is the first case report on the anterior ethmoidal artery aneurysm associated with AVM.

The Operative Treatment for the Meningiomas in the low Clivus and Foramen Magnum

The authors report the experiences of transcondylar approaches for five meningiomas in the low clivus and foramen magnum. These tumors were removed via transcondylar approach. The results show that there was no operative mortality and minimal operative morbidity;one patient had temporary oropharyngeal dysfunction. This approach offers the best direct vision of the ventral structures to low clivus and foramen magnum without additional retraction or manipulation of the brain stem.

The Study of Elements of Cerebral Arteriovenous Malformation

In a retrospective study of 52 patients who underwent elective surgery for cerebral arteriovenous malformation, statistical analysis of elements of AVM was undertaken, in order to discover the predictors of operative morbidity. All patients had a computed tomographic scan and the positive angiogram before surgery. Elements of AVM contains Indus, arterial feeders and draining veins. The size of nidus was classified by Yasargil's method. The results were same as below; 1) Size:Giant-6 cases, large-7 cases, moderate-7 cases, small-13 cases. 2) Arterial feeders:ACA-16 cases(23%), MCA-32 cases(45%), PCA-14 cases(20%), AnCh-4 cases(6%), SCA-1 case(1%), Post. Choroidal-2 cases(3%), Call. Marginal-1 cases(1%), Opthalmic-1 case(1%). 3) Type of venous drainage:type A-10 cases, type B-3 cases, type C-7 cases, type D-4 cases, type E-9 cases, type F-2 cases.