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1.
Vaccine ; 42(8): 1863-1867, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38355322

RESUMO

We evaluated the impact of COVID-19 vaccination on disease outcome in hospitalized patients with SARS-CoV-2 infection with a prospective study. 745 vaccinated and 451 unvaccinated patients consecutively admitted to a COVID-19 Hospital from 1st September 2021 to 1st September 2022 were included. Compared with unvaccinated cases, vaccinated patients were older, had more comorbidities, but had a lower risk of O2 need (odds ratio, OR, 0.46; 95 % CI 0.32-0.65) by logistic regression analysis adjusted for age, sex, comorbidity and WHO COVID-19 Clinical Progression Scale at admission. The ORs for O2 need were 0.38 (0.24-0.61), 0.50 (0.30-0.83) and 0.57 (0.34-0.96) in patients vaccinated 14-120, 121-180 and > 180 days prior to hospitalization, respectively. An anti-spike Ig titer higher than 5000 U/ml was associated with a reduced risk of O2 need (OR 0.52; 95 % CI 0.30-0.92). This study shows that COVID-19 vaccination has a significant impact on COVID-19 outcomes in hospitalized patients.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Vacinas contra COVID-19/uso terapêutico , SARS-CoV-2 , Estudos Prospectivos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinação , Comorbidade
2.
J Pediatr Adolesc Gynecol ; 34(3): 394-399, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32828966

RESUMO

STUDY OBJECTIVE: In a pediatric setting, laparoscopic management of large cystic ovarian neoplasms with low malignancy probability is not suitable, because of the mass size; nevertheless, an effort should be made to be as minimally invasive as possible, without violating the principles of oncologic surgery. We describe our experience in managing these neoplasms with leak-proof extracorporeal drainage through mini laparotomy, followed by cyst excision or oophorectomy. DESIGN: Case series study, describing interventions and outcomes. SETTING: Department of pediatric surgery in a tertiary pediatric and adult university hospital. PARTICIPANTS: Pediatric patients affected by large cystic ovarian mass. INTERVENTIONS: Hybrid minimally invasive approach using leak-proof extracorporeal drainage. MAIN OUTCOME MEASURES: Data on demographic characteristics, tumor marker values, and imaging findings were collected and analyzed. Outcome of surgical technique was evaluated and reported. RESULTS: Between 2011 and 2018, 17 patients (mean age, 10.2 years; range, 2-14 years) affected by large cystic ovarian mass, were eligible for this technique. All patients had negative preoperative tumor markers. Of the seventeen subjects, 13/17 girls (76%) underwent pelvic magnetic resonance imaging. No sign of lymphadenopathy or metastasis was found. Surgery was successful in all patients, with ovarian preservation in 5/17 cases (29.4%). Mean surgical time was 98 minutes; no intra-abdominal leakage of neoplasm content or postoperative complications occurred. Mature cystic teratoma was the most frequent histopathological diagnosis (71%). CONCLUSION: After a thorough patient selection, the management of large cystic ovarian neoplasms with leak-proof extracorporeal drainage performed through a mini laparotomy is a feasible and safe approach, with excellent cosmetic results. When achievable, ovarian-sparing surgery has to be considered.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Cistos Ovarianos/cirurgia , Neoplasias Ovarianas/cirurgia , Adolescente , Adulto , Criança , Drenagem/métodos , Feminino , Humanos , Laparoscopia/métodos , Imageamento por Ressonância Magnética , Duração da Cirurgia , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/patologia , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Estudos Retrospectivos
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