Vaccine breakthrough hypoxemic COVID-19 pneumonia in patients with auto-Abs neutralizing type I IFNs

Life-threatening `breakthrough' cases of critical COVID-19 are attributed to poor or waning antibody response to the SARS- CoV-2 vaccine in individuals already at risk. Pre-existing autoantibodies (auto-Abs) neutralizing type I IFNs underlie at least 15% of critical COVID-19 pneumonia cases in unvaccinated individuals; however, their contribution to hypoxemic breakthrough cases in vaccinated people remains unknown. Here, we studied a cohort of 48 individuals ( age 20-86 years) who received 2 doses of an mRNA vaccine and developed a breakthrough infection with hypoxemic COVID-19 pneumonia 2 weeks to 4 months later. Antibody levels to the vaccine, neutralization of the virus, and auto- Abs to type I IFNs were measured in the plasma. Forty-two individuals had no known deficiency of B cell immunity and a normal antibody response to the vaccine. Among them, ten (24%) had auto-Abs neutralizing type I IFNs (aged 43-86 years). Eight of these ten patients had auto-Abs neutralizing both IFN-a2 and IFN-., while two neutralized IFN-omega only. No patient neutralized IFN-ss. Seven neutralized 10 ng/mL of type I IFNs, and three 100 pg/mL only. Seven patients neutralized SARS-CoV-2 D614G and the Delta variant (B.1.617.2) efficiently, while one patient neutralized Delta slightly less efficiently. Two of the three patients neutralizing only 100 pg/mL of type I IFNs neutralized both D61G and Delta less efficiently. Despite two mRNA vaccine inoculations and the presence of circulating antibodies capable of neutralizing SARS-CoV-2, auto-Abs neutralizing type I IFNs may underlie a significant proportion of hypoxemic COVID-19 pneumonia cases, highlighting the importance of this particularly vulnerable population

Arthroscopic excision of elastofibroma dorsi at scapulothoracic joint: a surgical technique

Elastofibroma dorsi is a rare soft tissue pseudotumor which is located at the anteroinferior aspect of the scapula. In this article, we report a 19-year-old female case who had arthroscopic marginal excision of elastofibroma dorsi at the scapulothoracic joint without recurrences during follow-up. The artiaroscopic marginal excision of the elastofibroma dorsi may have good clinical results in selected cases

Evaluation Of Diagnostic Tests Using Information Theory For Multi-Class Diagnostic Problems And Its Application For The Detection Of Occlusal Caries Lesions

Background: Several methods are available to evaluate the performance of the tests when the purpose of the diagnostic test is to discriminate between two possible disease states. However multi-class diagnostic problems frequently appear in many areas of medical science. Hence, there is a need for methods which will enable us to characterize the accuracy of diagnostic tests when there are more than two possible disease states. Aims: To show that two information theory measures, information content (IC) and proportional reduction in diagnostic uncertainty (PRDU), can be used for the evaluation of the performance of diagnostic tests for multi-class diagnostic problems that may appear in different areas of medical science. Study Design: Diagnostic accuracy study. Methods: Sixty freshly extracted permanent human molar and premolar teeth suspected to have occlusal caries lesions were selected for the study and were assessed by two experienced examiners. Each examiner performed two evaluations. Histological examination was used as the gold standard. The scores of the histological examination were defined as sound (n=11), enamel caries (n=22) and dentin caries (n=27). Diagnostic performance of i) visual inspection, ii) radiography, iii) laser fluorescence (LF) and iv) micro-computed tomography (M-CT) caries detection methods was evaluated by calculating IC and PRDU. Results: Micro-computed tomography examination was the best method among the diagnostic techniques for the diagnosis of occlusal caries in terms of both IC and PRDU. M-CT examination supplied the maximum diagnostic information about the diagnosis of occlusal caries in the first (IC: 1.056; p<0.05), (PRDU: 70.5%) and second evaluation (IC: 1.105; p<0.05), (PRDU: 73.8%) for the first examiner. M-CT examination was the best method among the diagnostic techniques for the second examiner in both the first (IC: 1.105; p<0.05), (PRDU: 73.8%) and second evaluation (IC: 1.061; p<0.05), (PRDU: 70.8%). IC and PRDU were lowest for visual inspection. Conclusion: The present study demonstrates that IC and PRDU can be used to evaluate diagnostic test performance when multiple disease states are being evaluated.WoSScopu

THE EFFECT OF MALFUNCTIONS IN AIR HANDLING UNITS ON ENERGY AND EXERGY EFFICIENCY

In this study, the effects of malfunctions and problems occurring in the system components of air handling units, which are the main elements of the air conditioning system, on the energy consumption were investigated. Investigations were carried out in 10 air handling units located in 5 different shopping centers of Turkey. The malfunctions and problems that may occur in operation of air handling units were determined and the problems causing the decrease in the efficiency prescribed by the design characteristics were determined. For this purpose, rod-type anemometer measuring the airflow in the air handling unit ducts, propeller-type anemometer, and thermal camera were used to measure air tightness and heat losses in the body structure. Also, the tension control of the belt of the fan motors, which is one of the main components of the energy consumption unit, and the pollution control of the air filter have also been carried out. The flow rate of water circulating in air handling units was determined, and losses were detected by energy and exergy analyses with thermodynamic parameters for summer and winter periods. As a result of the calculations, it was determined that the energy efficiency of the air handling units in the cooling period was 63.7% and the exergy efficiency was 59.6%. The energy loss is 471 kW and the exergy loss is 27 kW in the cooling period. The energy loss is 957 kW and the exergy loss is 127 kW in the heating period. The energy efficiency and the exergy efficiency during the heating period was calculated to be 75% and 41.7%, respectively.WOS:0005578810000022-s2.0-8508796808

Effect of Intravenous Active Vitamin-D Treatment on the Left Ventricular Mass Index in Chronic Hemodialysis Patients with Secondary Hyperparathyroidism

Objective: We investigated the effect of active D vitamin therapy on echocardiographic examination results in hemodialysis patients with hyperparathyroidism. Materials and Methods: This prospective study involved 20 patients who undergoing HD for a total of 12 hours per week at least 6 months. Patients with serum intact parathormone level (iPTH) >= 20.8 pmol/L, phosphorus level 3.5 - 5.5 mg/dL, calcium level <9.5 mg/dL included in this study. Before and after 6 months active vitamin D treatment, left ventricular mass index (LVMI) of all patients were investigated by echocardiography. Results: The mean age was 51.2 +/- 15.0 Ten patients were female and ten patients were male. The mean iPTH level in serum before and six months after active vitamin-D treatment were 35.97 +/- 16.41 and 24.92 +/- 13.28 pmol/L respectively (p<0.001). Before and six months after active vitamin-D treatment the mean LVMI were 294.40 +/- 103.2 gr/m(2) and 250.40 +/- 101.44 gr/m(2) respectively. LVMI was statistically significant decreased after six months treatment compared to before treatment (p<0.001). Conclusion: Increased serum iPTH levels in patients undergoing HD decrease with active vitamin-D treatment and this results in significant reduction in LVMI. Our results show that treatment of hyperparathyroidism plays an important role in correcting LVH

WARFARIN INCREASES THE RISK OF VASCULAR CALCIFICATION IN HAEMODIALYSIS PATIENTS: A MULTICENTER CASE-CONTROL STUDY

57th ERA-EDTA Congress -- JUN 06-09, 2020 -- ELECTR NETWORKUstuner, Evren/0000-0003-0932-1508; Sadioglu, Rezzan Eren/0000-0001-9761-0320WOS: 000562392100273[No abstract available]ERA, EDT