Approach to SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis

For more than a year now, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been causing the coronavirus disease (COVID-19) pandemic with high mortality and detrimental effects on society, economy, and individual lives. Great hopes are being placed on vaccination as one of the most potent escape strategies from the pandemic and multiple vaccines are already in clinical use. However, there is still a lot of insecurity about the safety and efficacy of vaccines in patients with autoimmune diseases like multiple sclerosis (MS), especially under treatment with immunomodulatory or immunosuppressive drugs. We propose strategic approaches to SARS-CoV-2 vaccination management in MS patients and encourage fellow physicians to measure the immune response in their patients. Notably, both humoral and cellular responses should be considered since the immunological equivalent for protection from SARS-CoV-2 after infection or vaccination still remains undefined and will most likely involve antiviral cellular immunity. It is important to gain insights into the vaccine response of immunocompromised patients in order to be able to deduce sensible strategies for vaccination in the future

Recurrent Miscarriage: Diagnostic and Therapeutic Procedures. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry Number 015/050).

Purpose Official guideline of the German Society of Gynecology and Obstetrics (DGGG), the Austrian Society of Gynecology and Obstetrics (ÖGGG) and the Swiss Society of Gynecology and Obstetrics (SGGG). The aim of this guideline was to standardize the diagnosis and treatment of couples with recurrent miscarriage (RM). Recommendations were based on the current literature and the views of the involved committee members. Methods Based on the current literature, the committee members developed the statements and recommendations of this guideline in a formalized process which included DELPHI rounds and a formal consensus meeting. Recommendations Recommendations for the diagnosis and treatment of patients with RM were compiled based on the international literature. Specific established risk factors such as chromosomal, anatomical, endocrine, hemostatic, psychological, infectious and immunological disorders were taken into consideration

Diagnostik und Therapie von Frauen mit wiederholten Spontanaborten. Leitlinie der DGGG, OEGGG und SGGG (S2k-Level, AWMF-Registernummer 015/050, Mai 2022)

Purpose The aim of this guideline is to standardize the diagnosis and therapy of recurrent miscarriage (RM) using evidence from the recent literature. This is done by using consistent definitions, objective evaluations and standardized treatment protocols. Methods When this guideline was compiled, special consideration was given to previous recommendations in prior versions of this guideline and the recommendations of the European Society of Human Reproduction and Embryology, the Royal College of Obstetricians and Gynecologists, the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine, and a detailed individual search of the literature about the different topics was carried out. Recommendations Recommendations about the diagnostic and therapeutic procedures offered to couples with RM were developed based on the international literature. Special attention was paid to known risk factors such as chromosomal, anatomical, endocrinological, physiological coagulation, psychological, infectious and immune disorders. Recommendations were also developed for those cases where investigations are unable to find any abnormality (idiopathic RM).Ziel Ziel der vorliegenden Leitlinie ist es, die Diagnostik und Therapie von wiederholten Spontanaborten (WSA) anhand der aktuellen Literatur evidenzbasiert zu standardisieren. Dies erfolgt unter Verwendung einheitlicher Definitionen, objektivierter Bewertungsmöglichkeiten und standardisierter Therapieprotokolle. Methoden Die Erstellung dieser Leitlinie erfolgte unter besonderer Berücksichtigung der bisherigen Empfehlungen der Vorversionen dieser Leitlinie, den Empfehlungen der European Society of Human Reproduction and Embryology, des Royal College of Obstetricians and Gynecologists, des American College of Obstetricians and Gynecologists und der American Society for Reproductive Medicine sowie einer ausführlichen individuellen Literaturrecherche zu den jeweiligen Themen. Empfehlungen Es wurden Empfehlungen zur Diagnostik und Therapie von Paaren mit WSA anhand der internationalen Literatur erarbeitet. Insbesondere wurde auf die bekannten Risikofaktoren wie chromosomale, anatomische, endokrinologische, gerinnungsphysiologische, psychologische, infektiologische und immunologische Störungen eingegangen. Aber auch für die Fälle einer unauffälligen Abklärung (idiopathische WSA) wurden Empfehlungen erarbeitet