Adult Kawasaki disease in a European patient: a case report and review of the literature

© 2015 Kontopoulou et al.; licensee BioMed Central.Introduction: Kawasaki disease is an acute necrotising vasculitis of the medium- and small-sized vessels, occurring mainly in Japanese and Korean babies and children, aged 6 months to 5 years. Its main complication is damage of coronary arteries, which has the potential to be fatal. Here we report a rare case of Kawasaki disease that occurred in a 20-year-old Greek adult. Case presentation: A 20-year-old Greek man presented with high fever, appetite loss, nausea and vomiting, headache and significant malaise. He had an erythema of the palms and strikingly red lips and conjunctiva. As he did not respond to broad-spectrum antibiotics and after having excluded other possible diagnoses, the diagnosis of Kawasaki disease was set. He was treated with intravenous immunoglobulin and oral aspirin on the 10th day since the onset of the illness. His clinico-laboratory response was excellent and no coronary artery aneurysms were detected in coronary artery computed tomography performed 1 month later. Conclusions: This report of an adult case of European Kawasaki disease may be of benefit to physicians of various specialties, including primary care doctors, hospital internists, intensivists and cardiologists. It demonstrates that a case of prolonged fever, unresponsive to antibiotics, in the absence of other diagnoses may be an incident of Kawasaki disease. It is worth stressing that such a diagnosis should be considered, even if the patient is adult and not of Asian lineage

Significant Increase in Antibody Titers after the 3rd Booster Dose of the Pfizer-BioNTech mRNA COVID-19 Vaccine in Healthcare Workers in Greece.

The aim of our study was to assess the immunogenicity of the third dose of the BNT162b2 mRNA COVID-19 vaccine (Comirnaty) in a cohort of 129 health-care workers in Greece whose anti-S1 RBD IgG titers were monitored over the course of nine months. Titers were measured for each participant just before the third dose (nine months after the second dose) and also one month after the third dose. Of the 129 participants, 19 had been previously infected before starting the vaccination scheme. The SARS-CoV-2 IgG II Quant assay on the Architect System was employed to longitudinally assess the titers of IgG against the receptor-binding domain of the S1 subunit of the spike protein (anti-S1 RBD). Boosters raised Geometric Mean Concentrations (GMCs) by a factor of approximately 47 relative to levels at 9 months and by a factor of approximately 23 relative to levels at 6 months. The immune response one month after the third dose was significantly higher than the response achieved one month after the second dose (p = 0.008). In conclusion, our findings verify the potent immunogenicity elicited by the third dose in all age and prior COVID-19 status groups, suggesting that the timely administration of the third (booster) dose maximizes the immunogenic potential of the vaccine

The effect of materials' rheology on process energy consumption and melt thermal quality in polymer extrusion

YesPolymer extrusion is an important but an energy intensive method of processing polymeric materials. The rapid increase in demand of polymeric products has forced manufactures to rethink their processing efficiencies to manufacture good quality products with low-unit-cost. Here, analyzing the operational conditions has become a key strategy to achieve both energy and thermal efficiencies simultaneously. This study aims to explore the effects of polymers' rheology on the energy consumption and melt thermal quality (ie, a thermally homogeneous melt flow in both radial and axil directions) of extruders. Six commodity grades of polymers (LDPE, LLDPE, PP, PET, PS, and PMMA) were processed at different conditions in two types of continuous screw extruders. Total power, motor power, and melt temperature profiles were analyzed in an industrial scale single-screw extruder. Moreover, the active power (AP), mass throughput, torque, and power factor were measured in a laboratory scale twin-screw extruder. The results confirmed that the specific energy consumption for both single and twin screw extruders tends to decrease with the processing speed. However, this action deteriorates the thermal stability of the melt regardless the nature of the polymer. Rheological characterization results showed that the viscosity of LDPE and PS exhibited a normal shear thinning behavior. However, PMMA presented a shear thickening behavior at moderate-to-high shear rates, indicating the possible formation of entanglements. Overall, the findings of this work confirm that the materials' rheology has an appreciable correlation with the energy consumption in polymer extrusion and also most of the findings are in agreement with the previously reported investigations. Therefore, further research should be useful for identifying possible correlations between key process parameters and hence to further understand the processing behavior for wide range of machines, polymers, and operating conditions

Designing a consequentially based study into the online support of pre-service teachers in the UK

This paper reports on the design of a pilot doctoral study into the online support of pre-service teachers. It highlights the significance of a consequential, rather than deontological, perspective in guiding the development of a study's design. The study initially aimed to explore pre-service teachers’ perceptions and use of social media on their school placements by setting up groups on Facebook and Twitter. However, several problems occurred in relation to the recruitment of participants. It became increasingly clear that there was significance in the positionality of the researcher as an “outsider” to the research context and the potential role for gatekeepers in understanding remote research sites. An ethical framework was used to make a more comprehensive analysis of the issues at play, which helped identify ways of proceeding. A redesign of the study followed with a stronger rationale for the way consequential considerations can help address deontological concerns

The combination of colistin and doripenem is synergistic against Klebsiella pneumoniae at multiple inocula and suppresses colistin resistance in an in vitro pharmacokinetic/pharmacodynamic model

There has been a resurgence of interest in aerosolization of antibiotics for treatment of patients with severe pneumonia caused by multidrug-resistant pathogens. A combination formulation of amikacin-fosfomycin is currently undergoing clinical testing although the exposure-response relationships of these drugs have not been fully characterized. The aim of this study was to describe the individual and combined antibacterial effects of simulated epithelial lining fluid exposures of aerosolized amikacin and fosfomycin against resistant clinical isolates of Pseudomonas aeruginosa (MICs of 16 mg/liter and 64 mg/liter) and Klebsiella pneumoniae (MICs of 2 mg/liter and 64 mg/liter) using a dynamic hollow-fiber infection model over 7 days. Targeted peak concentrations of 300 mg/liter amikacin and/or 1,200 mg/liter fosfomycin as a 12-hourly dosing regimens were used. Quantitative cultures were performed to describe changes in concentrations of the total and resistant bacterial populations. The targeted starting inoculum was 10(8) CFU/ml for both strains. We observed that neither amikacin nor fosfomycin monotherapy was bactericidal against P. aeruginosa while both were associated with rapid amplification of resistant P. aeruginosa strains (about 10(8) to 10(9) CFU/ml within 24 to 48 h). For K. pneumoniae, amikacin but not fosfomycin was bactericidal. When both drugs were combined, a rapid killing was observed for P. aeruginosa and K. pneumoniae (6-log kill within 24 h). Furthermore, the combination of amikacin and fosfomycin effectively suppressed growth of resistant strains of P. aeruginosa and K. pneumoniae In conclusion, the combination of amikacin and fosfomycin was effective at maximizing bacterial killing and suppressing emergence of resistance against these clinical isolates

Antibody Titers After a Third Dose of the SARS-CoV-2 BNT162b2 Vaccine in immunocompromised adults in Greece: is a fourth dose necessary?

Real-world data suggests that protection against COVID-19 declines a few months after vaccination, particularly in the elderly and immunocompromised individuals. Our study aimed to analyze the humoral response induced by a third supplemental dose of BNT162b2 vaccine in a mixed group of immunocompromised individuals by determining anti-spike (anti-S) IgG antibody titers at baseline (pre-third vaccine dose) and 4 weeks after the dose. Serum samples were obtained from a total group of 85 immunocompromised individuals (history of cancer: n=20, lymphoma: n=4, leukemia: n=3, transplant recipients: n=4, autoimmune disease: n=42, inflammatory disease: n=6, autoimmune diabetes type 1: n=6) all of whom had previously received a two-dose schedule of the vaccine. The average number of days between 2nd and 3rd dose was 139.6145 (±41.39071). The overall IgG GMCs four weeks post vaccination were increased by more than 35 times (fold change = 35. 30, p<0.001). Fold changes were not significantly correlated with underlying condition, age, sex nor with days between 2nd and 3rd dose. Considering the predominance of omicron variants in the current period and the results of studies showing a decrease in the effectiveness of the 3rd dose after 10 weeks we highly recommend a fourth dose to this vulnerable population group. This article is protected by copyright. All rights reserved

Clinico-laboratory values of an adult patient with Kawasaki disease in Europe

Kawasaki disease is an acute febrile syndrome that mainly hurts the skin, mucosa and lymph nodes, occasionally causing coronary artery aneurysms if left untreated. It occurs most often in Japan and Korea, affecting infants and small children, whereas few adult cases have been reported. Its pathogenesis remains mostly unknown. This dataset consists of clinico-laboratory values of a case of adult Kawasaki disease in Europe.Kawasaki disease is an acute febrile syndrome that mainly hurts the skin, mucosa and lymph nodes, occasionally causing coronary artery aneurysms if left untreated. It occurs most often in Japan and Korea, affecting infants and small children, whereas few adult cases have been reported. Its pathogenesis remains mostly unknown. This dataset consists of clinico-laboratory values of a case of adult Kawasaki disease in Europe

Immunogenicity after the first dose of the BNT162b2 mRNA Covid-19 vaccine: real-world evidence from Greek healthcare workers

Real-world data regarding the effectiveness, safety and immunogenicity of the Pfizer-BioNTech BNT162b2 mRNA vaccine are accumulating in the literature, suggesting that this vaccine generates high titres of S1-binding IgG antibodies that exhibit potent virus neutralization capacity. This is the first phase IV immunogenicity study to recruit a large number of Greek healthcare workers (n=425) including 63 previously-infected subjects. We measured titres of neutralizing IgGs against the receptor-binding domain of the S1 subunit of the spike protein of SARS-CoV-2 14 days post-immunization with the first dose, employing the SARS-CoV-2 IgG II Quant assay. A total of 92.24 % of our study cohort received a positive assay outcome and titres varied with age. Post-hoc analysis revealed that although titres did not significantly differ among participants aged 20-49 years, a significant decline was marked in the age group of 50-59 years, which was further accentuated in subjects aged over 60. Antibody titres escalated significantly among the previously-infected, indicating the potential booster effect of the first dose in that group