Covid-19 disease, women’s predominant non-heparin vaccine-induced thrombotic thrombocytopenia and kounis syndrome: A passepartout cytokine storm interplay

Coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitute one of the deadliest pandemics in modern history demonstrating cardiovascular, gastrointestinal, hematologic, mucocutaneous, respiratory, neurological, renal and testicular manifestations and further complications. COVID-19-induced excessive immune response accompanied with uncontrolled release of cytokines culminating in cytokine storm seem to be the common pathogenetic mechanism of these complications. The aim of this narrative review is to elucidate the relation between anaphylaxis associated with profound hypotension or hypoxemia with pro-inflammatory cytokine release. COVID-19 relation with Kounis syndrome and post-COVID-19 vaccination correlation with heparin-induced thrombocytopenia with thrombosis (HITT), especially serious cerebral venous sinus thrombosis, were also reviewed. Methods: A current literature search in PubMed, Embase and Google databases was performed to reveal the pathophysiology, prevalence, clinical manifestation, correlation and treatment of COVID-19, anaphylaxis with profuse hypotension, Kounis acute coronary syndrome and thrombotic events post vaccination. Results: The same key immunological pathophysiology mechanisms and cells seem to underlie COVID-19 cardiovascular complications and the anaphylaxis-associated Kounis syndrome. The myocardial injury in patients with COVID-19 has been attributed to coronary spasm, plaque rupture and microthrombi formation, hypoxic injury or cytokine storm disposing the same pathophysiology with the three clinical variants of Kounis syndrome. COVID-19-interrelated vaccine excipients as polysorbate, polyethelene glycol (PEG) and trometamol constitute potential allergenic substances. Conclusion: Better acknowledgement of the pathophysiological mechanisms, clinical similarities, multiorgan complications of COVID-19 or other viral infections as dengue and human immunodeficiency viruses along with the action of inflammatory cells inducing the Kounis syndrome could identify better immunological approaches for prevention, treatment of the COVID-19 pandemic as well as post-COVID-19 vaccine adverse reactions

Relationships Between Capability Indices and Signal-to-Noise Ratios for Use in the Manufacturing Industry

This paper reports on the implications when using capability indices and signal-to-noise ratios for continuous improvements. The aim was to address the problems that are created when trying to use both at the same time, and forms part of a wider study into their implication. When robust designs are required on processes that have adequate capability indices it was found that in many cases the new parameters can reduce the capability index. Likewise, when trying to improve capability indices on robust designs the signal-to-noise ratio will no longer be at its optimum. Reviewing these two situations shows that for achieving robustness and acceptable capability a compromise must be achieved

Preliminary Experiments on a Model to Relate Cpk and SNR Indices

This paper investigates the difficulties of using both Signal-to-Noise Ratios (SNR) and Capability Indices (Cpk) as quality improvement techniques. Recognising the possible contradictory indications of the indices, Cpk and SNR as process quality measures, a 2D geometrical construction is described which relates these indicators. The model has previously been demonstrated theoretically to be capable of clearly indicating the contradictions between indicators. Essentially, it is able to balance the requirements of robustness and reduction of rejects

Etude rétrospective de l’efficacité de la nutrition entérale enrichie par le Transforming Growth Factor beta-2 (Modulen®) dans la maladie de Crohn de l’adulte.

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