Association between reactogenicity and SARS-CoV-2 antibodies after the second dose of the BNT162b2 COVID-19 vaccine

High vaccine reactogenicities may reflect stronger immune responses, but the epidemiological evidence for coronavirus disease 2019 (COVID-19) vaccines is sparse and inconsistent. We observed that a fever of ≥38℃ after two doses of the BNT162b2 vaccine was associated with higher severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike IgG titers.     

Forecasting respiratory infectious outbreaks using ED-based syndromic surveillance for febrile ED visits in a Metropolitan City

Background

Monitoring and detecting sudden outbreaks of respiratory infectious disease is important. Emergency Department (ED)-based syndromic surveillance systems have been introduced for early detection of infectious outbreaks. The aim of this study was to develop and validate a forecasting model of respiratory infectious disease outbreaks based on a nationwide ED syndromic surveillance using daily number of emergency department visits with fever.

颅脑创伤术后非感染性发热的原因分析与处理

目的分析颅脑创伤（TBI）开颅术后非感染性发热的原因，探讨其诊治措施。 方法收集广州医科大学附属第六医院脑外科自2016年5月至2019年7月行TBI开颅术后非感染性发热的23例患者的病例资料，对其发热原因及相应临床特点进行分析。 结果TBI开颅术后23例患者出现非感染性发热，其中吸收热3例，中枢性发热3例，植物神经功能紊乱2例，无菌性脑膜炎7例，皮下积液2例，假性囊肿1例，脑脊液漏3例，药物源性发热2例，经治疗后好转。 结论TBI开颅术后非感染性发热的原因复杂，应针对不同原因采取个体化的治疗措施。     

COVID - 19流行期间基于信息系统上报的27 455名发热就诊病例资料分析

目的 分析COVID - 19流行期间，济南市发热门诊重点对象健康管理系统报告的发热就诊病例的流行病学特征，为疾病预防与控制提供参考。方法 对济南市发热门诊重点对象健康管理系统报告的27 455发热门诊就诊病例的流行病学、临床表现、来院/离院方式、流向等资料进行描述分析。结果 自2月5日系统创建启用至3月5日，共报告27 455发热就诊人次，男女性别比1.25∶1。年龄中位数29岁，其中1岁儿童最多，以5岁以内、20～39岁人群居多。来院、离院方式均以非公共交通工具为主，其中自驾占来院方式60.46%，离院49.33%。就诊者以发热为主诉占74.09%。重复就诊病例2 422人，占发热就诊总病例数的8.82%。男性重复就诊比例高于女性，重复就诊者年龄中位数高于非重复就诊者。是否重复就诊患者的最终流向分布也不同（P＜0.05）。发热就诊病例中发现常见法定报告传染病76例，COVID - 19病例11例。结论 COVID - 19流行期间建立的发热门诊重点对象健康管理系统报告的发热就诊病例以儿童、中青年居多，来院/离院方式以非公共交通工具为主。该系统对包含COVID - 19在内的以发热、咳嗽为主诉的呼吸道传染病预警具有一定价值。     

Parents’ experiences and information needs related to childhood fever: A systematic review

ObjectiveTo synthesize current evidence about experiences and information needs of parents/caregivers managing pediatric fever.MethodsWe used systematic review methodology with an a priori protocol. We searched Medline, Embase, PsycINFO, CINAHL and ProQuest Dissertations and Theses Global, from 2000 to May 2018.ResultsWe included thirty-six studies (n = 29 quantitative, n = 7 qualitative; 15,727 participants). Quantitative data contained four themes; 1) caregivers seek information about pediatric fever, 2) low knowledge is coupled with misconceptions and anxiety, 3) fever assessment and management practices vary, 4) demographic factors (e.g., ethnicity, age, socioeconomic status, education) influence information needs and health practices. Qualitative data contained three themes; 1) tension between logic and emotion, 2) responsibility contrasted with sense of vulnerability, 3) seeking support and information to build confidence.ConclusionParents often overestimate the risks associated with pediatric fever and struggle to make decisions during a child’s febrile illness — leading to caregiving actions that may not reflect current clinical recommendations. Parents seek knowledge about how to care for a febrile child at home and what indicators should prompt them to seek medical attention.Practice ImplicationsIn addition to providing clear, reliable information, interventions that address educational, pragmatic, and emotional domains may be effective in supporting parents.     

The pyrin inflammasome and the Yersinia effector interaction

Pyrin is a cytosolic pattern-recognition receptor that normally functions as a guard to trigger capase-1 inflammasome assembly in response to bacterial toxins and effectors that inactivate RhoA. The MEFV gene encoding human pyrin is preferentially expressed in phagocytes. Key domains in pyrin include a pyrin domain (PYD), a linker region, and a B30.2 domain. Binding of ASC to pyrin by a PYD-PYD interaction triggers inflammasome assembly. Pyrin is held in an inactive conformation by negative regulation mechanisms to avoid premature inflammasome assembly. One mechanism of negative regulation involves phosphorylation of the linker by PRK kinase which in turn is positively regulated by active RhoA. The B30.2 domain also negatively regulates pyrin. Gain of function mutations in MEFV responsible for the autoinflammatory disease Familial Mediterranean Fever (FMF) map to exon 10 encoding the B30.2 domain. Insights into pyrin regulation have come from studies of several Yersinia effectors, which are injected into phagocytes and interact with the RhoA-PRK-pyrin axis during infection. Two effectors, YopE and YopT, inactivate RhoA to disrupt phagocytic signaling. To counteract an effector-triggered immune response, a third effector, YopM, binds to and inhibits pyrin by hijacking PRK and RSK and directing linker phosphorylation. Inhibition of pyrin by YopM is required for virulence of Yersinia pestis, the agent of plague. Recent results from infection studies with human phagocytes and mice producing pyrin B30.2 FMF variants show that gain of function MEFV mutations bypass inhibition by YopM. Population genetic data suggest that MEFV mutations were selected for in individuals of Mediterranean decent during historic plague pandemics. This review discusses current concepts of pyrin regulation and its interaction with Yersinia effectors.     

Carotid intima-media thickness,lipid profile,serum amyloid A and vitamin D status in children with familial Mediterranean fever

Aim of the workIt was to estimate the carotid intima-media thickness (CIMT), lipid profile, serum amyloid A and vitamin D in Familial Mediterranean Fever (FMF) patients and to explore the relationship between CIMT and FMF.Patients and methodsThe study comprised forty-five FMF patients diagnosed during the attack free period and 40 healthy children with similar demographic features as control. The diagnosis of the FMF cases was confirmed by clinical, laboratory assessments and confirmed by the molecular diagnosis. The CIMT, lipid profile, complete blood picture, serum amyloid A (SAA) levels, vitamin D and the growth pattern were investigated.ResultsThe study showed no significant difference of CIMT among patients and controls, significant decrease of vitamin D levels, while lipid profile parameters, triglyceride (TG) to HDL-Cholesterol (HDL-C) ratio, serum amyloid A were significantly increased. A significant correlation was present between the CIMT with the serum cholesterol, low density lipoprotein and triglycerides as well as between SAA and the number of attacks. In addition, vitamin D levels showed significant negative correlation with colchicine. M694I mutation was the most prevalent among FMF patients. Growth parameters were normal in FMF cases.ConclusionThis study sheds light that the normal CIMT in the FMF patients makes it difficult to describe the children as having subclinical atherosclerosis although the higher TG/HDL ratio reflects their risk of atherosclerosis. Moreover, significant decrease of vitamin D in FMF patients was observed. The growth parameters of the FMF patients on regular treatment of colchicine were not affected.