The use of Statins in the perioperative period

3 Hydroxy 3 Methyl Glutaryl Coenzyme A Reductase Inhibitors’ (statins) are increasingly being used in patients with cardiovascular disease. The Scottish Intercollegiate Guidelines Network (SIGN) and National Institute of Health and Clinical Excellence (NICE) recommend their use in primary and secondary prevention of cardiovascular events. Patients on preoperative statins will frequently present for surgical procedures. The increase in adverse cardiovascular outcomes in high risk patients if statins are withheld in the immediate postoperative period should be weighed against the small but serious risk of rhabdomyolysis associated with statins. The potential for drug interactions should be considered when prescribing for patients on statins.     

A report on the Fetal Alcohol Spectrum Disorders Study Group meeting of 2012, theme title, “Biomarkers for FASD”

The 2012 meeting of the Fetal Alcohol Spectrum Disorders Study Group (FASDSG) focused on the development and ethics of biomarkers for fetal alcohol exposure. This one-day international conference brought students and trainees together with clinicians and researchers to discuss the latest research on FASD. One keynote speaker discussed the value of profiling epigenetic modifications in readily available fetal tissues to diagnose fetal exposure to environmental agents, while the second speaker discussed the ethics of biomarker development within the context of core principles of justice, autonomy, beneficence and non-maleficence. Three sessions of short data talks informed the audience of research advances with particular emphasis on the diagnosis of FASD. Other activities included updates on FASD-related activities by representatives of government agencies, a report on the implementation FASD-related diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association and a networking lunch, and the presentation of the “Merit Award” to Dr. Nathan Muraski for his work on behavioral outcomes of fetal alcohol exposure. The capstone of the meeting was the presentation of the “Henri Rosett” award to Dr. Denis Viljoen, in recognition of his role in raising awareness about the incidence of FASD in South Africa and in promoting FASD prevention and treatment programs as chairperson and chief executive officer of the Foundation for Alcohol Related Research (FARR).     

Anomalous left coronary artery from pulmonary artery (ALCAPA) repair and mitral valve replacement with bioprosthetic valve with in a 62 year old lady

Anomalous Left Coronary Artery from Pulmonary Artery (ALCAPA) is the commonest congenital anomaly involving coronary arteries. The combination of this anomaly with mitral regurgitation is very rare in adult population. We report the case of a 62?year old lady, who presented with breathlessness and was found to have this combined anomaly. She was treated successfully with closure of left coronary ostium from pulmonary artery and mitral valve replacement with Hancock 2 Porcine valve. To our knowledge, this is the oldest patient to have undergone successful ALCAPA repair with mitral valve replacement with bioprosthetic valve.     

Analyzing the attitude of Indian citizens towards COVID-19 vaccine – A text analytics study

Background and aimsThe government of India recently planned to start the process of the mass vaccination program to end the COVID-19 crises. However, the process of vaccination was not made mandatory, and there are a lot of aspects that arise skepticism in the minds of common people regarding COVID-19 vaccines. This study using machine learning techniques analyzes the major concerns Indian citizens voice out about COVID-19 vaccines in social media.MethodsFor this study, we have used social media posts as data. Using Python, we have scrapped the social media posts of Indian citizens discussing about the COVID- 19 vaccine. In Study 1, we performed a sentimental analysis to determine how the general perception of Indian citizens regarding the COVID-19 vaccine changes over different months of COVID-19 crises. In Study 2, we have performed topic modeling to understand the major issues that concern the general public regarding the COVID- 19 vaccine.ResultsOur results have indicated that 47% of social media posts discussing vaccines were in a neutral tone, and nearly 17% of the social media posts discussing the COVID-19 vaccine were in a negative tone. Fear of health and allergic reactions towards the vaccine are the two prominent issues that concern Indian citizens regarding the COVID-19 vaccine.ConclusionWith the positive sentiments regarding vaccine is just over 35%, the Indian government needs to focus especially on addressing the fear of vaccines before implementing the process of mass vaccination.     

Oral Immunization with Recombinant Vaccinia Virus Prime and Intramuscular Protein Boost Provides Protection against Intrarectal Simian-Human Immunodeficiency Virus Challenge in Macaques

Human immunodeficiency virus type 1 (HIV-1) acquisition occurs predominantly through mucosal transmission. We hypothesized that greater mucosal immune responses and protective efficacy against mucosal HIV-1 infection may be achieved by prime-boost immunization at mucosal sites. We used a macaque model to determine the safety, immunogenicity, and protective efficacy of orally delivered, replication-competent but attenuated recombinant vaccinia viruses expressing full-length HIV-1 SF162 envelope (Env) or simian immunodeficiency virus (SIV) Gag-Pol proteins. We examined the dose and route that are suitable for oral immunization with recombinant vaccinia viruses. We showed that sublingual inoculation of two vaccinia virus-naive pigtailed macaques with 5 × 10⁸ PFU of recombinant vaccinia viruses was safe. However, sublingual inoculation with a higher dose or tonsillar inoculation resulted in secondary oral lesions, indicating the need to optimize the dose and route for oral immunization with replication-competent vaccinia virus vectors. Oral priming alone elicited antibody responses to vaccinia virus and to the SF162 Env protein. Intramuscular immunization with the SF162 gp120 protein at either 20 or 21 weeks postpriming resulted in a significant boost in antibody responses in both systemic and mucosal compartments. Furthermore, we showed that immune responses induced by recombinant vaccinia virus priming and intramuscular protein boosting provided protection against intrarectal challenge with the simian-human immunodeficiency virus SHIV-SF162-P4.     

Extensive Nevus Comedonicus Involving the Palm: Questionable Role of the Pilosebaceous Unit in Pathogenesis

A 10‐year‐old boy had multiple grouped pits with black plugs arranged along the lines of Blaschko on his left chest, arm, and palm. Involvement of the palms is rarely reported in the literature. Recent reports have described mosaic acneiform conditions that could share pathogenetic mechanisms with nevus comedonicus. We briefly review the literature on mosaic conditions with acneiform lesions including nevus comedonicus.     

New therapeutics based on emerging concepts in pulmonary fibrosis

Introduction: Fibrosis is an irreversible pathological endpoint in many chronic diseases, including pulmonary fibrosis. Idiopathic pulmonary fibrosis (IPF) is a progressive and often fatal condition characterized by (myo)fibroblast proliferation and transformation in the lung, expansion of the extracellular matrix, and extensive remodeling of the lung parenchyma. Recent evidence indicates that IPF prevalence and mortality rates are growing in the United States and elsewhere. Despite decades of research on the pathogenic mechanisms of pulmonary fibrosis, few therapeutics have succeeded in the clinic, and they have failed to improve IPF patient survival.

Areas covered: Based on a literature search and our own results, we discuss the key cellular and molecular responses that contribute to (myo)fibroblast actions and pulmonary fibrosis pathogenesis; this includes signaling pathways in various cells that aberrantly and persistently activate (myo)fibroblasts in fibrotic lesions and promote scar tissue formation in the lung.

Expert opinion: Lessons learned from recent failures and successes with new therapeutics point toward approaches that can target multiple pro-fibrotic processes in IPF. Advances in preclinical modeling and single-cell genomics will also accelerate novel discoveries for effective treatment of IPF.