The safety of BCG revaccination: A systematic review

IntroductionRevaccination with Bacillus Calmette-Guérin (BCG) vaccine is not generally recommended due to a lack of proven efficacy of repeat doses for protection against tuberculosis. However, there is a growing interest in the use of BCG vaccine for its ‘off-target’ effects which might involve revaccination. We did a systematic review of the safety of BCG revaccination.MethodsMEDLINE (1946 to March 2020) and the BCG World Atlas (updated 2017) were searched, limiting to studies of BCG administration by the intradermal or percutaneous route. Adverse events as well as patient and vaccine characteristics were reviewed.ResultsThe search identified 388 articles, of which 24 met the inclusion criteria. These reported 22 studies comprising eight randomised trials, four case-control studies, four observational studies and six case series or reports. Overall, there was evidence for a small increase in the rate of mild local and systemic reactions. No serious adverse events were reported in immunocompetent individuals.ConclusionsEvidence to date suggests that revaccination with BCG vaccine carries minimal risk. Future studies of BCG vaccine for novel applications should report adverse event data stratified by prior BCG vaccination status.     

Pre-vaccination vulnerability and suspected adverse events following HPV vaccination. A case-control study nested in the Danish national birth cohort

Previous studies have indicated that girls experiencing suspected adverse events (AE) following HPV vaccination were more vulnerable prior to vaccination. However, no study has previously investigated differences in vulnerability using prospectively collected self-reported measures of vulnerability. The objective of this study therefore was to describe the distribution of biological and psychosocial indicators of vulnerability in girls referred to a hospital setting due to suspected adverse events and compare it with a sample of non-referred HPV vaccinated girls.The study was conducted as a case control study based within the Danish National Birth Cohort. Cases were defined as HPV vaccinated girls referred to a hospital setting between 2015 and 2017 due to suspected adverse events (n = 80), and 5 controls were randomly selected from the remaining source population, matched to cases on age at vaccination, region of residence and year of vaccination. The final study population consisted of 480 girls. Prior exposures were based on information gathered from an 11 year follow up of the DNBC and included information on self-rated health, frequent health complaints, medication use, bullying, stressful life events and physical activity. Conditional logistic regression analysis was used to estimate the association between each exposure and referral.The percentage of individuals in the exposed category of each exposure was generally higher for cases than controls. Particularly, the odds of being referred were higher for those with low self-rated health compared to high (OR [95%-CI] 2.43 [1.07–5.5]1), those being bullied (OR 3.19 [1.17–8.73]), and those who had taken medication (OR 2.22 [1.32–3.67]).Overall, these results indicated that girls experiencing suspected AE following HPV vaccination were more vulnerable prior to vaccination.     

我国空中医疗急救发展现状与体系构建建议

目的 探讨我国空中医疗急救发展现状及体系构建策略。方法 基于现有资料分析我国空中医疗急救发展现状、模式、问题与挑战。结果 近年来我国通航企业及飞行器数量发展迅速,但是存在总体不足、多数通航企业规模较小等问题。空中急救网络主要有航空公司主导、医院或急救中心主导、通航企业-医院联合和政府主导4种发展模式;各模式均为自由发展,距离国家规划的目标尚远;现有体系内要素分散、结构不完整,大范围的空中急救网络尚未形成。结论 我国地形复杂,建成覆盖面广、运行模式统一的空中医疗急救网络困难较大,建议全国范围内构建多个主体共同参与的多元化区域性空中急救体系,而在青藏高原及周边区域优先构建公益性空中医疗急救体系。     

Acute unsolicited adverse events following BNT162b2 vaccine in Saudi Arabia,a real-world data

BackgroundAcute adverse events and anaphylaxis were reported after the administration of coronavirus disease (COVID-19) mRNA vaccines. We aim to explore the nature and outcome of adverse events following BNT162B2 vaccine in a community vaccination center, Riyadh, Saudi Arabia.MethodWithin 30 min post vaccination, all acute adverse events (AAEs) that occurred before March 31st, 2021, and in people older than 16 years were reviewed (AAE group). We used the case definition of Brighton collaboration on vaccine safety to define anaphylaxis. Patients’ demographics, comorbidities, allergy history, and outcome at disposition were collected. Observation duration after vaccination was short (<15 min) or extended (<3 h). Statistical analysis was performed to study AAEs association with the study variables and outcomes.ResultsOut of 71,221 vaccine recipients, 144 (0.002%) had developed 345 AAEs, at a rate of 48.4 events per 10,000 dose administered. The majority of cases in AAE group were first dose recipients (93.8%) and previously healthy (59%), while the minority had a previous history of allergy (6.3%) or a laboratory-confirmed COVID-19 (4.2%). We found a significant association between female gender and the occurrence of any AAE (p-value = 0.002). Per every 10,000 doses administered, non-anaphylactic AAEs were dizziness (17.8), headache (9.7), nausea (7.1), or syncope (3.2). Only one in every ten AAEs was considered serious and resulted in an extended observation (4.8 per 10,000 doses), but only 1/144 required hospitalization for non-anaphylaxis reasons (0.1 per 10,000 doses). According to the Brighton collaboration definition of anaphylaxis, no single case of high certainty anaphylaxis was recorded. No death was documented in this cohort.ConclusionAcute adverse events due to BNT162b2 vaccine were rare and mostly non-serious with a tendency to occur more in women. Further prospective studies on larger vaccine recipients to evaluate the incidence of anaphylaxis in the Saudi population are warranted.     

Voltage clamp of a small muscle membrane area by means of a circular sucrose gap arrangement

Summary A new method is described which permits the measurement of membrane currents of thick muscle fibres (diameter 300 m or more) ofAstacus fluviatilis orBalanus balanus under voltage clamp conditions.The potential difference across a small patch of membrane (60–100 m in diameter) is controlled by connecting a voltage source across it with two external electrodes. One of them is connected to the fluid bathing the muscle fibre. The other, tubular one is in touch with the test area. The current flowing through the electrodes represents the sum of the membrane current flowing across the test area and the leak current flowing in the external fluid between the electrodes. In the first version of the method the leak current is limited by a circular sucrose gap around the test area. In the second, more elaborate method, the leak current is eliminated by a system of two concentric sucrose rings with a guard ring electrode between them. This method permits in addition the measurement of full sized action potentials in the test area.This work has been briefly reported in Cs. fysiol.17, 48 (1968).     

食管癌与心理社会因素的关系探讨

目的 :本文采用 1:1配对的病例对照研究方法 ,探讨食管癌与病前心理社会因素的关系。方法 :采用 C型行为问卷和生活事件量表 ,调查病例和对照共 10 0对。结果 :食管癌病人 C型行为的 OR值为 3.0 9,明显高于对照组 ,P<0 .0 0 1;生活事件量表中病例与对照配对得分差的均数为 118.4 2± 52 .36 (LEU) ,食管癌病人得分明显高于对照组 ,P<0 .0 0 1。结论 :食管癌与不良的心理社会因素有关。     

Stress, attachment and skin diseases: a case-control study

Objectives In this case-control study we tested the hypothesis of an association between some psychosomatic skin diseases, attachment style and stress. Patients and methods A total of 177 cases and 194 controls seen between November 1992 and November 1993 at the Istituto Dermopatico dell'lmmacolata (IDD) in Rome, were enrolled into the study. Cases were outpatients with first diagnosis of hyperidrosis, chronic urticaria, generalized pruritus or alopecia areata. Controls were outpatients seen in the same period of time with first diagnosis of pigmenled nevi, keratosis or mycosis. The presence and weight of life stress events were assessed by u standard precoded questionnaire based on the Schedule of Recent Experiences (SRE) and on the Life Experiences Survey (LES). The attachment style was assessed by a modified version of the Shaver and Hazan questionnaire about feelings in a love relationship. We calculated 3 scores for each individual and classified study subjects in 2 groups: 1) "free" (= secure attachment); 2) "not free" (not secure attachment: anxious-ambivalent or avoidant). Questionnaires were self-administered in the presence of a trained psychologist. Adjusted odds ratios (OR) were calculated using a multiple logistic function. Results No association was found between the different stress scores and the skin diseases considered. The crude odds ratio for life stress events in the previous year was 1.4 (95% CI 0.8–2.7). After multiple adjustment for age, sex, marital status and education, the estimated OR was 1.6 (95% CI 0.8–3.0). One significant association emerged between the adult attachment style defined as “not free” and psychosomatic skin diseases: the adjusted OR was 4.0 (95% CI 1.4–12).     

Unaltered insulin sensitivity during calcium channel blockade with amlodipine

Summary The sensitivity of peripheral tissues to insulin is of pathophysiological, therapeutic and possibly also of prognostic relevance. Calcium channel blockers are widely used in the treatment of cardiovascular disorders that are commonly associated with decreased insulin sensitivity (S_I). To evaluate the effects of calcium channel blokkade on S_I, glucose homoeostasis and lipid profiles, studies were made of S_I (determined by the Minimal Model Method of Bergman), basal glucose and insulin levels, serum total triglyceride (Tg) and lipoprotein cholesterol (C) fractions and certain other variables in 38 healthy young men (24 y) during placebo and after 3 weeks of calcium channel blockade with amlodipine 5 mg once daily. Measurements were made after 3 days on a standard diet (2200 kcal · day^–1, 45% carbohydrates, 40% fat and 15% proteins) and after an overnight fast. Compared to placebo, amlodipine decreased supine systolic blood pressure (P<0.01). Heart rate, body weight and 24 h urinary sodium excretion were unaltered, and so were fasting plasma glucose (placebo vs amlodipine: 4.86 vs 4.83 mmol·1^–1, respectively) and insulin levels (7.7 vs 7.9 U·ml^–1), S_I (10.5 vs 9.6·10^–4 × min^–1 pro U·ml^–1), serum total Tg, C and lipoprotein C fractions.The findings demonstrate unchanged insulin sensitivity and secretion, as well as lipoprotein regulation, during maintenance administration of 5 mg amlodipine daily to healthy young men.This work was supported in part by the Swiss National Science Foundation     

The impact of anticipation of job loss on psychological distress and worksite blood pressure.

The impact of occupational stressful life events on psychological distress and blood pressure was examined among employees of a major New York City brokerage firm undergoing massive layoffs. One hundred thirty-nine employees of the firm, who had participated in a blood pressure screening in 1986, were rescreened during the period of layoffs within their company in 1989. About two-thirds of the 139 employees reported being "somewhat" or "very" anxious or upset in 1989 during the period of layoffs, and psychological distress was significantly elevated among those employees reporting possible or definite layoff or job change and/or difficulty in obtaining a comparable job. However, we found no increase in overall blood pressure level, and no effect of anticipation of job loss on 1989 blood pressure when controlling for 1986 blood pressure level, age, body mass index, work hours, and other demographic variables. On the other hand, employment in a department sold to another employer on the day of screening, as well as employment in a clerical job title, were both associated with significant increases in diastolic blood pressure of about 5 mm Hg.     

海洛因依赖者住院脱毒过程中的不良事件及其相关因素分析

目的:了解海洛因依赖者住院脱毒过程中出现的不良事件及其相关因素。方法:采用回顾性的方法,对630例海洛因依赖者在住院脱毒过程中出现的各种不良事件进行调查,并对相关因素进行分析。结果:不良事件的总发生率为17.6％。Logistic回归分析显示,整组不良事件患者的危险因素不明确。按不良事件的严重程度归类分组分析,其危险因素依次为:美沙酮最高剂量,血常规异常,合用抗精神病药物的种类以及目前吸食方式。结论:海洛因依赖者住院脱毒过程中不良事件较常见,它的发生既有患者自身的原因,又有医源性因素,值得重视。