Risk Of Serious Complications Research Articles

Clinical Efficacy and Safety of an Automatic Closed-Suction System in Mechanically Ventilated Patients with Pneumonia: A Multicenter, Prospective, Randomized, Non-Inferiority, Investigator-Initiated Trial.

Endotracheal suctioning is an essential but labor-intensive procedure, with the risk of serious complications. A brand new automatic closed-suction device was developed to alleviate the workload of healthcare providers and minimize those complications. We evaluated the clinical efficacy and safety of the automatic suction system in mechanically ventilated patients with pneumonia. In this multicenter, randomized, non-inferiority, investigator-initiated trial, mechanically ventilated patients with pneumonia were randomized to the automatic device (intervention) or conventional manual suctioning (control). The primary efficacy outcome was the change in the modified clinical pulmonary infection score (CPIS) in 3 days. Secondary outcomes were the frequency of additional suctioning and the amount of secretion. Safety outcomes included adverse events or complications. A total of 54 participants, less than the pre-determined number of 102, were enrolled. There was no significant difference in the change in the CPIS over 72 h (-0.13 ± 1.58 in the intervention group, -0.58 ± 1.18 in the control group, p = 0.866), but the non-inferiority margin was not satisfied. There were no significant differences in the secondary outcomes and safety outcomes, with a tendency for more patients with improved tracheal mucosal injury in the intervention group. The novel automatic closed-suction system showed comparable efficacy and safety compared with conventional manual suctioning in mechanically ventilated patients with pneumonia.

Anatomical outcomes and complications of sacrocolpopexy using Surelift Uplift mesh: A multicentric observational study.

The study evaluated the anatomical and functional outcomes, as well as the safety data of laparoscopic sacrocolpopexy (LSC) for pelvic organ prolapse (POP) using a lightweight macroporous mesh. A multicentric observational study was developed including five expert centers between March 2011 and December 2019. Inclusion criteria were female patients with symptomatic ≥stage II POP (POP-Q classification), who underwent a LSC. A lightweight and macroporous mesh device (Surelift Uplift) was used. Baseline anatomical positions were evaluated using POP-Q stage. The anatomical outcomes and procedural complications were assessed during the postoperative period. Primary outcomes were anatomical success, defined as POP-Q stage ≤I, and subjective success, defined as no bothersome bulge symptoms, and no repeat surgery or pessary use for recurrent prolapse. A total of 325 LSCs were analyzed with a median patient age of 66 (interquartile range [IQR] 61-73). After a median follow-up of 68 months (IQR 46.5-89), anatomical success was found in 88.9%, whereas subjective success was seen in 98.5% of the patients. Recurrent prolapse presented as cystocele (1.5%). Reported complications were bladder (4.6%) or rectum lesions (0.6%), de novo urinary incontinence (12.9%), and mesh extrusion (1.2%). LSC provides significant clinical improvement and excellent anatomical results, with a low risk of serious complications for women with ≥2 grade POP in a real clinical practice setting.

Clinical manifestations of EVALI in adolescents and the impact of e-cigarettes on the respiratory disease

In recent years there has been a significant increase in the popularity of electronic cigarettes among adolescents and young adults worldwide. E-cigarettes have reached the market without the extensive preclinical toxicology testing or long-term safety studies required for conventional therapeutics and medical devices. Their effectiveness as a smoking cessation intervention, their impact at the population level and whether they are less harmful than combustible tobacco products are highly controversial. Studies show measurable adverse biological effects on organ and cell health in humans, animals and in vitro. E-cigarette use also increases the risk of respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma. There is a serious risk of complications associated with e-cigarette use, such as EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury) - serious lung damage associated with, especially for adolescents. This paper reviews the effects of e-cigarettes on respiratory health.

National Outpatient Sexually Transmitted Infection Testing in Pregnant Patients in the United States.

Introduction: Sexually transmitted infections (STIs) continue to increase in the United States and pregnant patients who acquire STIs are at risk for serious complications. This study estimated the utilization of preventative STI testing among pregnant outpatients on a national scale. Methods: This was a retrospective, cross-sectional study of outpatient visits in the National Ambulatory Medical Care Survey from 2014 to 2016 and 2018 to 2019. All patients reported as pregnant were included to assess STI testing for chlamydia, gonorrhea, hepatitis, and HIV. STI testing was described per 1,000 total visits overall and by subpopulations. Data weights were applied to generate national estimates. Results: Over 177 million visits were included, of which 87.5 per 1,000 included an STI test. Chlamydia testing was the most common, followed by HIV, gonorrhea, and hepatitis (58.0 vs. 42.3 vs. 41.5 vs. 20.3 per 1,000). STI testing rates varied across subpopulations (72.1-236.6 per 1,000 visits). Patients of Hispanic ethnicity, Black race, age ≤25 years old, and those seen by an obstetrics and gynecology (OB/GYN) provider had the highest rates of STI testing. Independent predictors of STI testing included: Black race (adjusted odds ratio [aOR]: 2.24, 95% confidence interval [95% CI]: 2.23-2.24), first trimester (aOR: 5.15, 95% CI: 5.14-5.16), government and private insurance (aOR: 1.90, 95% CI: 1.89-1.91 and aOR: 1.70, 95% CI: 1.69-1.71), and an OB/GYN provider specialty (aOR: 2.93, 95% CI: 2.93-2.94). Conclusions: STI testing in United States outpatient physician offices varied by subpopulations and across individual test types. Certain patient attributes, such as race, provider specialty, and payment source, were predictive of testing.

180° versus 360° Selective Laser Trabeculoplasty in Open Angle Glaucoma and Ocular Hypertension: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis found that 360° selective laser trabeculoplasty (SLT) is significantly more effective than 180° SLT at reducing intraocular pressure at one month and one year follow-ups, without increased serious adverse event risk. To determine the efficacy of 180° versus 360° selective laser trabeculoplasty (SLT) in adults with open angle glaucoma (OAG) and ocular hypertension (OHT). A systematic review was performed using PubMed, Embase, and Scopus databases, from 1995 to December 30, 2023, for studies comparing 180° and 360° SLT in adults with OAG and OHT (PROSPERO ID: CRD42024497832). Meta-analyses were performed to calculate nominal percent and raw reductions in IOP between treatment groups at one-month, one-year, and two-year follow-ups, as well as success rates, defined as a 20% or greater IOP reduction. Nine studies with 1044 eyes were included; 491 received 180°SLT and 553 received 360° SLT. At the one-month follow-up, 360° SLT reduced IOP by 3.45% more (WMD=3.45; 95% CI: 2.02-4.88; P<0.00001) and 0.87mmHg more (WMD=0.87; 95% CI: 0.35-1.38; P=0.0010). At the one-year follow-up, 360° SLT reduced IOP by 4.33% more (WMD=4.33; 95% CI: 2.35-6.32; P<0.0001) and 1.15mmHg more (WMD=1.15; 95% CI: 0.25-2.04; P=0.01). At two years of follow up, 360° SLT reduced IOP by 4.86% more (WMD=4.86; 95% CI: -0.32, 10.0; P=0.07) and 1.25mmHg more (WMD=1.25; 95% CI: -0.29, 2.79; P=0.11), however the difference was not statistically significant. Compared to 360° SLT, 180° SLT had a significantly lower success rate (OR=0.50; 95% CI: 0.35-0.72; P=0.0002). There was no difference in serious complications between interventions. 360° SLT is more effective than 180° SLT at lowering IOP at one-month and one-year follow-ups as well as achieving successful IOP control without increased risk of serious complications.

Inter-rater Reliability of ACS-NSQIP Colorectal Procedure Coding in Canada

BackgroundThe American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) uses Current Procedural Terminology (CPT) codes for risk-adjusted calculations. This study evaluates the inter-rater reliability of coding colorectal resections across Canada by ACS-NSQIP surgical clinical nurse reviewers (SCNR) and its impact on risk predictions. MethodsSCNRs in Canada were asked to code simulated operative reports. Percent agreement and free-marginal kappa correlation were calculated. The ACS-NSQIP risk calculator was utilized to illustrate its impact on risk prediction. ResultsResponses from 44 of 150 (29.3%) SCNRs revealed 3 to 6 codes chosen per case, with agreement ranging from 6.7% to 62.3%. Free-marginal kappa correlation ranged from moderate agreement (0.53) to high disagreement (-0.17). ACS-NSQIP risk calculator predicted absolute differences in risk for serious complications (0.2% to 13.7%) and mortality (0.2% to 6.3%). ConclusionThis study demonstrated low inter-rater reliability in coding ACS-NSQIP colorectal procedures in Canada among SCNRs, impacting risk predictions.

Socio-demographic association with confirmed hepatitis C virus infection: A cross-sectional analysis from a teaching institute.

Hepatitis C virus (HCV) infection is the most common chronic blood-borne disease and is more commonly associated with chronic active hepatitis leading to cirrhosis, hepato-cellular carcinoma and end-stage liver disease. 160 consecutive screening positive (Enzyme linked immuno sorbent assay positive) Hepatitis C samples were tested by HCV RNA Real Time-PCR for confirmation. Prevalence of confirmed hepatitis C among screening positive patient in the present study was found to be 24.4%. Vaccinated individual with Hepatitis A and Hepatitis B had significant association with PCR positivity in screening positive Hepatitis C patient (p< 0.05). IV drug users and patient having multiple sex partners have significant association with PCR positivity among screening positive Hepatitis C patients (p< 0.05). Due to the lack of an effective vaccine and the increased risk of serious complications, it is important to focus on prevention and early detection of HCV.

CONCEPT OF AGNI IN ATHEROSCLEROSIS AND ITS MANAGEMENT THROUGH YOGA&amp; AYURVEDA

In Ayurveda, the concept of Agni is inevitable in determining the overall health of an individual, where Agni is said to be the base (moola) of life. The whole catabolic and metabolic processes are carried out in human body, regulated by Agni .But if due to Pragyaparadh or faulty lifestyle, the Agni is deranged then the metabolic activity becomes disturbed at cellular tissue and organ level and it fascilitates to the formation of Ama. Hence, Ama is a triggering factor of many diseases that in turn destroys the Agni. Atherosclerosis occurs mainly due to lifestyle abnormality which is a direct result of Ama accumulation in the body. It is observed that 17.7 million people die each year from Cardiovascular Disorders, in which Atherosclerosis is the precipitating factor and an estimated 31% of all deaths worldwide (acc to WHO). Atherosclerosis is a condition where the arteries become narrowed and hardened due to a build up of Plaque around the artery wall. This disease disrupts the flow of blood around the body, posing the risk of serious complications. The term ‘Atherosclerosis’ is derived from the Greek word ‘athero’ meaning gruel or wax corresponding to the necrotic core area at the base of atherosclerotic plaque and ‘sclerosis’ for hardening the plaques luminal edge. Apart from drug, Yoga therapy may play a pivotal role for alleviation of Atherosclerosis. Yoga therapy improves the blood flow to the organs by neuromuscular action. Practice of Pranayama stimulates and changes the lumen size of the arterioles, which helps to regulate the circulation.

Screening of diabetes mellitus in patients at risk in dermatology outpatient department

Background: Type 2 diabetes mellitus (T2DM) is a widely spread multidisciplinary condition that requires the attention of many different disciplines; yet, the involvement of dermatologists in this regard has not been recognized. The current study focused on the role of dermatologists in screening the prevalence and pattern of cutaneous manifestations in diabetic and pre-diabetic patients. Methods: A randomized study was carried out from April 2023 to October 2023 in the department of dermatology at SSB Heart and Multispecialty Hospital in Faridabad, Haryana. In the current study, patients with dermatological problems suspected of diabetes mellitus were enrolled. Dermatological problems such acanthosis nigricans, dermatophyte infections, psoriasis, endogenous eczema, chronic urticaria, generalized pruritus, lichen simplex chronicus, patients older than 40, and coexisting conditions like obesity were focused in this study. Results: This study enrolled a total of 100 patients. Only 37 patients were recognized as having a high risk of diabetes, with 67.57% having a verified history of the disease. Furthermore, 32% of T2DM patients were examined for specific skin symptoms during their initial visits, with 4 individuals being found to have generalized pruritus and dermatophyte infection. Conclusions: This study finally concluded that dermatologists may play a crucial role in fighting the T2DM epidemic by early detection of T2DM and treatment initiation which may reduce the risk of serious complications.

Extravasation and infiltration: under-recognised complications of intravenous therapy.

Occasionally, the administration of intravenous (IV) therapies can go wrong. Infiltration or extravasation is a complication when a drug or IV therapy leaks into the tissues surrounding the vascular access device. Extravasation can cause serious and often life-changing injuries. Extravasation is often associated with systemic anti-cancer therapy but non-chemotherapy drugs have been reported as having a greater risk of serious complications. This study outlines the first UK Infusion unit evaluation of the ivWatch infusion monitoring device which was undertaken from August 2023 to January 2024. Out of 2254 infusions monitored with ivWatch, the device prevented 122 cases of infiltration and extravasation from causing any harm to the patient, corresponding to a 5.4% 'check IV' notification rate.

Extended pelvic lymph node dissection in robot-assisted radical prostatectomy is an independent risk factor for major complications.

The aim of this study is to evaluate the major postoperative complication rate after robot-assisted radical prostatectomy (RARP) and to identify related risk factors.A consecutive series of patients who underwent RARP between September 2016 and May 2021, with or without extended pelvic lymph node dissection (ePLND) were analyzed for postoperative complications that occurred within 30 days following surgery. Potential risk factors related to complications were identified by means of a multivariate logistic analysis. Electronic medical records were retrospectively reviewed for the occurrence of major complications (Clavien-Dindo grade III or higher) on a per patient level. A multivariate logistic regression with risk factors was performed to identify contributors to complications.In total, 1280 patients were included, of whom 79 (6.2%) experienced at least 1 major complication. Concomitant ePLND was performed in 609 (48%) of patients. The majority of all complications were likely related to the surgical procedure, with anastomotic leakage and lymphoceles being the most common. Upon multivariate analysis, performing ePLND remained the only significant risk factor for the occurrence of major complications (OR 2.26, p = 0.001).In contrast to robot-assisted radical prostatectomy alone, the combination with extended pelvic lymph node dissection (ePLND) has a substantial risk of serious complications. Since the ePLND is performed mainly for staging purpose, the clinical contribution of the ePLND has to be reconsidered with the present use of the PSMA-PET/CT.

Teaching Ultrasonographic Basic Examination Skills (TUBES): Assessment of an Ultrasound Skill Simulator in Teaching Ultrasound-Guided Paracentesis, a Prospective Observational Study

Ultrasound guidance during centesis is recommended to reduce the risk of serious complications, improve success rate, and to choose appropriate sampling locations and equipment. The aim of this study was to develop an accessible and reusable ultrasound skill simulator for ultrasound guided centesis (USGC). Fifty second year veterinary students reviewed an instructional video prior to performing two USGC skill tests on the simulator, separated by a period of practice. Following practice there was a significant improvement in score ( p &lt; .0001), and average score and time improved by 8.6% and 163.3 seconds respectively. The proportion of successful aspirates improved by 9%, from 66% to 75%. Most post-session survey feedback was positive, and none was negative. Thirty-eight of 49 participants (78%) indicated they would prefer learning this skill with the simulator or in combination with individual practice and/or observation. Ninety-eight percent (49/50) strongly agreed that “this training simulator should be incorporated into the veterinary curriculum,” and 94% (47/50) strongly agreed with “I would use this training simulator again to practice basic ultrasound skills.” Eighty-four percent (42/50) strongly agreed their skills and knowledge improved using the simulator and 82% (41/50) strongly agreed they gained confidence with ultrasound using the simulator. The remainder of the responses for these four questions was agreement, and no student disagreed with any of the statements. The authors conclude this is an effective and well-received simulator for teaching ex vivo USGC and recommend incorporation into the veterinary curriculum for basic ultrasound skill training.

Determinants of serious in-hospital complications in patients with Killip class 1/2 ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention.

Killip classification has been used to stratify the risk of patients with acute myocardial infarction (AMI). There were many reports that Killip class 3 or 4 is closely associated with poor clinical outcomes. In other words, Killip class 1 or 2 is associated with favorable clinical outcomes in patients with AMI, especially when patients received primary percutaneous coronary intervention (PCI). However, some patients with Killip class 1/2 suffer from serious in-hospital complications. This study aimed to identify factors associated with serious in-hospital complications of ST-segment elevation myocardial infarction (STEMI) in patients with Killip class 1/2. The primary endpoint was serious in-hospital complications defined as the composite of in-hospital death and mechanical complications. We included 809 patients with STEMI, and divided them into the non-complication group (n = 791) and the complication group (n = 18). In-hospital death was observed in 14 patients (1.7%), and mechanical complications were observed in 4 patients (0.5%). Final TIMI flow ≤ 2 was more frequently observed in the complication group (33.3%) than in the non-complication group (5.4%) (p < 0.001). Multivariate logistic regression analysis revealed that serious in-hospital complication was associated with final TIMI flow grade ≤ 2 (Odds ratio 6.040, 95% confidence interval 2.042-17.870, p = 0.001). In conclusion, serious in-hospital complication of STEMI was associated with insufficient final TIMI flow grade in patients with Killip class 1/2. If final TIMI flow grade is suboptimal after primary PCI, we may recognize the potential risk of serious complications even when patients presented as Killip class 1/2.

Premature ventricular complexes: new possibilities of diagnostics and management

Premature ventricular complexes (PVC) is one of the most common arrhythmias in daily clinical practice. In the vast majority of cases, PVC has a good prognosis, but in some cases it can cause serious, including lifethreatening complications. On the other hand, asymptomatic, frequent PVC can lead to the development of left ventricular (LV) systolic dysfunction, which can be reversible with effective therapy. Medications remain the mainstay of therapy for PVC. However, the effectiveness of some drugs is quite low, while other drugs have significant side and proarrhythmic effects. Technological advances in the field of radiofrequency (RF) catheter ablation in recent years have opened up tremendous prospects in the radical correction of PVC and put forward this approach in selective cases as the method of choice. However, this invasive technology may at the same time carry the risks of serious complications, which can occur in up to 5% of individuals undergoing this procedure. The potential risks of RF catheter ablation largely depend on the accessibility of the ectopic focus. In this regard, differential diagnosis of the source of ectopia is of great importance for a balanced assessment of the possible risks and effectiveness of this invasive method. Standard diagnostic methods, such as 12-lead electrocardiography, Holter monitoring and echocardiography, allow in many cases to make the best decision regarding further management tactics. Frequent, asymptomatic PVC needs in annual monitoring to prevent LV systolic dysfunction development in cases high potential RF catheter ablation risks and drugs ineffectiveness. Traditional echocardiography and novel ultrasound technologies can help in this difficult of choice cases.

Platelet Reduction after Transcatheter Aortic Valve Implantation: Results from the PORTRAIT Study.

Background: An unexplained condition that follows transcatheter aortic valve implantation (TAVI) is platelet count reduction (PR). According to published research, patients with balloon-expandable valves (BEVs) had a greater PR than those with self-expandable valves (SEVs). Objectives: The purpose of this study was to investigate the incidence and clinical effects of PR following TAVI. Methods: In total, 1.122 adult TAVI patients were enrolled. Propensity score matching was carried out in a 1:1 ratio between patients with BEVs and those with SEVs. The analysis included changes in platelet count, in-hospital mortality, and early postoperative adverse events. Results: Notably, 632 patients were matched (BEV:316; SEV:316). All patients' post-procedural platelet counts changed according to a parabolic curve, using a mixed regression model for repeated analyses (estimate = -0.931; standard error = 0.421; p = 0.027). The platelet count varied comparably in patients with BEVs and SEVs (estimate = -4.276, standard error = 4.760, p = 0.369). The average time for obtaining the nadir platelet count value was three days after implantation (BEV: 146 (108-181) vs. SEV: 149 (120-186); p = 0.142). Overall, 14.6% of patients (92/632) had post-procedural platelet count <100,000/µL. There was no difference between the two prosthesis types (BEV:51/316; SEV:41/316; p = 0.266). Thrombocytopenia was found to be significantly linked to blood product transfusions, lengthier stays in the intensive care unit and hospital, and in-hospital mortality. Conclusions: TAVI, irrespective of the type of implanted valve, is linked to a significant but temporary PR. Thrombocytopenia increases the risk of serious complications and in-hospital death in TAVI patients. To explore and clarify the causes and associated effects, further prospective research is necessary.

Magnet ingestion in growing children: a multi-center observational study on single and multiple magnet incidents

Over the past 15 years, there has been a noticeable uptick in incidents involving children ingesting multiple magnetic foreign bodies which can cause injuries and gastrointestinal complications including death. The current study aimed to identify the prevalence, clinical presentation, and management of single or multiple magnet ingestions. A retrospective multi-central cross-sectional study was conducted to include all pediatric patients < 18 years presented to the emergency department with ingestion of single or multiple magnets and admitted across hospitals in Qatar, UAE, KSA, Tunisia, and Turkey between January 2011 and December 2021. Demographics, symptoms, management, and outcomes were analyzed. There were 189 magnet ingestions, of which 88 (46.6%) were multiple magnet ingestions. Most patients (55.6%) were male, and the median age was 3.9 (IQR 2–7) years. An abdominal X-ray was obtained in all cases. 119 (62%) patients were conservatively treated, 53 (28%) required surgical intervention and 17 (8.9%) underwent gastroscopy. None of the patients with single magnet ingestions experienced morbidity or severe outcomes. Multiple magnet ingestions led to significant morbidity including hospitalizations, perforations (44.3%), severe intestinal necrosis (19.3%), peritonitis (13.6%), severe abdominal infection (10.2%), and septic shock (4.5%). The rate of surgical intervention (59.1% vs. 1.0%) and gastroscopy (15.9% vs. 3.0%) was significantly higher in the multiple ingestion group compared to the single magnet ingestion group. No deaths were identified. A high risk of serious complications, including the need for surgery to remove the magnets and substantial morbidity may result from swallowing more than one magnet. Magnet safety requirements, public education, and improved legislation are urgently required.

Evidence for the benefits of negative pressure therapy in the treatment of diabetic foot in adults: a comprehensive approach to improved health

Diabetic foot ulcers represent an increase in recent years in the cures to be carried out by nursing staff. For this reason, the new negative pressure therapy has been chosen, which involves an increase in granulation tissue, leading to complete healing in a minimum time, highlighting the few complications derived from said therapy. Objective: To demonstrate the effectiveness of negative pressure therapy in patients with diabetic foot. Methodology: A narrative review was carried out between December 2022 and November 2023 in the databases of Pubmed, Dialnet, Google Scholar, WOS, Scopus and Cochrane, following a search string, which combines keywords derived from the thesauri “Health Sciences Descriptors” (DeCS) and “Medical Subject Headings” (MeSH), being combined with the Boolean operators “NOT”, “OR” and “AND”. Results: Negative pressure therapy offers a number of significant benefits for adult patients with diabetic foot, improving wound healing, reducing the risk of serious complications and contributing to a better quality of life. It is important to highlight that the implementation of this therapy must be guided by health professionals and adapted to the specific needs of each patient. Conclusion: After comparing the different selected articles, it was determined that the application of negative pressure therapy in diabetic foot ulcers is beneficial in relation to the reduction in healing time compared to conventional wound healing dressings. The associated complications being minimal. Furthermore, treatment with this therapy turns out to be cost-effective by reducing patients' hospital stays, leading to an increase in quality of life.

Cancer Patients' Attitudes Towards the Anti-Covid-19 Vaccine: A Collective Case Study.

The purpose of the present study was to determine cancer patients' attitudes toward the anti-COVID-19 vaccine. Historically, the scientific community's responsibility was to investigate attitudes about vaccination. The course of COVID-19 in cancer patients makes them a high priority for vaccination. Cancer patients are at greater risk of serious complications and death because of COVID-19 infection. The purpose of the present study was to determine cancer patients' attitudes toward the anti-COVID-19 vaccine. We examined several constructs that potentially influenced cancer patients' perceptions of the vaccine: health status, knowledge of COVID-19 and vaccination, cancer patients' perceptions of vulnerability, and attitudes toward general vaccines. We conducted a collective case study with 200 cancer patients undergoing treatment, and divided the sample into two groups: patients who "expected to heal" (Group A) and patients who "expected to chronicize" (Group B). Data were collected through a purpose-built questionnaire consisting of 22 questions and a study of medical records. Data analysis showed that both groups, Group A (M= 3.89 SD= 0.64) and Group B (M= 3.98 SD= 0.64), had a favorable attitude toward the anti-COVID-19 vaccine. This favorable attitude toward the anti-COVID-19 vaccine depended on several factors: perception of vulnerability to COVID-19, perception of the severity of their oncological situation, and communication with oncologists. Our study highlighted the plurality of factors that influence attitudes toward the anti-COVID-19 vaccine. It is therefore of fundamental importance to increase the use of the shared decision-making approach (SDM) to guide the patient to an informed choice.

Incidence of COVID-19 among Vaccinated with Sputnik V and CoviVac Vaccines (Results of the Telephone Survey for the Epidemic Season 2021–2022 in St. Petersburg)

Relevance. The emergence of a new SARS-COV-2 coronavirus in early 2020 radically changed the seasonal pattern of influenza and other acute respiratory infections worldwide. Along with a decrease in the frequency of RSV infection, the number of diagnosed cases of influenza virus infection decreased by 99% during the COVID-19 pandemic. Vaccines are known to be the best tool at our disposal for preventing infectious diseases and reducing the risk of serious complications and deaths. The Russian Federation has great experience in developing vaccines against viral and bacterial infections and is constantly improving the technology of their production putting new vaccine preparations into circulation. Domestic vaccines against a new coronavirus infection caused by SARS-CoV-2 virus were developed in the shortest possible time. This work evaluated the efficacy of Gam-Covid-Vac (Sputnik V) and CoviVac vaccines during periods of circulation of different variants of SARS-CoV-2 «Delta» and «Omicron» in St. Petersburg.Aims. To evaluate the prophylactic efficacy of domestic vaccines Gam-Covid-Vac (Sputnik V) and CoviVac in the epidemic season 2021–2022 in the periods of SARS-CoV-2 «Delta» and «Omicron» variants circulation in Saint-Petersburg.Materials and Methods. Vaccination and follow-up of vaccinated subjects was initiated in February 2021, with the arrival of the Gam-Covid-Vac (Sputnik V) and CoviVac vaccines at the specialized clinic of Smorodintsev Research Institute of Influenza. Follow-up of vaccinated subjects for one year after vaccination included 346 men and women aged 19-85 years, who were interviewed in two telephone surveys.Results. Telephone interviews among individuals vaccinated with Gam-Covid-Vaс (Sputnik V) and CoviVac vaccines revealed that during the circulation of «Delta» variant, 2nd half of 2021, COVID-19 disease occurred in 16.3% of people vaccinated with the CoviVac vaccine and in 15.8% of those vaccinated with Sputnik V vaccine – differences between groups were not statistically significant (p &gt; 0.05). COVID-19 disease in both vaccine groups was predominantly mild with 61.95% of observed falling ill in the CoviVac vaccine group and 84.4% (slightly more, 1.4-fold) in Sputnik V vaccine group. At the same time, moderate and severe diseases were slightly more in absolute value among those vaccinated with "CoviVac" vaccine. Cough, lung damage from 30% to 80%, loss of sense of smell and taste dominated among the symptoms in both groups of patients. During the second observation period (January-April 2022), when «Omicron» variant were actively circulating, the number of cases among CoviVac and Sputnik V vaccines was 37.5% and 43.8%, respectively; the differences between the vaccine groups were not statistically significant (p &gt; 0.05). During this period, diseases in CoviVac and Sputnik V vaccine groups were predominantly mild in 84.4% and 90.5%, respectively, with statistically insignificant differences. There were also no significant differences in cases of moderate severity. Among those observed in « CoviVac» group during this period, a greater number of diseases, in absolute value, proceeding in a severe form and requiring hospitalization was noted. Clinically, the diseases caused by «Omicron» variant manifested in symptoms characteristic of flu and common cold: headache and muscle pain, fever, chills, chest pain, nasal congestion, severe fatigue, fatigue, weakness.Conclusions. During periods of active « Delta» variant circulation in the fall of 2021patients vaccinated with SARS-COV-2 coronavirus vaccines were 2.3 to 2.8 times less ill than during circulation periods of «Omicron» variants ВА.1 и ВА.2 in January-April 2022: 16.3% and 15.8%, 37.5% and 43.8%, respectively. Mild COVID-19 disease predominated among patients vaccinated with both vaccines during periods of circulation of «Delta» and «Omicron» variants. Differences in the manifestation of clinical symptoms of the disease in the periods of circulation of different strains were noted. It was shown that the vaccines against SARS-CoV-2 infection Gam-Covid-Vac (Sputnik V) and CoviVac do not protect 100% against the disease, but protect against a severe course of the disease and lethal outcomes.

Diabetes-related skin lesions : a frequently underdiagnosed problem

Skin disorders are common in diabetes, affecting both patients with type 1 and type 2 diabetes. These cutaneous manifestations can be classified into three categories: dermatoses associated with the presence of diabetes, cutaneous complications of diabetes (acute and chronic) and dermatoses linked to antidiabetic treatments. These conditions vary considerably in terms of severity (from insignificant cosmetic problems to life-threatening) and prevalence (from relatively frequent to rare). Despite the high prevalence of diabetes and associated skin disorders, the dermatological manifestations of diabetes are generally neglected and often under-diagnosed. Failure to diagnose and treat skin disorders at an early stage can lead to clinical worsening, whereas early detection and treatment can reduce the risk of serious complications.