Vaccines - beliefs and concerns: the voice of patients with inflammatory immunomediated diseases

BACKGROUND

Vaccination is a key issue in patients with immunomodulated inflammatory diseases on immune-mediated therapy. Still, vaccination rates in these patients are low. This study aimed to assess the knowledge and fears of patients with immune-mediated inflammatory diseases (IMIDs) regarding vaccines, with the ultimate goal of increasing vaccination rates through the definition and implementation of more effective communication strategies with the patient.

METHODS

This study was conducted in a Portuguese hospital, between January 2019-December 2020, and included adult patients with an IMID. A questionnaire was developed and applied to evaluate knowledge and fears regarding vaccines.

RESULTS

From the 275 included patients, more than 90% answered correctly to all questions on general knowledge, with an exception for the question related to protection from severe disease, without differences between age groups or education levels, except for the question about vaccine contraindications (P = 0.017). Regarding vaccines in immunocompromised hosts, the proportion of correct answers was lower and significantly different between education levels (P = 0.00-0.042),. More than 50% of the participants showed moderate to very high concern about several aspects of vaccines, with differences between age groups (P = 0.018).

CONCLUSION

Our patients have general knowledge of vaccines but regarding vaccines in immunocompromised patients knowledge is lower and dependent on the education level. In addition, age influences the pattern of concerns related to vaccines. The information gathered in this study shall be considered to identify potential local interventions targeted to improve vaccination.

Extra Corporeal Membrane Oxygenation in the Treatment of Human Immunodeficiency Virus-Related P. jirovecii Pneumonia

Despite the undeniable complexity one may encounter while managing critically ill patients with human immunodeficiency virus infection (HIV), intensive care unit-related mortality has declined in recent years, not only because of more efficacious antiretroviral therapy (ART) but also due to the advances in critical support. However, the use of extracorporeal membrane oxygenation (ECMO) in these patients remains controversial. We report four cases of HIV-infected patients with Pneumocystis jirovecii pneumonia (PJP) and acute respiratory distress syndrome (ARDS) treated with ECMO support and discuss its indications and possible role in the prevention of barotrauma and ventilator- induced lung injury (VILI). The eventually favorable clinical course of the patients that we present suggests that although immune status is an important aspect in the decision to initiate ECMO support, this technology can provide real benefit in some patients with severe HIV-related refractory ARDS.

Bone marrow mononuclear cells versus mesenchymal stem cells from adipose tissue on bone healing in an Old World primate: can this be extrapolated to humans?

ABSTRACT In veterinary medicine, the cell therapy is still unexplored and there are many unanswered questions that researchers tend to extrapolate to humans in an attempt to treat certain injuries. Investigating this subject in nonhuman primates turns out to be an unparalleled opportunity to better understand the dynamics of stem cells against some diseases. Thus, we aimed to compare the efficiency of bone marrow mononuclear cells (BMMCs) and mesenchymal stem cells (MSCs) from adipose tissue of Chlorocebus aethiops in induced bone injury. Ten animals were used, male adults subjected, to bone injury the iliac crests. The MSCs were isolated by and cultured. In an autologous manner, the BMMCs were infused in the right iliac crest, and MSCs from adipose tissue in the left iliac crest. After 4.8 months, the right iliac crests fully reconstructed, while left iliac crest continued to have obvious bone defects for up to 5.8 months after cell infusion. The best option for treatment of injuries with bone tissue loss in old world primates is to use autologous MSCs from adipose tissue, suggesting we can extrapolate the results to humans, since there is phylogenetic proximity between species.

X-ray pelvimetry in common marmoset (Callithrix jacchus - LINNAEUS, 1758)

ABSTRACT The common marmoset is an important Neotropical primate for biomedical research. With the intention of providing pelvimetric values that allow the selection of animals with better characteristics for reproduction, we studied the X-ray of the pelvis, in ventro-dorsal projection of 12 adult animals, six males and six females, belonging to the National Center of Primates - CENP. The measurements were made to right diagonal diameters (RDD), left diagonal diameter (LDD), bi-iliac middle diameter (BIMD), bi-iliac upper diameter (BIUD), bi-iliac lower diameter (BILD), sacrum-pubic diameter (SPD), and the input area of the pelvis (IAP), which were compared in relation to sex and bodily correlated with the biometrics. The results of the means and standard deviations regarding pelvimetry (cm) were: for the RDD in males of 1.91±0.14 and in the females of 2.05±0.08; LDD in males of 1.85±0.16 and in females of 2.03± 0.08; BIMD in males of 1.46±0.12 and in the females of 1.5±0; BIUD showed in males 1.3±0.1 and in females of 1.3±0.06; BILD in males of 1.35±0.15 and in females of 1.25±0.08; SPD in males of 1.68±0.09 and in females of 1.93±0.13; IAP in males of 1.9±0.26 and in the females of 2.23±0.13. It was concluded that the pelvis of Callithrix jacchus could be classified as dolicopelvic type, there is sexual dimorphism in relation to the pelvis of adult animals and that the bodily measurements have low positive correlation with pelvic measurements.

Tongue papillae morphology of brown-throated sloth Bradypus variegatus (SCHINZ, 1825)

The Bradypusvariegatus inhabits the forests of South America and feeds from leaves, branches and sprouts from different plants. Due to its diet and the lack of literature on the morphological aspect of Xenarthras, five Bradypusvariegatus tongues from animals which died from natural causes were evaluated, and they came from Pará State Museum Emílio Goeldi and were donated to the Laboratory of Animal Morphological Research (LaPMA) from UFRA, for revealing the different types of papillae and epithelial-connective tissue. Macroscopically, the tongues presented elongated shape, rounded apex, body, root, median sulcus in the root's apex, and two vallate papillae. The mucous membrane of the tongue revealed a keratinized stratified pavement epithelium, while the ventral surface of the tongue was thin and smooth, not provided with any type of papillae. However, the dorsal surface of the tongue was irregular with the presence of three types of papillae: filiform, fungiform and vallate papillae. The filiform papillae found were of a simple type, presenting a rounded base, irregularly distributed with a larger concentration and development on the tongue's apex and body. The fungiform papilla showed a practically smooth surface with irregular format, with the presence of gustatory pores; these were found all over the dorsal surface, with larger concentration at the rostral part of the apex. Only two vallate papillae were observed disposed in the root of the tongue, surrounded by a deep groove, and revealing several taste buds. The tongues from Bradypusvariegatus presented gustatory papillae similar to the ones described for other Xenarthras species and wild mammals.

Dextrocardia with situs solitus and inversion apex-basis axis in lesser anteater (Tamandua tetradactyla): case report

Dextrocardia is a rare cardiac anomaly where the heart is situated on the right antimeres of the thorax. This study had the objective of describing a case of dextrocardia with situs solitus and apex-basis axis inversion in a lesser anteater (Tamandua tetradactyla) between five evaluated animals, all from the area of Mine Bauxite - Paragominas - Para. The arterial system was filled with contrasted latex and the animals were fixed with 10% formaldehyde and a posterior dissection was done. The heart of an animal was found in right antimere with inversion of the base-apex axis. The right atrium was more developed then the left and the pulmonary veins arrived directly in the left ventricle. The main vases of the base were identified with some topographic alterations resulting in: aorta dorsal to the cava caudal vein, pulmonary artery dorsal and cranial to aorta, pulmonary veins ventral to the pulmonary artery, cava caudal vein in ventral plain and cava cranial vein in dorsal plan in relation to the other vessels. Internally there were four cardiac chambers, with absence of septal communication.