Frequency And Factors Associated With Adverse Reactions After Administration of Inactivated COVID-19 Vaccine Among Health Workers

BACKGROUND

The 2019 coronavirus (COVID-19) has precipitated a significant public health crisis. Our study aimed to evaluate the prevalence and risk factors associated with adverse reactions to the inactivated CoronaVac vaccine.

METHODS

The study involved voluntary health workers who received CoronaVac vaccine. We documented the sociodemographic information of 2,019 participants who volunteered for our study. Of these, 1,964 and 1,702 participants were interviewed by phone 1 month after the first and second dose, respectively, during which they were queried about any adverse reactions.

RESULTS

Within the first week after the first dose, adverse reactions were observed in 856 (43.3%) participants, with 133 (6.7%) experiencing them during the second week, and 96 (4.9%) people at the end of the first month. For the second dose, 276 individuals (16.2%) reported adverse reactions. The prevalence of both local and systemic adverse events ranged from 9.5-11.2% overall. Fatigue was the most common adverse reaction overall, while pain at the injection site was the most frequent local adverse reaction.

CONCLUSIONS

The evaluation of both systemic and local side effects revealed no significant adverse reactions to the inactivated CoronaVac vaccine (Sinovac Life Sciences, Beijing, China). Our study found that the incidence of systemic and local adverse responses to the CoronaVac vaccination was lower than the rates reported in studies involving the recombinant adenovirus type-5, BNT162b1, and ChAdOx1nCoV-19 COVID-19 vaccines, all of which underwent the World Health Organization LULUC/PQ evaluation process.

Deformity correction and limb lengthening with externally controlled motorized extendable intramedullary nails: Comparison of 2 different nails

OBJECTIVE

The aim of this study was to assess and compare the clinical, radiological, and functional results of patients treated with FITBONE or PRECICE nails due to deformity and length discrepancy in their lower extremities.

METHODS

This retrospective cohort study included 41 patients with length discrepancy and deformity in their lower extremities, who underwent limb lengthening surgery with either FITBONE (group F) or PRECICE (group P) nails between 2010 and 2020. The mean postoperative follow-up period was 15.95 ± 4.75 months in group F (20 patients) and 20.48 ± 7.57 months in group P (21 patients). Lower extremity mechanical and anatomical axes were measured on x-rays preoperatively and at the end of treatment. Consolidation and distraction indexes were also calculated to assess bone healing. Lower Extremity Functional Scale test was used to evaluate functional outcomes and quality of life.

RESULTS

Neither of the treatment methods caused deviations in the mechanical axes and femoral distal angles (P > .05). No statistically significant difference in consolidation and distraction indexes was found between the groups (P > .05). Postoperative complications were seen in 3 of the patients in group F and 4 of the patients from group P. There was no significant difference in Lower Extremity Functional Scale scores between groups (P = .425).

CONCLUSION

This study has demonstrated that treatment with both the FITBONE and PRECICE nails resulted in improved physical and emotional functional outcomes. Both nails had similar radiographic results, complication rates, high patient compliance, and good cosmesis.

LEVEL OF EVIDENCE

Level III, Therapeutic Study.

Treatment with Buttress Plate Technique for Symptomatic Ulnar Styloid Base Nonunion

Background  Surgical treatment options for symptomatic ulnar styloid base nonunion can be divided into two groups: styloid excision and styloid fixation methods. Styloid fixation is commonly performed using tension band wiring or distal ulna hook plate. However, these methods are more suitable for large styloids than small ones. For this reason, fixation of small styloids still remains a problem. Purpose  To present the surgical details and results of patients operated using the buttress plate technique, due to the symptomatic ulnar styloid base nonunion. Patients and Methods  In this study, 11 patients who underwent surgery for symptomatic ulnar styloid base nonunion using buttress plate technique were evaluated retrospectively. The patients were evaluated with the help of forearm and wrist range of motion, grip strength, disabilities of the arm, shoulder, and hand (DASH) score and visual analogue pain score. Results  The mean follow-up period was 15 months (range: 13-21 months). Union was achieved in 10 patients. At the final follow-up, the forearm supination and pronation active range of motions were significantly higher than those in the preoperative period, the visual analogue pain score mean value was 0.7 (range: 0-5), and the DASH score mean value was 7 (range: 1-32). Conclusion  We conclude that good results can be achieved with the buttress plate technique in patients with both large and small fragmented ulnar styloid base nonunions and no distal radioulnar joint instability. Level of Evidence  This is a Level IV, therapeutic study.

An interesting finding: What is the relation between aortic enlargement and COVID-19?

BACKGROUND

We aim to compare the diameters of ascending aorta in COVID-19 patients and COVID-19-free individuals referred to our pandemic hospital.

METHODS

The medical records and thorax tomographies of patients admitted to the "pandemic central" state hospital with symptoms of COVID-19 were observed between April 2020 and May 2020 in this case-control study. The first group consisted of patients diagnosed with COVID-19, and the second group consisted of patients without the disease. The diameter of the ascending aorta is measured via tomography and compared to each other. The most causative risk factors for aortic enlargements underwent a multivariate regression analysis.

RESULTS

Charts of 156 patients (104 COVID-19 positives, 52 COVID-19 negatives) were reviewed. There was a statistical difference (p: .01) between the mean aortic diameter of COVID-19 patients (39 mm) and COVID-free patients (32.5 mm) even though comorbid factors and patient characteristics were similar in the two groups at the time of hospital admission. The regression analysis result demonstrates that COVID-19 (leading factor), age, and coronary artery disease were the most significant factors associated with increasing aortic dimensions. (p: .001, B: 5.3/, p: .02, B: 3.36/, p: .002, B: 0.13/, R square: 40.2%).

CONCLUSION

This study shows that the mean aortic diameter of COVID-19 patients is larger than non-COVID-19 patients with similar comorbidities referred to a pandemic hospital. COVID-19, age, and coronary artery disease are the most influential factors that affect the aortic diameter, and the COVID-19 was the leading factor.

The Effect of Diabetes Mellitus on Mortality in Patients Hospitalized Intensive Care Unit in Covid-19 Pandemic

Backgorund and aim: There are many studies on the effects of Diabetes Mellitus on the clinical course in COVID-19 patients. Factors that increase the risk of contracting COVID-19 disease and increase disease progression have been caused, and diabetes mellitus is one of them. We aimed to evaluate the incidence of Diabetes Mellitus in patients treated in the intensive care unit in respiratory failure due to COVID-19 pneumonia, and the effect of Diabetes Mellitus on the length of stay in intensive care and mortality.

METHODS

Our study is a single-center retrospective study. The study includes patients hospitalized in our COVID intensive care unit between March 16, 2019, and May 16, 2020 Patients over 18 years of age with and without a history of Diabetes Mellitus were compared in 2 groups. Demographic data of the patients, length of stay in the intensive care unit, respiratory support methods, presence of other comorbid diseases, effects of Diabetes Mellitus to mortality in ICU were recorded.

RESULTS

The information of 150 patients was obtained in the COVID-19 intensive care units of our hospital. Diabetes Mellitus was detected in 49 of the patients hospitalized in intensive care. 34.7% of these patients were female and 65.3% were male. There was no significant difference in survival in both groups (p = 0.942). The BMI of the patients with Diabetes Mellitus was 27.07 ± 2.55, significantly higher (p = 0.005). Intensive care stay periods were similar in both groups. The presence of hypertension was significantly higher in those with Diabetes Mellitus (p = 0.000). There was no statistically significant difference between respiratory support methods.

CONCLUSIONS

Diabetes Mellitus did not affect the duration of stay in the intensive care unit and mortality in patients who were followed up and treated in the intensive care unit due to COVID-19 pneumonia.

Comparison of chest computed tomography findings of RT-PCR negative and RT-PCR positive cases in COVID-19 patients

OBJECTIVE

The purpose was to compare the results of the RT-PCR test, with the findings of Chest CT and to determine the features of CT for the diagnosis of COVID-19 and how to approach RT-PCR negative patients.

MATERIAL METHOD

Chest CT findings of 569 COVID-19 diagnosed patients, followed up at the pandemic wards between March and June 2020 were retrospectively examined. Patients were grouped according to RT-PCR results, gender, and age.

RESULTS

284 (49%) were RT-PCR(+), 285 (50.8%) were RT-PCR(-) of total 569 patients. 11 (1.9%) of RT-PCR(+) had no involvement in Chest CT while all the RT-PCR(-) patients were CT(+). The distribution of lesions in CT were; 544 (95.6%) bilateral, 553 (97.2%) multilobar, 557(98%) peripherally 151 (26.5%) posteriorly localized. The most common findings were; 539 (94.7%) ground-glass opacity (GGO), 365 (64.1%) consolidation, 160 (28.1%) crazy paving interlobular septal thickening. CO-RADS mean value was 5.4 ± 0.7. GGO and reticulation in RT-PCR(-) patients were 280 (98.2%) and 24 (8.4%); while they were 259 (91.2%) and 12 (4.2%) in RT-PCR(+) patients, were significantly higher (p < 0.05). No significant difference was observed, in CT findings for gender. Only the findings of crazy paving interlobular septal thickening and reticulation in 18-64 age group were significantly higher than that in 65-94 age group, 105 (24.8%)-55 (37.9%), 19 (4.5%)-17 (11.7%) respectively (p < 0.05).

CONCLUSION

The typical findings of COVID-19 pneumonia in Chest CT are: GGO, consolidation and crazy paving in bilateral, peripheral, posterior localization. CT plays an essential role for diagnosis, isolation and treatment in cases of COVID-19 and RT-PCR negative test should be verified by CT.

Evaluating the home isolation of COVID-19 patients in primary care

Background: This study aims to evaluate the effectiveness of home isolation and medical follow-up by analyzing data collected over the phone from isolated individuals. Methods: A cross-sectional phone-based survey designed to evaluate the home isolated COVID-19 suspected patients at the Şişli Hamidiye Etfal Family Health Center in Istanbul city between 16th  March  5th May 2020.  A semi-structured questionnaire and the universal sampling technique were recruited to collect data about the socio-demographic and the COVID-19 related laboratory and clinical findings. The SPSS for Windows program was used to perform a univariate and bivariate statistical analysis. The Statistical alpha significance level was accepted at less than 0.05. Results: A total of 463 confirmed, probable, or suspected cases of COVID-19 took part in this study with a mean age of 35.38 ∓17.1 (range: 0-86 years). Tow-third 310 (67.0%) underwent the PCR tests, and 67 (21.6%) confirmed positive results. Moreover, one-third (159, 34.3%) exposed to CT scans; however, 51(32.3%) were compatible with COVID-19. The median age of individuals with PCR positive was 38 years. More than half (40, 59.7%) were males, compared to 27 (40.3%) were females. There was no significant relationship between PCR positivity and pandemic period, age, or gender (P = 0.149; P = 0.545; P = 0.285), respectively. Although older individuals had a higher rate of CT scan compatible with COVID-19, the relation between increased age and COVID-19 compatible CT was found not to be statistically significant (P = 0.053). Moreover, there was  significant relationship between CT scan positivity and coughing, the tobacco smoking and diabetes (P = 0.003; P = 0.032; P = 0.016),  respectively. Conclusion: Combining PCR, symptoms, and CT together doubles the likelihood of a correct diagnosis. Quarantined patients must be regularly monitored.

Association of abductor hip muscle atrophy with fall-related proximal femur fractures in the elderly

OBJECTIVE

The purpose of this study was to evaluate an association between fall-related intertrochanteric or femoral neck fractures and gluteus medius and minimus atrophy, furthermore, to find a correlation of whether any difference between femoral neck or intertrochanteric fracture and degree of muscle atrophy MATERIALS AND METHODS: A retrospective review of 230 patients with intertrochanteric or femoral neck fracture, aged > 65 years, and 60 age- matched controls was performed. We assessed gluteus medius and minimus atrophy and calculated the cross-sectional area (CSA) and ratio of lean muscle to adipose infiltration (M/A ratio) for each muscle.

RESULTS

The atrophy scores for the g.medius and g.minimus muscles on the fractured side were significantly higher than scores on the healthy side and scores in the control group. The atrophy scores for the g.medius on the healthy side were not significantly different from scores in the control group. The atrophy scores for g.medius were significantly different between the fractured side and the healthy side for all ages, the atrophy scores for g.minimus was significantly different in the patients aged over 75. There was no significant difference in the following parameters between the fractured side and healthy side of the patients aged 65 - 75 years; the atrophy score, CSA and M/A ratio. The patients have a lower CSA and M/A ratio on the fractured side than on the healthy side and lower CSA and M/A ratio than in the control group. However, there were no significant differences in the M/A ratio between the healthy side and the control group. CSA was not significantly different between the fractured side and healthy side in the male patients and in the patients with lower BMI (<30). There was no significant difference in the atrophy scores between subjects with intertrochanteric versus femoral neck fractures, the CSAs of the g.medius and g.minimus were significantly different between the intertrochanteric fracture and femoral neck fracture groups.

CONCLUSIONS

The fractured sides showed greater g.medius and g.minimus muscle atrophy, which may be a predictor of fall-related hip fractures in the elderly. Gluteal muscle volume may be associated with proximal femur fracture subtype.

The efficacy of in situ local autograft in adolescent idiopathic scoliosis surgery: a comparison of three different grafting methods

Background/aim: This study was performed to show the efficacy of in situ local autograft with a comparison of in situ local autograft, local autograft with allograft, and local autograft with posterior iliac crest autograft.Materials and methods: In this prospective randomized study, a total of 65 adolescent idiopathic scoliosis (AIS) patients were separated into 3 groups: Group 1 using local autograft and allograft, Group 2 using local autograft only, and Group 3 using local autograft and posterior iliac crest autograft. Posterior segmental instrumentation was also applied to all patients. The mean follow-up period was 28.5 months (range, 15-40 months). Pseudarthrosis was investigated with the multiplanar and three-dimensional images obtained using multislice computed tomography, thoracolumbar bone single-photon emission computed tomography, and three-phase regional and whole body bone scintigraphy. Results: Pseudarthrosis was not observed in any patient. Fusion was obtained in all patients at the end of the follow-up periods.Conclusion: Similar results were obtained in respect of fusion in all 3 groups. Without the use of additional grafts, sufficient fusion can be achieved with the use of local autograft alone for posterior spinal fusion in patients with AIS.

Anconeus interposition arthroplasty in acute multiligamentous elbow injuries with irreparable radial head fractures: a novel approach

OBJECTIVE

The purpose of this study was to evaluate the results of a new reconstruction with anconeus interposition arthroplasty in acute multiligamentous elbow injuries with irreparable radial head fractures.

METHODS

Five patients (3 males, 2 females) with a mean age of 42.6 years who underwent reconstruction with anconeus arhtroplasty were evaluated. With lateral approach, lateral capsuloligamentous structures were repaired, the radial head was excised, and anconeus interposition arthroplasty was performed. With medial intervention, the medial collateral ligament was repaired, and the ulnar nerve was transposed anteriorly. Clinical and radiological evaluation was performed the end of a mean follow-up period of 63 months.

RESULTS

Mean Mayo Elbow Performance, Oxford Elbow, and Disabilities of the Arm, Shoulder and Hand (DASH) scores were 91, 41.4, and 13.76, respectively. Average elbow extension loss was 10.2° and average forearm supination loss was 5.2°. Dynamic elbow instability tests were within normal limits. On elbow radiographs, the average increase in cubitus valgus angle was 5.4°. No patient reported limitation in daily activities. There was no heterotopic ossification in any patient. Mean radial shortening was 1.39 mm, and no patient suffered from wrist pain at final follow-up. Average Mayo wrist score was 91 points.

CONCLUSION

The combination of repair of the medial and lateral structures, radial head resection, and anconeus interposition arthroplasty may be a good alternative in the treatment of acute multiligamentous elbow injuries with irreparable radial head fracture.

Effects of cepae extract, allantoin, and heparin mixture on developing andalready formed epidural fibrosis in a rat laminectomy model

BACKGROUND/AIM

The study was designed to investigate whether local administration of a mixture composed of cepae extract, allantoin, and heparin (CAH) decreased already formed epidural fibrosis (EF) at the laminectomy site.

MATERIALS AND METHODS

Twenty-four adult male Sprague Dawley rats were equally divided into four groups. Laminectomy was performed at the L5 level in all rats. The group 2 and group 4 rats were treated with local drug administration. While the group 1 and 2 rats were sacrificed after 6 weeks, the remaining rats were reoperated and CAH mixture was applied in group 4. The vertebral columns of all rats were removed en bloc. Fibroblast numbers, EF, and arachnoidal involvement (AI) were evaluated.

RESULTS

The results of the treatment groups were separately compared with the control groups. The numbers of fibroblasts in the treatment groups were significantly lower than those in the control groups (P < 0.001). The grade of EF in group 2 was significantly less than that in group 1 (P < 0.05). There was no statistically significant difference regarding EF and AI grade between group 3 and group 4, and local application of the drug on EF and AI yielded better results than in the control groups.

CONCLUSION

The mixture composed of CAH might be a successful candidate for preventing EF in clinical practice.

The effects of ankaferd blood stopper and microporous polysaccharide hemospheres on epidural fibrosis in rat laminectomy model

PURPOSE

To investigate whether topically administered hemostatic agents ankaferd blood stopper and microporous polysaccharide hemospheres can decrease epidural fibrosis after laminectomy in rats.

METHODS

Eighteen adult male Sprague-Dawley rats were equally and randomly divided into three groups. In the treatment groups, ankaferd blood stopper and microporous polysaccharide hemospheres topically administrated upon duramater surface after laminectomy. Fibroblast count, epidural fibrosis and arachnoidal involvement were evaluated and graded histopathologically.

RESULTS

Our data revealed that the count of fibroblasts, the grading of epidural fibrosis and arachnoideal involvement in the rats treated with microporous polysaccharide hemospheres were significantly less than the control group. Although the arachnoideal involvement in ankaferd blood stopper group were significantly less than the control group, there were no statistical differences when comparing the grading of epidural fibrosis and the fibroblasts count between the treatment groups and the control group.

CONCLUSION

The ankaferd blood stopper and microporous polysaccharide hemospheres reduced epidural fibrosis and arachnoideal involvement after laminectomy in rats.