bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Published Guidelines for the Diagnosis and the Management of Vaccine-Induced Immune Thrombotic Thrombocytopenia
Authors: Zazzeron Luca , Rosovsky Rachel P. , Bittner Edward A. , Chang Marvin G. 
Published: September 2021

OBJECTIVES:
The development of thrombocytopenia and thrombosis after the administration of the AstraZeneca and Johnson & Johnson/Janssen vaccines has been recently described. This new condition has been called vaccine-induced immune thrombotic thrombocytopenia. The objective of this review is to summarize the clinical characteristics and therapeutic options of vaccine-induced immune thrombotic thrombocytopenia based on available published case series. Furthermore, we provide a comparison of the diagnostic pathway and treatment recommendations provided by six major medical societies.

DATA SOURCES:
We searched MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials databases.

STUDY SELECTION:
We included case series and case reports on patients who developed vaccine-induced immune thrombotic thrombocytopenia. We also included guidelines for the diagnosis and management of vaccine-induced immune thrombotic thrombocytopenia from major medical societies.

DATA EXTRACTION:
We examined baseline risk factors, symptoms, physical signs, laboratory and imaging findings, and treatment in patients with vaccine-induced immune thrombotic thrombocytopenia reported in the case series. We also analyzed the diagnostic and treatment recommendations provided by major societal guidelines on the management of vaccine-induced immune thrombotic thrombocytopenia.

DATA SYNTHESIS:
Patients who developed vaccine-induced immune thrombotic thrombocytopenia were more likely to be young women (age 20–50) who were given the AstraZeneca or Johnson & Johnson/Janssen 4–28 days prior to presentation. Patients showed signs, symptoms, and imaging findings consistent with cerebral venous sinus thrombosis and splanchnic thrombosis. Laboratory findings showed thrombocytopenia, low fibrinogen, and elevate d-dimer levels, while positive platelet factor 4 antibodies were always positive. Major societal guidelines recommend avoidance of heparin and platelets. Treatment with nonheparin anticoagulants and IV immunoglobulin is also recommended.

CONCLUSIONS:
Vaccine-induced immune thrombotic thrombocytopenia is a rare but highly morbid complication related to the administration of the AstraZeneca and Johnson & Johnson/Janssen vaccines. Clinicians should be prepared for the early identification of patients with suspicious symptoms and prompt treatment should be initiated to avoid catastrophic deterioration. Major societal guidelines provide useful recommendations for the diagnosis and management of patients with vaccine-induced immune thrombotic thrombocytopenia.
Argatroban for Anticoagulation in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation in Coronavirus Disease 2019
Authors: Sattler Lauren A. , Boster Joshua M. , Ivins-O’Keefe Kelly M. , Sobieszczyk Michal J. , Reel Bradley A. , Mason Phillip E. , Walter Robert J. , Sams Valerie G. 
Published: September 2021

OBJECTIVES:
A significant proportion of patients with coronavirus disease 2019 requiring venovenous extracorporeal membrane oxygenation at our institution demonstrated heparin resistance, which in combination with a heparin shortage resulted in the transition to argatroban with or without aspirin as an alternative anticoagulation strategy. The optimal anticoagulation strategy for coronavirus disease 2019 patients requiring venovenous extracorporeal membrane oxygenation is unknown, and therefore, we sought to evaluate the efficacy and safety of argatroban with or without aspirin as an alternative anticoagulation strategy in this patient population.

DESIGN:
Retrospective cohort.

SETTING:
Single-center tertiary-care facility in Fort Sam Houston, TX, from 2020 to 2021.

PATIENTS:
Twenty-four patients who were cannulated for venovenous extracorporeal membrane oxygenation due to respiratory failure secondary to coronavirus disease 2019.

INTERVENTIONS:
Argatroban, with or without aspirin, was substituted for heparin in coronavirus disease 2019 patients requiring venovenous extracorporeal membrane oxygenation.

MEASUREMENTS AND MAIN RESULTS:
Eighty percent of our coronavirus disease 2019 patients requiring venovenous extracorporeal membrane oxygenation demonstrated heparin resistance, and patients who were initially started on heparin were significantly more likely to require a change to argatroban than vice versa due to difficulty achieving or maintaining therapeutic anticoagulation goals (93.4% vs 11.1%; p < 0.0001). The time to reach the therapeutic anticoagulation goal was significantly longer for patients who were initially started on heparin in comparison with argatroban (24 vs 6 hr; p = 0.0173). Bleeding and thrombotic complications were not significantly different between the two cohorts.

CONCLUSIONS:
Argatroban, with or without aspirin, is an effective anticoagulation strategy for patients who require venovenous extracorporeal membrane oxygenation support secondary to coronavirus disease 2019. In comparison with heparin, this anticoagulation strategy was not associated with a significant difference in bleeding or thrombotic complications, and was associated with a significantly decreased time to therapeutic anticoagulation goal, likely as a result of high rates of heparin resistance observed in this patient population.
Prescription Opioid Misuse and Sports-Related Concussion Among High School Students in the United States
Authors: Tham See Wan , Palermo Tonya M. , Chrisman Sara P. D. , Groenewald Cornelius B. 
Published: September 2021

Study Objective:
Concussion is highly prevalent in adolescents and associated with a higher risk of substance use. With the rising use of opioids among adolescents, one form of substance use of concern is the misuse of prescription opioids. This study aimed to examine the association between a history of sports-related concussion in the past year and current prescription opioid misuse among high school students in the United States.

Setting:
Secondary data analysis from the 2019 Youth Risk Behavior Survey.

Participants:
Nationally representative sample of high school students (n = 7314).

Design:
Cross-sectional study.

Main Measures:
Participants were asked whether they experienced any concussions related to sports or being physically active during the past 12 months and whether they had any prescription opioid misuse within the past 30 days.

Results:
Among this cohort, 14.0% reported sustaining a concussion in the past 12 months and 6% reported current prescription opioid misuse. The prevalence of prescription opioid misuse was higher among those with a history of concussion (9.9%) than among those without concussion (5.5%, P = .002). Controlling for covariates (sex, race/ethnicity, other substance use, depressive symptoms), the odds of prescription opioid misuse was 1.5 times higher for adolescents with concussion than those without (adjusted odds ratios [aOR] = 1.5; 95% CI, 1.0-2.3; P = .029).

Conclusion:
Concussion was associated with prescription opioid misuse among the US youth, even after accounting for depressive symptoms and other substance use. Longitudinal studies are needed to test causal relationships and understand biobehavioral mechanisms that underlie associations between concussion and opioid misuse in adolescents.
Scoping Review of Opioid Use After Traumatic Brain Injury
Authors: Starosta Amy J. , Adams Rachel Sayko , Marwitz Jennifer H. , Kreutzer Jeffrey , Monden Kimberley R. , Dams O'Connor Kristen , Hoffman Jeanne 
Published: September 2021

Objective:
To summarize the current literature to identify what research has been conducted, examine the approaches used, and determine what is presently known about prescription and nonprescription opioid receipts and use among individuals with traumatic brain injury (TBI).

Data Sources:
The search strategy included the following: opioid; opiate; analgesics, opioid; opiate alkaloids; or opioid-related disorders; AND brain injury; brain injuries; brain injuries, traumatic; head injury; head injuries; head injuries, closed; head injuries, penetrating; brain concussion; diffuse axonal injury; diffuse axonal injuries; brain trauma/s; head trauma/s; concussion; craniocerebral trauma/s; or TBI. Filters included English and Adults (19+ years). Study Selection: Inclusion: English language, adults with stable TBI, and prescription opioid receipt or use after TBI. Exclusion: Animal models, populations with other acquired brain injury, acute TBI management, and non–peer-reviewed articles, theses, or conference abstracts. Multiple reviewers screened abstracts and full-text articles for eligibility. In total, 771 abstracts were screened, 183 full texts were reviewed, and 21 met eligibility criteria. Data Extraction: Relevant content was independently extracted by multiple observers, including authors, design, sample identification and data source/s, TBI severity, TBI assessment, opioid assessment, study population (demographics, N), military affiliation, comparison groups, date of data collection, and summary of findings.

Results:
Studies were published between 1987 and 2019; most data were collected prior to 2015. The majority utilized administrative and electronic medical record data from the Department of Veterans Affairs and retrospective cohort designs, and most focused on prescription opioids. There were no studies evaluating interventions to reduce use of opioids in TBI populations. Preliminary findings suggest that prescription opioid receipt is strongly related to psychological symptoms, including comorbid depression, anxiety, and posttraumatic stress disorder.

Conclusions:
Despite increased awareness of opioid receipt and use following TBI, there is limited investigation on the examination of this issue. Future studies should include more varied patient populations as well as evaluate interventions to reduce opioid use following TBI.
Receipt of Concurrent VA and Non-VA Opioid and Sedative-Hypnotic Prescriptions Among Post-9/11 Veterans With Traumatic Brain Injury
Authors: Ashraf Alexandria J. , Gilbert Tess A. , Holmer Haley K. , Cook Lawrence J. , Carlson Kathleen F. 
Published: September 2021

Objective:
Receipt of concurrent psychotropic prescription medications from both US Department of Veterans Affairs (VA) and non-VA healthcare providers may increase risk of adverse opioid-related outcomes among veterans with traumatic brain injury (TBI). Little is known about patterns of dual-system opioid or sedative-hypnotic prescription receipt in this population. We estimated the prevalence and patterns of, and risk factors for, VA/non-VA prescription overlap among post-9/11 veterans with TBI receiving opioids from VA providers in Oregon.

Setting:
Oregon VA and non-VA outpatient care.

Participants:
Post-9/11 veterans in Oregon with TBI who received an opioid prescription from VA providers between the years of 2014 and 2019.

Design:
Historical cohort study.

Main Measures:
Prescription overlap of VA opioids and non-VA opioids or sedative-hypnotics; proportions of veterans who received VA or non-VA opioid, benzodiazepine, and nonbenzodiazepine sedative-hypnotic prescriptions were also examined by year and by veteran characteristics.

Results:
Among 1036 veterans with TBI receiving opioids from the VA, 210 (20.3%) received an overlapping opioid prescription from a non-VA provider; 5.3% received overlapping benzodiazepines; and none received overlapping nonbenzodiazepine sedative-hypnotics. Proportions of veterans with prescription overlap tended to decrease over time. Veterans with other than urban versus urban addresses (OR = 1.4; 95% CI, 1.0-1.8), high versus medium average annual VA visits (OR = 1.7; 95% CI, 1.1-2.6), and VA service connection of 50% or more versus none/0% to 40% (OR = 4.3; 95% CI, 1.3-14.0) were more likely to have concurrent VA/non-VA prescriptions in bivariable analyses; other than urban remained associated with overlap in multivariable models. Similarly, veterans with comorbid posttraumatic stress disorder diagnoses were more likely to have concurrent VA/non-VA prescriptions in both bivariable and multivariable (OR = 2.1; 95% CI, 1.0-4.1) models.

Conclusion:
Among post-9/11 veterans with TBI receiving VA opioids, a considerable proportion had overlapping non-VA prescription medications. Providers and healthcare systems should consider all sources of psychotropic prescriptions, and risk factors for overlapping medications, to help mitigate potentially unsafe medication use among veterans with TBI.
Long-term corticosteroid therapy for patients with severe coronavirus disease 2019 (COVID-19)
Authors: Calcaianu George , Degoul Samuel , Payen Thibault , Michau Bénédicte , Calcaianu Mihaela , Lawson Bree , Bresson Didier , Debieuvre Didier 
Published: September 2021

Summaryearlier and longer corticosteroid therapy with methylprednisolone could reduce the mortality and/or rate of ICU admission by 26% in patients with severe COVID-19, hospitalized in conventional medical ward.BackgroundLow dose of dexamethasone reduced mortality in hospitalized COVID-19 patients who required respiratory support. Less is known about the efficacy of other corticosteroids in severe COVID-19 patients. This study was designed to determine if longer and earlier corticoid therapy in severe COVID-19 patients is associated with reduced mortality and/or reduced rate of ICU admission for worsening of respiratory state.MethodsWe performed a retrospective study with patients aged ≥ 18 years, with epidemiological and/or radiological suspected COVID-19, hospitalized in a regional hospital GHRMSA Mulhouse, France. Twenty-three patients received methylprednisolone (MP) as compassionate use, 1 mg/kg/day for seven days followed by prednisolone at a gradually reduced dosage, for 4 to 6 weeks. MP was started one week after COVID-19 symptoms first appeared. The primary composite outcome was mortality and/or ICU admission during hospitalisation.ResultsBetween March 14th to June 5th 2020, 255 patients were screened, 181 were included, and 92 were analysed, 23 patients treated with MP and 69 received standard care. SARS-CoV2 infection was confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) in 82.3%. The overall composite outcome was higher in the control group: 42/69 patients (60.9%) versus 8/23 (34.8%) in the interventional group (p= 0.018). The correction of lymphopenia between days 1 to 7 was associated with better outcome (p=0.006).ConclusionThese results suggest that earlier and longer corticosteroid therapy with methylprednisolone could reduce the mortality and/or rate of ICU admission in patients with severe COVID-19, hospitalized in conventional medical ward.
Association between City-wide Lockdown and COVID-19 Hospitalization Rates in Multigenerational Households in New York City
Authors: Ghosh Arnab K. , Venkatraman Sara , Reshetnyak Evgeniya , Rajan Mangala , An Anjile , Chae John K. , Unruh Mark A. , Abramson David , DiMaggio Charles , Hupert Nathaniel 
Published: September 2021

ABSTRACTBackgroundCity-wide lockdowns and school closures have demonstrably impacted COVID-19 transmission. However, simulation studies have suggested an increased risk of COVID-19 related morbidity for older individuals inoculated by house-bound children. This study examines whether the March 2020 lockdown in New York City (NYC) was associated with higher COVID-19 hospitalization rates in neighborhoods with larger proportions of multigenerational households.MethodsWe obtained daily age-segmented COVID-19 hospitalization counts in each of 166 ZIP code tabulation areas (ZCTAs) in NYC. Using Bayesian Poisson regression models that account for spatiotemporal dependencies between ZCTAs, as well as socioeconomic risk factors, we conducted a difference-in-differences study amongst ZCTA-level hospitalization rates from February 23 to May 2, 2020. We compared ZCTAs in the lowest quartile of multigenerational housing to other quartiles before and after the lockdown.FindingsAmong individuals over 55 years, the lockdown was associated with higher COVID-19 hospitalization rates in ZCTAs with more multigenerational households. The greatest difference occurred three weeks after lockdown: Q2 vs. Q1: 54% increase (95% Bayesian credible intervals: 22 – 96%); Q3 vs. Q1: 48%, (17 – 89%); Q4 vs. Q1: 66%, (30 – 211%). After accounting for pandemic-related population shifts, a significant difference was observed only in Q4 ZCTAs: 37% (7 –76%).InterpretationBy increasing house-bound mixing across older and younger age groups, city-wide lockdown mandates imposed during the growth of COVID-19 cases may have inadvertently, but transiently, contributed to increased transmission in multigenerational households.FundingNational Center for Advancing Translational Sciences; Clinical and Translational Science Center at Weill Cornell Medical College.
Immunogenicity of Pfizer mRNA COVID-19 vaccination followed by J&J adenovirus COVID-19 vaccination in two CLL patients
Authors: Lyski Zoe L. , Kim Sunny , Lee David Xthona , Sampson David , Raué Hans P. , Raghunathan Vikram , Ryan Debbie , Brunton Amanda E. , Slifka Mark K. , Messer William B. , Spurgeon Stephen E. 
Published: September 2021

ImportanceIndividuals with Chronic Lymphocytic Leukemia have significant immune disfunction, often further disrupted by treatment. While currently available COVID-19 vaccinations are highly effective in immunocompetent individuals, they are often poorly immunogenic in CLL patients. It is important to understand the role heterologous boost would have in patients who did not respond to the recommended two-dose mRNA vaccine series with a SARS-CoV-2 specific immune responseObjectiveTo characterize the immune response of two CLL patients who failed to seroconvert after initial mRNA vaccine series following a third, heterologous, COVID-19 vaccination with Ad26.COV2.S.DesignTwo subjects with CLL were enrolled in an IRB-approved observational longitudinal cohort study of the immune response to COVID-19 vaccination. After enrollment, they received a third vaccination with Ad26.COV2.S. Blood was drawn prior to original vaccination series, four weeks after mRNA vaccination, and again four weeks after third vaccination.SettingEligible subjects were approached by oncologist overseeing CLL treatment and informed about study, at time of enrollment subjects consented to join the cohort study.ParticipantsSixteen subjects enrolled in the larger CLL cohort study, of whom two subjects received a third COVID-19 vaccination and were included in this analysis. Subject 1 is CLL treatment naive, while Subject 2 is currently on active treatment.Main Outcome(s) and Measure(s)SARS-CoV-2 specific immune response, including plasma antibodies, memory B-cells, CD4 and CD8 T-cells were assessed prior to vaccination (baseline) as well as post vaccination series and post third dose.ResultsOf the two subjects who received Ad26.COV2.S doses, Subject 1 seroconverted, had RBD-specific memory B-cells as well as spike-specific CD4 T-cells while Subject 2 did not. Both subjects had a spike-specific CD8 T-cell response after original mRNA vaccination series that was further boosted after third dose (Subject 1), or remained stable (Subject 2).Conclusions and RelevanceThe results of this study, however small, is especially promising to CLL individuals who did not seroconvert following initial mRNA vaccination series. Especially those that are treatment naive, not currently in active treatment, or who may consider vaccination before beginning active treatment.
Genome-wide by environment interaction study of stressful life events and hospital-treated depression in the iPSYCH2012 sample
Authors: Suppli Nis P. , Andersen Klaus K. , Agerbo Esben , Rajagopal Veera M. , Appadurai Vivek , Coleman Jonathan R. I. , Breen Gerome , Bybjerg-Grauholm Jonas , Bækvad-Hansen Marie , Pedersen Carsten B. , Pedersen Marianne G. , Thompson Wesley K. , Munk-Olsen Trine , Benros Michael E. , Als Thomas D. , Grove Jakob , Werge Thomas , Børglum Anders D. , Hougaard David M. , Mors Ole , Nordentoft Merete , Mortensen Preben B. , Musliner Katherine L. 
Published: September 2021

AbstractResearchers have long investigated a hypothesized interaction between genetic risk and stressful life events in the etiology of depression, but studies on the topic have yielded inconsistent results. We conducted a genome-wide environment interaction study in 18,532 depression cases from hospital-based settings and 20,184 population-representative non-cases from the iPSYCH2012 case-cohort study, a nationally representative sample identified from Danish national registers. Stressful life events including family disruption, serious medical illness, death of a first-degree relative, parental disability and child maltreatment were identified from population-based registers and operationalized as a time-varying count variable (0-4+). Hazard ratios for main and interaction effects were estimated using Cox regressions weighted to accommodate the case-cohort design. The analyses yielded three novel, genome-wide significant (P < 5 × 10-8) loci located in the ATP-binding cassette transporter C 1 (ABCC1) gene, in the A-kinase anchor protein 6 (AKAP6) gene, and near the Major facilitator superfamily domain 1 (MFSD1) gene, as well as 50 loci of suggestive significance. These top 3 hits did not replicate in a case-control sample of depression drawn from the UK Biobank. These results suggest that there may be individual genetic variants that confer risk for or protection against clinical depression only in the presence of stressful life events; however, replication in a sample with similar design and ascertainment methods is needed before any firm conclusions can be drawn. Future gene-by-stress research in depression should focus on establishing even larger collaborative genome-wide environment interaction studies to attain sufficient power.
The international and intercontinental spread and expansion of antimicrobial-resistant Salmonella Typhi
Authors: da Silva Kesia Esther , Tanmoy Arif Mohammad , Pragasam Agila Kumari , Iqbal Junaid , Islam Sajib Mohammad Saiful , Mutreja Ankur , Veeraraghavan Balaji , Tamrakar Dipesh , Qamar Farah Naz , Dougan Gordon , Bogoch Isaac , Seidman Jessica C , Shakya Jivan , Vaidya Krista , Carey Megan E. , Shrestha Rajeev , Irfan Seema , Baker Stephen , Luby Steve P. , Cao Yanjia , Dyson Zoe Anne , Garrett Denise O. , John Jacob , Kang Gagandeep , Hooda Yogesh , Saha Samir K. , Saha Senjuti , Andrews Jason R. 
Published: September 2021

AbstractThe emergence of increasingly antimicrobial-resistant (AMR) Salmonella enterica serovar Typhi (S. Typhi) threatens to undermine effective treatment and control. Here, aiming to investigate the temporal and geographic patterns of emergence and spread of AMR S. Typhi, we sequenced 3,489 S. Typhi isolated from prospective surveillance in South Asia and combined these with a global collection of 4,169 S. Typhi genomes. Our analysis revealed that independent acquisition of plasmids and homoplastic mutations conferring AMR have occurred repeatedly in multiple lineages of S. Typhi, predominantly arising in South Asia. We found evidence of frequent international and intercontinental transfers of AMR S. Typhi, followed by rapid expansion and replacement of antimicrobial-susceptible clades.