Cellular and humoral immunogenicity of the COVID-19 vaccine and COVID-19 disease severity in individuals with immunodeficiency.

Background: A well-coordinated adaptive immune response is crucial for limiting COVID-19 disease. Some individuals with immunodeficiency are at a high risk of developing severe COVID-19. Therefore, the development of standardized methods for measuring different arms of the vaccine response in the setting of immunodeficiency is of particular interest. In this study, we compared the vaccine response of individuals living with immunodeficiency with healthy controls in terms of interferon gamma (IFN-γ) production and spike protein-specific antibody level post primary COVID-19 vaccination and booster vaccines. Additionally, the disease severity of those individuals who contracted COVID-19 was assessed. Methods: Whole blood was stimulated overnight from 71 participants and 99 healthy controls. Commercially available PepTivator® peptide pool and trimeric spike protein stimulation were used. ELISA was used to analyze IFN-γ levels. The total SARS-CoV-2 spike protein antibody titre was measured using a Roche Elecsys® S total antibody assay. Patient characteristics, COVID-19 infection status and IDDA 2.1 'Kaleidoscope' scores were recorded. Vaccine responses were scored from zero to three. Results: 99% of healthy controls, 89% of individuals with IEI and 76% with secondary immunodeficiency (SID) had an IFN-γ level above the validated reference range after peptide mix stimulation following primary vaccination. There was an increase in IFN-γ levels in patients with inborn errors of immunity (IEI) following the booster vaccine (p = 0.0156). 100% of healthy controls, 70% of individuals living with IEI and 64% of individuals living with SID had detectable spike protein-specific antibody levels following the primary vaccination. 55% of immunodeficiency patients who had mild COVID-19 and 10% with moderate/severe COVID-19 had detectable antibody and IFN-γ levels post vaccine. The mean pre-infection IDDA 2.1 scores were higher in individuals who developed moderate/severe COVID-19 (25.2 compared to 9.41). Conclusions: Covid whole-blood IGRA is a highly accurate, straightforward and robust assay and can be easily adapted to measure cellular response to COVID-19. A complete evaluation of the vaccine response may be particularly important for individuals living with immunodeficiency. A clinical immunodeficiency score and a validated vaccine response score may be valuable tools in estimating COVID-19 disease risk and identifying individuals living with immunodeficiency who may benefit from enhanced vaccination schedules.

The provision of a semen cryopreservation service for male cancer sufferers in the Republic of Ireland.

BACKGROUND: Chemotherapy, radiotherapy and surgery for cancer all carry risks of sterility. Semen cryopreservation would allow procreational ability to be preserved. METHODS: A human-assisted reproduction unit was set up in the Rotunda Hospital where semen was cryopreserved and stored for use. RESULTS: Semen was frozen for procreational potential during 1998 from 58 males about to have oncology therapy likely to render them sterile. The planning for this service and the modus operandi now in place are described. While cryopreservation was not unsuccessful in any case, substandard samples were obtained from 14 men. Pre-freeze viral tests tested positive for CMV in six patients. One pregnancy is already on-going utilising IVF with thawed semen. One patient's death has been notified and the frozen semen disposed of. CONCLUSION: The service is, at present, outside public purse provision. It is hoped that in the near future this will change, as the deficit between charges and costs cannot be sustained in-house forever.

Classification of bone healing after intertrochanteric osteotomies. Consequences for the surgical procedure and postoperative rehabilitation.

Intertrochanteric osteotomies produce a rate of 1 to 7% delayed union and pseudarthrosis, mainly as a result of the quality of the surgical procedure employed. In this retrospective and prospective study we have divided the models of bone healing after intertrochanteric osteotomy into 4 groups based on the postoperative x rays, and have taken into account only the factors of sclerosis, radiolucency and fragment contact in the osteotomy plane. This grouping enables us to evaluate the quality of the surgical procedure and to predict the postoperative course at an early stage, thus facilitating timely modification of the postoperative rehabilitation.

Calculation of 3-D deformity in scoliosis by standard roentgenograms.

The standard radiological diagnosis of advanced scoliosis consists of roentgenograms of the total spine in anterior-posterior and lateral views. The deformity of the spine is measured by using the Cobb angle, thus only giving the projected angle of deformity, without showing the true 3-dimensional aspect. The 3-D calculation of the deformity is relevant to diagnosis and therapy of scoliosis. In this paper we define angles according to the Cobb definition, evaluate them trigonometrically and show them in two tables. These angles allow the 3-dimensional deformity in scoliosis to be calculated using the standard roentgenograms in two perpendicular views. This procedure enables us to avoid techniques costly in time and effort in hospital routine, such as stereo radiography, computer-analysis or 3-dimensional reconstruction of CT- and MRI-investigations.

Degradation of glial fibrillary acidic protein by a calcium dependent proteinase: an electroblot study.

In situ and in vitro degradation of glial fibrillary acidic (GFA) protein in mouse spinal cord was examined with electroblots stained for GFA protein by the peroxidase anti-peroxidase method. Non-degraded, intact GFA protein had a molecular weight of 48 Kdaltons and isoelectric points ranging from pH 5.8 to 6.4. The molecular weights of immunoreactive degradation products ranged from 47 to 28 Kdaltons. All of the degradation products had acid shifted isoelectric points (pH 5.8-5.2). Degradation was prevented by chelating calcium with EGTA. In contrast to in situ degradation, degradation in vitro with 3 mM CaCl2 occurred at a faster rate. The effect of pH and temperature on the degradation process were determined by incubating homogenized spinal cords in 3 mM CaCl2 solutions varying in pH from 4 to 10 and at 4, 37, and 60 degrees C. The greatest number of immunoreactive bands with the lowest molecular weights occurred at pH 8 and 37 degrees C. The results suggest that turnover of glial filaments is in part controlled by a calcium dependent proteinase active near neutral pH similar to that postulated for neurofilament turnover.