Is there a link between pre-existing antibodies acquired due to childhood vaccinations or past infections and COVID-19? A case control study.

BACKGROUND: There is growing evidence indicating that children are less affected from COVID-19. Some authors speculate that childhood vaccinations may provide some cross-protection against COVID-19. In this study, our aim was to compare the circulating antibody titers for multiple childhood vaccine antigens, as an indicator of the state of immune memory between patients with COVID-19 and healthy controls, with a specific aim to identify the association between disease severity and antibody titrations which may indicate a protective function related to vaccine or disease induced memory. METHODS: This study is a case-control study including 53 patients with COVID-19 and 40 healthy volunteers. COVID-19 severity was divided into three groups: asymptomatic, mild and severe. We measured the same set of antibody titers for vaccine antigens, and a set of biochemical and infection markers, in both the case and control groups. RESULTS: Rubella (p = 0.003), pneumococcus (p = 0.002), and Bordetella pertussis (p < 0.0001) titers were found to be significantly lower in the case group than the control group. There was a significant decline in pneumococcus titers with severity of disease (p = 0.021) and a significant association with disease severity for Bordetella pertussis titers (p = 0.014) among COVID patients. Levels of AST, procalcitonin, ferritin and D-dimer significantly increased with the disease severity. DISCUSSION: Our study supports the hypothesis that pre-existing immune memory, as monitored using circulating antibodies, acquired from childhood vaccinations, or past infections confer some protection against COVID-19. Randomized controlled studies are needed to support a definitive conclusion.

Outcome Measurements for Pain Relief in Elderly Patients with Spinal Stenosis Undergoing Epidural Steroid Injection: Is Conservative Approach an Option?

AIM: To evaluate the short-term outcomes of epidural steroid injections (ESIs) among elderly patients with lumbar spinal stenosis. MATERIAL AND METHODS: This was a retrospective study. The sample consisted of 44 patients aged 65 or older who underwent epidural steroid injections secondary to lumbar spinal stenosis between 2014 and 2016 at a single center. Data were collected using the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), and Istanbul Low Back Pain Disability Index (ILBPDI) before and at 3-month follow-up visit. RESULTS: Participants had lower mean scale scores at all times after ESI administration than before. Four patients (9.1%) needed additional injections while two (4.5%) needed operation. No minor or major ESI-related complications were observed. CONCLUSION: Epidural steroid injections are an effective nonsurgical option for pain relief and improvement of physical function in elderly patients. The NRS, ODI, and ILBPDI are reliable and valid scales that can be used to evaluate the outcomes of ESIs in a selected group of elderly patients.

Evaluation and comparison of tick detachment techniques and technical mistakes made during tick removal.

BACKGROUND: Tick is among the important ectoparasites of humans and animals. Ticks may transmit disease-causing pathogens to humans. Tick contact may be resulted in several viral and bacterial infections, including Crimean-Congo Hemorrhagic Fever. Timely removal of ticks with appropriate methods is important in prevention of disease transmission. There are many methods reported for tick detachment. In this study, we aimed to evaluate two of them, suture lassoing and freezing and to compare both methods and to examine technical mistakes with these techniques. METHODS: This study was designed as a prospective cross-sectional study, and included the ticks detached by healthcare professionals or directly by patients who presented to the emergency department due to tick contact. The ticks were recorded as larvae, nymphs, and adults according to their growth period. Ticks detachment types with surgical sutures and removal mistakes were recorded. RESULTS: The majority (77.4%) of the ticks were removed by healthcare professionals and a lower rate by patients themselves with hand (22.6%). No technical mistake was found in 72 (77.4%) patients, and the tick was detached as a whole, while detached broken in 15 (16.1%) patients, and the tick was detached as a whole, but the sutures were attached wrong in six (6.5%) patients. Tick broken off due to technical mistakes was most commonly seen in the ticks removed by the individuals themselves. CONCLUSION: The results of this study suggest that when appropriately and correctly used, both suture lassoing and tweezers are effective in tick removal. Public awareness-raising and training programs should be increased on this issue.