Monoarthritis induced by the Oxford-AstraZenecaR SARS-CoV-2 vaccine

We describe the case of a 25-year-old woman who presented with monoarthritis of the proximal interphalangeal articulation of the fourth left finger 4 days after receiving the second dose of the Oxford-AstraZenecaR SARS-CoV-2 vaccine. She had no abnormalities in her X-ray or blood exams, but she had a cousin diagnosed with juvenile rheumatoid arthritis. The patient had an excellent response to anti-inflammatory medication, the arthritis was transient and left no sequelae. Studies have shown some vaccines may be associated with acute arthritis, in particular the measles-mumps-rubella vaccine. Young women such as our patient seem to be more susceptible to post-vaccination arthritis. Most of the cases reported were transient and left no articular sequelae, thus we did not contraindicate further doses of the Oxford-AstraZenecaR SARS-CoV-2 vaccine (should they be recommended in the future) in this case.

Describimos el caso de una mujer de 25 años que presentó monoartritis de la articulación interfalángica proximal del cuarto quirodáctil izquierdo 4 días después de recibir la segunda dosis de la vacuna Oxford-AstraZenecaR SARS-CoV-2. No presentaba anomalías en sus radiografías ni en los exámenes de sangre, pero tenía una prima diagnosticada con artritis reumatoide juvenil. La paciente tuvo una excelente respuesta a la medicación antiinflamatoria, la artritis fue transitoria y no dejó secuelas. Los estudios han demostrado que algunas vacunas pueden estar asociadas con la artritis aguda, en particular las vacunas contra el sarampión, las paperas y la rubéola. Las mujeres jóvenes como nuestra paciente parecen ser más susceptibles a la artritis posvacunación. La mayoría de los casos notificados fueron transitorios y no dejaron secuelas articulares, por lo que no contraindicamos nuevas dosis de la vacuna Oxford-AstraZenecaR SARS-CoV-2 (en caso de recomendarse en el futuro) en este caso.

Fatores de risco para cirurgia de revascularização miocárdica em pacientes com angioplastia coronariana prévia com stent / Risk factors for myocardial revascularization surgery in pacients with prior coronary angioplasty with stent

Este estudo analisou os fatores de risco que possam ter contribuído para a necessidade de cirurgia de revascularização miocárdica nos pacientes após angioplastia coronariana com stent convencional, em um serviço de alta complexidade em cardiologia no oeste de Santa Catarina. O estudo configura-se como caso-controle, não pareado, com variáveis coletadas através dos prontuários e via telefone. Os pacientes que realizaram cirurgia de revascularização miocárdica com angioplastia coronariana prévia com stent convencional, no período de 2009-2013, constituem os casos e os que efetuaram apenas angioplastia coronariana com stent convencional, no período de 2011-2012, os controles. Para cada caso foram selecionados quatro controles. Avaliou-se 175 pacientes, sendo 35 casos e 140 controles, sendo aproximadamente 60% da população homens. Dentre os fatores de risco analisados, a hipertensão arterial sistêmica e a dislipidemia foram mais frequentes nos casos que nos controles (100% vs. 72,9%, p< 0,01 e 97,1% vs. 66,4%, p< 0,01, respectivamente). A hipertensão arterial sistêmica e a dislipidemia são fatores de risco para necessidade de cirurgia de revascularização miocárdica após angioplastia coronariana com stent convencional. As demais variáveis não apresentaram significância para a evolução a cirurgia.

This study analyzed the risk factors that may have contributed to the need for myocardial revascularization surgery in patients after percutaneous transluminal coronary angioplasty with conventional stent, in a high complexity cardiology service in Western Santa Catarina. The study is characterized as a case-control study, unpaired, with variables collected through medical records and by telephone. The patients who underwent myocardial revascularization surgery with percutaneous transluminal coronary angioplasty with prior conventional stents in the period 2009-2013 constitute the cases, and the ones who have only percutaneous transluminal coronary angioplasty with conventional stent in the period of 2011-2012 constitute the controls. For each case it was selected four controls. It were assessed 175 patients, being that 35 were cases and 140 were controls, approximately 60% of the population men. Among the risk factors analyzed, systemic arterial hypertension and dyslipidemia were more frequent in cases than in controls (100 % vs. 72.9 %, p < 0.01 and 97.1 % vs. 66.4 %, p < 0.01, respectively). The systemic arterial hypertension and dyslipidemia are risk factors for the need of myocardial revascularization surgery after percutaneous transluminal coronary angioplasty with conventional stent. The other variables had no significance for the evolution to a surgery.