Determinants of COVID-19 vaccine acceptance in a high infection-rate country: a cross-sectional study in Russia.

BACKGROUND: COVID-19 vaccine development is proceeding at an unprecedented pace. Once COVID-19 vaccines become widely available, it will be necessary to maximize public vaccine acceptance and coverage. OBJECTIVE: This research aimed to analyze the predictors of COVID-19 vaccine acceptance in Russia. METHODS: A cross-sectional online survey was conducted among Russian adults from September 26th to November 9th, 2020. Predictors of the intent to take up COVID-19 vaccination were explored using logistic regression. RESULTS: Out of 876 participants, 365 (41.7%) would be willing to receive the vaccine if it became available. Acceptance increased for a vaccine with verified safety and effectiveness (63.2%). Intention to receive the COVID-19 vaccine was relatively higher among males (aOR=2.37, 95% CI 1.41-4.00), people with lower monthly income (aOR=2.94, 95%CI 1.32-6.57), and with positive trust in the healthcare system (aOR=2.73, 95% CI 1.76-4.24). The Russian people were more likely to accept the COVID-19 vaccine if they believed that the vaccine reduces the risk of virus infection (aOR=8.80, 95%CI 5.21-14.87) or relieves the complications of the disease (aOR=10.46, 95%CI 6.09-17.96). Other barriers such as being unconcerned about side-effects (aOR=1.65, 95%CI 1.03-2.65) and the effectiveness and safety of the vaccination (aOR=2.55, 95%CI 1.60-4.08), also affected acceptance. CONCLUSIONS: The study showed the usefulness of the health belief model constructs in understanding the COVID-19 vaccination acceptance rate in the Russian population. This rate was influenced by sociodemographic and health-related characteristics, and health beliefs. These findings might help guide future efforts for policymakers and stakeholders to improve vaccination rates by enhancing trust in the healthcare system.

Determinants of COVID-19 vaccine acceptance in a high infection-rate country: a cross-sectional study in Russia

BACKGROUND: COVID-19 vaccine development is proceeding at an unprecedented pace. Once COVID-19 vaccines become widely available, it will be necessary to maximize public vaccine acceptance and coverage. OBJECTIVE: This research aimed to analyze the predictors of COVID-19 vaccine acceptance in Russia. METHODS: A cross-sectional online survey was conducted among Russian adults from September 26th to November 9th, 2020. Predictors of the intent to take up COVID-19 vaccination were explored using logistic regression. RESULTS: Out of 876 participants, 365 (41.7%) would be willing to receive the vaccine if it became available. Acceptance increased for a vaccine with verified safety and effectiveness (63.2%). Intention to receive the COVID-19 vaccine was relatively higher among males (aOR=2.37, 95% CI 1.41-4.00), people with lower monthly income (aOR=2.94, 95%CI 1.32-6.57), and with positive trust in the healthcare system (aOR=2.73, 95% CI 1.76-4.24). The Russian people were more likely to accept the COVID-19 vaccine if they believed that the vaccine reduces the risk of virus infection (aOR=8.80, 95%CI 5.21-14.87) or relieves the complications of the disease (aOR=10.46, 95%CI 6.09-17.96). Other barriers such as being unconcerned about side-effects (aOR=1.65, 95%CI 1.03-2.65) and the effectiveness and safety of the vaccination (aOR=2.55, 95%CI 1.60-4.08), also affected acceptance. CONCLUSIONS: The study showed the usefulness of the health belief model constructs in understanding the COVID-19 vaccination acceptance rate in the Russian population. This rate was influenced by sociodemographic and health-related characteristics, and health beliefs. These findings might help guide future efforts for policymakers and stakeholders to improve vaccination rates by enhancing trust in the healthcare system

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Development and validation of a scale to measure the quality of patient medication counseling using Rasch model.

OBJECTIVE: The purpose of this study is to develop and validate the psychometric properties of a scale for measuring the quality of patient medication counseling by using the Rasch model. METHODS: In this study, the scale was developed based on the literature review. It consisted of 31 items across five subscales: introduction, problem identification, content, behavior, and conclusion. A convenient sample of community pharmacists was recruited from four major cities in Vietnam: Hanoi, Da Nang, Ho Chi Minh, and Can Tho. Data collection was conducted from June 10 to October 30, 2017. A Rasch analysis for polytomous data was performed to assess the suitability of the item and the reliability of the scale. RESULTS: The research results showed that all items had a positive point-measure correlation coefficient between 0.47 and 0.77. All items had infit and outfit values in the optimal range between 0.5 and 1.5 except for D5, but its value was within acceptable range. Differential item function analysis indicated that all items had no DIF, except for items B4 and E4 containing moderate magnitude of DIF. Response category statistics found that there was a gradual increase in difficulty level from category 1 to 5 and no presence of reversal. Infit and outfit statistics of these categories were also considered good, with their values close to 1. The test result of the item characteristic curve and the person-item map showed that there were some overlapping items. Their appearance, however, might play an important role in measuring different aspects of construct. The overall scale reliability index (0.97) was high and the overall scale separation index (6.11) was good. CONCLUSIONS: The developed scale satisfied the requirements of the Rasch model. The scale is a useful tool that could be used to measure the quality of patient medication counseling among community pharmacists.

[Hepatic portal venous gas: surgery or not surgery?]. / L'aéroportie: bloc ou pas bloc?

Finding hepatic portal venous gas with pneumatosis intestinalis on computed tomography (CT) represents diagnostic and therapeutic challenge. The intestinal necrosis, particularly associated with acute mesenteric ischemia, is the very first hypothesis to assess, with the underlying question of an urgent surgery. However, knowing the non-surgical causes that have been identified in the last decade seems necessary to better assess the risk-benefit ratio of emergency surgery. Among these causes, we report the case of the acute colonic pseudo-obstruction, also known as Ogilvie's syndrome, whose first line treatment is medical.

[Intracerebral haemorrhage and postpartum cerebral angiopathy associated with the administration of sulprostone and norepinephrine]. / Hémorragie intracrânienne et angiopathie cérébrale réversible du post-partum associées à l'utilisation de sulprostone et de noradrénaline.

We report the case of a 29-year-old female who had developed a postpartum cerebral angiopathy (PCA) complicated by an intracerebral haematoma and convulsions, after a postpartum haemorrhage with sulprostone and norepinephrine infusion. PCA is an under diagnosed neurovascular pathology, responsible of reversible and non-specific symptoms. However, it can be complicated by haemorrhagic or ischemic stroke with vital or functional risks. As PCA is favored by vasoactive treatments, their administration in peripartum period, when it is imperative, should be strictly controlled.

[Ultrasound guided locoregional anaesthesia: realization and diagnosis of complications]. / L'anesthésie locorégionale sous échographie: de la réalisation au diagnostic des complications.

Ultrasound has become a daily practice for anesthesiologists for central venous catheterization and regional anaesthesia, but also for the diagnosis of pleuro-pulmonary, cardiac, and vascular diseases; this is illustrated by our observation. We report a case of a cirrhotic patient who underwent emergency surgery for a Colle's fracture under ultrasound-guided supraclavicular block which was complicated by acute dyspnoea. The use of ultrasound in the operating theater has revealed hepatic hydrothorax which occurred during a diaphragmatic paralysis secondary to the blocking of phrenic nerve due to the regional anaesthesia.

[Management of transdermal therapeutics in perioperative care]. / Gestion des thérapeutiques transdermiques en anesthésie.

OBJECTIVE: To provide guidance on perioperative management of most frequently encountered transdermal therapeutics in anaesthesiology: nicotine, fentanyl, nitroglycerin, scopolamine and estradiol. DATA SOURCES: A review of the last decade literature was carried out on the Pubmed database using the following keywords (transcutaneous or percutaneous or transdermal or transdermic or skin or dermal) and (drug delivery systems or therapeutic systems or drug administration) grouped under the Mesh terms cutaneous administration, perioperative care, surgery, pharmacokinetics, nicotine, fentanyl, nitroglycerin, scopolamine, estradiol. STUDY SELECTION: Original articles, general articles reviews, guidelines, letters to the editor and case reports have been selected. DATA EXTRACTION: Articles were analyzed for each transdermal treatment in terms of pharmacokinetics as well as anaesthetics and surgical interactions. DATA SYNTHESIS: Transdermal nicotine must be removed before anaesthesia of patients with coronary disease or with high risk of inhalation and in case of reconstructive surgery. Transdermal fentanyl must be maintained during the perioperative period and associated with preventive treatments of hyperalgesia. Transdermal administration of fentanyl by iontophoresis is a promising system for postoperative analgesia. Transdermal nitroglycerin must be maintained before scheduled surgery of a coronary patient. Transdermal scopolamine must be removed the day before surgery because of its side effects. It could have an interest in the prevention of postoperative nausea and vomiting, but its therapeutic method remain to be defined. Transdermal estradiol can be maintained during the perioperative period. CONCLUSION: The management of transdermal therapeutics in peri operative care can be adapted for each treatment and for each patient by knowing pharmacokinetics as well as anaesthetics and surgical interactions. In emergency situations, the actions to be taken do not generally differ, but one must be aware that the effects of trandermal treatments do not disappear immediately when removed, due to their pharmacokinetics properties.

[Diabetic ketoacidosis with a fatal issue: is it a MODY3 (maturity-onset diabetes of the young type 3)?]. / Acidocétose diabétique d'évolution fatale: serait-ce un MODY3 (maturity-onset diabetes of the young de type 3)?

Ketoacidotic coma is one of the possible diabetes mellitus first symptoms. It results from complete or relative lack of insuline and is often associated with type 1 diabetes. The authors report a case of a 45-years old woman with inaugural diabetes of which atypical features have motivated the study of MODY gene (maturity-onset diabetes of the young). Gly574ser polymorphism in the HNF-1alpha gene was found, in homozygous state, and the question of the responsibility of this polymorphism in this diabete is asked.

[The myxoedema coma exists, we met it]. / Le coma myxoedémateux existe, nous l'avons rencontré

The myxoedema coma corresponds to the ultimate evolution of a hypothyroidism and is characterized by a major deficit in thyroid hormones responsible for a collapse of the metabolism. The preventive and curative treatment is based on the administration of thyroid hormones, whose benefits are opposed to the cardiovascular risks related to an iatrogenic hyperthyroidism for patients often old with cardiopathy. We report the case of a 92-year-old patient with unbalanced hypothyroidism and chronic cardiac deficiency, who presented a myxoedema coma in the postoperative period of an urgent digestive surgery. This observation illustrates the difficulties in treating patients with unbalanced hypothyroidism following emergency surgery, in the absence of consensus on the type and the amounts of thyroid hormones substitution.

[Intravenous ketoprofen for severe lithium-induced polyuria]. / Traitement par kétoprofène intraveineux d'une polyurie sévère survenue au cours d'une intoxication au lithium.

INTRODUCTION: Although lithium has a narrow therapeutic range, it is widely used in psychiatry because of its antipsychotic and antidepressant properties. During long-term treatment, the onset of nephrogenic diabetes insipidus is common, but few cases of severe hypotonic polyuria, which would be an aggravating factor, have been reported. Appropriate treatment in such cases is an open question. CASE: We report a case of acute lithium poisoning in a 42-year-old man, due to chronic lithium treatment (plasma lithium=2.6 mmol/L). This patient, admitted to our intensive care unit, presented neurological disorders complicated by the early emergence of severe nephrogenic diabetes insipidus. After perfusion of hypotonic solution and intravenous treatment with ketoprofen (100 mg x 3/24 h), the polyuria improved rapidly. COMMENTS: The beneficial action of nonsteroidal antiinflammatory drugs lies in their capacity to inhibit prostaglandin synthesis. Lithium causes excess production of prostaglandins, which decrease the ability of kidneys to reabsorb free water. Some publications report indomethacin to be effective in this case. Because it is available only in oral or rectal forms, however, its effect may be delayed. Our case suggests that intravenous ketoprofen, with its rapid onset of action, is effective in the treatment of severe lithium-induced nephrogenic diabetes insipidus. Rehydration must be strictly monitored because of the risk of renal failure connected with nonsteroidal antiinflammatory drugs.

[Restlessness in intensive care unit: think to the nicotinic withdrawal syndrome]. / Agitation en réanimation: penser au syndrome de sevrage nicotinique.

We report a case of tobacco-addicted woman who has been hospitalized in intensive care unit. During mechanical ventilation, management of sedation was difficult, when she was awake, we observed restlessness associated with failure of the mechanical ventilation weaning. The improvement of restlessness and mechanical ventilation were obtained when we set a transdermal nicotine patch. This observation suggests that the nicotine withdrawal syndrome is an unrecognized cause of restlessness and that the transdermal nicotine patch should be a diagnosis means which is safe, cheap and easy to use.