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1.
Medicina (Kaunas) ; 59(1)2023 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-36676783

RESUMO

Background: Bacteria-caused acute pericarditis is a very rare entity. It is usually associated with an underlying infection or compromised immune system. Primary purulent pericarditis in a previously healthy individual is highly unexpected; therefore, it is likely to have a delayed diagnosis and poor outcomes. Case: We report a case of an adult immunocompetent patient with primary bacterial pericarditis caused by a member of the commensal oral flora Streptococcus constellatus. The patient presented with septic shock and cardiac tamponade, and was further complicated with constrictive pericarditis, which was successfully treated with pericardiectomy. Conclusions: Bacterial pericarditis is a fulminant disease with a high mortality and complication rate. Fast recognition and prompt therapy are required to achieve a full recovery.


Assuntos
Tamponamento Cardíaco , Pericardite Constritiva , Pericardite , Streptococcus constellatus , Adulto , Humanos , Pericardite/complicações , Pericardite/diagnóstico , Pericárdio , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/terapia
2.
Pediatr Infect Dis J ; 42(2): 166-171, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36638405

RESUMO

BACKGROUND: Acute pericarditis/myocarditis is a rare complication of the mRNA-based vaccines and although mostly self-limiting, long-term sequelae remain unclear. METHODS: We enrolled all patients admitted to the emergency department between September 2021 and February 2022 meeting the CDC work case definition, with symptoms onset after mRNA-based COVID-19 vaccine. Alternative virologic causes were excluded. Clinical data, laboratory values, cardiologic evaluation, electrocardiogram (ECG), and echocardiogram (ECHO) were collected on admission, at discharge, and during follow-up in all patients. Cardiac Magnetic Resonance (CMR) was performed only in those with signs consistent with myocarditis. RESULTS: We observed 13 patients (11M and 2F), median age 15 years, affected by acute pericarditis/myocarditis after COVID-19 mRNA vaccination (11 after Comirnaty® and 2 after Spikevax®). Symptoms'onset occurred at a median of 5 days (range, 1 to 41 days) after receiving mRNA vaccine (13 Prizer 2 Moderna): 4 patients (31%) after the 1st dose, 6 (46%) after the 2nd, and 3 (23%) after 3rd dose. Increased levels of high-sensitive troponin T (hsTnT) (median 519,5 ng/mL) and N-terminal-pro hormone BNP (NT-proBNP) (median 268 pg/mL) and pathognomonic ECG and ECHO abnormalities were detected. On admission, 7 of 13 (54%) presented with myopericarditis, 3 (23%) with myocarditis, and 3 (23%) with pericarditis; CMR was performed in 5 patients upon pediatric cardiologist prescription and findings were consistent with myocarditis. At 12 weeks of follow-up, all but one patient (92%), still presenting mild pericardial effusion at ECHO, were asymptomatic with normal hsTnT and NT-proBNP levels and ECG. On CMR 6 of 9 patients showed persistent, although decreased, myocardial injury. Higher hsTnT levels on admission significantly correlated with persistent CMR lesions. CONCLUSION: Evidence of persistent CMR lesions highlights the need for a close and standardized follow-up for those patients who present high hsTnT levels on admission.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Miocardite , Pericardite , Adolescente , Criança , Humanos , COVID-19/diagnóstico , COVID-19/prevenção & controle , COVID-19/complicações , Vacinas contra COVID-19/efeitos adversos , Espectroscopia de Ressonância Magnética/efeitos adversos , Miocardite/diagnóstico , Miocardite/etiologia , Pericardite/diagnóstico , Pericardite/etiologia , Troponina , Vacinação/efeitos adversos
3.
Int J Rheum Dis ; 26(2): 337-343, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36537284

RESUMO

AIMS: To identify peripheral blood cellular correlates of active pericarditis and to verify whether peripheral blood neutrophils, lymphocytes and the neutrophil to-lymphocyte ratio (NLR) are associated with disease phenotype or prognosis. METHODS: Observational prospective study on a cohort of 63 patients with idiopathic pericarditis followed for 12 months after each pericarditis recurrence. Two distinct analyses were performed: the "index attack" analysis focused on the first pericarditis episode in each patient, while the "all attacks" analysis included all episodes occurring during the study. RESULTS: Absolute and relative neutrophilia and lymphopenia, together with high NLR, were observed during active pericarditis, as compared with disease remission, at both analyses. Neutrophils showed a positive correlation with plasma C-reactive protein levels, while lymphocyte count showed a negative correlation. Relative neutrophil count was higher, and lymphocyte count lower in patients with pleural effusion; a higher NLR and lower absolute lymphocyte count were observed in those with peritoneal involvement. No correlations were found between peripheral blood neutrophil or lymphocyte counts and size of pericardial effusion, or with the presence of myocardial involvement. Peripheral neutrophilia, lymphopenia and NLR during acute attacks predicted the number of recurrences in the following 12 months. CONCLUSIONS: Peripheral blood neutrophilia and lymphopenia are typical of acute idiopathic pericarditis. Acute attacks of pericarditis are associated with neutrophilia and lymphopenia, as compared with disease remission. During acute attacks, neutrophilia and lymphopenia reflect the extent of serosal inflammation and could help to customize therapeutic management after remission has been achieved.


Assuntos
Doenças da Medula Óssea , Linfopenia , Pericardite , Humanos , Neutrófilos , Estudos Prospectivos , Linfopenia/diagnóstico , Linfócitos , Contagem de Linfócitos , Prognóstico , Inflamação , Pericardite/diagnóstico , Pericardite/terapia , Estudos Retrospectivos
5.
J Am Coll Cardiol ; 80(20): 1900-1908, 2022 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-36357091

RESUMO

BACKGROUND: Postmarketing evaluations have linked myocarditis to COVID-19 mRNA vaccines. However, few population-based analyses have directly compared the safety of the 2 mRNA COVID-19 vaccines. OBJECTIVES: This study aimed to compare the risk of myocarditis, pericarditis, and myopericarditis between BNT162b2 and mRNA-1273. METHODS: We used data from the British Columbia COVID-19 Cohort (BCC19C), a population-based cohort study. The exposure was the second dose of an mRNA vaccine. The outcome was diagnosis of myocarditis, pericarditis, or myopericarditis during a hospitalization or an emergency department visit within 21 days of the second vaccination dose. We performed multivariable logistic regression to assess the association between vaccine product and the outcomes of interest. RESULTS: The rates of myocarditis and pericarditis per million second doses were higher for mRNA-1273 (n = 31, rate 35.6; 95% CI: 24.1-50.5; and n = 20, rate 22.9; 95% CI: 14.0-35.4, respectively) than BNT162b2 (n = 28, rate 12.6; 95% CI: 8.4-18.2 and n = 21, rate 9.4; 95% CI: 5.8-14.4, respectively). mRNA-1273 vs BNT162b2 had significantly higher odds of myocarditis (adjusted OR [aOR]: 2.78; 95% CI: 1.67-4.62), pericarditis (aOR: 2.42; 95% CI: 1.31-4.46) and myopericarditis (aOR: 2.63; 95% CI: 1.76-3.93). The association between mRNA-1273 and myocarditis was stronger for men (aOR: 3.21; 95% CI: 1.77-5.83) and younger age group (18-39 years; aOR: 5.09; 95% CI: 2.68-9.66). CONCLUSIONS: Myocarditis/pericarditis following mRNA COVID-19 vaccines is rare, but we observed a 2- to 3-fold higher odds among individuals who received mRNA-1273 vs BNT162b2. The rate of myocarditis following mRNA-1273 receipt is highest among younger men (age 18-39 years) and does not seem to be present at older ages. Our findings may have policy implications regarding the choice of vaccine offered.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Miocardite , Pericardite , Adolescente , Adulto , Humanos , Masculino , Adulto Jovem , Vacina de mRNA-1273 contra 2019-nCoV , Vacina BNT162 , Estudos de Coortes , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Miocardite/epidemiologia , Miocardite/etiologia , Miocardite/diagnóstico , Pericardite/epidemiologia , Pericardite/etiologia , Pericardite/diagnóstico , Vacinação , Vacinas
7.
BMJ Case Rep ; 15(11)2022 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-36414337

RESUMO

Brucellosis is one of the most common zoonotic infections with worldwide distribution. The clinical presentation of brucellosis ranges from asymptomatic to severe disease involving haematological, gastrointestinal, neurological and osteoarticular systems. Cardiovascular manifestations are rare in brucellosis cases with endocarditis being the most common presentation. Isolated pericarditis with massive pericardial effusion without endocarditis is extremely rare. Here, we describe a case of brucellosis with sole manifestation of pericarditis with massive pericardial effusion in a patient with end stage renal disease diagnosed based on the isolation of Brucella melitensis from pericardial fluid.


Assuntos
Brucelose , Endocardite , Falência Renal Crônica , Derrame Pericárdico , Pericardite , Humanos , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Brucelose/complicações , Brucelose/diagnóstico , Brucelose/tratamento farmacológico , Falência Renal Crônica/complicações , Pericardite/complicações , Pericardite/diagnóstico , Endocardite/complicações
8.
Intern Med ; 61(22): 3415-3419, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36385047

RESUMO

Chest symptoms and pleural effusion due to serositis in familial Mediterranean fever (FMF) are occasionally misdiagnosed as acute pneumonia. However, the actual pulmonary involvement of FMF is extremely rare. A 67-year-old man was referred to our hospital due to repeated and transient anterior chest pain. Chest images revealed a moderate amount of pericardial fluid, slight bilateral pleural effusion, and infiltrations in both lower lung lobes. Colchicine treatment without antibiotics rapidly improved these symptoms and findings. Pericarditis, pleurisy and the response to colchicine indicated FMF. FMF should be considered as a causative disease of pulmonary infiltrations, especially if it occurs repeatedly.


Assuntos
Febre Familiar do Mediterrâneo , Pericardite , Derrame Pleural , Pleurisia , Masculino , Humanos , Idoso , Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/diagnóstico , Febre Familiar do Mediterrâneo/tratamento farmacológico , Colchicina/uso terapêutico , Pericardite/complicações , Pleurisia/etiologia , Derrame Pleural/complicações
9.
BMC Infect Dis ; 22(1): 844, 2022 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-36371165

RESUMO

INTRODUCTION: We aimed to assess harms (post-vaccine myocarditis and pericarditis) and benefits (preventing severe disease) of COVID-19 vaccination. METHODS: We conducted a population-based retrospective cohort study. Using the integrated platform of the vaccination campaign of Lombardy Region (Italy), after the exclusion of 24,188 individuals not beneficiaries of the Regional Health Service, 9,184,146 citizens candidates to vaccine at December 27, 2020 were followed until November 30, 2021 (the loss to follow-up rate was 0.5%). From the date of administration of each vaccine dose to day 28 post-administration, three periods that covered exposure to the first, second, and third dose were defined. The benefit-risk profile of vaccines was performed by comparing the number needed to harm (NNH) and number needed to treat (NNT) by sex, age, and vaccine type. RESULTS: Incidence rates of myocarditis were 9.9 and 5.2 per million person-months during the exposure and no-exposure periods, respectively, and the incidence rates of pericarditis were 19.5 and 15.9 per million person-months, respectively. The risk of myocarditis was highest following exposure to the second dose of the Moderna vaccine (adjusted HR: 5.5, 95% CI: 3.7 to 8.1). Exposure to the Moderna vaccine was also associated with an increased risk of pericarditis (adjusted HR 2.2, 1.5 to 3.1). NNT was higher than NNH (9471 vs. 7213) for 16 to 19-year-old men who received the Moderna vaccine, while all other sex, age, and vaccine subgroups had a favourable harm-benefit profile. CONCLUSIONS: Men 16 to 19 years of age has the highest rates of myocarditis within a few days after receiving the Moderna vaccines. The balance between harms and benefits was almost always in favour of vaccination.


Assuntos
COVID-19 , Miocardite , Pericardite , Masculino , Humanos , Adolescente , Adulto Jovem , Adulto , Miocardite/epidemiologia , Miocardite/etiologia , Estudos de Coortes , Vacinas contra COVID-19/efeitos adversos , Estudos Retrospectivos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinação/efeitos adversos , Pericardite/epidemiologia , Pericardite/etiologia , Itália/epidemiologia
10.
Vnitr Lek ; 68(E-7): 23-27, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36402556

RESUMO

Primary cardiac synovial sarcoma is an extremely rare tumor with a higher incidence in young men. The mean age of occurrence is 32 years. Synovial sarcomas are tumors with high aggressiveness, proliferate rapidly and metastasize to regional and distant lymph nodes or surrounding organs. The typical location of synovial sarcoma of the heart is the atrial and ventricular septum. Its size, the degree of infiltration of the surrounding tissues and the presence of metastases influence clinical symptoms, which are very non-specific. The low specificity of the symptoms complicates the clinical diagnosis and in most cases the tumor is detected during its progression or incidentally. The final diagnosis is based on histological examination. The primary and only method of treatment is a surgical solution with an effort to completely resect the tumor, followed by aggressive palliative chemotherapy. In the following paper, we present a case report of a 32-year-old man who was diagnosed with synovial cardiac sarcoma only on the basis of exacerbation of non-specific subjective complaints due to the complication in the form of of aneurysmal bleeding of the tumor mass.


Assuntos
COVID-19 , Neoplasias Cardíacas , Pericardite , Sarcoma Sinovial , Neoplasias do Timo , Masculino , Humanos , Adulto , Sarcoma Sinovial/diagnóstico , Sarcoma Sinovial/patologia , Sarcoma Sinovial/cirurgia , SARS-CoV-2 , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/terapia
12.
Am J Case Rep ; 23: e937196, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36367847

RESUMO

BACKGROUND The purpose of this case report was to present a rare course of pericarditis starting with transverse sinus inflammation in a patient with recurrent chest pain. Typically, the effusion accumulates along the diaphragmatic surface of the back heart, and other localizations, such as the transverse sinus, are uncommon. The main risk factor for pericarditis in Europe is viral infection. In this uncommon case, we strongly suspected underlying Takayasu syndrome. The positive response to treatment with steroids in pericarditis and Takayasu arteritis may be misleading. CASE REPORT A 61-year-old woman was admitted to the Cardiology Clinic because of recurrent chest pain in the form of a retrosternal burning pain with radiation to both arms. With the results of laboratory tests, electrocardiogram, and computer tomography (CT), we excluded acute coronary syndrome, pulmonary embolism, and aortic dissection. In chest CT and transthoracic echocardiography (TTE), we found an effusion around the ascending aorta with uncertain inflammation and in the transverse sinus of the pericardium. After typical pericarditis treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and afterward with steroids, which is similar to Takayasu syndrome treatment, we observed a significant improvement of the patient's clinical condition and no recurrence of chest pain. CONCLUSIONS Despite clinical symptoms, laboratory results, and aorta thickening with surrounding inflammation, Takayasu syndrome was excluded by rheumatologists because of the patient's age. Transverse sinus inflammation is a very rare presentation of pericarditis, but should be considered, especially based on TTE and CT imaging, when other possible causes of retrosternal pain are excluded.


Assuntos
Pericardite , Arterite de Takayasu , Feminino , Humanos , Pessoa de Meia-Idade , Arterite de Takayasu/complicações , Arterite de Takayasu/diagnóstico , Pericárdio/diagnóstico por imagem , Pericardite/diagnóstico , Dor no Peito/etiologia , Inflamação
14.
Int Heart J ; 63(6): 1212-1214, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36450560

RESUMO

The coronavirus infection 2019 (COVID-19) pandemic has led to the development of mRNA vaccines with proven efficacy. However, it remains unclear whether patients who developed pericarditis after the first COVID-19 mRNA would be fit to receive the second vaccination. Herein, we present the case of a 64-year-old man who visited our emergency department with substernal chest discomfort that began 4 days after his first mRNA COVID-19 vaccination. Acute pericarditis was diagnosed based on symptoms and ST-segment elevation on an electrocardiogram. Chest pain improved 2 days after treatment.Since there are no guidelines on whether to administer an additional vaccination to a patient who developed pericarditis after the initial vaccination, we considered whether or not to administer the additional vaccination. We informed the patient about the risks and benefits and decided to administer the second dose. He did not experience any major adverse reactions. The indications for the second vaccination need to be thoroughly considered.


Assuntos
COVID-19 , Pericardite , Masculino , Humanos , Pessoa de Meia-Idade , RNA Mensageiro , COVID-19/diagnóstico , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Pericardite/diagnóstico , Pericardite/etiologia , Vacinação/efeitos adversos
15.
Isr Med Assoc J ; 24(11): 747-751, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36436043

RESUMO

BACKGROUND: Statins have anti-inflammatory effects that are independent of their lipid-lowering activity. OBJECTIVES: To examine whether prior statins therapy affects the clinical course of the first episode of acute idiopathic pericarditis (AIP) as the 1-year recurrence and length of hospitalization (LOH). METHODS: This retrospective study included 148 subjects with first episode AIP admitted between the years 2015 and 2019. Data were collected from two hospitals in Northern Israel. We divided the patients in into two groups: 117 those without statins use and 31 those with prior statins use. We compared age, sex, co-morbidities, drugs, laboratory data, 1-year recurrence, and LOH. RESULTS: The mean age of participants was 43.1 ± 19.4 years. Comparisons between subjects without statins and with prior statins use were made according to age (37.5 ± 16.7 years vs. 64.4 ± 12.7 years, P < 0.01), C-reactive protein (50 ± 40 vs. 48 ± 35 mg/dl, P = 0.9), LOH (5.4 ± 2.85 vs. 8.03 ± 4.92 days, P < 0.01), 1-year recurrence of pericarditis (23 vs. 6 cases, P = 0.95), respectively. Multivariate logistic regression analysis revealed that 1-year recurrence (odds ratio [OR] 0.8, 95% confidence interval [95%CI 0 0.6-1.1, P = 0.41), was not associated with prior statin use, while LOH (OR 2.56, 95%CI 2.08-2.75, P = 0.01) was prolonged with prior statins use in patients with first episode of AID. CONCLUSIONS: Prior statins use in patients with the first episode of AIP did not reduce the 1-year recurrence of pericarditis and prolong the LOH.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases , Pericardite , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Estudos Retrospectivos , Hospitalização , Pericardite/tratamento farmacológico , Pericardite/epidemiologia , Comorbidade
16.
Med. clín (Ed. impr.) ; 159(9): 440-446, noviembre 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-212239

RESUMO

El SARS-CoV-2 está causando actualmente una pandemia sostenida de COVID-19, con el riesgo de causar secuelas cardiacas a largo plazo en la población. El temor de que el SARS-CoV-2 cause un daño miocárdico mayor que otros virus convencionales se basa en su mecanismo de infección de células humanas a través del receptor de la enzima convertidora de la angiotensina 2 y las defensas antivirales innatas, hasta ahora reducidas contra un nuevo virus. El conocimiento de la aparición durante la infección aguda de otras afectaciones cardiacas, además de las clásicas miocarditis y pericarditis, las manifestaciones cardiacas observadas a largo plazo (COVID-19 persistente) y la incidencia incrementada de miocarditis y pericarditis tras la vacunación resulta de especial interés a fin de ofrecer a nuestros pacientes la mejor atención posible basada en la evidencia científica actual. (AU)


SARS-CoV-2 is currently causing a persistent COVID-19 pandemic, which poses a risk of causing long-term cardiovascular sequels in the population. The viral mechanism of cell infection through the angiotensin 2 converter enzyme receptor and the limited antiviral innate immune response are the suspected causes for a more frequent cardiovascular damage in SARS-CoV-2 infection. Knowledge of the appearance during acute infection of other cardiac conditions beyond the classical myocarditis and pericarditis, the long-term cardiac manifestations (persistent COVID-19), and the increased incidence of myocarditis and pericarditis after vaccination is of special interest in order to offer our patients best practices based on current scientific evidence. (AU)


Assuntos
Humanos , Vírus da SARS , Miocardite/diagnóstico , Miocardite/epidemiologia , Miocardite/etiologia , Pericardite , Infecções por Coronavirus/epidemiologia , Pandemias
17.
J Am Heart Assoc ; 11(20): e023252, 2022 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-36250662

RESUMO

Background Recurrent pericarditis is characterized by painful flares and inflammation, which negatively impact health-related quality of life. RHAPSODY (rilonacept inhibition of interleukin-1 alpha and beta for recurrent pericarditis: a pivotal symptomatology and outcomes study) evaluated the efficacy and safety of rilonacept (IL-1α and -ß cytokine trap) in recurrent pericarditis. A secondary analysis of these data evaluated the patient-reported outcome questionnaire score change during the trial. Methods and Results Participants completed 5 patient-reported outcome (PRO) questionnaires assessing pericarditis pain, health-related quality of life, general health status, sleep impact, and overall symptom severity. PRO score changes during the treatment run-in period (12 weeks) and the blinded randomized withdrawal period (up to 24 weeks) were evaluated using descriptive statistics and mixed model repeated measures analyses. Participants with PRO data from the run-in period (n=84) and the randomized withdrawal period (n=61; 30 rilonacept, 31 placebo) were included in analyses. Run-in baseline PRO scores indicated that pericarditis symptoms during pericarditis recurrence impacted health-related quality of life. All PRO scores significantly improved (P<0.001) on rilonacept treatment during the run-in period. For the randomized withdrawal period, PRO scores were maintained for participants receiving rilonacept. For those receiving placebo and who experienced a recurrence, PRO scores deteriorated at the time of recurrence and then improved following rilonacept bailout. At randomized withdrawal Week 24/End of Study, scores of participants who received bailout rilonacept were similar to those of participants who had continued rilonacept. Conclusions These results demonstrate the burden of pericarditis recurrences and the improved physical and emotional health of patients with recurrent pericarditis while on rilonacept treatment. These findings extend prior rilonacept efficacy results, demonstrating improvements in patient-reported health-related quality of life, sleep, pain, and global symptom severity while on treatment. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03737110.


Assuntos
Interleucina-1alfa , Pericardite , Humanos , Dor , Pericardite/tratamento farmacológico , Qualidade de Vida , Sono , Resultado do Tratamento
18.
JAAPA ; 35(11): 18-19, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36282574

RESUMO

ABSTRACT: The interleukin (IL)-1 antagonist rilonacept is approved by the FDA to treat recurrent pericarditis. In adults and adolescents with multiple recurrences of pericarditis, compared with placebo, rilonacept is associated with a lower risk of recurrent pericarditis, more persistent clinical response, normalized C-reactive protein within 7 days, and a higher number of days with no or minimal pericarditis symptoms. Patients receiving rilonacept could be weaned off of standard therapies for recurrent pericarditis and eventually be transitioned to rilonacept monotherapy. The most common adverse reactions to rilonacept include injection-site reactions, upper respiratory tract infections, and increased lipids. A loading dose of rilonacept is administered subcutaneously (SQ), along with weekly SQ maintenance dosing, which can be self-administered. Rilonacept is indicated for the treatment of recurrent pericarditis and reduction in risk of recurrence in patients age 12 years and older who have an elevated C-reactive protein level and significant disease burden.


Assuntos
Proteína C-Reativa , Pericardite , Adulto , Adolescente , Humanos , Criança , Proteína C-Reativa/metabolismo , Método Duplo-Cego , Pericardite/tratamento farmacológico , Interleucinas , Lipídeos , Recidiva , Resultado do Tratamento
19.
J Infect Dev Ctries ; 16(9): 1517-1523, 2022 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-36223630

RESUMO

INTRODUCTION: Sepsis is a serious problem in felines with a mortality rate ranging from 29-79%. Neisseria spp. is considered a commensal microorganism of the oral cavity of dogs and cats and is usually isolated from human wounds resulting from bites of these animals. CASE REPORT: The present report describes clinical, imaging and laboratory findings of a feline with sepsis wherein commensal and multidrug-resistant (MDR) Neisseria spp. was isolated. The feline presented a history of four days of anorexia, dyspnea, prostration, and, pericardial, pleural and abdominal effusions. Pericardiocentesis was performed and hemorrhagic exudate was observed. The animal died after 11 days of treatment with gentamicin and amoxicillin combined with clavulanic acid. During necropsy, the abdominal cavity was found to be filled with greenish-yellow content and the pericardial sac was thickened with a large amount of purulent secretion. Histopathology revealed sepsis with necrotizing suppurative pericarditis, diffuse mononuclear pneumonia and necrotic pleuritis, leading to secondary bacterial infection. CONCLUSIONS: Commensal Neisseria spp. are important zoonotic bacteria, which trigger a serious disease in felines. However, it has not been reported to cause sepsis with pneumonia, suppurative necrotizing pericarditis and pericardial effusion.


Assuntos
Doenças do Gato , Doenças do Cão , Pericardite , Pneumonia , Sepse , Amoxicilina , Animais , Doenças do Gato/tratamento farmacológico , Gatos , Ácido Clavulânico , Cães , Gentamicinas , Humanos , Neisseria , Pericardite/microbiologia , Pericardite/terapia , Pneumonia/complicações , Sepse/tratamento farmacológico , Sepse/veterinária
20.
Vaccine ; 40(45): 6481-6488, 2022 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-36195472

RESUMO

BACKGROUND: Active monitoring of safety outcomes following COVID-19 vaccination is critical to understand vaccine safety and can provide early detection of rare outcomes not identified in pre-licensure trials. We present findings from an early warning rapid surveillance system in three large commercial insurance databases including more than 16 million vaccinated individuals. METHODS: We evaluated 17 outcomes of interest following COVID-19 vaccination among individuals aged 12-64 years in Optum, HealthCore, and CVS Health databases from December 11, 2020, through January 22, 2022, January 7, 2022, and December 31, 2021, respectively. We conducted biweekly or monthly sequential testing and generated rate ratios (RR) of observed outcome rates compared to historical (or expected) rates prior to COVID-19 vaccination. FINDINGS: Among 17 outcomes evaluated, 15 did not meet the threshold for statistical signal in any of the three databases. Myocarditis/pericarditis met the statistical threshold for a signal following BNT162b2 in two of three databases (RRs: 1.83-2.47). Anaphylaxis met the statistical threshold for a signal in all three databases following BNT162b2 vaccination (RRs: 4.48-10.86) and mRNA-1273 vaccination (RRs: 7.64-12.40). DISCUSSION: Consistent with published literature, our near-real time monitoring of 17 adverse outcomes following COVID-19 vaccinations identified signals for myocarditis/pericarditis and anaphylaxis following mRNA COVID-19 vaccinations. The method is intended for early detection of safety signals, and results do not imply a causal effect. Results of this study should be interpreted in the context of the method's utility and limitations, and the validity of detected signals must be evaluated in fully adjusted epidemiologic studies.


Assuntos
Anafilaxia , COVID-19 , Miocardite , Pericardite , Humanos , Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Anafilaxia/etiologia , Miocardite/etiologia , Vacina BNT162 , Vacinação/efeitos adversos , Vacinação/métodos , Pericardite/etiologia , RNA Mensageiro
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