A BSTRACT Due to the high morbidity and mortality of the coronavirus disease 2019 (COVID-19) in patients with malignancy, the necessity of vaccination in this group of patients became particularly important. Although a large number of studies have reported the safety of COVID-19 vaccination in multiple myeloma (MM) patients, the effect of the COVID-19 vaccine on MM relapse has not yet been reported. Here, we report a case of a possible association between relapse of MM and COVID-19 vaccination with Sinopharm ® , an inactivated virus vaccine, in a patient with MM who has remained in complete remission for about 4 years. The MM relapse in the patient was diagnosed by both clinical findings and laboratory workup including serum protein electrophoresis, bone marrow aspiration, and biopsy. Despite this possible association between COVID-19 vaccination and MM relapse in the patient, given its importance in reducing mortality and having an acceptable safety profile, the COVID-19 vaccine should be administered to all cancer patients. However, careful monitoring and follow-up are recommended in patients with MM after COVID-19 vaccination.
One of the most prevalent healthcare-associated infections in the pediatric intensive care unit is ventilator-associated pneumonia (VAP). VAP not only results in prolonged hospital and intensive care unit (ICU) stays but also imposes higher costs on patients and the healthcare system. Therefore, it is essential to implement preventive measures. The lung-protective properties of taurine are recognized, and this research focuses on assessing the impact of taurine supplementation in preventing VAP. This double-blind, randomized clinical trial was conducted at Namazi Hospital's PICUs. The study included pediatrics on mechanical ventilation for over 48 h. Patients were randomly divided into two groups: the taurine and placebo groups. Alongside the standard care, participants from both groups were administered taurine or placebo capsules (30 mg/kg. day) in divided doses from the day of PICU admission through PICU discharge. The incidence of VAP through clinical and laboratory evidence was considered the primary outcome. Seventy-seven patients were included in the study, with 38 in the taurine group and 39 in the placebo group. VAP incidence was 7.9% in the taurine group and 64.1% in the placebo group. Taurine significantly reduced the duration of mechanical ventilation, ICU and hospital stay, and inotrope duration. The occurrence of septic shock was lower in the taurine group at 5.3%. Stepwise logistic regression showed that placebo receipt was the only risk factor for VAP, with placebo recipients being 20.8 times more likely to develop VAP. (P < 0.0001, OR 20.8, 95% CI 6.11-97.93) Taurine treatment also significantly reduced inflammatory markers such as CRP, pro-calcitonin, and interleukin-6 compared to placebo. Our results showed that taurine supplementation can reduce the incidence of VAP and the duration of mechanical ventilation, ICU, and hospital stay in critically ill pediatric patients. This study received approval from the Iranian registry clinical trial, registered on 29 June 2023 (IRCT20120731010453N4, http://www.irct.ir/).
Drug-related problems (DRPs) are frequently observed in intensive care units, resulting in a higher occurrence of drug side effects and increased treatment expenses. This study aimed to assess the prevalence of DRPs in pediatric patients admitted to the most prominent surgical and medical pediatric intensive care units (PICUs) in southern Iran, given the susceptibility of children to the effects of DRPs.
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