In an ongoing multinational trial, we obtained blood samples from 365 volunteers vaccinated with mRNA vaccines (Moderna, BioNTech), viral DNA-vectored vaccines (AstraZeneca, Sputnik-V, and Johnson and Johnson), or the attenuated virus vaccine from Sinopharm. After collecting reactogenicity data, the expression of S-Protein binding IgG and IgA was analyzed using an automated sandwich ELISA system. Serum neutralizing potentials were then investigated using an ACE-2-RBD neutralizing assay. Moderna’s vaccine induced the highest amounts of SARS-CoV-2 specific neutralizing antibodies compared to the other groups. In contrast, Sinopharm and Johnson and Johnson’s vaccinees presented the lowest SARS-CoV-2-specific antibody titers. Interestingly, moderate to high negative correlations between age and virus-specific IgG expression were observed in the Johnson and Johnson (ρ =-0.3936) and Sinopharm (ρ =-0.6977) groups according to Spearman’s rank correlation analysis. A negative correlation was seen between age and IgA expression in the Sputnik-V group (ρ =-0.3917). The analysis of virus neutralization potentials in age categories demonstrated that no significant neutralization potential was observed in older vaccinees (61and 80 years old) in the Sputnik-V Johnson and Johnson and Sinopharm vaccinees’ groups. In contrast, neutralization potentials in sera of Moderna, BioNTech, and AstraZeneca vaccinees were statistically comparable in all age categories. Furthermore, while the AstraZeneca vaccine alone induced moderate IgG and IgA expression, the combination with Moderna or BioNTech mRNA vaccines induced significantly higher antibody levels than a double dose of AstraZeneca and similar IgG expression and neutralization potential compared to Moderna or BioNTech vaccines used alone. These results suggest that mRNA vaccines are the most immunogenic after two doses. DNA vectored vaccines from AstraZeneca and Sputnik-V presented lower but significant antibody expression and virus neutralizing properties after two doses. The lowest antibody and neutralization potential were observed in the Sinopharm or Johnson and Johnson vaccinees. Especially elderly over 60 presented no significant increase in neutralizing antibodies after vaccination. The data also indicate that heterologous vaccination strategies combining the AstraZeneca DNA vectored vaccines and mRNA vaccines are more effective in the induction of neutralizing antibodies compared to their homologous counterparts.

The early diagnosis of metastatic pulmonary calcification is beneficial, as some patients may develop restrictive changes in respiratory function or in some cases lethal acute respiratory distress. The aim of the study was to evaluate whether scanning with ⁹⁹(m)Tc DPD might be useful in early diagnosis of pulmonary calcification in setting of chronic renal failure and hemodialysis and if presence of pulmonary calcification is associated with an abnormality in respiratory parameters. Forty-two patients with end-stage renal disease, who were treated by regular haemodialysis, were investigated. Twenty five (59.5%) out of forty two patients had increased lung uptake of ⁹⁹(m)Tc DPD at whole body scintigraphy-grade 2 group. These patients were on dialysis 149±26 months compared with 57±16 months in 17 patients with a normal lung uptake of ⁹⁹(m)Tc DPD at whole body scintigraphy- grade 1 group (p<0.01). In grade 2 group 22 patients (88%) had significantly lower (p<0.01) parameters of spirometry (FEF25-75, FEF75 FEF50, FEF25) compared to predicted values while in grade 1 group the parameters were significantly lower in only six patients (35.3%). There was statistically insignificant difference between these two groups regarding parathyroid hormone level (p>0.05). These observations confirm previous findings that scintigraphy with ⁹⁹(m)Tc DPD may be efficious in early diagnosis of pulmonary calcification in hemodialised patients as well as the fact that spirometry is useful in patients with confirmed pulmonary calcifications.

Uremic lung is different entity then oedema present in cardiovascular diseases or in adult respiratory distress syndrome as well. This state is one of the possible complications in patients with chronic renal failure (CRF) receiving regular hemodialysis (HD). There are several studies suggesting that in these patients in 30-40% cases pulmonary hypertension was developed. It is known that patients with primary pulmonary hypertension have peripheral airway obstruction The data also showed that primary as well secondary pulmonary hypertension are more often developed in females; even real reason is still unknown. The aim of the study was to estimate the ventilator function improvement in patients with CRF receiving regular HD related to sex differences. The study population consisted in 39 patients with CRF, with no cardiac and pulmonary diseases. These patients were treated by regular hemodialysis using bicarbonate or acetate mode, respectively. They were divided into two groups according to the sex. Spirometry parameters before and after onset of hemodialysis were recorded. The results were analyzed using Student t-test and presented as mean +/-SD. All p values <0,05 were considered significant. The result showed that ventilatory function in male patients is significantly improved, especially VC and FEV1, whereas in female patients improvement had not statistical significance. It can be concluded that one of the possible reasons for slight improvement of ventilator function in female patients is pulmonary hypertension.

BACKGROUNDSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (COVID-19) have afflicted millions of people in a worldwide pandemic. Several vaccines have been developed to prevent infection and illness. However, the safety and efficacy of most of the vaccines currently available are still being questioned by part of the public opinion. Even if vaccine-resistant individuals represent a minority in most countries, their hesitancy is sufficient to delay the highly desired ‘herd-immunity threshold.’ METHODSIn an ongoing multinational trial, we collected blood samples from 365 adults, 18 years of age or older, vaccinated with mRNA vaccines (Moderna, BioNTech), viral DNA-vectored vaccines (AstraZeneca, Sputnik-V, and Johnson and Johnson), or the attenuated virus vaccine from Sinopharm. Out of the 365 vaccinated individuals included in the study, 41 received two doses of Moderna Biotech's Spikevax, 92 received two doses of BioNTech’s Comirnaty, 52 were vaccinated with two doses of Oxford-AstraZeneca’s Vaxzevria, 34 received one dose of Johnson and Johnson’s Jansen, 35 two doses of Gamaleja’s Sputnik-V and 28 two doses of Sinopharm’s BBIBP-CorV. In addition, 40 received a prime dose of AstraZeneca followed by BioNTech as a booster, whereas 43 received Moderna’s vaccine as a booster after a prime dose of AstraZeneca. After collecting reactogenicity data, the expression of S-Protein binding IgG and IgA were analyzed before and after full vaccination in each group using an automated sandwich ELISA system. In addition, the neutralizing capacity of sera from individuals from all groups was investigated using an ACE-2-RBD neutralizing assay. RESULTSThe main side effects reported included short-term mild-to-moderate pain at the injection site, fatigue, and headache. More severe side effects were reported by vaccinees in the Moderna (10%), AstraZeneca (11%), Johnson and Johnson (5.9%), and Sputnik-V (7.2%) groups. No severe adverse reaction was reported in the BioNTech group, and the Sinopharm vaccinees presented the mildest reactogenicity profile, with 93.8% of the vaccinees declaring no adverse reactions. Moderna’s vaccine induced the highest amounts of SARS-CoV-2 specific IgG, IgA, and serum neutralization activity compared to the other groups. In contrast, people vaccinated with Sinopharm and Johnson and Johnson’s vaccines have the lowest SARS-CoV-2-specific antibody titers. Vaccinees from the Johnson and Johnson group presented significant levels of SARS-CoV-2 specific IgA but not IgG compared to the controls before vaccination. In the Sinopharm group, neither IgG nor IgA expression was significant. In addition, sera from vaccinees of these two groups presented no significant neutralization potential compared to the unvaccinated controls. Significant negative correlations between age and SARS-CoV-2- specific IgG expression were observed in the Johnson and Johnson (r=-0.4414, p=0.009) and Sinopharm (r=-0.6108, p=0.0006) groups. Remarkably, younger vaccinees (18-60 years old) in both Sinopharm and Johnson and Johnson groups produced substantial SARS-CoV-2 specific antibody expression and exhibited significant neutralization potential. While the AstraZeneca vaccine alone induced moderate IgG and IgA expression, the combination with Moderna or BioNTech mRNA vaccines induced higher antibody levels than a double dose of AstraZeneca and similar IgG expression and neutralization potential compared to Moderna, or BioNTech used alone. CONCLUSIONThe results suggest that the Moderna vaccine is the most immunogenic after two doses. AstraZeneca and Sputnik-V presented moderate but significant antibody expression and virus neutralizing properties. Low antibody and neutralization potential was observed in the elderly vaccinated with Sinopharm or Johnson and Johnson vaccines. The data also suggest that heterologous vaccination strategies combining the AstraZeneca DNA vectored vaccines and mRNA vaccines Moderna or BioNTech booster induced more robust antibody and virus neutralization potential compared to their homologous counterparts.

The aim of this study was to asses the accuracy of 99mTc-sestamibi scintimammography in patients with suspected recurrent breast cancer in the breast or loco regional tissues. After routine analyses in twenty-eight women (clinical examination, ultrasound, X-ray mammography, and fine needle aspiration biopsy) they were examined by scintimammography. All patients with suspected recurrent cancer in the breast or loco regional tissues (19) undergone surgery and the final diagnosis was determined by histopathological examination. Another 9 patients were followed 6-24 months. The scintigraphic studies were correlated with radiological findings and/or with histopathology. There were 19 patients with recurrent tumours (15 with loco-regional recurrent and 4 in another breast). X-ray mammography identified 13 of these cancers. 99mTc-sestamibi scintimammography identified seventeen of recurrent breast cancers. In the seven out of nine patients without cancer, scintimammography were reported as having no changes consistent with cancer. X-ray mammography showed suspected cancer lesions in four out of nine patients without cancer. There were two false-positive scintimammograms and one false negative. Axillary lymph node recurrence occurred in four patients. All of them were positive on scintimammography. 99mTc-sestamibi scintimammography showed higher sensitivity, specificity and accuracy per patient than did X-ray mammography (90,9% vs. 63,6%, 71,4% vs. 57,1% and 83,3% vs. 61,1%, respectively). To identifying recurrent breast cancer disease is better to use scintimammography than X-ray mammography.