In January 2020, SARS-COV-2 infection spread worldwide and was declared “pandemic” by WHO. Because of the high contagiousness of the virus and devastating effects of the epidemic on public health, numerous efforts have been made to develop suitable vaccines to prevent the infection. Among the side effects developed by patients who undergone vaccination, there are common symptoms but also more serious reactions such as the thrombosis syndromes. This paper presents two cases of thrombosis temporally associated with live-vectored Covid vaccination similar to vaccine-induced thrombocytopenia (VITT) in patients with inherited thrombophilia (respectively, the deficiency of protein S and a Factor II mutation). The clinical manifestation caused by VITT is characterized by widespread thrombosis especially affecting intracranial venous sinus, which may cause massive bleeding and intracranial hemorrhage. Although this condition is widely described in literature, there is no evident correlation between this side effect and inherited condition of thrombophilia. The authors suggest that the presence of inherited thrombophilia should be better investigated and, if necessary, screened during the anamnestic data collection before the vaccine administration, leading the healthcare professional to choose the appropriate vaccine to the patient.
Introduction: In fatal accidents during scuba diving it is necessary to differentiate a death from primary drowning from a secondary drowning death primarily due to other etiopathogenetic factors. The inhalation of water can only be the end point of a series of events alone capable of causing the diver’s exitus. The aim of this study is demonstrate that even low-risk heart diseases in daily life become potentially fatal during scuba diving. Methods: In this case series we describe all cases of death in the course of diving that came to the observation of the [ BLINDED ] over a period of 20 years (2000-2020). Judicial autopsy was performed on all subjects with ancillary execution of histological and toxicological investigations. Results: The results of the medicolegal investigations carried out in the complex identified heart failure with acute myocardial infarction as the cause of death in four cases characterized by severe myocardiocoronarosclerosis, a primary drowning in a subject without previous pathological substrate in one case, and a terminal atrial fibrillation induced by acute dynamic heart failure due to functional overload of the right ventricle in one case Conclusion: Our study demonstrates that lethal events during diving are often related to the presence of unrecognized or subclinical cardiovascular diseases. Such deaths could be prevented and avoided if a greater regulatory sensitivity to the prevention and control of diving was encouraged, considering both the inherent risks of this activity and the possible unrecognized or underestimated pathologies.
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