In the era of novel coronavirus epidemics, vaccines against coronavirus disease 2019 (COVID-19) have been recognized as the most effective public health interventions to control the pandemic. An adverse event following immunization (AEFI) is defined as any untoward occurrence following immunization, and the majority of AEFIs are caused by protective immune responses stimulated by vaccines. Most of the reported AEFIs are not serious, and many are not immunologically mediated or even reproducible on re-exposure. However, uncommon severe allergic adverse reactions, such as anaphylaxis or other allergic reactions, can occur after vaccinations. Confirmed allergic reactions to vaccines may be caused by residual non-human protein, preservatives, or stabilizers in the vaccine formulation (also known as excipients). There are 2 main potential allergenic/immunogenic excipients in COVID-19 vaccines, polyethylene glycol (PEG) and polysorbate 80. PEG, also known as macrogol, is an ingredient in various laxatives and injectable formulations, such as depot steroids. Polysorbate 80 is present in various medical products, creams, ointments, lotions, and medication tablets. Contraindications to the administration of COVID-19 vaccines include a previous history of severe allergic reactions to the first dose of COVID-19 vaccine or proven hypersensitivity to a vaccine component, such as PEG or polysorbate 80. Anaphylaxis or other allergic reactions following immunization can cause fear and loss of confidence in the safety of vaccines among the public. A better understanding of these events is thought to help alleviate concerns about the current COVID-19 vaccines and provide reassurance to the general population by analyzing the exact incidence of anaphylaxis and potential risk factors. COVID-19 vaccine-associated anaphylaxis could be prevented and managed by risk stratification based on our local and global experience.

Multiwalled carbon nanotubes (MWCNTs) were covalently modified with imidazolium salt-based ionic liquids (ILs). Coupling of acid chloride-functionalized MWCNTs with commercially available (3-aminopropyl)imidazole, followed by the reaction with n-butyl bromide, afforded 1-butylimidazolium bromide salt-functionalized MWCNTs ( f -3a). The bromide anion of f- 3a could be exchanged with BF4 -, PF6 -, and NTf2 - (N,N-bis((trifluoromethyl)sulfonyl)amide) by metathesis and afforded functionalized MWCNTs, f -3b (BF4 -), f -3c (PF6 -), and f -3d (NTf2 -), bearing different counteranions. Raman, IR, NMR, TGA, and XPS analyses clearly confirmed covalent functionalization and imidazolium salt formation as well as anion exchange of the IL-functionalized MWCNTs. UV−vis data imply that counteranions have an effect on the relative solubility of the IL-functionalized MWCNTs in water:  the solubility of f -3 in water is of the order f -3a (Br-) > f -3b (BF4 -) > f -3c (PF6 -) > f -3d (NTf2 -), and the water-soluble f -3a was phase-transferred from the aqueous phase to the chloroform phase via simple anion exchange with NTf2 -. All of the IL-functionalized MWCNTs, including the water-soluble f -3a, exhibited a preferential solubility in an ionic liquid, [bmim][NTf2].

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Interruption of the inferior vena cava (IVC) with azygos continuation is an uncommon vascular anomaly that results from aberrant development during embryogenesis. We report a rare case of this anomaly, presenting with massive pulmonary embolism. Subsequent evaluation with abdominal CT scan revealed the congenital absence of retrohepatic IVC. The patient was successfully treated with anticoagulation. When deep venous thrombosis (DVT) develops in patients with no apparent risk factors, the presence of congenital IVC anomalies should be considered.

SUMMARYPurpose Patterns of prescriptions are markedly influenced by regional disease entities, medical education, culture, economic status, and available pharmaceutical companies. Features of adverse drug reactions (ADRs) may vary in different countries. In this study, we analyzed the causative drugs and clinical manifestations of spontaneously reported ADRs in Korea. Methods Six Korean Regional Pharmacovigilance Centers collected 1418 cases of spontaneously reported adverse drug events (ADEs) by doctors, pharmacists, and nurses, and the clinical features and causative drugs were evaluated. The data were collected from general hospitals (76.5%), primary clinics, and pharmacies (23.5%). Results Based upon the World Health Organization (WHO)-Uppsala Monitoring Center criteria (certain-13.7%, probable-46.1%, possible-32.1%), 91.9% of the collected events were suspected to be ADRs and 15.8% of patients experienced serious ADRs. The most prevalent causative drugs were antibiotics (31.6%), followed by contrast dyes (14.0%), non-steroidal anti-inflammatory drugs (NSAIDs) (11.1%), anti-psychotics (5.4%), anti-convulsants (5.2%), cardiovascular agents (4.8%), anti-neoplastics (4.6%), and opiates and non-opiate pain killers (3.5%). Among the antibiotics, cephalosporins (8.1%) were the most common, followed by anti-tuberculosis agents (5.7%), quinolones (4.0%), vancomycin (3.1%), and penicillin (2.8%). The most common side effect was skin manifestations, which were seen in 42% of the patients, followed by neurologic manifestations (14%), gastrointestinal involvements (12.9%), generalized reactions (9.4%), and respiratory involvements (4.5%). Conclusion Antibiotics, contrast dyes, and NSAIDs were the most common causative drugs for ADRs, which reflects the prescription pattern and the prevalence of diseases in Korea. These data may be useful in establishing a Korean pharmacovigilance system.

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Aspirin may regulate IL4 expression in an allele-specific manner by altering the availability of transcription factors to the key regulatory elements in the IL4 promoter, leading to aspirin hypersensitivity.