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Immunoglobulin A vasculitis is historically more commonly found in children after certain viral infections such as Epstein-Barr, varicella virus, and parvovirus B19. COVID-19 has not been formally established in literature as a trigger for immunoglobulin A vasculitis. However, a main pathogenetic mechanism of COVID-19 is vascular damage, which makes it likely that vasculitis associated with COVID-19 (ie, COVID-19–mediated immunoglobulin A vasculitis) could be biologically plausible, with serious implications, especially for adults. The purpose of this review is to assist emergency nurses in gaining knowledge on the pathophysiology, symptoms, and treatment of COVID-19–mediated immunoglobulin A vasculitis. A systematic search for case reports of COVID-19–associated immunoglobulin A vasculitis was conducted in the PubMed and Scopus electronic databases. The search terms used were COVID-19, coronavirus 2019, SARS COVID-19, and IgA vasculitis, case reports. The following were the inclusion criteria: publication dates between December 1, 2019, and December 1, 2021; full-text article, clinical case studies, and letters to the editor available electronically in English. The following were exclusion criteria: a summary of reports and newspaper publications. Only 13 clinical cases met the inclusion criteria. The median age of patients described in the case reports were 38.1 years. Of them, 3 children were less than 5 years old. Twelve patients were male. In 7 of 13 cases of immunoglobulin A vasculitis, renal involvement was found. The analysis of published clinical cases showed that COVID-19–associated immunoglobulin A vasculitis affected mostly adults and was characterized by a more severe course because of renal involvement. COVID-19 may be a possible trigger for immunoglobulin A–related disorders. More research is needed to better understand the relationship between immunoglobulin A vasculitis and COVID-19. [ABSTRACT FROM AUTHOR]

• Children with autism spectrum disorder (ASD) frequently have gastrointestinal symptoms. • The intestinal microbiota may be different in ASD patients compared to controls. • In ASD, a connection may exist between the gut microbiome, GI symptoms, and behavior. • The gut-brain axis may affect brain development and behaviors. There is an emerging body of evidence associating children having autism spectrum disorder (ASD) with gastrointestinal (GI) symptoms, such as abdominal pain, chronic diarrhea, constipation, vomiting, gastroesophageal reflux, intestinal infections, and increased intestinal permeability. Moreover, in many studies, large differences in the composition of intestinal microbiota and metabolic products between ASD patients and controls were reported. Deepening the role and the biology of the gut microbiome may be fundamental to elucidate the onset of GI symptoms in ASD individuals and their etiopathogenetic causes. The gut-brain axis may affect brain development and behaviors through the neuroendocrine, neuroimmune, and autonomic nervous systems. [ABSTRACT FROM AUTHOR]

• Residency near the former Semipalatinsk Nuclear Test Site could be considered as safe. • Living in industrial cities has a significant impact on the elemental composition of blood. • The content of trace elements in head hair is rather stable in the study sites. • Residents of industrial cities have elevated levels of blood Ba, Mn, Pb, V, and Zn. Eastern and North-Eastern regions of Kazakhstan are considered to be environmentally disadvantaged due to industrial pollution and activity of the former Semipalatinsk Nuclear Test Site. Ferrous metallurgy is represented by the world's largest ferroalloy plant located in Aksu. In addition to a ferroalloy plant, Aksu is the home for the largest thermal power plant in Kazakhstan. Biomonitoring of 31 hair and blood trace elements (Ag, Ba, Be, Bi, Cs, Co, Ce, Cr, Cu, Eu, Gd, Hf, In, La, Li, Mn, Mo, Nb, Nd, Pb, Sc, Sn, Tl, Th, U, V, W, Y, Yb, Zn, and Zr) in non-occupationally exposed population residing in polluted areas of East Kazakhstan and Pavlodar regions. Five case groups, residing in the vicinity to the former Semipalatinsk Nuclear Test Site (Akzhar, Borodulikha, and Karaul) or in proximity to industrial plants (Aksu and Ust-Kamenogorsk) have been assessed vs. controls from a rural settlement in Kurchum. In total, 204 hair and blood samples were analyzed by inductively coupled plasma mass spectrometry. The observed blood concentrations of trace elements were in agreement with earlier studies on residents of industrially polluted areas. Elevated levels of blood Ba, Mn, Pb, V, and Zn were detected in residents of Aksu and Ust-Kamenogorsk. The elemental composition of head hair was characterized by greater stability between the study sites. Residency near the former Semipalatinsk Test Site could be considered as safe, while the environmental status of industrial settlements appears to be rather adverse. [ABSTRACT FROM AUTHOR]

Abstract The present study investigates the rates of depression, anxiety, somatic distress, and fatigue in a rural population of Abayskiy, Borodulikha and Mayskiy districts exposed to radiation from Semipalatinsk Nuclear Test Site in comparison with the unexposed population of Kurchum district. The sample size included 901 people, of whom 656 were residents of radioecological contaminated areas, while 245 resided at ecologically safe territories and had no radiation exposure in the past. Both study groups had no significant differences concerning age, sex, level of education, smoking habit, and alcohol consumption. The prevalence of depression, anxiety, somatic distress and fatigue in the exposed group was found to be considerably higher than that in the unexposed. Results of logistic regression analysis showed considerable differences in associations between depression and anxiety, as wells as between depression and somatic distress in the exposed group. Besides, depression was significantly associated with general fatigue, reduced activity, physical fatigue, reduced motivation and mental fatigue in the unexposed group. There is a need to tailor public health interventions focused on the identification and management of individuals exhibiting mental distress, including the provision of adequate information about radiation-induced health effects, quality routine check-ups and psychological counseling. Highlights • The population of Kazakhstan was exposed to radiation due to nuclear weapon testing. • People who are exposed to radiation have higher mental distress rates. • Associations between depression, anxiety, somatic distress, and fatigue were found. • There is the need to apply public health program to combat mental distress. [ABSTRACT FROM AUTHOR]

Abstract In this study, we investigated the association between depression, anxiety and medication adherence in patients with arterial hypertension living in East Kazakhstan region. The sample size included 795 patients, of whom 403 patients were exposed to radiation at the Semipalatinsk Nuclear Test Site from 1949 to 1989, while 395 patients were unexposed to radiation due to their very remote residence from the Site at the same period. Both exposed and unexposed patients showed no significant differences concerning body mass index, smoking habit, the presence of hypercholesterolemia, and hypertension grade. Patients with arterial hypertension previously exposed to radiation had significantly higher rates of low medication adherence, subclinical and clinical depression, situational anxiety of moderate and severe grade, and personal anxiety of moderate grade. A logistic regression analysis allowed us to identify the presence of significant positive association between medication adherence and anxiety in exposed patients (OR = 4041 (95%CI:1709–9556) p = 0.001) and marginal association (OR = 2998 (95%CI:1008–8915) p = 0.048) between the same parameters in unexposed patients. It might prove to be useful to introduce psychological and medical counseling with an emphasis on strengthening of medication adherence and to inform the local population about radiation effects and dosimetry data. Highlights • The population of Kazakhstan was exposed to radiation due to nuclear weapon testing. • Association between radiation exposure and hypertension was established. • Radiation exposed patients with hypertension have higher mental distress rates. • Depression and anxiety are associated with lower medication adherence. [ABSTRACT FROM AUTHOR]