Search Results for: La composizione del microbioma influenza la depressione

Introduction
Protecting non-native ethnic minority groups against cocirculation of influenza and COVID-19 is crucial, and vaccination could be a viable option. Smartphone-based chatbots offer promising opportunities for improving vaccine knowledge and addressing barriers encountered by ethnic minorities. This trial aims to evaluate the effects of smartphone-based chatbot intervention on influenza and COVID-19 vaccine uptake, intention to receive vaccination and vaccine hesitancy among South Asian ethnic minorities in Hong Kong.

Method and analysis
An assessor-blinded, cluster-randomised, waitlist-controlled trial will be conducted. This study consists of two phases. In phase I, a smartphone-based chatbot intervention will be developed, including designing a simple chatbot called ‘Ali’ to deliver prewritten educational text messages and vaccination reminders as well as respond to users’ questions, and on-demand option for communication with research assistants. An expert panel will be invited to review the designed chatbot, and pilot testing will be performed. In phase II, a total of 612 South Asians will be recruited from each of the six participating non-governmental community centres or ethnic minority associations. They will be randomly allocated to intervention (n=306) or waitlist control group (n=306). The intervention group will receive in-app notifications related to the education text messages and vaccination reminders via the smartphone-based chatbot twice a week for two weeks. The waitlist control group will receive usual care only. Evaluation will include vaccination uptake, intention to receive vaccination and vaccine hesitancy. Assessments will take place at baseline (T0), immediately postintervention (T1) and 3-month postintervention (T2).

Ethics and dissemination
This study has been approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CREC Ref. No.: 2021.688). The findings will be disseminated in peer-reviewed journals and through local or interventional conference presentations.

Trial registration number
ChiCTR2200061503.

Iss, in lieve aumento ma sotto i livelli della passata stagione

Un decalogo della Sip per benessere dell’asse intestino-cervello

Un decalogo della Sip per benessere dell’asse intestino-cervello

This Viewpoint discusses H5 influenza vaccine use in light of the current outbreak and how vaccine development, stockpiling, and deployment could shape the US’ response to future pandemics.

Introduction
Annual influenza vaccination reduces disease burden but vaccination rates are suboptimal, with persistent disparities among subpopulations. The purpose of this trial is to evaluate multicomponent behavioural economic nudge interventions to clinicians and patients to increase influenza vaccination. This trial also includes an intensification nudge to reduce disparities in vaccination among older adult, primary care patients.

Methods
This is a two-part, multisite cluster randomised, pragmatic clinical trial. In the first part, a multicomponent nudge intervention will be tested over approximately 6 months (September 2023–February 2024). The second part consists of a replication trial conducted at an additional site during the following influenza season (September 2024–February 2025). Primary care clinics will be randomised to the nudge intervention or usual care. Eligible clinicians and patients at intervention clinics will receive the intervention, and patients deemed high risk for not receiving a vaccine will be further randomised to receive an intensification nudge. The primary outcome is vaccine completion during the eligible visit and the secondary outcome is vaccine completion within 3 months of the eligible visit.

Analysis
The effect of the clinic-level nudge intervention on the primary and secondary outcomes will be evaluated using generalised estimating equations (GEEs) with a clinic-level exchangeable working correlation to account for clustering of observations within the clinic. GEE models with an independent working correlation will be used to evaluate the impact of the additional intensification nudge on the primary and secondary outcomes.

Ethics and dissemination
The University of Pennsylvania Institutional Review Board (IRB) approved this trial and serves as the single IRB of record (IRB #851838). Results will be disseminated via peer-reviewed publication and conference presentations.

Trial registration number
NCT06057727.

Tra il 4 e il 10 novembre 373mila casi

This randomized trial showed no difference in local or systemic side effects in patients receiving their vaccines on either schedule.

The US Food and Drug Administration (FDA) recently approved the nasal spray influenza vaccine FluMist for at-home administration beginning in 2025, making it the first flu vaccine that won’t need to be administered by a clinician.

Circulation, Volume 150, Issue Suppl_1, Page A4142796-A4142796, November 12, 2024. Background:Peripartum cardiomyopathy (PPCM) is defined as a dilated form of cardiomyopathy that occurs within the last month of pregnancy and up to 5 months postpartum. Previous studies have shown that PPCM more often occurs in the Southern United States compared to other geographic locations. Although the etiology of PPCM is likely multifactorial, viral infections may account for up to a third of those cases. We aimed to examine the association of PPCM to active influenza infection in the Southern United States.Methods:National Inpatient Sample 2016-2021 was queried to identify women admitted with PPCM with (group A) and without (group B) concurrent influenza infection in the Southern United States.Results:A total of 13540 women were admitted with PPCM, of whom 3511 (35%) had concurrent influenza infection. Group A PPCM followed a seasonal pattern with peak incidence in winter (62%) followed by spring (25%), fall (13%) and summer (0) [p

Circulation, Volume 150, Issue Suppl_1, Page A4123849-A4123849, November 12, 2024. Background:Older adults and adults with comorbidities are at increased risk for severe respiratory syncytial virus (RSV) disease and related complications.Aims:To estimate the risk of myocardial infarction (MI) and all−cause mortality among adults aged ≥50 years hospitalized with RSV compared to those with no recent acute respiratory illness (ARI) and those hospitalized with influenza.Methods:Data from Optum’s de−identified Clinformatics® Data Mart Database were analyzed (October 2015–June 2023) in this retrospective cohort study. Adults aged ≥50 years with ≥12 months of continuous enrollment were assigned to cohorts based on RSV or influenza hospitalization (from ICD−10 codes; RSV and flu cohorts) or no recent ARI (control cohort). Index dates for RSV and flu cohorts were the start of an ARI that included hospitalization. Baseline characteristics were measured in the 12 months pre−index. MI (from ICD−10 codes) and all−cause mortality were measured during follow−up and compared between cohorts using time−varying coefficient multivariable adjusted Cox models (MI results accounted for the competing risk of death).Results:In the RSV cohort (n=14,759), mean age (76.5 years) and mean Charlson comorbidity index (CCI; 3.3) were higher than the flu (n=77,468; 75.4 years, CCI=2.9) and control (n=73,795; 69.5 years, CCI=1.0) cohorts. Adjusted HRs (95% CI) for MI and all−cause mortality risk were significantly higher in the RSV vs control cohort across follow−up, ranging from 30.96 (26.22–36.54) within 30 days post−index to 2.26 (2.04–2.51) >365 days post−index for MI and 10.77 (9.19–12.63) within 30 days post−index to 2.29 (2.18–2.42) >365 days post−index for mortality. Compared to the flu cohort, adjusted MI and mortality risk in the RSV cohort were lower during the 30 days post−index (MI: 0.87 [0.82–0.92]; mortality: 0.84 [0.78–0.90]) but higher >365 days post−index (MI: 1.11 [1.01–1.22]; mortality: 1.05 [1.01–1.10]).Conclusion:MI and all−cause mortality risk were higher for hospitalized RSV cases compared to controls. Smaller differences in outcomes were observed when comparing hospitalized RSV cases with hospitalized influenza cases, with varying direction over time. With existing evidence of increased MI and mortality risk after influenza and these findings on MI and mortality risk after RSV, future research should aim to further understand the impact of RSV on cardiovascular outcomes and assess the role of RSV prevention in lowering the risk of MI and mortality.

Circulation, Volume 150, Issue Suppl_1, Page A4133460-A4133460, November 12, 2024. Background and hypothesis:Influenza is a significant public health and economic threat around the world. Although pneumonia is the most common complication associated with influenza, there are several clinical reports demonstrating increased risk for cardiovascular disease. Influenza infection induces interferons, proinflammatory cytokines and chemokines, and recruits’ macrophages and neutrophils to control the virus. However, an excessive influx of innate immune cells and dysregulated production of inflammatory mediators results in pathological responses during influenza infection. Studies have shown that influenza infection correlates with increased incidence of myocardial infarction. Atherosclerosis is the most known cause of ischemic heart diseases and stroke. Vascular cell adhesion molecule-1 (VCAM1) has been shown to promote adhesion of monocytes and promotes atherosclerosis. In this study, we hypothesize that VCAM1 plays a role in exacerbation of atherosclerosis during influenza infection.Methods:High-Fat diet (HFD)-fed Apoe-/-mice were infected with influenza A/PR/8/34 (H1N1) and weight loss, survival rate, and gene expression of vascular endothelial adhesion molecules, inflammatory cytokines and chemokines were measured. HFD-fed Apoe-/-mice were infected with influenza, and treated with anti-VCAM1 antibody, and weight loss and cellular responses were measured.Results and conclusions:Increased weight loss and decreased survival of mice were observed in response to influenza infection in HFD-induced atherosclerosis in Apoe-/-mice. Further, the expression of VCAM1, and the levels of IL-6, CCL2, CCL3, CCL5 were significantly increased in aorta in Apoe-/-mice when compared to PBS-treated controls. Increased survival, decreased weight loss, decreased lesion area, decreased frequency of CD11b+F4/80+Ly6C+, CD4+RORgt+cells and increased frequency of CD4+FoxP3+Treg cells were observed in aorta in response to antibody mediated VCAM1 neutralization. These results suggest that VCAM1 plays a pathological role in influenza-induced exacerbation of atherosclerosis.

Circulation, Volume 150, Issue Suppl_1, Page A4144440-A4144440, November 12, 2024. Background:More than 20% of Americans do not regularly receive cholesterol screening and flu shots, the two important preventive services for cardiorespiratory self-care. Uncontrolled dyslipidemia leads to cardiovascular diseases (CVD), the leading cause of death and disability among American workers, while influenza contributes to health-related workplace absenteeism. Despite the loss of productivity in workers due to cardiorespiratory illness, only a few studies examined occupational disparities in cardiorespiratory preventive care services. This study aimed to examine the association between occupational characteristics and the utilization of cholesterol screening and flu shots.Methods:The Health and Retirement Study (HRS) is a longitudinal survey of middle-aged and older adults in the U.S. This study focused on 3,222 participants in the HRS from 2004 to 2018, representing the past and current working population. Respondents who did not report cholesterol screening, influenza vaccination, or job information, passed away by 2019, never worked for pay, or had CVD/stroke were excluded from the analysis. Occupation was coded based on the U.S. Census 2000 and configured into five groups: (1) management/science, (2) social services, (3) general services, (4) health services, and (5) industrial workers. Job characteristics, including psychological and physical strains at work, ergonomic risk, lifting of heavy loads, and job stability, were based on self-reported questions. The multivariable logistic and ordered logistic regression models were used for analysis.Results:Compared to the management/science workers, industrial and general services workers were less likely to have optimal cholesterol screening and influenza vaccination. For cholesterol screening behaviors, frequent heavy lifting at work (p=0.010), lower job mental strain (p=0.004), and lower job stability (p=0.025) were associated with a lower likelihood of optimal cholesterol screening, after the adjustment for demographic and health covariates. For flu-shot intake, higher job physical strain (p

Circulation, Volume 150, Issue Suppl_1, Page A4144754-A4144754, November 12, 2024. Background:Pneumococcal and influenza vaccination have shown cardioprotective effects by reducing adverse cardiovascular events among high-risk patients. However, the effectiveness of combined pneumococcal and influenza vaccinations compared to influenza vaccination alone in patients with coronary artery disease (CAD) has not been thoroughly established to date.Objective:This study aims to investigate the cardiovascular events in patients with CAD following combined pneumococcal and influenza vaccination compared to influenza vaccination alone.Method:The TriNeTX US Collaborative Network research database was used to identify patients aged ≥18 years of age from January 2005 to April 2021. Patients were divided into two groups, one with pneumococcal and influenza vaccination and a control group with influenza vaccination only. Patients were followed for one year. Propensity score-matched analysis (1:1, Figure 1) was conducted based on age, sex, race, body mass index, hypertension, diabetes mellitus, and chronic kidney disease. The main outcome was major adverse cardiovascular events (MACE), defined as a composite of all-cause mortality, myocardial infarction, heart failure and ischemic stroke. Secondary outcomes included all-cause mortality, acute myocardial infarction, heart failure and ischemic stroke.Results:After propensity score matching, the study cohort comprised 132,646 patients in the pneumococcal and influenza vaccination group and 132,646 patients in the influenza alone group. The mean age of patients was 79.2 years. Patients who received pneumococcal and influenza vaccinations had a significantly lower risk of MACE (RR, 0.925 (95%CI: 0.896-0.955),P

Circulation, Volume 150, Issue Suppl_1, Page A4142363-A4142363, November 12, 2024. Background:Increased risk of thrombotic outcomes has been observed during respiratory infections. This phenomenon likely involves platelet-leukocyte crosstalk via pattern recognition receptors (PRRs), including Toll-like receptors (TLR), Retinoic acid-inducible gene I-like receptors (RLR) and cGAS.Purpose:We studied correlations between PRRs and select pro-thrombotic/procoagulant transcripts (ITGA2B, GP1BA, GP9, GP5, GP6, PF4, PF4V1, F13A1, SELP, SERPING1) in platelets and leukocytes of COVID19 (α-δ variants) patients; and determined if those correlations were present in blood from patients with 3 respiratory infections (COVID19, Influenza, Tuberculosis-TB).Methods:RNA sequencing data of platelets and leukocytes isolated from COVID19 patients (n=10) and non-infected controls (n=15) was generated using AmpliSeq. Whole blood RNAseq was obtained from public databases for COVID19 (GSE217948), influenza (GSE161731), and TB patients (0m-peak infection, GSE181143). Transcripts with significantly greater mean expression in infected patients versus the respective control were assessed for positive correlations with PRRs using Spearman’s correlation coefficients. Data was analyzed in R.Results:Platelets and leukocytes showed distinct patterns of the top five highest expressed PRRs, based on BaseMean (Platelets: TLR9 >DDX58 >IFIH1 >CGAS >TLR4, Leukocytes: TLR4 >IFIH1 >DDX58 >TLR8 >TLR2). PRR that were significantly increased in COVID19 platelets versus controls were DDX58 (p=0.017) and IFIH1 (p=0.005); in leukocytes only IFIH1 (p=0.015) showed significant difference. The only overlapping correlation between a PRR and transcript in the two cell populations was TLR1 with F13A1 (platelets, R=0.56, p=0.04; leukocytes, R=0.56, p=0.02). In COVID19 platelets, TLR9 correlated with GP1Ba (R=0.62, p=0.002); DDX58 correlated with GP9 and PF4; and IFIH1 correlated with GP9 and GP6. In COVID19 leukocytes, IFIH1 and DDX58 correlated with SERPING1. In whole blood RNAseq analysis of all 3 infections, only DDX58 and TLR1 uniformly associated with PF4 and F13A1, respectively. Surprisingly, correlations between PRRs and the listed transcripts overlapped predominantly between COVID19 and acute TB, but not with influenza.Conclusion:Platelets and leukocytes show distinct patterns of PRR expression and correlations with pro-thrombotic/procoagulant transcripts. Whole blood correlations between PRRs and thrombotic transcripts in COVID19 infection demonstrate more overlap with TB than influenza.

Circulation, Volume 150, Issue Suppl_1, Page A4147488-A4147488, November 12, 2024. Background:Previous studies have shown that influenza vaccination (IV) may reduce the incidence of cardiovascular events in patients with cardiovascular disease. In this meta-analysis, we aimed to clarify the effects of IV in patients with myocardial ischemia (MI) and heart failure (HF).Hypothesis:The influenza vaccine reduces the incidence of major adverse cardiovascular events among patients with MI and HF.Methods:A comprehensive search was performed in PubMed, Cochrane Library, and Embase databases from inception up to march 2024. We included randomized clinical trials (RCTs) that assessed the effects of IV in patients with HF and MI, and reported outcomes of major adverse cardiovascular events (MACE), cardiovascular death, and all-cause death. Analyses were conducted using R software. Heterogeneity was assessed using the I2 statistic. A random-effects model was applied to calculate pooled Relative Risk (RR). A stratified analysis was performed to investigate ST-segment elevation myocardial infarction (STEMI) and non-STEMI subgroups. Sensitivity analysis was performed to explore heterogeneity. Confidence Interval (CI) was set at 95%.Results:We identified six RCTs comprising a total population of 9229 participants. Of these, 4100 were patients with MI, and 5129 were HF patients. Overall, MACE (RR 0.65; 95%CI 0.47-0.89; p=0.007; I2=75%) (Figure 1A) and cardiovascular death (RR 0.60; 95%CI 0.37-0.96; p=0.035; I2=62%) (Figure 1B) were significantly lower in group receiving IV compared to placebo/no treatment. No statistically significant difference was observed for all-cause death. In sensitivity analysis, after excluding HF patients, IV significantly decreased the risk of MACE (RR 0.57; 95%CI 0.43-0.76; p