Risultati per: La composizione del microbioma influenza la depressione

La previsione dei medici di famiglia è che l’influenza potrebbe diventare prevalente già fra un paio di settimane. Sul Covid si viaggia al buio senza tracciamento

Tre quarti dell’obiettivo, ma c’è ancora del tempo

Pregliasco, fondamentale immunizzarsi e scelta vaccino adatto

This study provides survey results from state and territorial public health preparedness directors regarding antiviral shortages during the 2022-2023 respiratory viral season.

Presidente SID: “Non aspettare a vaccinarsi”

Circulation, Volume 148, Issue Suppl_1, Page A14631-A14631, November 6, 2023. Introduction:Biventricular thrombi (BT) are a rare occurrence in clinical practice and when they occur in alcoholic dilated cardiomyopathy (ADCM), they are a complication of this condition. Secondary predisposing conditions that can promote thrombus formation include infections like Influenza B. Herein, we report a rare case of ADCM and influenza B propagating the development of biventricular thrombi and pulmonary embolism.Case Presentation:A 47-year-old healthy gentleman with a history of tobacco, marujuana and alcohol abuse presented with shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, non-productive cough, fevers and bilateral lower extremity swelling. Initial vitals were significant for tachycardia and slightly elevated blood pressure. On examination, the patient had decreased breath sounds in the right lower lobe with rales and trace lower extremity edema. Initial labs revealed elevated BNP, High-sensitivity troponin and d-dimer. Rapid influenza B was positive. Chest x-ray showed pleural effusion and CT angiogram chest revealed filling defect in the segmental and subsegmental branches of the right pulmonary artery. Echocardiogram revealed biventricular thrombi and LVEF of 10-15% with global LV hypokinesis. He was treated with oseltamivir, enoxaparin and was started on guideline directed medical therapy.Discussion:BT formation can occur in heart failure with reduced ejection fraction. ADCM induces LV dilation which creates a stagnant environment conducive to thrombus development. Influenza B can cause a prothrombotic state due to endovascular injury by proinflammatory mediators. Due to advanced diagnostic techniques, the incidence of BT has increased however, they remain a significant challenge due to embolization risks. This is the first case that highlights that patients with ADCM in combination with influenza B are predisposed to hypercoagulable states inducing fatal BT formation thus, prompt recognition is vital.

Circulation, Volume 148, Issue Suppl_1, Page A18007-A18007, November 6, 2023. Introduction and Hypothesis:Influenza infection 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. In influenza infection type I, type II and type III IFNs play an indispensable role in controlling the virus. In atherosclerosis, type I and type II IFNs promote atherosclerosis by inducing chemokines from macrophages and vascular endothelial cells. Studies have shown that the influenza infection exacerbates atherosclerosis. However, there are no studies determining the role of type III IFNs on influenza-induced exacerbation of atherosclerosis. In this study, we hypothesize that the type III IFN (IFNL3) may play a protective role in atherosclerosis.Methods:ApoE-/-mice were fed with a high-fat diet (HFD) containing 42% Kcal fat (Teklad) for 11 weeks. Mice were then infected with influenza A/PR/8/34 (H1N1) (100 pfu) and treated with recombinant IFNL3 by oropharyngeal (O/P) aspiration or intraperitoneal (I/P) injection, and weight loss, and gene expression of inflammatory cytokines and chemokines were measured. In another study, HFD-fed ApoE-/-and ApoE-/-IFNLR1-/-mice were infected with influenza, and the disease outcomes were measured as described above.Results and Conclusions:IFNL3 treatment decreased influenza-induced weight loss in ApoE-/-mice during the early phase (4-6 days) of influenza infection. Further, IFNL3 treatment decreased gene expression levels of IL-6 and CCL2 in the aorta in influenza-infected ApoE-/-mice. Based on these findings, it seems likely that INFL3 plays a protective role in acute influenza-induced exacerbation of atherosclerosis. However, ApoE-/-IFNLR1-/-mice recovered body weight faster than wild-type mice suggesting a detrimental role for IFNL after acute infection. These data show that IFNLR plays a protective role during the early phase of influenza infection and potentially a pathological role during the recovery phase of influenza infection.

Circulation, Volume 148, Issue Suppl_1, Page A19059-A19059, November 6, 2023. Background:Influenza vaccines are recommended for patients with CVD due to their protective effects and favorable safety profile. Patients with recent MI/HF hospitalization are at high risk of multiple events, but it is not known which flu vaccine type can mitigate recurrent events.Research Questions:What are predictors of recurrent cardiopulmonary hospitalization and death in patients with CVD and does the high-dose trivalent flu vaccine reduce the rate of recurrent events compared with standard-dose quadrivalent vaccine?Methods:In this pragmatic, active comparator trial, patients with recent MI/HF hospitalization across 157 sites were randomized to either vaccine type and revaccinated each enrolled season (2016-2019). Recurrent event analysis with a Markov multistate model, negative binomial, and Lin-Wei-Yang-Ying regression models was applied, adjusting for clinical and sociodemographic factors, flu infection and vaccine history, with vaccine type as the main exposure. Cardiopulmonary hospitalization and all-cause death comprised the multistate model’s main states and the composite primary outcome for remaining analyses.Results:Among 5260 patients (mean age 65.5 years; 28% women; 63% with recent HF), 12% were readmitted ≥1 for cardiopulmonary causes, accounting for half of total cardiopulmonary hospitalization. In the multistate model, a history of comorbidities (e.g., low LVEF and COPD) was associated with recurrent hospitalization (Figure), whereas age and frailty primarily determined a higher rate of death, particularly after a first hospitalization. There were no significant differences between the vaccines on the rate of recurrent events and death in the multistate and negative binomial regression models.Conclusions:As hospitalizations accrue, the association of certain predictors changes in this population. Alternative strategies beyond vaccine type are needed to mitigate the total burden of cardiopulmonary disease.

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Studio confronta risposte a pazienti con operato di 1200 medici

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