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
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Abstract 4135303: Acute Pericarditis Secondary to Secukinumab Therapy
Circulation, Volume 150, Issue Suppl_1, Page A4135303-A4135303, November 12, 2024. Background:Pericarditis is the most common pericardial disease worldwide and has a high recurrence rate of 15-30%. It is primarily idiopathic but can arise from infectious and non-infectious causes; drug related cases are rare. Secukinumab, a fully human anti-interleukin-17A monoclonal antibody used for treating psoriasis, has been identified through the FDA Adverse Event Reporting System as potentially inducing pericarditis, though literature is scant. We report a case of acute pericarditis related to secukinumab use.Case presentation:A 28-year-old male with history of psoriasis on secukinumab therapy presented with sharp, central chest pain, and progressive shortness of breath for 3 weeks. He was evaluated for similar chest pain 3 weeks prior; CT chest showed small pericardial effusion and he was managed with analgesics without improvement. This admission, he had tachycardia, and ECG showed sinus rhythm with diffuse ST elevation and PR depression (Figure 1A). Troponin I levels were normal and inflammatory markers were elevated. Transthoracic echocardiogram (TTE) revealed a large pericardial effusion without tamponade physiology (Figure 1B). CT chest confirmed large pericardial effusion, increased in size compared to CT done 3 weeks prior (Figure 2). He was diagnosed with pericarditis and started on ibuprofen and colchicine which improved his symptoms. Search for viral etiology including testing for COVID, influenza A and B, RSV, hepatitis and HIV were negative. Immunological workup for ANA and rheumatoid factor was negative. Thus, secukinumab was thought to be the likely culprit. Follow-up TTE in 3 months showed resolution of pericardial effusion.Conclusion:This case underscores the importance of considering medication-induced pericarditis in patients presenting with typical symptoms, especially when on treatment with drugs like secukinumab. Given the growing evidence from pharmacovigilance databases and the severe potential outcomes of untreated pericarditis, clinicians should maintain vigilance for such adverse effects. Further research is warranted to clarify the mechanisms by which secukinumab may contribute to pericardial inflammation in order to optimize management strategies in affected patients.
Abstract 4140656: Educational Attainment Level and Risk of Mortality and Cardiopulmonary Outcomes in High-Risk Cardiovascular Disease Patients: The INVESTED Trial
Circulation, Volume 150, Issue Suppl_1, Page A4140656-A4140656, November 12, 2024. Background:Social determinants, such as educational attainment level (EAL), are indicators of socioeconomic status and have been shown to be inversely related with adverse health outcomes. However, the association between EAL and risk of cardio-pulmonary events in heart failure (HF) and myocardial infarction (MI) survivors has not been extensively investigated.Methods:In the INVESTED trial, 5260 patients from the US and Canada with recent HF or MI hospitalization were randomized 1:1 to high-dose trivalent or standard-dose quadrivalent influenza vaccine from Sep 2016 to Jan 2019. We examined the association between EAL and risk of adverse clinical outcomes for each participant across all enrolling seasons using Cox models adjusted for treatment assignment and clinically relevant confounders and stratified by trial entry year. Participants were categorized by EAL (high school or less [HS], post-high school or trade [post-HS/T], and college or more [Col+]).Results:Of the 4,912 participants (mean age: 65.5 years, 28% females, 80% White, 39% with MI and 61% with HF hospitalization as qualifying event) with EAL information, 43% were in the HS group, 28% were in the post-HS/T group, and 29% were in the Col+ group. At baseline, those with higher EAL were more likely to be White or Asian, be married/with long-term partner, have higher left ventricular ejection fraction, have lower NYHA class, and less likely to have cardiovascular comorbidities and risk factors than those with lower EAL. During follow-up (median: 9 months [6-16]), 1,706 (35%) participants experienced the composite of all-cause death or cardiopulmonary hospitalization. Compared to HS, higher EAL was associated with a stepwise decrease in the risk of the composite outcome (post-HS/T: HR: 0.88 95%CI: [0.79-0.99]; Col+: HR: 0.71 95%CI: [0.63-0.81], overall p-value
Abstract 4147488: Effects of Influenza Vaccination Among Patients With Myocardial Ischemia and Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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
Knowledge of antibiotics and antibiotic resistance, antibiotic use and eHealth literacy among nursing students in Thailand: a cross-sectional study
Objectives
Antibiotic resistance poses a major global public health threat. However, research on this issue is limited, especially among nursing students. This study aims to examine knowledge of antibiotics and antibiotic resistance, antibiotic use, and eHealth literacy in Thailand.
Design
A cross-sectional study was conducted using an online self-administered questionnaire. The WHO Antibiotic Resistance: Multi-Country Public Awareness Survey and the eHealth Literacy Scale were used. Descriptive and multiple regression analyses were performed.
Setting
Thailand’s North, South, Central and Northeast between January and February 2024.
Participants
A total of 1180 nursing students aged 18 or older, from first to fourth year and fluent in Thai, were invited to participate.
Results
The participants were mostly female (89.8%), with an average age of 20.64±1.81 years. Over half of the respondents (67.7%) have used antibiotics, mistakenly believing that antibiotics could treat colds and influenza (70.3%), malaria (66.8%), measles (63.6%) and sore throats (60.9%). About 71.5% recognised the impact of antibiotic resistance on themselves and their families, but 93.1% incorrectly believed antibiotic resistance means the body resists antibiotics. Participants scored 35.92±4.21 out of 40 on eHealth literacy. In a multiple regression analysis, three factors predict knowledge of antibiotic resistance: knowledge of antibiotics (B=0.199, p
Sanità: Mulé, proposta di legge per lavorare sul microbioma
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This Medical News article discusses a recent study of H5N1 avian influenza transmission in dairy cows.
Primo ricovero da variante australiana dell'influenza. Atteso un aumento delle encefaliti
In virus può colpire anche il cervello. L’appello a vaccinarsi
Simit, “atteso aumento encefaliti con influenza australiana”
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Un 76enne con sintomi importanti per H3N2. “Non sarà una bella stagione”
A Genova primo ricovero da variante australiana dell'influenza
Un 76enne con sintomi importanti per H3N2. “Non sarà una bella stagione”
Do summaries of evidence enable informed decision-making about COVID-19 and influenza vaccination equitably across more and less disadvantaged groups? Study protocol for a multi-centre cluster randomised controlled trial of 'fact boxes in health and social care in Germany
Introduction
Evidence summaries on the benefits and harms of treatment options support informed decisions under controlled conditions. However, few studies have investigated how such formats support decision-making across different social groups. There is a risk that only disadvantaged people will be able to make informed health decisions—possibly increasing the health equity gap. It is also unclear whether they support decision-making in the field at all. The aim of our study is to assess whether evidence summaries based on the fact box format can help people from different social groups make informed decisions about COVID-19 and influenza vaccinations, and thus reduce inequity in health communication.
Methods and analysis
In a multi-centre, cluster-randomised, controlled trial, health educators from usual care and outreach work in Germany will be randomised in a 1:1 ratio to provide either usual health communication plus an evidence summary (‘fact box’) or usual health communication. Health educators provide a flyer about COVID-19 or influenza vaccination which contains a link to an online study either with (intervention) or without (control) fact box on the reverse side. Flyer and online study will be available in Arabic, German, Turkish and Russian language. The primary outcome is informed vaccination intention, based on vaccination knowledge, attitudes, intentions and behaviour. Secondary outcomes include risk perception, decisional conflict and shared decision-making. We will use linear mixed models to analyse the influence of both individual (eg, education status) and cluster level factors and account for the expected cluster variability in realising usual health communication or the intervention. The statistical analysis plan includes the selection of appropriate measures of effect size and power calculation, assuming a sample size of 800 patients.
Ethics and dissemination
The trial has been approved by the Ethics Committee of the University of Potsdam, Germany (application numbers: 34/2021 and 57/2022).
Results will be disseminated through peer-reviewed journals, conferences and to relevant stakeholders.
Protocol version
Version 6 (4 October 2024); Preprint available on Research Square: https://doi.org/10.21203/rs.3.rs-3401234/v3
Trial registration number
NCT06076421.
Un anziano su 5 è caduto nell'ultimo anno,il 6% più di una volta
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Virus simil influenzali, in un anno 5 milioni di bambini colpiti
Vaccinare contro influenza e bronchioliti. La Guida dei pediatri
Uno spot per non dimenticarsi del vaccino contro l'influenza
Da solo o con anti-Covid, sul sito ministero Salute e reti Rai