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Il processo di validazione clinica di un algoritmo computerizzato per il monitoraggio della TAO
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Prospective assessment of clinical endpoints of vka treatment in a primary care computer assisted management model.
No full textAntibody Responses after Influenza Vaccination in Elderly People: Useful Information from a 27-Year Study (from 1988– 1989 to 2014–2015)
No full textElderly people are more likely than younger people to get flu complications and respond suboptimally to influenza vaccination because of the presence of comorbidities and immunosenescence. In order to collect information about this issue, we evaluated data obtained in 27 winters of study, from 1988–1989 to 2014–2015, in frail elderly institutionalized people (≥60 years) vaccinated with commercially available seasonal trivalent inactivated influenza vaccines. The antibody response was examined comparing hemagglutination inhibition antibody titers in sera collected from 4461 volunteers before and 30 days after vaccination. Examining the results as crude mean responses, we evidenced the ability of influenza vaccines to induce significant increases in antibody titers against all the three vaccine antigens satisfying at least one of the three criteria of the Committee for Medical Products for Human Use (CHMP). Higher responses were found against A/H3N2 vaccine components and, examining different subgroups, in volunteers receiving 45 μg vaccine as compared with 30 μg and in female as compared with male subjects. Very elderly people (>75 years) gave better responses than younger elderly (≤75 years) at least against A/H1N1 strain and the last licensed potentiated vaccines (MF59-adjuvanted and intradermal) were more immunogenic than traditional vaccines (whole, subunit, and split)
Laboratory confirmed pandemic H1N1 influenza virus infections in hospitalization in Umbria, a region of central Italy (May-November 2009).
No full textPROSPECTIVE ASSESSMENT OF CLINICAL ENDPOINTS OF VKA TREATMENT IN A PRIMARY CARE COMPUTER ASSISTED MANAGEMENT MODEL
No full textSondaggio conoscitivo coproparassitologico in una zona andina della Cordillera Blanca, Peru'.
No full textAntibody response against unchanged influenza vaccine components in elderly people vaccinated in consecutive years
No full textBackground: Annual influenza vaccination is recommended for high risk groups because of the frequent mutations of influenza viruses and the rapid decline of vaccine induced antibody titers. Field studies demonstrated that annually repeated vaccination is efficacious in reducing morbidity and mortality. Serologic studies, however, showed divergent results on the induction of protective antibodies after annually repeated vaccination and a decline of immune antibody response was observed especially in the years when vaccine strains did not change.
To further address the effect of annual vaccination we studied the haemagglutination inhibiting (HI) antibody response of elderly institutionalized yearly vaccinated volunteers against vaccine antigens which for sequential years were not changed over 16 consecutive seasons, from 1998/99 to 2013/14.
Materials and Methods: The volunteers enrolled were elderly institutionalized people aged >60 years, annually vaccinated for influenza. HI titers were determined in serum samples taken before and 1 month after vaccination by a standard microtiter method. Differences in HI titers were analyzed by Student’s t-test for continuous statistics, and by chi-square test for qualitative statistics.
Results: HI antibody responses were studied in 6 cohorts of volunteers against vaccine antigens not changed in consecutive years. Responses against A/H1N1 antigens were examined in 16 subjects against A/New Caledonia/20/99 for 7 consecutive years (from 1998/99 to 2006/07), and in 36 subjects against A/California/7/09 for 4 years (from 2010/11 to 2013/14). Against A/H3N2 antigens 38 subjects were examined against A/Moscow/10/99 for 4 years (from 2000/01 to 2003/04). Responses for B antigens were studied in 51 subjects against B/Beijing/184/93 for 3 years (from 1998/99 to 2000/01), and in 41 subjects against B/Brisbane/60/08 for 3 years (from 2009/10 to 2011/12). The pre-vaccination HI antibody titers found after the first year of administration tended to be higher for A/H3N2 and B/Brisbane antigens and similar or slightly lower for the two A/H1N1 and for B/Beijing antigens. The vaccine-induced HI antibody response against the different antigens studied was substantially positive, comparing pre- and post-vaccination sera, the increases in HI antibody titers resulted in most instances statistically significant. The post-vaccination values observed in the sequential years were in general similar for B/Beijing, slightly lower for the two A/H1N1 antigens and higher for B/Brisbane and A/H3N2 strains. The requirements of the European Commission were satisfied more frequently in the early years of administration with the exception for the B antigens.
Conclusions: The results obtained confirm the complexity of antibody induction in sequential annual influenza vaccination. Although we cannot exclude other mechanisms, our data seem to support the possibility of an impairment of antibody response against unaltered influenza A/H1N1 antigens that have circulated for prolonged periods whereas the responses against the A/H3N2 and B vaccine strains, more frequently changed, tended to be similar or higher
Clinical characteristics of influenza A/H1N1, A/H3N2 and B infections in children during three consecutive winter seasons (2012-13, 2013-14 and 2014-15)
No full textBACKGROUND: Influenza in children ranges from subclinical to complicated disease, however few data are available regarding the possibility of differences in clinical manifestations following infection with different influenza viruses. We report the results of a retrospective study regarding clinical symptoms of laboratory-confirmed influenza A/H1N1, A/H3N2 or B infection in subjects aged less than 15 years in three consecutive winter seasons (2012-13, 2013-14 and 2014-15).
METHODS: Real-time reverse polymerase chain reaction was performed in throat/nasal swabs collected from children presenting influenza like illness to identify A and B influenza viruses and to subtype samples positive for influenza A. Demographic characteristics, underlying medical conditions, clinical symptoms and influenza vaccination were collected for each patient.
RESULTS: A total of 359 swabs was collected: 348 by pediatricians of the Italian Influenza Surveillance Network (InfluNet) and 11 by hospital staff. Influenza viruses were detected in 203 samples: 141 were influenza A (67 A/H1N1 and 74 A/H3N2) and 63 influenza B. One patient was positive for influenza A/H3N2 and B. The mean age of children was 4.2 ± 3.0 for A/H1N1, 5.7 ± 3.4 for A/H3N2, and 5.6 ± 2.5 for B. The mean age of the 10 children hospitalized with laboratory confirmed influenza (3.3± 3.0) was lower as compared with patients not requiring hospitalization (p<0.05) and frequently caused by A/H1N1viruses (6/10) The most common symptoms observed were fever (100%), rhinorrhea (94%), cough (92%), and sore throat (65%). Comparing the symptoms found in children positive for influenza A or B, the respiratory ones were similar, whereas headache and gastrointestinal symptoms were associated more frequently with influenza B infection (p<0.05). Comparing children infected with A/H1N1 or A/H3N2 viruses, rhinorrhea (p<0.01), headache (p<0.01) and sore throat were found to be more frequent in A/H3N2 infected children.
CONCLUSION: Although the number of observations was limited, our results seem to suggest a higher frequency of some symptoms in children infected with influenza B or A/H3N2 viruses. Influenza A/H1N1 infections were found to be more frequent among patients in the first five years of life
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