Gender differences in vaccine therapy: where are we in Covid-19 pandemic?

Vaccination is one of the greatest achievements of public health. Vaccination programs have contributed to the decline in mortality and morbidity of various infectious diseases. This review aims to investigate the impact of sex/gender on the vaccine acceptance, responses, and outcomes. The studies were identified by using PubMed, until 30th June 2020. The search was performed by using the following keywords: SARS-CoV-2, Covid-19, gender, sex, vaccine, adverse reaction. Clinical trials, retrospective and prospective studies were included. Studies written in languages other than English were excluded. Three authors (TC, EB and IA) reviewed all study abstracts. Studies were included if gender differences in response to vaccination trials were reported. All selected studies were qualitatively analyzed. Innate recognition and response to viruses, as well as, adaptive immune responses during viral infections, differ between females and males. Unfortunately, a majority of vaccine trials have focused on healthy people, with ages between 18 to 65 years, excluding the elderly, pregnant women, post-menopausal female and children. In conclusion, it is apparent that the design of vaccines and vaccine strategies should be sex-specific, to reduce adverse reactions in females and increase immunogenicity in males. It should be mandatory to examine sex-related variables in pre-clinical and clinical vaccine trials, such as their crucial role for successful prevention of pandemic Covid-19

Le malattie respiratorie nell'ottica di genere

Introduzione I. Ambrosino, E. Barbagelata Differenze di genere nello sviluppo embrionale, nell’anatomia, nella fisiologia e nella patologia dell’apparato respiratorio E. Barbagelata, I. Ambrosino Le principali malattie respiratorie in ottica di genere dall’epidemiologia alla diagnosi e alla terapia: asma T. Ciarambino, O. Para, I. Ronga Le principali malattie respiratorie in ottica di genere dall’epidemiologia alla diagnosi e alla terapia: broncopneumopatia cronica ostruttiva S. Mangiacapra Le principali malattie respiratorie in ottica di genere dall’epidemiologia alla diagnosi e alla terapia: polmoniti T.M. Attardo Le principali malattie respiratorie in ottica di genere dall’epidemiologia alla diagnosi e alla terapia: tromboembolia polmonare M. Porru, P. Pitto Le principali malattie respiratorie in ottica di genere dall’epidemiologia alla diagnosi e alla terapia: versamento pleurico C. Zaninetti, C. Tana Come una società scientifica può diffondere la cultura di genere? P. Gnerre, C. Politi, A. Fontanell

The ischemic preconditioning effect of adenosine in patients with ischemic heart disease

<p>Abstract</p> <p>Introduction</p> <p><it>In vivo </it>and <it>in vitro </it>evidence suggests that adenosine and its agonists play key roles in the process of ischemic preconditioning. The effects of low-dose adenosine infusion on ischemic preconditioning have not been thoroughly studied in humans.</p> <p>Aims</p> <p>We hypothesised that a low-dose adenosine infusion could reduce the ischemic burden evoked by physical exercise and improve the regional left ventricular (LV) systolic function.</p> <p>Materials and methods</p> <p>We studied nine severely symptomatic male patients with severe coronary artery disease. Myocardial ischemia was induced by exercise on two separate occasions and quantified by Tissue Doppler Echocardiography. Prior to the exercise test, intravenous low-dose adenosine or placebo was infused over ten minutes according to a randomized, double blind, cross-over protocol. The LV walls were defined as ischemic if a reduction, no increment, or an increment of < 15% in peak systolic velocity (PSV) was observed during maximal exercise compared to the baseline values observed prior to placebo-infusion. Otherwise, the LV walls were defined as non-ischemic.</p> <p>Results</p> <p>PSV increased from baseline to maximal exercise in non-ischemic walls both during placebo (<it>P </it>= 0.0001) and low-dose adenosine infusion (<it>P </it>= 0.0009). However, in the ischemic walls, PSV increased only during low-dose adenosine infusion <it>(P </it>= 0.001), while no changes in PSV occurred during placebo infusion (<it>P </it>= NS).</p> <p>Conclusion</p> <p>Low-dose adenosine infusion reduced the ischemic burden and improved LV regional systolic function in the ischemic walls of patients with exercise-induced myocardial ischemia, confirming that adenosine is a potential preconditioning agent in humans.</p

Randomized elimination and prolongation of ACE inhibitors and ARBs in coronavirus 2019 (REPLACE COVID) Trial Protocol

Severe acute respiratory syndrome coronavirus 2 (SARS- CoV- 2), the virus responsible for coronavirus disease 2019 (COVID- 19), is associated with high incidence of multiorgan dysfunction and death. Angiotensin- converting enzyme 2 (ACE2), which facilitates SARS- CoV- 2 host cell entry, may be impacted by angiotensin- converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), two commonly used antihypertensive classes. In a multicenter, international randomized controlled trial that began enrollment on March 31, 2020, participants are randomized to continuation vs withdrawal of their long- term outpatient ACEI or ARB upon hospitalization with COVID- 19. The primary outcome is a hierarchical global rank score incorporating time to death, duration of mechanical ventilation, duration of renal replacement or vasopressor therapy, and multiorgan dysfunction severity. Approval for the study has been obtained from the Institutional Review Board of each participating institution, and all participants will provide informed consent. A data safety monitoring board has been assembled to provide independent oversight of the project.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163400/2/jch14011_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163400/1/jch14011.pd

Baseline characteristics of patients in the reduction of events with darbepoetin alfa in heart failure trial (RED-HF)

&lt;p&gt;Aims: This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital admission for worsening heart failure, and improve other outcomes.&lt;/p&gt; &lt;p&gt;Methods and results: Key demographic, clinical, and laboratory findings, along with baseline treatment, are reported and compared with those of patients in other recent clinical trials in heart failure. Compared with other recent trials, RED-HF enrolled more elderly [mean age 70 (SD 11.4) years], female (41%), and black (9%) patients. RED-HF patients more often had diabetes (46%) and renal impairment (72% had an estimated glomerular filtration rate &#60;60 mL/min/1.73 m2). Patients in RED-HF had heart failure of longer duration [5.3 (5.4) years], worse NYHA class (35% II, 63% III, and 2% IV), and more signs of congestion. Mean EF was 30% (6.8%). RED-HF patients were well treated at randomization, and pharmacological therapy at baseline was broadly similar to that of other recent trials, taking account of study-specific inclusion/exclusion criteria. Median (interquartile range) haemoglobin at baseline was 112 (106–117) g/L.&lt;/p&gt; &lt;p&gt;Conclusion: The anaemic patients enrolled in RED-HF were older, moderately to markedly symptomatic, and had extensive co-morbidity.&lt;/p&gt

Valutazione di efficacia dell&#8217;Esperienza Immaginativa in pazienti con orticaria cronica spontanea : Dati preliminari

Le allergie multifattoriali sono sostenute anche da fattori psichici che condizionano il vissuto di malattia, i coping comportamentali, la ricaduta biologica. Nel lavoro vengono esposti i dati preliminari della valutazione quantitativa e qualitativa della psicoterapia breve con l\u2019Esperienza Immaginativa, in orticaria cronica idiopatica. RISULTATI: Il dato della correlazione fra ansia e depressione era atteso in quanto il fenomeno della comorbidit\ue0 fra le due aree sintomatologiche \ue8 notevole. Interessante \ue8 la riduzione della sintomatologia ansiosa e la conseguente normalizzazione. Da un punto di vista clinico va sottolineato il miglioramento in sonno, limitazioni e aspetto estetico certamente rilevanti per la qualit\ue0 della vita. Per quanto riguarda il Brief Cope non c\u2019\ue8 modifica negli stili di coping e si confermano in primo piano stili di coping orientati all\u2019azione (pianificare e affrontare operativamente) e a seguire quelli orientati alla gestione delle emozioni (es., accettazione). DISCUSSIONE: Alla luce dei risultati, il trattamento sembra risultare cost-effective per disturbi diffusi in pazienti ambulatoriali

Simulation Models for the Evaluation of Energy Consumptions of Electric Buses in Different Urban Traffic Scenarios

The paper presents a methodology to estimate the energy consumptions of a full electric bus in different traffic and operating conditions. Starting from driving cycles, evaluated through a simulation model developed in Aimsun, the Matlab/Simulink energy model of the bus calculates the main electrical and mechanical performance indicators such as the state of charge of the battery as well as power and torque provided by the electric motor. The methodology is applied to a real case study, that is an Italian town in the North of Italy, for which different traffic conditions and drivers' behaviors are analyzed