cardiovascular-agents and Influenza--Human

Topics: Adult; Cardiovascular Agents; Combined Modality Therapy; Continuous Positive Airway Pressure; Electrocardiography; Extracorporeal Membrane Oxygenation; Female; Heart Failure; Hemodynamics; Humans; Influenza B virus; Influenza, Human; Pacemaker, Artificial; Shock, Cardiogenic; Signal Processing, Computer-Assisted

US and European guidelines diverge on whether to vaccinate adults who are not at high risk for cardiovascular events against influenza. Here, we investigated the associations between influenza vaccination and risk for acute myocardial infarction, stroke and pulmonary embolism during the 2009 pandemic in Norway, when vaccination was recommended to all adults.. Using national registers, we studied all vaccinated Norwegian individuals who suffered AMI, stroke, or pulmonary embolism from May 1, 2009 through September 30, 2010. We defined higher-risk individuals as those using anti-diabetic, anti-obesity, anti-thrombotic, pulmonary or cardiovascular medications (i.e. individuals to whom vaccination was routinely recommended); all other individuals were regarded as having lower-risk. We estimated incidence rate ratios with 95% CI using conditional Poisson regression in the pre-defined risk periods up to 180 days following vaccination compared to an unexposed time-period, with adjustment for season or daily temperature.. Overall, we observed lower risk for cardiovascular events following influenza vaccination. When stratified by baseline risk, we observed lower risk across all three outcomes in association with vaccination among higher-risk individuals. In this subgroup, relative risks were 0.72 (0.59-0.88) for AMI, 0.77 (0.59-0.99) for stroke, and 0.73 (0.45-1.19) for pulmonary embolism in the period 1-14 days following vaccination when compared to the background period. These associations remained essentially the same up to 180 days after vaccination. In contrast, the corresponding relative risks among subjects not using medications were 4.19 (2.69-6.52), 1.73 (0.91-3.31) and 2.35 (0.78-7.06).. In this nationwide study, influenza vaccination was associated with overall cardiovascular benefit. This benefit was concentrated among those at higher cardiovascular risk as defined by medication use. In contrast, our results demonstrate no comparable inverse association with thrombosis-related cardiovascular events following vaccination among those free of cardiovascular medications at baseline. These results may inform the risk-benefit balance for universal influenza vaccination.

Topics: Aged; Aged, 80 and over; Cardiovascular Agents; Cardiovascular Diseases; Female; Heart Disease Risk Factors; Humans; Incidence; Influenza Vaccines; Influenza, Human; Male; Mass Vaccination; Middle Aged; Myocardial Infarction; Norway; Prognosis; Pulmonary Embolism; Registries; Risk Assessment; Stroke; Time Factors

We present three cases of pediatric patients with thrombocytopenia-associated multiple organ failure and the evidence for providing extracorporeal organ support. All three patients had severe cardiac dysfunction, respiratory failure, and acute kidney injury treated with venoarterial extracorporeal membrane oxygenation, continuous renal replacement therapy, and plasma exchange. Despite the presence of multiple organ failure and high risk of mortality, all three patients survived with minimal long-term sequelae.

Topics: ADAM Proteins; ADAMTS13 Protein; Adolescent; Bacteremia; Cardiopulmonary Resuscitation; Cardiovascular Agents; Child; Combined Modality Therapy; Extracorporeal Membrane Oxygenation; Fluid Therapy; Heart Arrest; Hemofiltration; Hemolytic-Uremic Syndrome; High-Frequency Ventilation; Humans; Infarction, Middle Cerebral Artery; Influenza A virus; Influenza, Human; Male; Methicillin-Resistant Staphylococcus aureus; Multiple Organ Failure; Osteomyelitis; Plasma Exchange; Staphylococcal Infections; Thrombotic Microangiopathies; Tracheostomy

Cardiomyopathy refers to nonspecific myocardial dysfunction that may be due to a variety of causes. Viral illnesses have long been known to cause cardiomyopathy, and the list of viral causes is extensive. Influenza infection is a rare cause of myocarditis. Recent reports, however, indicate that influenza A (H1N1) can cause acute myocarditis and cardiomyopathy in adults and fulminant myocarditis in children as seen during the 2009 global outbreak of the H1N1 influenza virus. The following presents a case series of adult patients with acute reversible cardiomyopathy associated with influenza A (H1N1) infection (see Table 1 for patient characteristics).

Topics: Acute Disease; Aged; Antiviral Agents; Cardiomyopathies; Cardiovascular Agents; Female; Humans; Influenza A Virus, H1N1 Subtype; Influenza, Human; Male; Middle Aged; Myocarditis; Recovery of Function; Treatment Outcome; Ultrasonography; Ventricular Dysfunction, Left; Ventricular Function, Left

Influenza and respiratory syncytial virus (RSV) infections are responsible for considerable morbidity, mortality and health-care resource use. For the Netherlands, we estimated age and risk-group specific numbers of antibiotics, otologicals and cardiovascular prescriptions per 10,000 person-years during periods with elevated activity of influenza or RSV, and compared these with peri-season rates. Data were taken from the University of Groningen in-house prescription database (www.iadb.nl) and virological surveillance for the period 1998-2006. During influenza and RSV periods excess antibiotic prescriptions were estimated for all age groups. In the age groups 0-1 and 2-4 years, excess antibiotic prescriptions during periods with elevated RSV activity (65% and 59% of peri-seasonal rates) exceeded the surpluses estimated during the influenza-activity periods (24% and 34% of peri-seasonal rates) while for otologicals excess prescriptions were higher for influenza (22% and 27%) than for RSV (14% and 17%). Among persons of 50 years and older, notably those without medical high-risk conditions, excess prescriptions for cardiovascular medications were estimated during the influenza periods at approximately 10% (this was also already seen in persons aged 45-49). Our results may have implications for influenza vaccination policies. In particular, extension of influenza vaccination to groups of non-elderly adults and young children may lower excess prescriptions during these influenza periods for all three types of drug prescriptions investigated.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Infective Agents; Cardiovascular Agents; Child; Child, Preschool; Drug Prescriptions; Humans; Infant; Infant, Newborn; Influenza, Human; Middle Aged; Netherlands; Respiratory Syncytial Virus Infections; Vaccination; Young Adult

To evaluate in patients with heart failure (HF) due to systolic dysfunction the occurrence of polypharmacy, alternative medicine, immunization against influenza, and patients' knowledge about their medication.. Sixty-five patients, 49 men, mean age 60.5+/-12.0 years answered a confidential questionnaire during 2002. Polypharmacy was frequent, 48 (74%) were taking six or more pills per day and 18 (28%) 11 or more. Fifteen patients (23%) used over-the-counter analgesics. Eight patients (12%) used alternative medicine [five women (31%) vs. three men (6%), P=0.02]. Forty-four patients (68%) received immunization against influenza (18 patients <65 years (54%) vs. 25 patients > or =65 years (79%), P=0.03). Half the patients knew that beta-blockers and vasodilators decreased blood pressure, 31 patients receiving diuretics (88%) knew that this drugs help to eliminate liquids, 12 patients (38%) recognized this effect with low dose spironolactone and 23% or less with other drugs. Only 12 patients (42%) treated with acenocoumarol and 13 of those treated with aspirin (32%) recognized the action of these drugs.. Patients with HF and systolic dysfunction have a poor knowledge about the medication they receive. Polypharmacy, over-the-counter, homeopathic and alternative medicine use is frequent whereas the rate of immunization against influenza is low.

Topics: Adult; Aged; Cardiovascular Agents; Complementary Therapies; Female; Health Knowledge, Attitudes, Practice; Heart Failure; Humans; Immunization; Influenza, Human; Male; Middle Aged; Patient Selection; Polypharmacy; Surveys and Questionnaires

Topics: Anti-HIV Agents; Anti-Obesity Agents; Antineoplastic Agents; Cardiovascular Agents; Drug Approval; Hepatitis; Humans; Hypoglycemic Agents; Immunologic Factors; Influenza, Human; Lyme Disease; Pneumonia; United States; United States Food and Drug Administration

Topics: Biomedical Research; Cardiovascular Agents; Communicable Disease Control; Drug Therapy; Epidemiology; Humans; Influenza, Human; Muscle Relaxants, Central; Penicillins; Sulfathiazoles

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Ascorbic Acid; Aspirin; Cardiovascular Agents; Dermatologic Agents; Flavonoids; Humans; Influenza, Human; Protein Synthesis Inhibitors; Tetracycline; Vitamins

Topics: Anesthetics; Anesthetics, Local; Cardiovascular Agents; Humans; Influenza, Human