[The importance of flu vaccination during CoViD time]. / L'importanza della vaccinazione anti influenzale ai tempi della CoViD.

In the next months, the risk of coinfection with f lu virus and Sars-CoV-2 is high. Despite the number of studies dealing with the consequences of the interaction between the two viruses, the impact of this coexistence on human health is still uncertain. However, achieving high f lu vaccination coverage would mean avoiding hospital overload due to hospitalizations for f lu complications and facilitating a timely differential diagnosis that allows a quick and appropriate treatment of CoViD-19 cases. These are two valid reasons for actively promoting f lu vaccination, particularly this year when the risk of a "twindemic" determined by f lu and CoViD-19 is high. In Italy this year, for the first time, f lu vaccination is offered free of charge also to people aged 60 to 64, expanding individuals entitled to free vaccination. Furthermore, it is strongly recommended to healthcare workers and to elderly who live in residential or long-term care facilities.

Immediate Breast Reconstruction after mastectomy with polyurethane implants versus textured implants: A retrospective study with focus on capsular contracture.

BACKGROUND: Capsular contracture (CC) is the most common complication following Immediate Breast Reconstruction (IBR) with breast implants. Different implant surfaces were developed aiming to reduce the incidence of CC. We evaluated the incidence and degree of CC after Direct-to-Implant (DTI) IBR with insertion of textured (TE) or polyurethane (PU) covered implants. METHODS: A retrospective review of consecutive patients treated at our Institution with mastectomy and one-stage IBR and implant reconstruction between 2013 and 2018, with or without post mastectomy radiation therapy (PMRT), was conducted. Immediate breast reconstruction was performed by implanting 186 PU covered implants and 172 TE implants. RESULTS: Three-hundred-twelve women underwent 358 DTI IBR with PU or TE implants, were analyzed with a median follow-up time of 2.3 years (range 1.0-3.0). The overall rate of CC Baker grade III and IV was 11.8% (95%CI: 8.4-16.3), while, after PU and TE implant placement it was 8.1% (95% CI: 4.1-15.7) and 15.8% (95% CI: 4.1-15.7) [p = 0.009]), respectively. Irradiated breasts developed CC more frequently rather than non-irradiated breasts (HR = 12.5, p < 0.001), and the relative risk was higher in the TE group compared with the PU group (HR = 0.3, p = 0.003). CONCLUSIONS: After mastectomy and one-stage IBR, the use of PU covered implants is associated with a lower incidence of CC compared to TE implants. This advantage is amplified several folds for patients who necessitate PMRT. Footnote: Capsular contracture (CC); Immediate Breast Reconstruction (IBR); Directto- Implant (DTI); Textured (TE); Polyurethane (PU); Post mastectomy radiation therapy (PMRT); Nipple Sparing mastectomy (NSM).