SARS-CoV-2 infection and H1N1 vaccination: does a relationship between the two factors really exist? A retrospective analysis of a territorial cohort in Ferrara, Italy.

OBJECTIVE: SARS-CoV-2 has been compared with other strains of coronaviruses, SARS-CoV and MERS-CoV, and with the flu viruses: all of them manifest themselves with respiratory symptoms and, although their genetic patterns are similar, the spread of SARS-CoV-2 infection has quickly reached global dimensions, demonstrating that SARS-CoV-2 is a virus with greater spreading capacity, albeit less lethal. Compared with influenza viruses, coronaviruses have a longer incubation period and the patients with coronaviruses' syndromes develop more severe diseases requiring frequent hospitalizations and intensive care admissions. The aim was to explore the relationships between seasonal influenza vaccination and coronavirus infection and to understand whether this hypothetic role by the flu vaccines modifies SARS-CoV-2 infection's outcomes. PATIENTS AND METHODS: In this retrospective, multicenter study, we enrolled 952 patients diagnosed with SARS-CoV-2 infection; 448 were admitted to our two main hospitals in Ferrara territory, while the remaining 504 were isolated at home. We compared the group of patients who had been vaccinated for influenza in the previous 12 months to that of unvaccinated patients. RESULTS: Significant differences were found for both the need for hospitalization and 30-day mortality between vaccinated and unvaccinated patients. We found age to be the only independent risk factor for a worse 30-day prognosis, while gender, influenza vaccinations and age itself were independent risk factors for undergoing hospitalization. CONCLUSIONS: In our groups of patients, we found a relationship between seasonal influenza vaccinations and SARS-CoV-2 infection. Age seems to be the main risk factor for short-term mortality in COVID-19 inpatients, while the influenza vaccination is, together with gender and age itself, a determining factor in predicting the need for hospitalization.

[Evaluation of the tolerance of a lipid emulsion administrated during total parenteral nutrition in surgical patients]. / Valutazione della tollerabilità di una emulsione lipidica somministrata in corso di nutrizione parenterale totale in pazienti chirurgici.

Tolerance's evaluation of a lipid emulsion given in course of parenteral total nutrition in surgical patient's. The first fat emulsions for intravenous application were thrown on the market in the 1920's years. Authors make a study on a limited sample of surgical patients about type and incidence of both immediate and late adverse reactions versus intravenous administration of Lipofundin S. They also suggest, on the same time, a protocol for the survey of these reactions. The results suggest a good tolerance to Lipofundin S intravenous administration and no influence on haematic biochemical parameters.

Pharmacokinetics of amikacin in neonates.

Only a few data have thus far been published on the pharmacokinetics of amikacin in neonates. To gain further information on this issue, we studied a series of 32 neonates who were treated with amikacin for suspected or documented bacterial infection. Nineteen neonates were preterm (mean gestational age = 32.0 +/- 3.6 weeks, mean body weight = 1.74 +/- 0.81 kg) while the remaining 13 were full-term (mean body weight = 3.19 +/- 0.82 kg). The 32 neonates were given amikacin by intramuscular route. A total of 121 concentrations were measured (average number of concentrations per patient = 3.8; range 3-6). To estimate amikacin pharmacokinetic parameters, the serum concentration values of the drug were fitted to the one-compartment pharmacokinetic model. The calculated pharmacokinetic parameters were the following (mean +/- SD): clearance = 64.6 +/- 30.8 ml/h/kg; volume of distribution = 0.655 +/- 0.414 liters/kg; half-life = 7.6 +/- 4.4 h. These results are similar to the values reported previously, with the important exception of the volume of distribution, which was considerably higher in our study. The intraindividual variability of amikacin pharmacokinetics was evaluated by the standard two-stage method yielding an intraindividual variability coefficient of 28.9%. No previous estimate of this parameter has as yet been published. The population parameters of amikacin in neonates, derived from the present study (i.e. coefficient for intraindividual variability and means +/- SD for clearance and volume of distribution), can be applied to a further series of neonates to facilitate the prospective use of the bayesian method for individualizing amikacin dosage.

PKRD: a pharmacokinetic program for least-squares and bayesian analysis of repeated-dose pharmacokinetic curves.

A microcomputer program is presented which analyses multiple-dose pharmacokinetic curves using either a least-squares nonlinear analysis or a bayesian fit. The least-squares subroutine is designed to fit retrospective pharmacokinetic curves and can generate the so-called population pharmacokinetic parameters using the Standard Two-Stage method. The bayesian subroutine can instead be used prospectively to individualise the dosage regimen of a patient based on the concentrations measured in the initial phases of the drug treatment. All the pharmacokinetic subroutines of the program use the one-compartment model with either constant-rate intravenous infusion or oral route with zero-order absorption. The program was tested in a series of ten bone marrow transplantation patients treated with cyclosporine. The least-squares estimates of the one-compartment parameters, calculated by the program, were compared with those generated by the SIMKIN program.