Human herpesvirus‐8 (HHV‐8) infection is associated with neoplastic and non‐neoplastic diseases in immunocompromised patients. Kaposi sarcoma (KS) is a common malignancy reported in solid organ transplant recipients (SOTR). Kaposi sarcoma inflammatory cytokine syndrome (KICS), initially described in HIV patients, is characterized by high viral loads, elevated levels of cytokines, cytopenia, high fever, organ failure, and poor outcome. We report the case of a 54‐year‐old patient who developed simultaneous occurrence of KS of lymph nodes and KICS as a complication of primary donor‐transmitted HHV‐8 infection, after heart transplantation (HT). The diagnosis, management, and prognosis of this condition are unclear and needs a multidisciplinary approach.
Patients with heart transplantation (HT) have an increased risk of COVID-19 disease and the efficacy of vaccines on antibody induction is lower, even after three or four doses. The aim of our study was to assess the efficacy of four doses on infections and their interplay with immunosuppression. We included in this retrospective study all adult HT patients (12/21–11/22) without prior infection receiving a third or fourth dose of mRNA vaccine. The endpoints were infections and the combined incidence of ICU hospitalizations/death after the last dose (6-month survival rate). Among 268 patients, 62 had an infection, and 27.3% received four doses. Following multivariate analysis, three vs. four doses, mycophenolate (MMF) therapy, and HT < 5 years were associated with an increased risk of infection. MMF ≥ 2000 mg/day independently predicted infection, together with the other variables, and was associated with ICU hospitalization/death. Patients on MMF had lower levels of anti-RBD antibodies, and a positive antibody response after the third dose was associated with a lower probability of infection. In HT patients, a fourth dose of vaccine against SARS-CoV-2 reduces the risk of infection at six months. Mycophenolate, particularly at high doses, reduces the clinical effectiveness of the fourth dose and the antibody response to the vaccine.
Background: Immigration towards Ferrara is a recent occurrence. We evaluated the immigrants’ health requests. Methods: This report is based on data collected by Local Health Authority.
Results: The analysis of ambulatory cares and hospitalizations are comparable. It emerges the age class 31- 65 is the most represented. Females’ requests are more than males’ one, due to pregnancy and gynaecological health requests. The capital hospital sustained the heaviest workload. We found differences respect European Union population regarding length of stay. The predominant kind of access are through emergency room and self-access.
Conclusions: This complex pattern of health care requests requires dedicated approaches.
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