Influenza vaccination is widely used in transplant recipients, but there is little known about the significance and correlating factors of its effectiveness. In the current study, we reviewed the existing literature on clinical trials performed in transplant recipients on the effectiveness of influenza vaccination and to evaluate the relevance of the type of immunosuppression employed in these patients on the humoral reaction to the vaccine. A comprehensive search of the literature was performed through Pubmed and Google Scholar to find reports indicating immunogenicity of influenza vaccination in transplant patients. Finally, data from 15 published clinical trials were included in the meta-analysis. Data of 947 transplant recipients retrieved from 15 clinical trials investigating the immunogenicity of influenza vaccination were analyzed in this meta-analysis. Analysis showed significantly lower rates of sero-conversion among transplant recipients receiving mycophenolate mofetil (MMF) than other immunosuppressive agents (relative risk: 0.724; 95% confidence interval: 0.596-0.880; P = 0.001). No significant correlation was found with tacrolimus, sirolimus, cyclosporine and azathioprine. Different immunosuppressive agents seem to have different effects on the humoral response rate to influenza vaccination, with MMF having the most significant deleterious effect. The limited and controversial data available in the literature do not support any differential effect for other immunosuppressive agents.

This paper shows that the gastric linitis plastica can present with many deceptive clinical presentations, raising the risk of postponed diagnosis.

The incidence of CAD and angiographic changes were significantly increased with exposure to SM. Further studies on cardiovascular effects of SM are needed.

This is a challenging issue about the effects of lipid-profile-lowering agents (i.e. fibrates) on myocardial structure and function in patients with coronary artery diseases and dyslipidemia although there are many studies which confirmed the efficacy of these medications on lipid profile via laboratory findings. In this study we focused on the cardiac effect of lipid profile lowering agents via echocardiography and exercise test. Background:Various treatment protocols for dyslipidemia and coronary artery disease have been suggested. In spite of lipid-lowering effects, various effects of statins and fibrates have been reported in the literature. Objectives: The aim of this study was to assess the cardiac efficacy of Simvastatin with or without fenofibrate on cardiac function. Patients and Methods: A cohort study was conducted on 124 patients with dyslipidemia and coronary artery disease. Patients were randomly divided into two groups: the first group (n = 64) received Simvastatin (60 -20 mg/day) and fenofibrate (200 mg/day), and the second group (n = 60) received Simvastatin (20 -60 mg/day) alone. Treatment lasted 1 year, and the patients were evaluated after treatment. Results: The mean age was 54.3 ± 6.5 years, and 53.2% of patients were male. Compared to baseline, after 12 months of treatment the lipid profiles of both groups decreased significantly (P < 0.05). The change in left-ventricular ejection fraction in the first group was statistically significant (P = 0.01). The exercise test time and metabolic equivalent of tasks index significantly increased in the first group (P = 0.014, P = 0.006 ), but these changes were not significant in the second group (P = 0.289, P = 0.744). Conclusions: Lipid-regulating therapies including Simvastatin and fenofibrate improved myocardial function and reduced myocardial ischemia, so combined therapy is recommended for treating dyslipidemia in high-risk patients for cardiovascular problems.

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