Cystic lymphangiomas originate as benign masses which occur mostly in children especially in the ... more Cystic lymphangiomas originate as benign masses which occur mostly in children especially in the head and neck region and/or the groin. Although abdominal lymphangiomas are rare, they are most commonly reported in adults. In addition, pancreatic involvement is rare. Lymphatic malformation with blockage of the lymphatic flow is the most common etiology leading to the formation of lymphangiomas. Cystic lymphangiomas should always be included in the differential diagnosis of abdominal masses which present with mass effect signs and symptoms. Due to its rarity, it forms a diagnostic and therapeutic challenge for the clinician. We herein report the case of a 43-year-old man with a cystic lymphangioma detected in the head of the pancreas and describe the surgical procedure utilized as the therapeutic medium. To remove this mass, we utilized a modified approach to a classic pancreaticoduodenectomy. This technique involved resection of the head of the pancreas while preserving the upper 2nd portion of the duodenum and the ampulla of Vater. The result of our 30-month follow-up of this patient has been very satisfactory with no complications.
The presence, characteristics, and potential clinical relevance of neural progenitor populations ... more The presence, characteristics, and potential clinical relevance of neural progenitor populations within the neural placodes of myelomeningocele patients remain to be studied. Neural stem cells are known to reside adjacent to ependyma-lined surfaces along the central nervous system axis. Given such neuroanatomic correlation and regenerative capacity in fetal development, we assessed myelomeningocele-derived neural placode tissue as a potentially novel source of neural stem and progenitor cells. Nonfunctional neural placode tissue was harvested from infants during the surgical repair of myelomeningocele and subsequently further analyzed by in vitro studies, flow cytometry, and immunofluorescence. To assess lineage potential, neural placode-derived neurospheres were subjected to differential media conditions. Through assessment of platelet-derived growth factor α (PDGFRα) and CD15 cell marker expression, Sox2+Olig2+ putative oligodendrocyte progenitor cells were successfully isolated. PDGFRαCD15 cell populations demonstrated the highest rate of self-renewal capacity and multipotency of cell progeny. Immunofluorescence of neural placode-derived neurospheres demonstrated preferential expression of the oligodendrocyte progenitor marker, CNPase, whereas differentiation to neurons and astrocytes was also noted, albeit to a limited degree. Neural placode tissue contains multipotent progenitors that are preferentially biased toward oligodendrocyte progenitor cell differentiation and presents a novel source of such cells for use in the treatment of a variety of pediatric and adult neurological disease, including spinal cord injury, multiple sclerosis, and metabolic leukoencephalopathies. OPC, oligodendrocyte progenitor cellPDGFRα, platelet-derived growth factor receptor αSCI, spinal cord injury.
Diabetic Nephropathy (DN) is one of the main complications of diabetes mellitus, mostly ending to... more Diabetic Nephropathy (DN) is one of the main complications of diabetes mellitus, mostly ending to end-stage renal disease. Leptin and C-reactive protein (CRP), as inflammatory markers implicated in the progression of DN, increase in diabetes mellitus, while transferrin and albumin, as members of anti-oxidant defense mechanism, are found to decline. In a controlled clinical trial, 65 patients with type 2 DN were assigned to receive lovastatin or placebo, for 3 months, to assess statins' impact on serum levels of leptin, CRP, transferrin, albumin, and lipid profile. Serum levels of CRP (3.52 +/- 4.16 mg/dL to 2.84 +/- 3.06 mg/dL, P = .02), leptin (10.78 +/- 8.30 mg/dL to 7.80 +/- 5.41 mg/dL, P = .006), low-density lipoprotein cholesterol (116.16 +/- 46.54 mg/dL to 85.46 +/- 29.22 mg/dL, P = .001), and total cholesterol (199.00 +/- 43.33 mg/dL to 164.67 +/- 35.19 mg/dL, P = .001) were lowered after lovastatin therapy. Mean serum level of high-density lipoprotein cholesterol increased (40.00 mg/dL to 42.80 mg/dL, P = .005) after the treatment. Lovastatin had no significant effect on albumin and transferrin. Placebo did not change any of the parameters after 3 months. The effect of statins on the inflammatory markers involved in the development of DN is a new approach to evidence supporting the pleiotropic effect of this drug group.
Glioblastoma (GBM) is the most malignant primary brain tumor in adults, with a median survival ti... more Glioblastoma (GBM) is the most malignant primary brain tumor in adults, with a median survival time of one and a half years. Traditional treatments, including radiation, chemotherapy, and surgery, are not curative, making it imperative to find more effective treatments for this lethal disease. γ-Glutamyl transferase (GGT) is a family of enzymes that was shown to control crucial redox-sensitive functions and to regulate the balance between proliferation and apoptosis. GGT7 is a novel GGT family member that is highly expressed in brain and was previously shown to have decreased expression in gliomas. Since other members of the GGT family were found to be altered in a variety of cancers, we hypothesized that GGT7 could regulate GBM growth and formation. To determine if GGT7 is involved in GBM tumorigenesis, we modulated GGT7 expression in two GBM cell lines (U87-MG and U138) and monitored changes in tumorigenicity in vitro and in vivo. We demonstrated for the first time that GBM patients with low GGT7 expression had a worse prognosis and that 87% (7/8) of primary GBM tissue samples showed a 2-fold decrease in GGT7 expression compared to normal brain samples. Exogenous expression of GGT7 resulted in a 2- to 3-fold reduction in proliferation and anchorage-independent growth under minimal growth conditions (1% serum). Decreasing GGT7 expression using either short interfering RNA or short hairpin RNA consistently increased proliferation 1.5- to 2-fold. In addition, intracranial injections of U87-MG cells with reduced GGT7 expression increased tumor growth in mice approximately 2-fold, and decreased mouse survival. To elucidate the mechanism by which GGT7 regulates GBM growth, we analyzed reactive oxygen species (ROS) levels in GBM cells with modulated GGT7 expression. We found that enhanced GGT7 expression reduced ROS levels by 11-33%. Our study demonstrates that GGT7 is a novel player in GBM growth and that GGT7 can play a critical role in tumorigenesis by regulating anti-oxidative damage. Loss of GGT7 may increase the cellular ROS levels, inducing GBM occurrence and growth. Our findings suggest that GGT7 can be a promising biomarker and a potential therapeutic target for GBM.
Aberrant activation of receptor-tyrosine kinase c-Met/HGF pathway is shown to be associated with ... more Aberrant activation of receptor-tyrosine kinase c-Met/HGF pathway is shown to be associated with cell proliferation, invasion, metastasis and poor-prognosis in several tumor types, including upper gastrointestinal-malignancies. The interaction of c-Met with multiple signalling-pathways involved in tumorigenic-properties and invasive-phenotype has gained substantial attention, suggesting its role as an intriguing-target for cancer-therapy. In recent years, there have been considerable efforts in the development of effective c-Met inhibitors with potential clinical-applications and one of them, crizotinib (dual c-Met/ALK inhibitor), has recently been approved for lung-cancers with ALKrearrangement. However several important questions remain to be answered on the molecular mechanisms underlying the antitumor effects of crizotinib, as well as on its possible role in the treatment of different tumor types, including uppergastrointestinal- cancers. The aim of this review is to give an overview on critical role of the c-Met/HGF pathway in cancer, and the preclinical/clinical studies on c-Met inhibitors. There are accumulating evidences on therapeutic potential of c-Met inhibitors for the treatment of other malignancies, such as gastric and pancreatic cancers. However, further investigations are needed to identify determinants of the activity of c-Met inhibitors, through the analysis of genetic/ environmental alterations affecting c-Met and parallel pro-cancer pathways; mechanisms result in developing resistance to anti-c-Met agents; and selection of patients that might benefit from therapy. These studies will be essential to improve the selectivity/efficacy of future anticancer strategies of c-Met targeted-therapies in the treatment of upper gastrointestinal- cancers.
Background: Acinetobacter infections are associated with high morbidity and mortality. The aim of... more Background: Acinetobacter infections are associated with high morbidity and mortality. The aim of the present study was to review the incidence of acinetobacter in 2 tertiary care hospitals in Tehran, Iran and also to find out pattern of antibiotic resistance of acinetobacter. Methods: From January 2007 to January 2008, in a retrospective study, we detected 100 positive cultures of acinetobacter baumannii from different wards of two tertiary care hospitals in Tehran, Iran. Disk diffusion method was used to determine the resistance of isolated acinetobacters. The available antimicrobial sensitivity to 11 antibiotics was analyzed. Results: Acinetobacter baumannii was isolated from sputum in 28%, blood in 26%, bronchoalveolar lavage (BAL) in 21%, wound in 11%, urine in 4%, tracheal secretion in 4%, tip of catheter (CV line) in 3%, CSF in 2%, pleural fluid in 1%. Acinetobacter showed resistance to cefriaxone, cefotaxime, ceftazidime, trimethoprim-sulfamethoxazole and gentamicin more tha...
Background: Recent studies suggested influenza vaccine may reduce the risk of ischemic events in ... more Background: Recent studies suggested influenza vaccine may reduce the risk of ischemic events in coronary artery disease (CAD) patients. We are conducting a clinical trial to investigate the efficacy of 2007-08 influenza vaccine (FluVacc) in inducing serologic response as well as in reducing the number of flu episodes in CAD patients (ClinicalTrials.gov # NCT00607217). We are now presenting the serologic response to the FluVacc antigens. Methods: A trial is being conducted from January to August 2008 and enrolled 355 study subjects (278 CAD and 70 healthy controls [HC]). CAD patients were randomized to receive either FluVacc (CAD-Exp, n=142) or placebo (CAD-Placebo, n=143). HC group also received FluVacc. Antibody (Ab) titers were measured before and 1 month after vaccination. The proportion of protective Ab titers (i.e. ≥1:40), the serological response (i.e. ≥4-fold rise in titers) rates, and the magnitudes of change in titers were the main outcome measures. The number of flu episo...
Abdominal tuberculosis is one of the most prevalent forms ofextra-pulmonary tuberculosis. Various... more Abdominal tuberculosis is one of the most prevalent forms ofextra-pulmonary tuberculosis. Various regions of gastrointestinaltract including cecum, terminal ileum, peritoneum, lymphaticsystem, and solid viscera can be affected by tuberculosis.Here we report a 33-year-old woman presented with fever,chills, and a history of abdominal discomfort. Lymphadenopathywas detected on physical examination. Contrast computedtomography of chest and abdomen showed patchy densitiesand thickening of the ileocecal wall respectively. Histologicalstudies of the biopsy samples documented the existence oftuberculosis.
Background: Endocarditis is the most common cardiovascular complication and the leading cause of ... more Background: Endocarditis is the most common cardiovascular complication and the leading cause of death in brucellosis. Unfortunately, the treatment methods (medical, surgical, or both), the choice of antibiotics, and duration of medical treatment are not clear because of the low number of patients and lack of controlled trials.This review was undertaken to determine the role of surgery in brucella endocarditis by reviewing all cases of brucella endocarditis since the advent of surgical intervention for this condition. Methods: In a comprehensive search using “brucella endocarditis” and “brucella AND endocarditis” as keywords in Pubmed and Google search engines, 95 articles in english (266 analyzable cases) (1966-2010) were identified and variables (demographics, risk factors, treatment, and outcome) were recorded. Reports prior to 1966 were excluded to eliminate potential bias related to limited antibiotic access and heart surgery techniques at that time. Linear and Logistic regress...
Background: Brucellosis is transmitted orally through unpasteurized milk products manifesting wit... more Background: Brucellosis is transmitted orally through unpasteurized milk products manifesting with fever, chills, bone pain, fatigue and myalgia. If left untreated or partially treated, complications may occur. Here, we present the clinical, serological and echocardiographic features, therapeutic approach, and follow-up of 13 patients with brucella endocarditis, in what may be the largest case series to date. Methods: 701 cases defined as endocarditis (Duke Criteria) (1991-2008) in 4 referral cardiac hospital (Iran) were retrospectively evaluated. Those who had definitions of brucellosis (serology or culture) and endocarditis at the same time were considered to have brucella endocarditis (BE). Results: BE was confirmed in 13 of 701 (1.8%) patients (9 men, 4 women, median age 30 years, range, 15-61 years). High serological titers were observed. Vegetation was found on the aortic (61.5 %) or mitral (15.4%) valves, or both (15.4%).Valsalva sinus was infected in one patient. Blood cultu...
Safety of and humoral immune response to the anti-influenza vaccine in coronary artery disease (C... more Safety of and humoral immune response to the anti-influenza vaccine in coronary artery disease (CAD) patients were evaluated. The trivalent vaccine was administered to 137 eligible CAD patients and 67 age- and sex-matched healthy individuals. Antibody (Ab) titers were measured before and 1 month after vaccination. CAD and HC groups were not significantly different in serologic response and magnitude of change in antibody titers against each of the vaccine antigens. In multivariate analyses, regular exercise and using multivitamin supplements were independently associated with better antibody response among CAD patients. There were no major cardiac or general adverse effects. Influenza vaccine was found safe in CAD patients and antibody responses were similar to HCs.
Cystic lymphangiomas originate as benign masses which occur mostly in children especially in the ... more Cystic lymphangiomas originate as benign masses which occur mostly in children especially in the head and neck region and/or the groin. Although abdominal lymphangiomas are rare, they are most commonly reported in adults. In addition, pancreatic involvement is rare. Lymphatic malformation with blockage of the lymphatic flow is the most common etiology leading to the formation of lymphangiomas. Cystic lymphangiomas should always be included in the differential diagnosis of abdominal masses which present with mass effect signs and symptoms. Due to its rarity, it forms a diagnostic and therapeutic challenge for the clinician. We herein report the case of a 43-year-old man with a cystic lymphangioma detected in the head of the pancreas and describe the surgical procedure utilized as the therapeutic medium. To remove this mass, we utilized a modified approach to a classic pancreaticoduodenectomy. This technique involved resection of the head of the pancreas while preserving the upper 2nd portion of the duodenum and the ampulla of Vater. The result of our 30-month follow-up of this patient has been very satisfactory with no complications.
The presence, characteristics, and potential clinical relevance of neural progenitor populations ... more The presence, characteristics, and potential clinical relevance of neural progenitor populations within the neural placodes of myelomeningocele patients remain to be studied. Neural stem cells are known to reside adjacent to ependyma-lined surfaces along the central nervous system axis. Given such neuroanatomic correlation and regenerative capacity in fetal development, we assessed myelomeningocele-derived neural placode tissue as a potentially novel source of neural stem and progenitor cells. Nonfunctional neural placode tissue was harvested from infants during the surgical repair of myelomeningocele and subsequently further analyzed by in vitro studies, flow cytometry, and immunofluorescence. To assess lineage potential, neural placode-derived neurospheres were subjected to differential media conditions. Through assessment of platelet-derived growth factor α (PDGFRα) and CD15 cell marker expression, Sox2+Olig2+ putative oligodendrocyte progenitor cells were successfully isolated. PDGFRαCD15 cell populations demonstrated the highest rate of self-renewal capacity and multipotency of cell progeny. Immunofluorescence of neural placode-derived neurospheres demonstrated preferential expression of the oligodendrocyte progenitor marker, CNPase, whereas differentiation to neurons and astrocytes was also noted, albeit to a limited degree. Neural placode tissue contains multipotent progenitors that are preferentially biased toward oligodendrocyte progenitor cell differentiation and presents a novel source of such cells for use in the treatment of a variety of pediatric and adult neurological disease, including spinal cord injury, multiple sclerosis, and metabolic leukoencephalopathies. OPC, oligodendrocyte progenitor cellPDGFRα, platelet-derived growth factor receptor αSCI, spinal cord injury.
Diabetic Nephropathy (DN) is one of the main complications of diabetes mellitus, mostly ending to... more Diabetic Nephropathy (DN) is one of the main complications of diabetes mellitus, mostly ending to end-stage renal disease. Leptin and C-reactive protein (CRP), as inflammatory markers implicated in the progression of DN, increase in diabetes mellitus, while transferrin and albumin, as members of anti-oxidant defense mechanism, are found to decline. In a controlled clinical trial, 65 patients with type 2 DN were assigned to receive lovastatin or placebo, for 3 months, to assess statins' impact on serum levels of leptin, CRP, transferrin, albumin, and lipid profile. Serum levels of CRP (3.52 +/- 4.16 mg/dL to 2.84 +/- 3.06 mg/dL, P = .02), leptin (10.78 +/- 8.30 mg/dL to 7.80 +/- 5.41 mg/dL, P = .006), low-density lipoprotein cholesterol (116.16 +/- 46.54 mg/dL to 85.46 +/- 29.22 mg/dL, P = .001), and total cholesterol (199.00 +/- 43.33 mg/dL to 164.67 +/- 35.19 mg/dL, P = .001) were lowered after lovastatin therapy. Mean serum level of high-density lipoprotein cholesterol increased (40.00 mg/dL to 42.80 mg/dL, P = .005) after the treatment. Lovastatin had no significant effect on albumin and transferrin. Placebo did not change any of the parameters after 3 months. The effect of statins on the inflammatory markers involved in the development of DN is a new approach to evidence supporting the pleiotropic effect of this drug group.
Glioblastoma (GBM) is the most malignant primary brain tumor in adults, with a median survival ti... more Glioblastoma (GBM) is the most malignant primary brain tumor in adults, with a median survival time of one and a half years. Traditional treatments, including radiation, chemotherapy, and surgery, are not curative, making it imperative to find more effective treatments for this lethal disease. γ-Glutamyl transferase (GGT) is a family of enzymes that was shown to control crucial redox-sensitive functions and to regulate the balance between proliferation and apoptosis. GGT7 is a novel GGT family member that is highly expressed in brain and was previously shown to have decreased expression in gliomas. Since other members of the GGT family were found to be altered in a variety of cancers, we hypothesized that GGT7 could regulate GBM growth and formation. To determine if GGT7 is involved in GBM tumorigenesis, we modulated GGT7 expression in two GBM cell lines (U87-MG and U138) and monitored changes in tumorigenicity in vitro and in vivo. We demonstrated for the first time that GBM patients with low GGT7 expression had a worse prognosis and that 87% (7/8) of primary GBM tissue samples showed a 2-fold decrease in GGT7 expression compared to normal brain samples. Exogenous expression of GGT7 resulted in a 2- to 3-fold reduction in proliferation and anchorage-independent growth under minimal growth conditions (1% serum). Decreasing GGT7 expression using either short interfering RNA or short hairpin RNA consistently increased proliferation 1.5- to 2-fold. In addition, intracranial injections of U87-MG cells with reduced GGT7 expression increased tumor growth in mice approximately 2-fold, and decreased mouse survival. To elucidate the mechanism by which GGT7 regulates GBM growth, we analyzed reactive oxygen species (ROS) levels in GBM cells with modulated GGT7 expression. We found that enhanced GGT7 expression reduced ROS levels by 11-33%. Our study demonstrates that GGT7 is a novel player in GBM growth and that GGT7 can play a critical role in tumorigenesis by regulating anti-oxidative damage. Loss of GGT7 may increase the cellular ROS levels, inducing GBM occurrence and growth. Our findings suggest that GGT7 can be a promising biomarker and a potential therapeutic target for GBM.
Aberrant activation of receptor-tyrosine kinase c-Met/HGF pathway is shown to be associated with ... more Aberrant activation of receptor-tyrosine kinase c-Met/HGF pathway is shown to be associated with cell proliferation, invasion, metastasis and poor-prognosis in several tumor types, including upper gastrointestinal-malignancies. The interaction of c-Met with multiple signalling-pathways involved in tumorigenic-properties and invasive-phenotype has gained substantial attention, suggesting its role as an intriguing-target for cancer-therapy. In recent years, there have been considerable efforts in the development of effective c-Met inhibitors with potential clinical-applications and one of them, crizotinib (dual c-Met/ALK inhibitor), has recently been approved for lung-cancers with ALKrearrangement. However several important questions remain to be answered on the molecular mechanisms underlying the antitumor effects of crizotinib, as well as on its possible role in the treatment of different tumor types, including uppergastrointestinal- cancers. The aim of this review is to give an overview on critical role of the c-Met/HGF pathway in cancer, and the preclinical/clinical studies on c-Met inhibitors. There are accumulating evidences on therapeutic potential of c-Met inhibitors for the treatment of other malignancies, such as gastric and pancreatic cancers. However, further investigations are needed to identify determinants of the activity of c-Met inhibitors, through the analysis of genetic/ environmental alterations affecting c-Met and parallel pro-cancer pathways; mechanisms result in developing resistance to anti-c-Met agents; and selection of patients that might benefit from therapy. These studies will be essential to improve the selectivity/efficacy of future anticancer strategies of c-Met targeted-therapies in the treatment of upper gastrointestinal- cancers.
Background: Acinetobacter infections are associated with high morbidity and mortality. The aim of... more Background: Acinetobacter infections are associated with high morbidity and mortality. The aim of the present study was to review the incidence of acinetobacter in 2 tertiary care hospitals in Tehran, Iran and also to find out pattern of antibiotic resistance of acinetobacter. Methods: From January 2007 to January 2008, in a retrospective study, we detected 100 positive cultures of acinetobacter baumannii from different wards of two tertiary care hospitals in Tehran, Iran. Disk diffusion method was used to determine the resistance of isolated acinetobacters. The available antimicrobial sensitivity to 11 antibiotics was analyzed. Results: Acinetobacter baumannii was isolated from sputum in 28%, blood in 26%, bronchoalveolar lavage (BAL) in 21%, wound in 11%, urine in 4%, tracheal secretion in 4%, tip of catheter (CV line) in 3%, CSF in 2%, pleural fluid in 1%. Acinetobacter showed resistance to cefriaxone, cefotaxime, ceftazidime, trimethoprim-sulfamethoxazole and gentamicin more tha...
Background: Recent studies suggested influenza vaccine may reduce the risk of ischemic events in ... more Background: Recent studies suggested influenza vaccine may reduce the risk of ischemic events in coronary artery disease (CAD) patients. We are conducting a clinical trial to investigate the efficacy of 2007-08 influenza vaccine (FluVacc) in inducing serologic response as well as in reducing the number of flu episodes in CAD patients (ClinicalTrials.gov # NCT00607217). We are now presenting the serologic response to the FluVacc antigens. Methods: A trial is being conducted from January to August 2008 and enrolled 355 study subjects (278 CAD and 70 healthy controls [HC]). CAD patients were randomized to receive either FluVacc (CAD-Exp, n=142) or placebo (CAD-Placebo, n=143). HC group also received FluVacc. Antibody (Ab) titers were measured before and 1 month after vaccination. The proportion of protective Ab titers (i.e. ≥1:40), the serological response (i.e. ≥4-fold rise in titers) rates, and the magnitudes of change in titers were the main outcome measures. The number of flu episo...
Abdominal tuberculosis is one of the most prevalent forms ofextra-pulmonary tuberculosis. Various... more Abdominal tuberculosis is one of the most prevalent forms ofextra-pulmonary tuberculosis. Various regions of gastrointestinaltract including cecum, terminal ileum, peritoneum, lymphaticsystem, and solid viscera can be affected by tuberculosis.Here we report a 33-year-old woman presented with fever,chills, and a history of abdominal discomfort. Lymphadenopathywas detected on physical examination. Contrast computedtomography of chest and abdomen showed patchy densitiesand thickening of the ileocecal wall respectively. Histologicalstudies of the biopsy samples documented the existence oftuberculosis.
Background: Endocarditis is the most common cardiovascular complication and the leading cause of ... more Background: Endocarditis is the most common cardiovascular complication and the leading cause of death in brucellosis. Unfortunately, the treatment methods (medical, surgical, or both), the choice of antibiotics, and duration of medical treatment are not clear because of the low number of patients and lack of controlled trials.This review was undertaken to determine the role of surgery in brucella endocarditis by reviewing all cases of brucella endocarditis since the advent of surgical intervention for this condition. Methods: In a comprehensive search using “brucella endocarditis” and “brucella AND endocarditis” as keywords in Pubmed and Google search engines, 95 articles in english (266 analyzable cases) (1966-2010) were identified and variables (demographics, risk factors, treatment, and outcome) were recorded. Reports prior to 1966 were excluded to eliminate potential bias related to limited antibiotic access and heart surgery techniques at that time. Linear and Logistic regress...
Background: Brucellosis is transmitted orally through unpasteurized milk products manifesting wit... more Background: Brucellosis is transmitted orally through unpasteurized milk products manifesting with fever, chills, bone pain, fatigue and myalgia. If left untreated or partially treated, complications may occur. Here, we present the clinical, serological and echocardiographic features, therapeutic approach, and follow-up of 13 patients with brucella endocarditis, in what may be the largest case series to date. Methods: 701 cases defined as endocarditis (Duke Criteria) (1991-2008) in 4 referral cardiac hospital (Iran) were retrospectively evaluated. Those who had definitions of brucellosis (serology or culture) and endocarditis at the same time were considered to have brucella endocarditis (BE). Results: BE was confirmed in 13 of 701 (1.8%) patients (9 men, 4 women, median age 30 years, range, 15-61 years). High serological titers were observed. Vegetation was found on the aortic (61.5 %) or mitral (15.4%) valves, or both (15.4%).Valsalva sinus was infected in one patient. Blood cultu...
Safety of and humoral immune response to the anti-influenza vaccine in coronary artery disease (C... more Safety of and humoral immune response to the anti-influenza vaccine in coronary artery disease (CAD) patients were evaluated. The trivalent vaccine was administered to 137 eligible CAD patients and 67 age- and sex-matched healthy individuals. Antibody (Ab) titers were measured before and 1 month after vaccination. CAD and HC groups were not significantly different in serologic response and magnitude of change in antibody titers against each of the vaccine antigens. In multivariate analyses, regular exercise and using multivitamin supplements were independently associated with better antibody response among CAD patients. There were no major cardiac or general adverse effects. Influenza vaccine was found safe in CAD patients and antibody responses were similar to HCs.
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