Gonzalezmcclure2823

The following chapter is focused on the impact of comorbidities on the effectiveness of vaccination in older persons. Relevant comorbidities are cardiovascular diseases like hypertension, coronary artery disease or congestive heart failure, which lead to reduction of vaccine immunogenicity; or chronic obstructive pulmonary disease with a decline in lung function and a higher risk for pneumonia or infections due to influenza. End-stage renal disease has a high impact on developing infections and causes immune dysfunction over all parts of the immune system. Depression and dementia as well as psychological stress are associated with poor antibody response and a higher range of inflammation markers. Chronic inflammatory processes like rheumatoid arthritis also alter the immune system. In addition, geriatric syndromes and lowered functional status have implications for the vaccination response. Malnutrition is characterized by depletion of structural and functional proteins. This leads to a low antibody response. Negative immunomodulatory effects are also observed in vitamin D insufficiency. Frailty as well is associated with immunological changes and lowered performance in the activities of daily living, but moderate physical activity improves immune function. © 2020 S. Karger AG, Basel.Respiratory syncytial virus (RSV) causes infection throughout life, with infants, adults who are severely immunocompromised, and the elderly at special risk of developing lower respiratory tract disease, hospitalisation, and death. The burden of severe disease in the elderly is comparable to seasonal influenza, and there remains no effective anti-viral drugs or vaccine for any target population. The development of a vaccine to confer immunity against severe disease is a major global health priority. A multitude of safe and immunogenic vaccine candidates have failed to induce the protective immunity needed for licensure, and in recent years this has included the largest clinical trials of RSV vaccines in history. The obstacles to vaccine development in elderly populations include an incomplete understanding of the immune responses needed for protection, the effect of aging on induction and maintenance of immunity (natural and vaccine induced immunity), and the high rate of co-morbid disease in older adults. Recent advances in structural biology, new biological platforms for antigen delivery, and insights from experimental challenge models mark the latest developments in over 50 years of research. This continues to be an active and evolving field of scientific discovery with renewed hope for a vaccine in the future. © 2020 S. Karger AG, Basel.The increase in the prevalence of obesity represents a worldwide phenomenon which is associated with several chronic diseases. In this review, we summarize published data showing how obesity, alone or together with the metabolic syndrome, induces defects in B cells similar to those induced by aging, contributes to systemic and B cell intrinsic inflammation and increases the secretion of autoimmune antibodies. We show that obese individuals contract more bacterial, viral, and fungal infections as compared to lean controls. CX-5461 These include periodontal, cutaneous, gastric, and respiratory tract infections, as well as postsurgical infections occurring after solid organ transplantation and surgeries for weight loss. Moreover, because obese individuals have a compromised immune system, they respond poorly to vaccination against influenza, hepatitis B, tetanus, and rabies. The results in this review highlight the importance to vaccinate individuals with obesity and/or with metabolic syndrome to prevent morbidity from vaccine-preventable diseases. © 2020 S. Karger AG, Basel.OBJECTIVE To evaluate the effect of C constant for ray tracing-assisted intraocular lens (IOL) power calculation in the patients with different refractive power, we compared the refractive outcome of ray-tracing method based on C constant and conventional IOL calculation formula. METHODS 215 eyes which underwent phacoemulsification and IOL implantation were enrolled. According to the average corneal power, patients were divided into three groups high corneal power(K＞45D) group, medium corneal power (43D≤K≤45Dm) group and low corneal power(K＜43D) group. The predicted sphero-equivalent refractive outcome for the IOL power implanted at surgery were calculated using ray tracing method, SRK/T and Haigis formulas. RESULTS On the basis of the corneal refractive power, there were 65 eyes of K>45D group (30.23%), 96 eyes of 43D≤K≤45Dm group (44.65%),54 eyes of K＜43D (25.12%). In general, the ray tracing group had the smallest value of MAE and ME, and the proportion of the eyes which AE＜0.50D and AE＜0.75D was significantly higher than that of the other two formulas (P=0.010). In each group, the value of MAE was smallest in the ray tracing group. And for the proportion of AE＜0.50D,＜0.75D, the ray tracing group was higher than SRK/T and Haigis groups. Especially, in the high corneal refractive group and low corneal refractive group, the proportion of AE＜0.25D was also obviously higher, but only in low corneal refractive power group, the difference had statistically significant(P=0.006). CONCLUSIONS Compared with the conventional formulas, C constant for ray tracing-assisted IOL power calculation has more accuracy for the patients with different corneal refractive powers. Ray tracing could provide better guidance for the selection of IOL clinically. © 2020 S. Karger AG, Basel.Vaccine-preventable diseases represent a considerable burden on world health, and can have long-lasting consequences in those infected, especially in older adults, who can suffer functional decline, disability, and death. Vaccine uptake across the life course is desirable, but often suboptimal. A number of factors have been identified as contributors to low vaccine coverage, including sociodemographic characteristics, logistic factors such as ease of access and convenience, cultural attitudes including health literacy, and vaccine hesitancy. Strategies to improve vaccine uptake can target all the components underpinning low coverage, and include technology and communication-based strategies, physician-centered approaches, targeting healthcare workers for influenza vaccination, system-based factors, improved vaccine efficacy, and above all, political will and leadership. © 2020 S. Karger AG, Basel.