• A study found that heart failure patients who had received flu and pneumonia vaccines had a lower risk of in-hospital death 
• It is a known fact that respiratory infections make heart failure worse 
• Despite that, very few heart failure patients receive these immunisations

Flu and pneumonia vaccines lead to fewer hospital deaths among heart failure patients, a new study finds.

“Our study provides further impetus for annual immunisations in patients with heart failure. Despite advice to do so, uptake remains low,” said study author Dr Karthik Gonuguntla, of the University of Connecticut.

In heart failure, your heart can’t pump blood as well as it should. This leads to fluid buildup in the lungs that causes shortness of breath, coughing and reduced quality of life.

Lower in-hospital death rate

Respiratory infections like pneumonia and the flu make heart failure worse, so annual vaccinations are recommended for patients. However, few studies have compared outcomes among heart failure patients who have and haven’t received these vaccinations.

In this study, the researchers looked at nearly three million heart failure patients, average age 70, in the United States who were hospitalised between 2010 and 2014. Only 1.4% of the patients had received the flu vaccine and just 1.4% had received the pneumonia vaccine.

Rates of in-hospital death were much lower among patients who received the flu and pneumonia vaccines (just over 1% for each) than among those who didn’t receive either vaccine (almost 4%), the researchers found.

The study findings were released on Friday and scheduled for presentation at the European Society of Cardiology virtual annual meeting.

Pandemic changed perceptions

“Pneumonia and flu vaccines are vital to preventing these respiratory infections and protecting patients with heart failure. Although many people have rejected common and safe vaccines before Covid-19, I am optimistic that the pandemic has changed perceptions about the role of immunisations in safeguarding our health,” Gonuguntla said in a society news release.

Serious reactions to flu and pneumonia vaccinations are rare, occur within a few hours and can be treated, he said.

Studies presented at meetings should be considered preliminary until peer-reviewed for publication in a medical journal.

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• A study found that disagreeableness did not give people an advantage in the competition for power
• Organisations may allow ‘jerks’ to gain power at the same rate as anyone else
• However, selfish, deceitful and aggressive people tend to be held back by poor relationships with others

Being a selfish jerk won’t pave a path to success, new research suggests.

The study involved hundreds of participants who completed personality assessments when they were undergraduates or MBA students at three universities.

The researchers checked in with the same people about 14 years later to find out how well they’d done in their careers, and their co-workers were asked about the participants’ workplace behaviour.

In general, people who were selfish, deceitful and aggressive weren’t more likely to have attained positions of authority than those who were generous, trustworthy and pleasant, according to the study published on 31 August in the Proceedings of the National Academy of Sciences.

Poor relationships with others

“I was surprised by the consistency of the findings. No matter the individual or the context, disagreeableness did not give people an advantage in the competition for power – even in more cutthroat, ‘dog-eat-dog’ organisational cultures,” said study co-author Cameron Anderson, a professor at the University of California, Berkeley’s School of Business.

The findings don’t mean that jerks don’t attain high positions, but rather that they don’t get there faster than others, Anderson said.

Any advantage that someone may get from being selfish, deceitful and aggressive is offset by their poor relationships with others, according to the study authors.

The researchers also found that extroverts were the most likely to have advanced in their organisations due to their sociability, energy and assertiveness, something found in previous research.

“The bad news here is that organisations do place disagreeable individuals in charge just as often as agreeable people. In other words, they allow jerks to gain power at the same rate as anyone else, even though jerks in power can do serious damage to the organisation,” Anderson explained.

A strong set of alliances

“My advice to managers would be to pay attention to agreeableness as an important qualification for positions of power and leadership,” he said in a university news release. “Prior research is clear: agreeable people in power produce better outcomes.”

Anderson noted that the findings don’t shed light on whether being a jerk helps or hurts in politics, because the power dynamics are different than in business. However, there are some likely parallels.

“Having a strong set of alliances is generally important to power in all areas of life,” Anderson said. “Disagreeable politicians might have more difficulty maintaining necessary alliances because of their toxic behaviour.”

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A committee to look into the issue was set up after the first gene-edited babies were born in 2018.

The discovery that our galaxy is teeming with exoplanets has also revealed the vast diversity of planetary systems out there and raised questions about the processes that shaped them. New work published in Science by an international team including Carnegie’s Jaehan Bae could explain the architecture of multi-star systems in which planets are separated by wide gaps and do not orbit on the same plane as their host star’s equatorial center.

If naked mole-rats were human, they would be prescribed hearing aids. With six mutations in genes associated with hearing, naked mole-rats can barely hear the constant squeaking they use to communicate with one another. This hearing loss, which is strange for such social, vocal animals, is an adaptive, beneficial trait, according to new findings published in the journal Current Biology.

A team of LSU Health New Orleans radiologists investigated the usefulness of chest x-rays in COVID-19 and found they could aid in a rapid diagnosis of the disease, especially in areas with limited testing capacity or delayed test results. Their findings are published in Radiology: Cardiothoracic Imaging, available here.

Some people are being asked to travel hundreds of miles for tests as labs struggle to keep up.

• EKG readings from a smartwatch were found to be nearly as accurate as standard EKGs
• EKGs are critical to establish if a patient with chest pain has had a heart attack
• Smartwatch EKGs could speed up diagnosis and treatment when time is of the essence

Could a smartwatch app save a heart attack patient’s life? Quite possibly, according to Italian researchers.

They found that electrocardiograph (EKG) readings from a smartwatch were nearly as accurate as standard EKGs among patients with suspected heart attacks.

“A [standard] electrocardiograph is not always readily available,” said study author Dr Ciro Indolfi. “[So] the ability to identify an ongoing heart attack quickly and easily thanks to the use of a simple smartphone could be of great help in certain situations in reducing the negative consequences of a heart attack.”

Indolfi is director of cardiovascular research at Magna Graecia University in Catanzaro, Italy.

FDA-approved for atrial fibrillation

An EKG is a graphic representation of the heart’s electrical activity. Indolfi noted that these readouts are critical for establishing whether a patient with chest pain has had a heart attack. It can also quickly identify specific causes.

To see whether smartphone electrocardiograms actually work, researchers assessed EKG reliability among 81 patients who sought care for a likely heart attack at one clinic between April 2019 and January 2020. Two-thirds were men (average age: 61).

All received a standard “12-lead” EKG, which uses 12 electrodes at different spots on the chest and limbs to produce a reading.

Patients also had an EKG using the Apple Watch Series 4. The US Food and Drug Administration (FDA) has approved the smartwatch’s built-in EKG tool as a reliable way to detect the serious heartbeat irregularity known as atrial fibrillation.

Instead of 12 electrode leads, the smartwatch is equipped with sensors designed to form a single electrode lead. As a workaround, researchers successively placed the watch in nine spots on each patient’s body to generate multiple readings. The readings were then uploaded to an Apple iPhone.

Watch doesn’t generate diagnosis

For comparison purposes, 19 men and women who were not suspected of having experienced a heart attack also had standard and smartwatch EKGs.

Watch-generated EKGs were 94% accurate when it came to correctly identifying and distinguishing between various types of heart attacks, according to Indolfi. The watch also correctly noted that no heart attack had taken place in more than nine out of 10 healthy patients.

The watch does not generate a diagnosis; the EKG readings need to be interpreted by a doctor. But the findings suggest that “with the Apple Watch it is possible to perform a nine-lead EKG with an almost similar reliability as the standard EKG,” Indolfi said.

That’s important, he added, because the faster post-heart attack treatments are administered, the better the outcome. That’s especially true, Indolfi said, among patients who experience a very severe form of heart attack known as a STEMI (ST-segment elevation myocardial infarction).

Such patients can do well after insertion of a stent or a balloon (coronary angioplasty) to widen a blocked artery, Indolfi noted. But that procedure only “reduces mortality if it is performed promptly”, meaning administering an EKG within 10 minutes and then, treatment within two hours.

Faster diagnosis and treatment

Dr Gregg Fonarow, director of the Ahmanson-University of California, Los Angeles Cardiomyopathy Center, welcomed the findings with cautious optimism.

“This new feasibility study shows that a smartwatch could be used to obtain multiple leads of an EKG,” he said, underscoring the “high level [of] agreement” between smartwatch and standard readings.

Fonarow said more follow-up work will be needed to confirm the findings.

But he agreed that smartwatch EKGs could ultimately prove very helpful in speeding up diagnosis and treatment in situations where time is of the essence, including heart attacks in setting where standard EKGs are not available.

The findings were published in the online edition of JAMA Cardiology.

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• Many studies have shown that flu shots during pregnancy are safe and won’t increase the risk of autism in babies
• Getting the flu is riskier than a flu vaccination
• A flu shot may also reduce the burden on healthcare systems, freeing up resources during a possible Covid-19 resurgence

Pregnant women are understandably worried about everything that goes into their bodies. But here’s one worry they can cross off that list: flu shots.

A large, new study has confirmed that an expectant woman’s flu shot doesn’t increase the risk of autism in her child. And that’s true even if the vaccine is given during the first trimester of pregnancy, the Swedish study found.

“The flu vaccine is safe during pregnancy. This study, as well as many others, have consistently shown that flu vaccine is safe,” noted vaccine expert Dr Paul Offit. He’s director of the Vaccine Education Center at Children’s Hospital of Philadelphia, and was not involved in the current research.

Developmental disorders

What can put mom and baby at risk is getting the flu.

“Pregnant women have a sevenfold increase of being hospitalised with pneumonia if they get the flu,” Offit said. And women who get the flu during pregnancy also have an increased risk of delivering their baby early, according to the American College of Obstetricians and Gynecologists.

Autism spectrum disorders are developmental disorders that affect communication and behaviour. Children with autism have varying degrees of impaired communication and social skills and they may engage in repetitive behaviours, the researchers said. These disorders are thought to stem from both hereditary and environmental factors.

The researchers – led by Dr Jonas Ludvigsson from the Karolinska Institute in Stockholm – used data from national Swedish health registers. They looked at information on babies born between October 2009 and September 2010.

During that time, nearly 40 000 infants were born to women who received a flu vaccine. The vaccine was specifically for the H1N1 (swine flu) strain. The children were compared to more than 29 000 infants whose mothers didn’t get a vaccine.

Flu vaccines safe in pregnancy

After a follow-up of almost seven years, the researchers saw no significant difference in the rates of autism spectrum disorders among the children. Results were similar for flu vaccines given in the first trimester of pregnancy.

Ludvigsson said that research like this is even more critical right now. “Anticipating a vaccine against Covid-19, millions of pregnant women are likely to be offered such a vaccination. While our research group did not study Covid-19 vaccine effects, our research on H1N1 vaccination adds to the current knowledge about vaccines, pregnancy and offspring disease in general,” he said in an institute statement.

The new study was published in the Annals of Internal Medicine. Funding was provided by the Swedish Research Council and the Swedish Council for Working Life and Social Research.

Anders Hviid, a professor of pharmacoepidemiology from the Statens Serum Institut and University of Copenhagen in Denmark, said, “The current evidence supports that flu vaccines are safe to use in pregnancy and that they provide protection against a potentially serious infectious disease for both mother and child.” He wrote an editorial accompanying the study.

“This year, a flu shot will not only provide protection during pregnancy for mother and child and protection in early infancy due to transfer of maternal antibodies, but may also reduce the burden on our healthcare systems freeing up resources, if needed, during a possible autumn and winter Covid-19 resurgence,” said Hviid.

Concerned and vigilant

He added that because of the potential benefits, it’s “somewhat disheartening that influenza vaccination in pregnancy is not embraced to a greater degree”.

Hviid said it’s understandable to be concerned and vigilant during pregnancy. “I hope that the many studies supporting the safety of vaccines and their benefits can help overcome any reservations,” he said.

Offit agreed that with the Covid-19 pandemic, it’s even more important to get a flu vaccine.

“To protect themselves and their unborn child, pregnant women should get the flu shot,” Offit advised, adding, “And get it as soon as possible.”

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