Search Results for: Caratterizzazione dell'asma in base all'età di insorgenza: uno studio di coorte multi-database

Studio italiano pubblicato su Headache, apre nuova strada

Introduction
Pre-eclampsia is a harmful and potentially life-threatening condition affecting maternal health and fetal well-being. In response to the need for timely and continuous monitoring, remote health technologies have been implemented for blood pressure control among this group over the last decades. The purpose of this study is to synthesise qualitative evidence on the experiences of adopting remote technologies for blood pressure control among women with pre-eclampsia and their healthcare providers.

Methods
Peer-reviewed publications published in English from January 2013 to March 2023 were searched using seven electronic databases: PubMed, Nursing & Allied Health Premium (ProQuest), Scopus, ScienceDirect, Taylor & Francis Online, Google Scholar and EBSCO Open Dissertations. The findings were subjected to meta-synthesis using the Joanna Briggs Institute meta-aggregation approach, whereby credible and unequivocal findings supported by participant quotations were extracted, grouped into categories and then integrated into synthesised findings through consensus among reviewers. A total of 4827 studies were identified in the initial database search. Twelve eligible studies were included in the meta-synthesis.

Results
Among 12 studies, five synthesised findings were elicited from women’s experiences with remote monitoring, including reassurance and increased self-confidence in health, a sense of autonomy, enhanced awareness of their health, acceptability and satisfaction with telehealth and reduced anxiety and stress. Providers’ perspectives on telehealth were presented in four synthesised findings: increasing value for oneself and work, strengthening knowledge and skills on pre-eclampsia, improving quality of care and concerns about technology challenges.

Conclusion
Healthcare providers reported professional growth and improved care delivery, though technical challenges persist. These findings support the integration of remote monitoring into maternal healthcare.

Introduction
Research on therapeutic mobility is abundant but the field of cancer has not yet been investigated thoroughly. This scoping review aims to examine the existing evidence on global therapeutic mobility and cancer, providing a comprehensive overview of the subject.

Methods
We conducted a scoping review and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodological guidelines. We developed a comprehensive search strategy and discussed it with the research team. We searched for peer-reviewed papers on Medline, Embase, ERIC and American Psychological Association via the Dialogue interface and Google Scholar and CAIRN bibliographic database for peer-reviewed articles. We also included grey literature, such as unpublished work and relevant reports from Érudit. We considered studies that employed quantitative or qualitative methods.

Results
Among the 1615 references initially selected, 767 duplicates were excluded. Then, 849 studies were screened on title and abstract and 800 were excluded as they did not meet inclusion criteria. 49 studies were fully screened and 21 were excluded as they did not meet inclusion criteria based on full-text assessment. Ultimately, 28 references were included in the data synthesis. This scoping review has shown that publications on therapeutic mobilities have multiplied in recent years, with a turning point in 2019. A range of academic disciplines and research methodologies are currently employed to describe them. A significant proportion of fieldwork is concentrated in Asia, Africa, Europe and North America. Despite the heterogeneity of the approaches and fields, there are certain common features that emerge: first, the decision to migrate for healthcare is primarily made by the patient themselves and is perceived by them as being non-choice; second, the family plays a central role at all stages of the migration; and third, the migration has a catastrophic impact in terms of social and financial burden.

Conclusion
In conclusion, this scoping review highlights the underexplored relationship between global therapeutic mobility and cancer, emphasising the need for increased research efforts to understand the global dynamics of cancer care mobility.

Objectives
Inflammatory bowel diseases (IBDs) and multiple sclerosis (MS) are inflammatory diseases resulting from an interplay of genetic and environmental factors. This study aims to describe the prevalence of patients diagnosed with both conditions among those receiving hospital care in England, as well as the characteristics and healthcare resource use (HCRU) of such patients.

Design
This study is a retrospective observational cohort study.

Setting
The study was conducted through secondary use of the English Hospital Episode Statistics (HES) Database. HES records care delivered by hospitals in England and associated diagnoses.

Participants
Patients who had a diagnosis code for either IBD or MS recorded in HES between January 2014 and May 2020 were included. Patients were classified as having each diagnosis individually or as having both diagnoses, in which case they were further categorised based on temporal occurrence.

Primary and secondary outcome measures
The primary outcome was the prevalence of patients with a recorded diagnosis of either IBD, MS or both during the study period. Secondary outcome measures included patient demographic and clinical characteristics, as well as HCRU in the 6 months before and after the diagnosis of interest.

Results
From an overall cohort of 352 698 patients, 1016 (0.3%) had both diagnoses. Among those with both, 29.8% (303) had a record of IBD first, 40.5% (411) had MS diagnosed first and 29.7% (302) had the first record of both diagnoses in the same episode. From the overall cohort, 80.9% (285 439) of patients had a single diagnosis of IBD, and 18.8% (66 243) of patients had a single diagnosis of MS.

Conclusions
The population with a dual diagnosis of IBD and MS is larger than previously reported and shows evidence of frequent interactions with secondary care.

Objective
This study investigates consumer views of pharmacist-led professional services in Australia, emphasising factors influencing their uptake and attributes valued by users.

Design
Semi-structured online focus groups explored the awareness, experiences and expectations of pharmacists and pharmacy professional services. Audio recordings were transcribed verbatim and de-identified. Data were analysed using the thematic analysis technique to identify common themes.

Setting
Three online focus groups were conducted, inviting participants from Australia

Participants
15 adults aged 18 years and above, English-speaking and self-identified as a consumer of health services or a health carer.

Results
Participants recognised pharmacists primarily as medication experts but also valued additional services like health screening, vaccination and chronic disease management. Consumer perceptions and experiences of professional pharmacy services focused on three themes: (1) convenience, (2) credibility and trust, and (3) communication and awareness. More specifically, attributes that influence service uptake include pharmacist competency, general practitioner (GP) endorsement, service availability, convenience, awareness and cost. Competency was associated with visible qualifications and specialised training, fostering consumer trust. Limited awareness of available services and privacy concerns posed barriers. Collaborative relationships between pharmacists and GPs, flexible hours and minimal waiting times, provision of services within pharmacists’ scope of practice and recognition from the government were particularly appealing factors.

Conclusions
The findings highlight opportunities to expand pharmacists’ roles in primary care, emphasising the need for tailored attributes, robust competency frameworks, GP endorsement and government support for sustainable service models. This work contributes to the growing evidence base on enhancing consumer-centred pharmacy services, guiding policy and practice improvements to meet evolving healthcare demands. Future research quantifying how much consumers value each attribute can help providers with limited resources prioritise better.

Introduction
Multi-disciplinary discussions (MDDs) improve diagnosis and management of interstitial lung disease (ILD). The value of a virtual multi-centre MDD (V-MCMDD) incorporating expertise from multiple institutions remains underexplored. This study aimed to evaluate the impact of a V-MCMDD on diagnosis and management in ILD.

Methods
We conducted a retrospective multi-centre cohort study involving tertiary and secondary hospital clinics, private practices and community outpatient centres, all participating via a virtual platform. Between August 2020 and June 2023, patient cases were reviewed through V-MCMDDs, which included clinical, radiological, pathological and laboratory data. Each case was discussed to reach a consensus diagnosis and management plan.

Results
Following the V-MCMDD review, the diagnosis was revised in 51% of patients (p=0.031), and management plans were modified in 41% of cases. A significant shift in treatment was observed in patients with changed diagnoses vs unchanged diagnoses (p value=0.002).

Conclusions
Our findings suggest that the implementation of V-MCMDDs can be valuable in the diagnostic and therapeutic process for ILD. Incorporating input from multiple centres via a virtual format can lead to significant changes in both diagnosis and management, potentially improving patient outcomes.

Objectives
Unplanned pneumonia readmissions increase patient morbidity, mortality and healthcare costs. Among pneumonia patients, the middle-aged and elderly (≥45 years old) have a significantly higher risk of readmission compared with the young. Given that the 14-day readmission rate is considered a healthcare quality indicator, this study is the first to develop survival machine learning (ML) models using emergency department (ED) data to predict 14-day readmission risk following pneumonia-related admissions.

Design
A retrospective multicentre cohort study.

Setting
This study used the Taipei Medical University Clinical Research Database, including data from patients at three affiliated hospitals.

Participants
11 989 hospital admissions for pneumonia among patients aged ≥45 years admitted from 2014 to 2021.

Primary and secondary outcome measures
The dataset was randomly split into training (80%), validation (10%) and independent test (10%) sets. Input features included demographics, comorbidities, clinical events, vital signs, laboratory results and medical interventions. Four survival ML models—CoxNet, Survival Tree, Gradient Boosting Survival Analysis and Random Survival Forest—were developed and compared on the validation set. The best performance model was tested on the independent test set.

Results
The RSF model outperformed the other models. Validation on an independent test set confirmed the model’s robustness (C-index=0.710; AUC=0.693). The most important predictive features included creatinine levels, age, haematocrit levels, Charlson Comorbidity Index scores, and haemoglobin levels, with their predictive value changing over time.

Conclusions
The RSF model effectively predicts 14-day readmission risk among pneumonia patients. The ED data-based model allows clinicians to estimate readmission risk before ward admission or discharge from the ED, enabling timely interventions. Accurately predicting short-term readmission risk might also further support physicians in designing the optimal healthcare programme and controlling individual medical status to prevent readmissions.

Objective
To describe frequently investigated and recommended movement tasks, the underlying motor control functions and the domains of movement quality that are assessed in patients with non-specific low back pain (LBP).

Design
A scoping review. Preferred Reporting for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and JBI methodology for scoping reviews were followed. A thematic approach was used in an iterative process to identify broader themes in the data synthesis.

Data sources
MEDLINE, CINAHL, EMBASE, Web of Science, Scopus, Cochrane Library, COSMIN database and DiTA were systematically searched as part of a three-step search strategy (last search: 22 April 2025).

Eligibility criteria for selecting studies
Various types of evidence (qualitative and quantitative, primary and secondary) exploring and discussing movement tasks for assessing lumbopelvic motor control and movement quality in adult patients with non-specific LBP were considered. Grey literature was excluded.

Results
In total, 354 articles from 34 countries were included. Among them, 224 were primary research studies in laboratory settings, 68 studies in clinical settings, 7 meta-analyses, 13 systematic reviews and 42 articles classified as ‘other sources’. Overall, 20 movement task clusters were identified, with ‘hip movements in various positions’ and ‘forward bending’ being the two most common. A conceptual framework was constructed, consisting of five International Classification of Functioning, Disability and Health-based broad motor control functions and 10 movement quality domains, namely flexibility, stability, accuracy, symmetry, speed, smoothness, adaptability, variability, efficiency and coordination.

Conclusion
The provided conceptual framework for motor control functions and movement quality domains can serve as a structural foundation for future research on the content validity of assessment approaches in the context of LBP.

A fondatore Tigem il Beth Levine prize per studio su lisosomi

Introduction
HIV and tuberculosis (TB) are two of the most devastating disease conditions of public health concern globally. A co-infection of the two diseases poses serious health challenges to patients including mental health problems, ranging from mild to severe, with differing outcomes. This systematic review aims to assess the correlates of HIV-TB co-infection and mental health of adults living in sub-Saharan Africa.

Methods and analysis
We will conduct comprehensive database and non-database searches for studies (published and unpublished). We will search Google Scholar, PubMed, CINAHL, LILACS, JSTOR, Cochrane Library, SCOPUS, PsycINFO, HINARI and African Journals Online from inception to 31 May 2025, without restriction on language. We will also search the grey literature, including conference proceedings, preprint repositories, databases of dissertations, WHO and governmental databases. In the event where there is a need to contact experts and corresponding authors for further information, the review team will do so to enrich the content of the review. At least three reviewers will independently undertake study selection, data extraction and risk of bias assessment using validated tools. We will resolve discrepancies or disagreements through discussion. We will analyse dichotomous data as risk ratio, OR or proportion and continuous data as mean difference with their SD; all estimates will be presented with their 95% CI. Where applicable, we will determine SD from point estimates and the appropriate denominators assuming a binomial distribution. The magnitude of heterogeneity between the included studies will be assessed quantitatively using the index of heterogeneity (I2 statistic). The I2 values of 25%, 50% and 75% will be considered to represent low, moderate and significant heterogeneity. The significance of heterogeneity will be determined by the p value of the I2 statistic, and a p value of

Studio, è associato al mantenimento del volume delle aree cerebrali chiave

Studio, è associato al mantenimento del volume delle aree cerebrali chiave

Studio San Raffaele mette in discussione efficacia tecnica

Objectives
Ensuring equity in clinical trials has been declared a global priority. Australia is competitive in the international clinical trial sphere. We aimed to explore factors that influence oncology clinical trial participation in Australia.

Design
Scoping review.

Data sources
On 27 May 2024, a systematic search using a predefined strategy was conducted across four electronic databases (Medline, CINAHL, EMBASE and Scopus), grey literature and hand searches.

Eligibility criteria
All cancer (haematological and non-haematological) clinical trials that discussed factors influencing participation in Australia were included. There were no language or age restrictions.

Data extraction and synthesis
Data were extracted using a predesigned extraction tool. Quantitative results were analysed using descriptive statistics. Qualitative data were synthesised using a framework method into four domains (1) patients, (2) healthcare professionals, (3) clinical trials and (4) health services.

Results
Of 1084 citations identified, 393 duplicates were removed. Of the 691 titles and abstracts screened, 54 articles underwent full-text review, and 42 articles were included in the final analysis. Key factors that influence clinical trial participation were identified across all domains, many consistent with the international literature. For example, while self-reported willingness emerged as a key facilitator across diverse patient groups, cohort studies revealed lower participation rates for migrant populations, older patients and those residing in regional areas. Importantly, we were also able to identify the foundations of an evidence base of interventions that directly support increased clinical trial participation.

Conclusion
This scoping review contributes new findings to a body of international literature, while contributing a unique Australian perspective. These findings establish the foundations of an evidence base that supports inclusive clinical trial participation.

Objectives
Systemic immune-inflammation index (SII) is a biomarker of inflammatory conditions; however, no scoring system has been evaluated for predicting mortality in patients with renal failure in intensive care unit (ICU). This study aimed to determine associations between SII level and mortality in patients with renal failure.

Design
Using the Medical Information Mart for Intensive Care IV (V.2.0) database (USA), this retrospective study included 837 patients who were admitted to ICU with end-stage renal disease (ESRD), between 2008 and 2019.

Primary and secondary outcome measures
Cox proportional-hazards models were used to evaluate correlations between SII and outcomes, expressing results as hazard ratios (HRs) with 95% confidence intervals (95% CIs). Regression analysis was used to determine associations between variables and SII.

Results
In total, 837 adult patients from a total of 76 943 patients admitted to ICU were included, comprising 59.60% males with mean age 62.27±14.9 years and mean BMI 28.36±7.43 Kg/m2. Using median SII (1628 X 109 /L) as cut-off value, high (≥ 1628X109 /L) SII was also associated with an increased risk of ICU mortality (HR 1.97 (95% CI 1.15 to 3.35), p=0.034), in-hospital mortality (HR 1.95 (95% CI 1.23 to 3.09), p=0.017) and total mortality (HR 1.30 (95% CI 1.07 to 1.58), p=0.024).

Conclusions
SII may predict mortality in critically ill patients admitted to ICU with ESRD. SII ≥ 1628×109 /L correlates significantly with increased ICU mortality, in-hospital mortality and total mortality.

Objectives
To establish a practical tool for the prediction of mortality in polytrauma patients.

Design
Secondary analysis of data from a public database.

Setting
A tertiary hospital in Switzerland.

Participants
2406 polytrauma patients were enrolled in this study, and the mean age was 44.4±19.9 years with 74.8% men.

Interventions
No.

Outcome measures
Logistic regression analysis was conducted to explore the relationship between early deaths and variables. Nomogram model was established based on predictive factors. Model effectiveness was assessed by its discrimination, calibration and decision curve analysis. Causal mediation analysis was used to explore the relationships among risk factors.

Results
Independent predictive variables analysed by logistic regression were: age, Glasgow Coma Scale (GCS), base excess (BE) and serum lactate. A nomogram model was established based on those risk factors, and the area under the curve of the nomogram for early death was 0.85, which was better than existing traumatic scorings. Besides, calibration plots and decision curve analysis demonstrated better performance than traumatic scorings with better internal validation. The effect of GCS on early death partly depended on BE and lactate.

Conclusion
Our study found that early mortality was associated with age, GCS, BE and serum lactate on admission, and lactate was more important in early death. A simple prediction model of early mortality in polytrauma patients was developed with accessible parameters assessed on admission.