Risultati per: Diagnosi di COVID-19: dal sospetto alla conferma

This Viewpoint explores increasing mortality rates in the US due to a variety of causes unrelated to the COVID-19 pandemic.

Objectives
During the COVID-19 pandemic, healthcare professionals were faced with prioritisation dilemmas due to limited surgical capacity. While the views of healthcare professionals on fair allocation have been given considerable attention, the views of patients have been overlooked. To address this imbalance, our study aimed to identify which ethical principles are most supported by patients regarding the fair allocation of surgical resources.

Design
A Q-methodology study was conducted. Participants ranked ordered 20 statements covering different viewpoints on fair allocation according to their point of view, followed by an interview. Principal component analysis followed by varimax rotation was used to identify subgroups who broadly agreed in terms of their rankings.

Setting
The setting of this study was in the Netherlands.

Participants
16 patient representatives were purposively sampled.

Results
Two perspectives were identified, both of which supported utilitarianism. In perspective 1, labelled as ‘clinical needs and outcomes’, resource allocation should aim to maximise the health gains based on individual patient characteristics. In perspective 2, labelled as ‘population outcomes and contribution to society’, allocation should maximise health gains as with perspective 1, but this should also consider societal gains.

Conclusions
There was a broad agreement among patient representatives that utilitarianism should be the guiding ethical principle for fair allocation of scarce surgical resources. The insights gained from this study should be integrated into policymaking and prioritisation strategies in future healthcare crises.

Il 22 settembre si celebra la Giornata nazionale di informazione

La ricerca sulla comprensione e sulla gestione di questa malattia neurodegenerativa si apre ai fattori di protezione e allo screening con l’intelligenza artificiale

Objective
To estimate the effect of (a) the COVID-19 pandemic and (b) COVID-19 restriction stringency on daily minutes of device-measured moderate-to-vigorous physical activity (MVPA).

Design
Physical activity data were collected from the INTerventions, Equity, Research and Action in Cities Team (INTERACT) cohorts in Montreal, Saskatoon and Vancouver before (May 2018 to February 2019, ‘phase 1’) and during the pandemic (October 2020 to February 2021, ‘phase 2’). We estimated the effect of the two exposures by comparing daily MVPA measured (a) before vs during the pandemic (phase 1 vs phase 2) and (b) at different levels of COVID-19 restriction stringency during phase 2. Separate mixed effects negative binomial regression models were used to estimate the association between each exposure and daily MVPA, with and without controlling for confounders. Analyses were conducted on person-days with at least 600 min of wear time. Effect modification by gender, age, income, employment status, education, children in the home and city was assessed via stratification.

Setting
Montreal (Quebec), Saskatoon (Saskatchewan) and Vancouver (British Columbia), Canada.

Main outcome measure
Daily minutes of MVPA, as measured using SenseDoc, a research-grade accelerometer device.

Results
Daily minutes of MVPA were 21% lower in phase 2 (October 2020 to February 2021) compared with phase 1 (May 2018 to February 2019), controlling for gender, age, employment status, household income, education, city, weather and wear time (rate ratio=0.79, 95% CI 0.69, 0.92). This did not appear to be driven by changes in the sample or timing of data collection between phases. The results suggested effect modification by employment, household income and education. Restriction stringency was not associated with daily MVPA between October 2020 and February 2021 (adjusted rate ratio=0.99, 95% CI 0.96, 1.03).

Conclusions
Between October 2020 and February 2021, daily minutes of MVPA were significantly lower than 2 years prior, but were not associated with daily COVID-19 restriction stringency.

“Imparare a intercettare i primi segnali, spesso sottovalutati”

Se dalla fine dell’emergenza si sono contati quasi 8mila morti quello che non è sempre noto è l’impatto economico della mancata vaccinazione

la nuova circolare del ministero della Salute consente anche la doppia iniezione di vaccino: influenza-Covid.

Campagna adattata alla variante JN.1, raccomandata ai fragili

Le luci dell’Oms sulla Giornata per la sicurezza del paziente

Efficace in fase iniziale, con un’accuratezza fino al 98%

A small absolute reduction in noncardiovascular-related mortality among semaglutide recipients was attributable partly to fewer COVID-19 deaths.

Ora che ci sono i vaccini per far partire la campagna vaccinale si aspetta la nuova circolare del ministero della Salute attesa a giorni

Introduction
Post-COVID-19 condition (post COVID, also known as long COVID) is a global public health issue estimated to affect over 100 million people. Common symptoms include fatigue, dyspnoea and cognitive dysfunction (‘brain fog’). Over time, these symptoms have an adverse effect on mental health, physical activity and quality of life (QoL). The condition requires innovative and feasible treatment approaches that can be effective and self-managed. Physical activity is essential for good health; however, aerobic exercise or weightlifting may not be suitable for post COVID patients who experience fatigue or breathlessness. The benefits of yoga include improved flexibility, mobility, body strength and balance. It is also shown to reduce symptoms of fatigue and improve breathing efficiency, mental health and QoL. This study protocol describes the rationale and methods for a randomised controlled trial (RCT) of a yoga-based intervention designed for adults with post COVID.

Methods and analysis
A two-group, parallel, RCT with blinded follow-up assessments. Participants will be randomised with a 1:1 allocation to either a 12-week yoga-based intervention or a 12-week health promotion (active comparison) intervention. In total, 88 participants aged 30–65 years will be recruited and randomised. The primary outcome is health-related QoL (36-item Short-Form). Secondary outcomes are dyspnoea, fatigue, sleep quality, cognitive functions, mental fatigue, depression, anxiety, physical activity, demographic data and physical health measures. Data will be analysed as intention-to-treat basis, using linear mixed modelling. All assessments are conducted at Karolinska Institutet in Stockholm, Sweden. The yoga-based intervention will take place at a yoga studio centrally located in Stockholm city.

Ethics and dissemination
The study is approved by the Swedish Ethical Review Authority, reference number 2023/06518-01. All participants must sign written informed consent before enrolment and are free to withdraw from the study at any point. Key results will be available through research articles and seminars.

Trial registration number
German Clinical Trials Register, DRKS00032837.

Così dicono i segnali che arrivano dall’emisfero Sud del mondo dove con il passaggio dell’inverno i virus si sono massicciamente affacciati

New England Journal of Medicine, Volume 391, Issue 10, September 12, 2024.