Search Results for: Raccomandazioni sullo screening del diabete per gli adulti

All’Asl To5 progetto prevenzione coinvolgendo adulti e bambini

Da test colesterolo a screening oncologici, su sito Federfarma

Introduction
The integration of dental services within the broader healthcare landscape is crucial for achieving integrated healthcare delivery. However, we lack a clear representation of the full spectrum of possible dental service integration, which is necessary for policymakers, healthcare system organisers, researchers, professionals and patients themselves to optimise organisations. Our present research aims to establish the foundation for a taxonomy of dental services that is fully integrated into the health domain, while minimising historical, cultural or epistemological biases.

Methods and analysis
This protocol outlines a scoping review that will adhere to the framework of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. It has also been registered on the Open Science Framework. The research team, including a patient representative, advocate and transdisciplinary researcher, who has been involved from the inception, describes a two-phase dynamic screening process. An initial search will be conducted in the PubMed database using a Boolean search strategy based on theoretical frameworks that view health through a biopsychosocial continuum. New taxa will be progressively identified, and in the second phase, we will develop a new search strategy based on the results obtained and will explore deeper into certain categories or subcategories of taxa. Iterative strategies may also involve using new databases and even grey literature. This process will be repeated until taxon saturation is achieved and will be updated prior to submission to capture the latest literature, ultimately resulting in a comprehensive taxonomy, at the scale of individual healthcare pathways (micro- and meso-levels of organisation).

Ethics and dissemination
This scoping review will analyse published secondary data and does not require ethical review. The findings will be disseminated through publication in scientific journals, presentation at conferences and sharing through professional networks.

Introduction
Molar incisor hypomineralisation (MIH) is a qualitative developmental defect of the enamel with a complex, multifactorial nature and a significant genetic component. Individuals with MIH have a compromised stomatognathic system manifested by muscle hyperactivity under postural and dynamic conditions. However, there is a gap in knowledge on the specific functional abnormalities that these individuals experience. Early identification and intervention, with a focus on the prevention of orofacial dysfunctions and deviations in facial growth and development, are aspects of the utmost importance. Therefore, the aim of the proposed study is to perform a comparative analysis of orofacial functions with an emphasis on breathing and chewing patterns in individuals with and without MIH. The secondary objective is to assess whether dentin hypersensitivity and the severity of MIH lesions are associated with alterations in orofacial functions.

Methods and analysis
Assessments will be performed using the Nordic Orofacial Test-Screening (NOT-S). Descriptive analyses will characterise the sample. The Shapiro-Wilk test will assess normality. For normally distributed data, analysis of variance and Tukey’s post hoc test will be used. For non-normal data, the Mann-Whitney U test will be applied. The 2 test will analyse categorical variables and compare NOT-S domains between groups. Potential confounders (eg, age, sex, socioeconomic status) will be controlled through stratification or as covariates. Logistic and Poisson regressions will model associations for categorical and count-based outcomes, respectively. Statistical significance will be set at p

Objective
Surgical site infections (SSI) after hysterectomy constitute significant postoperative complications, affecting patient recovery and healthcare costs. We conducted a systematic review of risk factors for SSI in patients undergoing hysterectomy.

Design
The current study conducted a systematic review with meta-analysis to identify and summarise risk factors for SSI following hysterectomy.

Data sources
PubMed, Medline, Embase, Web of Science and Cochrane Central Register of Controlled Trials were searched through 1 November 2023.

Eligibility criteria
The inclusion criteria were (1) population: female participants who had post-hysterectomy SSI; (2) intervention: hysterectomy surgeries; (3) comparators: the number of participants who had or had not post-hysterectomy SSI; (4) outcomes: the number of participants exposed and not exposed to the risk factors of SSI. The exclusion criteria were (1) non-English studies and (2) studies that provided insufficient data.

Data extraction and synthesis
Two reviewers conducted the screening process independently. Articles that did not meet the inclusion criteria were excluded. For those that met the criteria, full-text papers were procured. Any discrepancies between the reviewers were resolved through discussion. The meta-analysis synthesised risk factors reported in ≥4 datasets via random-effects models, assessing heterogeneity, sensitivity (leave-one-out), publication bias (Egger’s test/funnel plots) and subgroup analyses (incision types).

Results
Blood transfusion emerged as the largest risk factor (OR=2.55, 95% CI (1.84, 3.56)), followed by tumour presence (OR=2.23, 95% CI (1.86, 2.66)), obesity (OR=1.79, 95% CI (1.43, 2.23)), diabetes (OR=1.70, 95% CI (1.26, 2.29)) and tobacco use (OR=1.43, 95% CI (1.26, 1.63)). The ORs varied by incision type.

Conclusions
The study establishes blood transfusion, tumour presence, obesity, diabetes and tobacco use as significant risk factors for SSI after hysterectomy, with variations in risk evident across different incision types. The findings also suggest vaginal and laparoscopic hysterectomies as preferable alternatives to abdominal hysterectomy in mitigating SSI risk. Future research should aim for more granular data to untangle the interplay between comorbidities and further elucidate the differential risk across SSI types.

Circulation, Ahead of Print. BACKGROUND:The somaticJAK2V617Fsequence variation, a key driver of myeloproliferative neoplasms, has been associated with increased risk of aortic aneurysms. This study aimed to explore associations between theJAK2V617Fvariant allele frequency (VAF) and ascending, descending, and abdominal aortic aneurysms.METHODS:In the DANCAVAS I and II trials (Danish Cardiovascular Screening), 15 000 individuals underwent cardiovascular risk assessments including blood samples and noncontrast ECG-gated computed tomography scans. In this cross-sectional substudy, individuals with screening-detected aortic aneurysms (≥45 mm ascending, ≥35 mm descending, or ≥30 mm abdominal), random aneurysm-free male controls, and all women (only included during the DANCAVAS I pilot study) were tested for theJAK2V617Fsequence variation.RESULTS:A total of 8056 individuals (90.9% men, mean age 68±4 years) were tested for theJAK2V617Fsequence variation, which presented an overall prevalence of 7.1%. Ascending, descending, and abdominal aneurysm prevalences were 6.6%, 2.9%, and 6.8%, respectively. InJAK2V617F-negative participants (n=7486),JAK2V617F-positive participants with VAF

Stroke, Ahead of Print. BACKGROUND:Aneurysmal subarachnoid hemorrhage (aSAH) causes a substantial proportion of all deaths among middle-aged people, especially women. Because female smokers in particular have a high risk of aSAH and subarachnoid hemorrhage deaths, targeted screening of 50- to 60-year-old female smokers could be justified as a preventive action to reduce premature deaths and morbidity.METHODS:This prospective screening study has been performed at Helsinki University Hospital in the Department of Neurosurgery in 2 phases during 2020 and 2023 to 2024. To minimize recruitment bias, the Helsinki Biobank and THL Biobank were responsible for sending out preliminary invitation letters to self-caring 50- to 60-year-old women (mean, 56 years) who were known to be active smokers. We informed the potential candidates about the study and answered any questions before their decision to participate. Once written consent was provided, participants filled in a detailed questionnaire on lifestyle and health, and underwent computed tomography angiography analysis. We studied the prevalence of unruptured intracranial aneurysms among the study participants. Moreover, we assessed immediate morbidity, mortality, and costs related to screening.RESULTS:Of the 458 preliminary invitation letters, 160 potential participants initially replied. Of these, 116 returned questionnaires and written consents. Ultimately, 108 smoking women underwent computed tomography angiography imaging. Eleven unruptured intracranial aneurysms were found in 11 (10%) female smokers, 1 of which was intracavernous and extradural. Two women were operated on without complications—1 with a middle cerebral artery aneurysm and 1 with a posterior communicating artery aneurysm. Most (n=8) patients with small (

Geriatri, ‘più screening e dispositivi monitor indossabili’

To the Editor A recent study reported improvement in patient outcomes observed with electronic alerts. However, we have some concerns about its generalizability to hospitals with well-established rapid response systems.

In Reply Health care systems vary considerably in terms of patient mix and clinical service structure. Therefore, it is unsurprising to observe wide variations in rapid response team activations (5 to 56 per 1000 admissions) and in the proportions of cardiac arrests (1 to 48.6 per 1000 admissions) and hospital mortality (0.2 to 49.1 per 1000 admissions). The proportions reported in the SCREEN trial and those reported by Drs Bellomo and Jones fall within these ranges. The sepsis alert was designed to identify clinically deteriorating patients early before meeting the rapid response team activation criteria. This explains why alerts occurred more frequently than rapid response team activations (14.6% compared with 4.8%). Therefore, rapid response teams should not be considered a replacement for systems for early identification of sepsis.

To the Editor In the Stepped-wedge Cluster Randomized Trial of Electronic Early Notification of Sepsis in Hospitalized Ward Patients (SCREEN) trial, the authors concluded that electronic sepsis screening compared with no screening reduced 90-day mortality in hospitalized patients. While the top-line conclusions are statistically valid, we would highlight 2 additional and related interpretations.

Circulation, Volume 151, Issue 22, Page 1547-1549, June 3, 2025.

Objective
To assess the appropriateness, acceptability and feasibility of implementing the Test-it PrCr Urinalysis Dipstick Test (LifeAssay Diagnostics, South Africa) in referral hospitals in Ghana.

Participants
96 healthcare professionals were trained on the protein-to-creatinine (PrCr) test, which was integrated into protocols alongside standard-of-care tests between November 2021 and April 2022. Test users completed questionnaires post training. Three focus group discussions (FGDs) and seven key informant interviews were conducted to evaluate test procedure comprehension, insights into training effectiveness, usability/user confidence, perceptions, attitudes towards the test and barriers and facilitators of use.

Results
High product usability, user confidence and satisfaction were reported. Staff perceived the test as easy to use and similar to current products. Misinterpretations of test results were less likely for strong results. Facilitators of use included effective trainings, sensitisation of the product and key stakeholder endorsement. Challenges impacting implementation feasibility included the short shelf life of test strips (3 months) after opening cannisters, the added complexity of the ratiometric result interpretation and the test’s lack of other parameters that are included in current products (eg, glucose, nitrate), limiting its broader clinical utility for antenatal care screening. All FGD participants agreed that the use of the PrCr test would not change current practices/protocols for dipstick use.

Conclusion
Although the Test-It PrCr test is easy to use and well accepted, key product attributes limit its implementation feasibility in this setting. It may be more appropriate for monitoring high-risk women in this context.