Search Results for: Prescrizione di ASA per uso antalgico in medicina generale

Per Veterinaria le immatricolazioni previste sono 1.222

Per Veterinaria le immatricolazioni previste sono 1.222

L’antica tecnica della medicina cinese usata da Martinenghi

Circulation, Ahead of Print. BACKGROUND:Biomarkers reflecting brain injury are not routinely used in risk assessment of stroke in atrial fibrillation (AF). Neurofilament light chain (NFL) is a novel biomarker released into blood after cerebral insults. We investigated the association between plasma concentrations of NFL, other biomarkers, and risk of stroke and death in patients with AF not receiving oral anticoagulation.METHODS:For this observational study, baseline plasma samples were available from 3077 patients with AF randomized to aspirin in ACTIVE A (Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events; 2003 to 2008) and AVERROES (Apixaban Versus Acetylsalicylic Acid [ASA] to Prevent Stroke in Atrial Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment; 2007 to 2009). Median follow-up was 1.5 years. NFL was analyzed with a Single Molecule Array (Simoa). Associations with outcomes (total stroke or systemic embolism, ischemic stroke, cardiovascular death, and all-cause death) were explored with Cox regression models.RESULTS:In the combined cohort, the median NFL level was 16.9 ng/L (interquartile range, 11.1–26.5 ng/L), the median age was 71 years, 58% were men, and 13% had a history of previous stroke. NFL was associated with older age, higher creatinine, lower body mass index, previous stroke, female sex, and diabetes but not cardiac rhythm. Higher NFL was associated with a higher risk of stroke or systemic embolism (n=206) independently of clinical characteristics (hazard ratio, 1.27 [95% CI, 1.10–1.46] per doubling of NFL) and other biomarkers (hazard ratio, 1.18 [95% CI, 1.01–1.37]) and including in patients without previous stroke (hazard ratio, 1.23 [95% CI, 1.02–1.48]). NFL was also independently associated with cardiovascular (n=219) and all-cause (n=311) death. The C index for stroke using only NFL was 0.642, on par with the currently used clinical risk scores. Addition of information on NFL improved discrimination in a model also including clinical information, NT-proBNP (N-terminal pro-B-type natriuretic peptide), and high-sensitivity cardiac troponin T, yielding a C index of 0.727.CONCLUSIONS:NFL reflects overt and covert episodes of cerebral ischemia and improves risk assessment of stroke and death in patients with AF without oral anticoagulation, including in patients without previous stroke. The combination of NFL with information on age, history of stroke, and other biomarkers should be explored as a future avenue for stroke risk assessments in patients with AF.

Un terzo dei posti rischia di restare vuoto. Boom di richieste per chirurgia plastica, dermatologia o ginecologia dove è più facile fare attività privata

Cambiare spesso l’acqua, attenta pulizia e uso personale

In due sono nel reparto Medicina d’urgenza

Francesca Pasinelli lascia ruoli operativi ma resta in Consiglio

PoliMi, l’IA rivoluzionerà medicina personalizzata entro 5 anni

Francesca Pasinelli lascia i ruoli operativi, ma resta nel Consiglio

Francesca Pasinelli lascia i ruoli operativi, ma resta nel Consiglio

To the Editor Several recent retrospective and prospective studies have shown that many patients using GLP-1 RAs may present for surgical procedures with significant residual gastric contents despite adhering to the recommended preoperative fasting guidelines. To mitigate the risk of intraprocedural pulmonary aspiration, the ASA and others have recommended several measures, including using full-stomach precautions (such as a rapid sequence general endotracheal anesthesia or a regional technique with minimal sedation), withholding GLP-1 RAs preoperatively (although the optimal withholding duration is currently uncertain), or determining the presence of gastric contents in each patient with ultrasound imaging.

To the Editor I have some concerns about a recent Research Letter that make the conclusions seem inaccurate and premature. In the opening paragraph, the authors incorrectly referenced the 2023 American Society of Anesthesiologists (ASA) guidance recommending preoperative withholding of GLP-1 RAs as guidelines. Although the words “guidelines” and “guidance” are similar and are often used interchangeably, there is a distinct difference in their meaning and intent.