Risultati per: Standard di qualità sulla Fibrillazione Atriale

Stroke, Volume 54, Issue Suppl_1, Page ATP99-ATP99, February 1, 2023. Introduction:Aortic stiffness is an independent predictor of fatal stroke in both hypertensive populations and healthy subjects, but traditional monitoring methods have had difficulty being incorporated into routine practice. The gold standard, carotid-femoral pulse wave velocity (cfPWV), poses methodological challenges as this method bypasses the most distensible vessel, the proximal aorta. We propose a new method, aortic arch pulse wave velocity (aaPWV) assessed via ultrasound, which encompasses the proximal aorta and can be performed during standard cardiac echocardiography. We sought to determine if the two methods were related.Methods:We recruited 44 healthy volunteers (38.1y [SEM: 2.39], range 20-62y, 80% female) for this study. Both aaPWV and cfPWV were measured by the wave-foot method using a commercial Logic S8 Ultrasound system (GE Healthcare) with synchronous electrocardiogram. cfPWV was calculated by determining the time delay between the two vessels and dividing by the measured distance between the two sites. aaPWV was calculated by determining the time delay between onset of aortic ejection from the apical 5-chamber view and the arrival of the pulse wave at the start of descending aorta in the suprasternal view. Distance for aaPWV was estimated using regression equation from the literature.Results:Paired t-tests revealed cfPWV was significantly greater than aaPWV (5.98 ± 0.17m/s vs. 4.7 ± 0.29m/s; P

Introduction
Early relapse in Crohn’s disease (CD) is associated with a more severe disease course. The microbiome plays a crucial role, yet strategies targeting the microbiome are underrepresented in current guidelines. We hypothesise that early manipulation of the microbiome will improve clinical response to standard-of-care (SOC) induction therapy in patients with a relapse-associated microbiome profile. We describe the protocol of a pilot study assessing feasibility of treatment allocation based on baseline faecal microbiome profiles.

Methods and analysis
This is a 52-week, multicentre, randomised, controlled, open-label, add-on pilot study to test the feasibility of a larger multicontinent trial evaluating the efficacy of adjuvant antibiotic therapy in 20 paediatric patients with mild-to-moderate-CD (10

This cluster randomized clinical trial assesses whether the use of population-based electronic screening in addition to standard targeted clinician education increases the early detection of psychosis and decreases the duration of untreated psychosis, compared with clinician education alone.

To the Editor I read with interest the final outcomes of the randomized clinical trial reported by Wang et al comparing DDGP (dexamethasone, cisplatin, gemcitabine, and pegaspargase) vs SMILE (dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide) for advanced extranodal natural killer/T-cell lymphoma (ENKL), in which the DDGP regimen provided a higher overall response rate (90% vs 60%) and superior 5-year overall survival (OS) rate (74.3% vs 51.7%), but was less toxic. I would like to congratulate the authors on designing this effective DDGP regimen, which would be considered as the standard of care for advanced ENKL if validated globally.

In Reply We appreciate Dr Wang’s valuable comments on our recent DDGP (dexamethasone, cisplatin, gemcitabine, and pegaspargase) randomized clinical trial. Because non-Hodgkin lymphomas show pathologic and clinical features different from Hodgkin lymphoma, the Ann Arbor staging system (AASS) has been shown to be suboptimal or inadequate to evaluate patients with non-Hodgkin lymphomas. This is especially true for extranodal natural killer/T-cell lymphoma (ENKL) due to its different cell origin and anatomic lesion.

Objectives
A clear development process and scientifically validated clinical practice competencies in standard critical care nursing (SCCN) have not yet been developed in Japan. Thus, this study aimed to develop a consensus-based set of SCCN competencies to provide a framework for critical care nursing education, training and evaluation.

Design
Multistep, modified Delphi study (a systematic review, focus group interviews, a three-round web-based Delphi survey and an external validation process).

Participants
A systematic review of 23 studies, focus group interviews by 12 experts, a Delphi survey by 239 critical care experts (physicians, nurses and physical therapists) and an external validation by 5 experts (physicians and nurses).

Results
A systematic review identified 685 unique competencies. The focus group interviews resulted in the addition of 3 performance indicator items, a synthesis of 2 subdomains and 10 elements. Of the 239 participants, 218 (91.2%), 209 (98.9%) and 201 (96.2%) responded in rounds 1, 2 and 3 of the Delphi survey, respectively. After round 3, 57 items were below the consensus level and were removed in the final round. External validation process feedback was received from experts after two revisions to ensure that the final competencies were valid, applicable, useful and clear. The final set of competencies was classified into 6 domains, 26 subdomains, 99 elements and 525 performance indicators.

Conclusions
This study found a set of SCCN competencies after a multistep, modified Delphi study. The results of this study are robust, and the competency framework can be used in multiple areas to improve clinical practice, including the assessment, training and certification of standard critical care nurses.

Objectives
Comparing language-supported group antenatal care (gANC) and standard antenatal care (sANC) for Somali-born women in Sweden, measuring overall ratings of care and emotional well-being, and testing the feasibility of the outcome measures.

Design
A quasi-experimental trial with one intervention and one historical control group, nested in an intervention development and feasibility study.

Setting
Midwifery-led antenatal care clinic in a mid-sized Swedish town.

Participants
Pregnant Somali-born women (

This randomized clinical trial compares the effect of early high-flow oxygen therapy vs standard oxygen therapy on length of hospital stay in children with acute hypoxemic respiratory failure.

This economic evaluation study of Swedish men compares the cost-effectiveness of magnetic resonance imaging–aided screening for prostate cancer with strategies using no screening or prostate-specific antigen alone.

Introduction
Anterior shoulder dislocation is a common reason for consultation at the emergency department (ED). Hypnosis could be a safe and effective alternative therapy for pain relief during shoulder dislocation reduction but nowadays, evidence is not sufficient. The main objective of this study is to show that reduction under hypnosis is associated with a decrease in the use of analgesic compared with usual care.

Methods and analysis
We will conduct an interventional, controlled, multicentre, randomised study. A total of 44 patients with shoulder dislocation will be randomised in two groups: the hypnosis group (N=22) and the usual care group (N=22). The primary endpoint will be the comparison of morphine equivalent analgesic consumption during a shoulder dislocation reduction manoeuvre. Secondary endpoints will include haemodynamic parameters monitoring, patient and practitioner satisfaction using a Likert scale, use of coanalgesic or sedative drugs, number of reduction attempts and time spent at ED. Adverse events will be recorded. Statistical analysis will include parametric tests, multivariate linear regression and descriptive statistics.

Ethics and dissemination
This study has received ethics approval from the Comité de Protection des Personnes of Sud-Est IV on 03/11/2021 (ANSM informed on 19 November 2021). The results will be published in scientific articles and communicated in national and international conferences.

Trial registration number
ClinicalTrial.gov: NCT04992598; National Clinical trial no ID RCB : 2021-A01382-39

This randomized clinical trial compares the efficacy of frozen embryo transfer (FET) timed according to endometrial receptivity testing vs standardized frozen embryo transfer in improving live birth rate.

Introduction
The Food and Drug Administration (FDA) announced its intention to reduce the nicotine content in cigarettes as a strategy to promote cessation and reduce smoking-related harm. A low nicotine product standard will apply to all cigarettes on the market, including menthol cigarettes. In December 2021, the FDA approved a modified risk tobacco product application for menthol and non-menthol flavoured very low nicotine cigarettes (VLNC) from the 22nd Century Group. Notably, experimentation with menthol cigarettes is linked to smoking progression, as well as greater nicotine dependence relative to non-menthol cigarette use. If menthol VLNCs are perceived as more appealing than non-menthol VLNCs, this would indicate that some aspect of menthol may maintain smoking even in the absence of nicotine and FDA’s regulatory authority to ban or restrict the sale of menthol cigarettes should apply to reduced nicotine content of cigarettes. In April 2022, the FDA announced proposed rulemaking to prohibit menthol cigarettes, however it is unclear if a menthol prohibition would apply to VLNCs.

Methods and analysis
This study will recruit 172 young adult menthol smokers (with a specific subsample of n=40 sexual and gender minority young adults) and measure appeal for smoking experimental menthol and non-menthol VLNCs, and the impact of proposed product standards on tobacco product purchasing behaviour using an Experimental Tobacco Marketplace. Appeal across product standards will be assessed in a controlled laboratory and using ecological momentary assessment.

Ethics and dissemination
The protocol was approved by the University of Oklahoma Health Sciences Center Institutional Review Board (#11865). Findings will examine the effects of a reduced nicotine standard and a menthol ban on young adult smoking and will be disseminated through peer-reviewed journal articles and presentations at scientific conferences.

Trial registration number
NCT04340947.