Risultati per: Studio REDUCE-IT e appropriatezza prescrittiva degli acidi grassi omega-3

Introduction
Sociodemographic variables influence health outcomes, either directly (ie, gender identity) or indirectly (eg, structural/systemic racism based on ethnoracial group). Identification of how sociodemographic variables can impact the health of critically ill adults is important to guide care and research design for this population. However, despite the growing recognition of the importance of collecting sociodemographic measures that influence health outcomes, insufficient and inconsistent data collection of sociodemographic variables persists in critical care studies. We aim to develop a set of core data variables (CoDaV) for social determinants of health specific to studies involving critically ill adults.

Methods and analysis
We will conduct a scoping review to generate a list of possible sociodemographic measures to be used for round 1 of the modified Delphi processes. We will engage relevant knowledge users (previous intensive care unit patients and family members, critical care researchers, critical care clinicians and research co-ordinators) to participate in the modified Delphi consensus survey to identify the CoDaV. A final consensus meeting will be held with knowledge user representatives to discuss the final CoDaV, how each sociodemographic variable will be collected (eg, level of granularity) and how to disseminate the CoDaV for use in critical care studies.

Ethics and dissemination
The University of Calgary conjoint health research ethics board has approved this study protocol (REB22-1648).

Military members and veterans with posttraumatic stress disorder (PTSD) who partnered with a psychiatric service dog in addition to receiving usual care for the condition had less severe symptoms after 3 months than those who received typical care only, according to results from a nonrandomized clinical trial involving 156 participants in the US.

After pan-proctocolectomy with ileal pouch–anal anastomosis (IPAA) for intractable ulcerative colitis (UC), about 50% of patients experience pouchitis.1 The prevalence of pouchitis is 5-fold higher in UC than in patients who undergo the same surgery for familial adenomatous polyposis (FAP), based on a systematic review and meta-analysis (SRMA) of 59 publications involving more than 18,000 patients with UC and 860 patients with FAP.1 This difference in the prevalence of pouchitis does not appear to be related to mechanical factors or complications from the pouch surgery.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Amid rising antimicrobial resistance that poses a “global threat,” the World Health Organization (WHO) recently announced recommendations aimed at reducing the number of people who are affected by sepsis and other serious infections caused by catheters placed in blood vessels. Up to 70% of hospital inpatients have a catheter placed in a vein or artery during their stay, which increases their risk of contracting bloodstream and soft tissue infections, the WHO reported.

Iziduh S, Abenoja A, Theodorlis M, et al Priority strategies to reduce socio-gendered inequities in access to person-centred osteoarthritis care: Delphi survey. BMJ Open 2024;14:e080301. doi: 10.1136/bmjopen-2023-080301
The above mentioned article is corrected since it was published. The second author is changed from “Angela Abenoja” to “Angelina Abbaticchio”.

Objectives
Oncologists need competence in clinical prognostication to deliver appropriate care to patients with cancer. Most studies on prognostication have been restricted to patients in palliative care settings. This paper investigates (1) the prognostic accuracy of physicians regarding a broad cohort of patients with cancer with a median life expectancy of >2 years and (2) whether a prognosis training can improve prognostication.

Design
Prospective single-centre study comprising 3 phases, each lasting 1 month.

Setting
Large teaching hospital, department of oncology and haematology, Germany.

Participants
18 physicians with a professional experience from entry level to 34 years. 736 patients with oncological and malignant haematological diseases.

Interventions
Baseline prognostication abilities were recorded during an ‘untrained’ phase 1. As an intervention, a specific prognosis-training programme was implemented prior to phases 2 and 3. In phase 3, physicians had to provide additional estimates with the inclusion of electronic prognostic tools.

Outcome measures
Prognostic estimates (PE) were collected using ‘standard’ surprise question (SQ), ‘probabilistic’ SQ (both for short-term prognostication up to 6 months) and clinician prediction of survival (CPS) (for long-term prognostication). Estimated prognoses were compared with observed survival. Phase 1 was compared with phases 2 and 3.

Results
We included 2427 PE for SQ, 1506 for CPS and 800 for probabilistic SQ. Median OS was 2.5 years. SQ accuracy improved significantly (p

New England Journal of Medicine, Ahead of Print.

Introduction
Health inequalities are rooted in inequality in vital resources for health, including financial resources, a supportive informal network, a stable living situation, work or daytime activities or education and literacy. About 25% of Dutch citizens experience deprivation of such resources. Social policy consists of crucial instruments for improving resources in those groups but can also have adverse effects and lead to additional burdens. This project aims to contribute to the reduction of health inequalities through (1) a better understanding of how social policy interventions can contribute to reducing health inequality through the redistribution of burdens and resources and (2) developing anticipatory governance strategies to implement those insights, contributing to a change in social policy systems.

Methods and analysis
Two systems approaches are combined for establishing a systems change in the Netherlands. First, a realist approach enables insights into what in social policy interventions may impact health outcomes, for whom and under what circumstances. Second, an institutional approach enables scaling up these insights, by acknowledging the crucial role of institutional actors for accomplishing a systems change. Together with stakeholders, we perform a realist review of the literature and identify existing promising social policy interventions. Next, we execute mixed-methods realist evaluations of selected social policy interventions in seven municipalities, ranging from small, mid-size to large, and in both urban and rural settings. Simultaneously, through action research with (national) institutional actors, we facilitate development of anticipatory governance strategies.

Ethics and dissemination
This study is not liable to the Medical Research Involving Subjects Act (WMO). Informed consent to participate in the study is obtained from participants for the use of all forms of personally identifiable data. Dissemination will be codeveloped with target populations and includes communication materials for citizens, education materials for students, workshops, infographics and decision tools for policy-makers and publications for professionals.

This Medical News story discusses new USPSTF recommendations about the timing of screening mammograms.

New England Journal of Medicine, Ahead of Print.

Stricturing Crohn’s disease (CD), a consequence of fibrosis occurring during chronic unresolved gut inflammation, is a common problem in clinical praxis for which we currently lack targeted medical therapy.1 Patients typically present with obstructive bowel symptoms and radiographic signs of a stricture that is commonly (but not exclusively) located in the terminal ileum or at the ileocecal valve.2 Histopathology of the stricture reveals CD features, such as submucosal fibrosis by excess extracellular matrix deposition, fibromuscular hyperplasia, chronic transmural inflammation and epithelioid granulomas that are often associated with creeping fat in the resection specimen.3 Creeping fat is partially driven by translocation of mucosal-associated gut bacteria,4 and fibronectin-mediated communication by muscle cells of the nearby bowel wall.5 Moreover, several mediators such as transforming growth factor β, and the family of interleukin 1 (IL-1), IL-6 and IL-36 cytokines promote gut fibrosis, while…

Annals of Internal Medicine, Ahead of Print.