Risultati per: GPG: Versione 5.7.5 (Novembre 2021)

Objective
To investigate monthly prescription refills for common immunosuppressive/immunomodulatory therapy (sulfasalazine, hydroxychloroquine, azathioprine, methotrexate, leflunomide) prescriptions in England during the complete first wave of the COVID-19 pandemic. Secondary analysis examined unit cost analysis and regional use.

Design and setting
A national cohort of community-based, primary care patients who anonymously contribute data to the English Prescribing Dataset, dispensed in the community in England, were included. Descriptive statistics and interrupted time series analysis over 25 months (14 months before, 11 months after first lockdown) were evaluated (January 2019 to January 2021, with March 2020 as the cut-off point).

Outcome measures
Prescription reimbursement variance in period before the pandemic as compared with after the first lockdown.

Results
Fluctuation in monthly medicines use is noted in March 2020: a jump is observed for hydroxychloroquine (Mann-Whitney, SE 14.652, standardised test statistic 1.911, p value=0.059) over the study period. After the first lockdown, medicines use fluctuated, with wide confidence intervals. Unit-cost prices changed substantially: sulfasalazine 33% increase, hydroxychloroquine 98% increase, azathioprine 41% increase, methotrexate 41% increase, leflunomide 20% decrease. London showed the least quantity variance, suggesting more homogeneous prescribing and patient access compared with Midlands and East of England, suggesting that some patients may have received medication over/under requirement, representing potential resource misallocation and a proxy for adherence rates. Changepoint detection revealed four out of the five medicines’ use patterns changed with a strong signal only for sulfasalazine in March/April 2020.

Conclusions
Findings potentially present lower rates of adherence because of the pandemic, suggesting barriers to care access. Unit price increases are likely to have severe budget impacts in the UK and potentially globally. Timely prescription refills for patients taking immunosuppressive/immunomodulatory therapies are recommended. Healthcare professionals should identify patients on these medicines and assess their prescription-day coverage, with planned actions to flag and follow-up adherence concerns in patients.

Report Ecdc, 2.268 gravi infezioni segnalate, 241 nostro paese

This study used a health care claims data set of enrollees in commercial and Medicare Advantage insurance plans to assess the association between the June 2021 heat wave and the rates of emergency department visits in Portland, Oregon, and Seattle, Washington.

Cardiologia e Dip.diretti da Sinagra, Cardiochirurgia da Mazzaro

Cardiologia e Dip.diretti da Sinagra, Cardiochirurgia da Mazzaro

Cardiologia e Dip.diretti da Sinagra, Cardiochirurgia da Mazzaro

Cardiologia e Dip.diretti da Sinagra, Cardiochirurgia da Mazzaro

Ma restano ancora al di sotto degli anni pre-pandemia

Valori migliorano ma ancora alti rispetto a soglie di sicurezza

Tra i pochi segnali positivi c’è la ripresa di alcuni interventi oncologici come quelli per il tumore della mammella

Programma Nazionale Esiti, acora 1,2 milioni in meno del 2019

Objectives
To examine the survival rate and predictors of mortality among preterm neonates in the neonatal intensive care unit at South Gondar public hospitals, 2021.

Design
Prospective follow-up study.

Setting
South Gondar public hospitals, Northwest, Ethiopia.

Participants
We recruited 283 preterm neonates who were admitted at neonatal intensive care unit at selected hospitals from 15 February 2020 to 22 January 2021.

Outcome measures
The primary outcome measure of this study was the survival rate of preterm neonates in the neonatal intensive care unit. Moreover, the study assessed the predictors for the occurrence of mortality by the Cox-proportional hazard model. Data were entered into Epi data V.4.2 and exported to Stata V.14 statistical software for analysis. The log-rank test determines the survival difference between predictor variables.

Results
A total of 283 preterm neonates, 61 died during the follow-up. Born from antepartum haemorrhage mother (adjusted HR (AHR)=2.2 (95% CI 1.10 to 4.37)), being small weight for gestational age (AHR=4.6 (95% CI 2.22 to 9.53)), not having kangaroo mother care practice initiated (AHR=2.7 (95% CI 1.39 to 7.74)), hypothermia (AHR=4.0 (95% CI 1.96 to 8.30)) and perinatal asphyxia (AHR=3.9 (95% CI 1.97 to 7.94)) were significant predictors of preterm neonate mortality.

Conclusion
In this study, the preterm neonates survival rate (78.4%) and the median survival time (21 days) were found to be low. Preventing and managing the predictors, including an antepartum haemorrhagic mother, small weight for gestational age, hypothermia and prenatal asphyxia, is crucial. In addition, more emphasis should be placed on initiating universal kangaroo mother care practice soon after birth to increase the survival of preterm neonates.

Oms, raddoppiare sforzi. Eventi e screening per World Day

Stroke, Volume 53, Issue 12, Page 3525-3528, December 1, 2022.

‘Ridotte risorse, eradicazione a rischio.Raddoppiare gli sforzi’

Objectives
To assess the patients’ awareness of their rights, associated factors and the practice of these rights by the medical team from the patients’ perspective at Tikur Anbessa Specialized Hospital.
Design
An institution-based prospective cross-sectional study was carried out.

Setting
The research was conducted from January to May 2021 in a specialised hospital in central Ethiopia.

Participants
392 people who had elective surgery were included in this study; 217 men and 175 women responded. Systematic random sampling was employed to choose the research subjects, and K (skip interval) was calculated using the 3-month surgical waiting list at the hospital. Patients under the age of 18, those with severe illnesses, those who were not inpatients, and those who had diagnosable mental conditions were not eligible.

Primary and secondary outcome measures
A structured questionnaire was administered in a face-to-face interview by trained data collectors after surgery at the surgical ward and analysed by using SPSS V.24. Bivariate and multivariable regression analyses were used to identify the associated factors. A p